Stable COPD — SCE Respiratory MCQ

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A patient with motor neurone disease has preserved cognition and only mild bulbar symptoms, but mouth leakage makes maximal inspiratory pressure and forced vital capacity poorly reproducible. Which volitional respiratory-strength test is the most useful alternative?

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Correct answer: B — Sniff nasal inspiratory pressure

Sniff nasal inspiratory pressure is a practical measure of inspiratory muscle strength that avoids the sustained mouth seal required for maximal inspiratory pressure and spirometric vital capacity. NICE recommends SNIP or MIP alongside FVC or VC in respiratory assessment of motor neurone disease, except when severe bulbar impairment prevents reliable testing.

Reference: NICE NG42 recommendations for motor neurone disease (Updated 23 July 2019; surveillance reviewed 2024): https://www.nice.org.uk/guidance/ng42/chapter/Recommendations; NICE QS126 respiratory assessment and NIV in motor neurone disease (Published 27 July 2016): https://www.nice.org.uk/guidance/QS126/chapter/Quality-statement-2-Respiratory-assessment-and-noninvasive-ventilation