Lung volume recruitment manoeuvres are often prescribed to maintain respiratory health in neuromuscular disease. Unfortunately, no current system accurately records delivered dose. This study determined the performance characteristics of a novel, objective, manual lung volume recruitment bag counter (‘the counter’) with bench and healthy volunteer testing, as well as in individuals with neuromuscular disease. We undertook (1) bench test determination of activation threshold, (2) bench and healthy volunteer fidelity testing during simulated patient interface leak and different pressure compressions and (3) comparisons with self-report in individuals with neuromuscular disease. The data are reported as summary statistics, compression counts, percentage of recorded versus delivered compressions and concordance (Cohen’s kappa (K) and absolute agreement). Results Minimum counter activation pressure under conditions of zero leak was 1.9±0.4 cm H2O. No difference was observed between the number of repetitions delivered and recorded during high airway pressure condition. Interface leak approximating 25% resulted in underestimation of repetition counts, and once the leak was at 50% or beyond, the counter recorded no activity. Faster sampling frequency collected data with more fidelity. Counter data agreed with diary self-report during community trials (16 participants, 960 participant days, 77% agreement, Cohen’s Κ=0.66 and p<0.001). Disagreement typically favoured more diary reported (18%) than counter (5%) sessions. Conclusions The performance characteristics of a new lung volume recruitment counter have been established in both laboratory and community settings. Objective usage and dosage data should accelerate new knowledge development and better translation of lung volume recruitment therapy into policy and practice. Data are available upon reasonable request from the corresponding author

中文翻译：

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肺容量补充疗法的客观测量：实验室和临床验证

在神经肌肉疾病中，肺容量募集操作通常用于维持呼吸系统健康。不幸的是，当前没有系统准确记录递送剂量。本研究通过长凳和健康志愿者测试，以及在患有神经肌肉疾病的个体中，确定了一种新颖、客观、手动肺容量补充袋计数器（“计数器”）的性能特征。我们进行了 (1) 激活阈值的台架测试确定，(2) 在模拟患者界面泄漏和不同压力按压期间的台架和健康志愿者保真度测试，以及 (3) 与神经肌肉疾病患者的自我报告进行比较。数据报告为汇总统计、压缩计数、记录与交付的按压和一致性的百分比（Cohen's kappa (K) 和绝对一致性）。结果 零泄漏条件下的最小反启动压力为 1.9±0.4 cm H2O。在高气道压力条件下传送和记录的重复次数之间没有观察到差异。接近 25% 的接口泄漏导致重复计数的低估，一旦泄漏达到 50% 或更高，计数器就没有记录任何活动。更快的采样频率以更高的保真度收集数据。计数器数据与社区试验期间的日记自我报告一致（16 名参与者，960 个参与者天，77% 的一致性，Cohen's Κ=0.66 和 p<0.001）。与反击 (5%) 会话相比，分歧通常更倾向于报告日志 (18%)。结论 在实验室和社区环境中已经建立了新的肺容量补充计数器的性能特征。客观使用和剂量数据应加速新知识的发展，并将肺容量补充疗法更好地转化为政策和实践。数据可根据通讯作者的合理要求提供