Reliability of Breathing Rate Assessment and Chest Expansion Measurement: A Pilot Study in Typically Developing Children

Abstract

Purpose: Despite the apparent acceptance of breathing rate assessment and chest expansion measurement (CEM) among physical therapists, little is known about the measurement properties of these tests and measures especially when administered to children. Reference data from typically developing children have been reported in the literature without investigating the reliability of measurements. This pilot study aimed to systematically explore the feasibility and inter-rater and test-retest reliability of these chest examination methods in children. Method: Nineteen children, 10 males and 9 females, with mean (SD) age of 11.11 (±1.29) years, were selected through convenience sampling. Assessors measured the breathing rate and chest expansion of the participants using a well-defined protocol. A second assessment was conducted after two weeks under similar testing conditions. Results:Breathing rate assessment yielded poor reliability across raters and testing occasions. CEM taken at the level of the fourth intercostal space revealed poor to excellent reliability (ICC=0.48 to 0.81), while measurements taken along the xiphoid process produced acceptable inter-rater reliability (ICC=0.6 to 0.7) and excellent test-retest reliability (ICC=0.88 to 0.94). Conclusions and Recommendations: CEM may be feasible and reliable to use on typically developing children given a well-defined protocol. Assessment of breathing rate may need to be evaluated further for clinical acceptability given potentially poor reliability in children.