Feasibility of pulmonary function testing in adults with intellectual disabilities: pilot study

In adults with intellectual disabilities, early diagnosis of chronic pulmonary
disease and evaluation of treatment effects are hampered by difficulties with
cooperation with standard pulmonary function testing by means of spirometry.
Because of a rapidly increasing life expectancy in this population, an increase
of chronic pulmonary disease is to be expected. Internationally, no
epidemiological information is available on chronic pulmonary disease in this
group.
At this moment, 4.5% of the adult client population of five large Dutch
intellectual disability care providers are being treated with inhalation
corticosteroids, without any objective information on pulmonary functions.
Because usually, subjective symptoms are insufficiently communicated by these
persons, it is to be expected that chronic pulmonary disease often will be
diagnosed in an advanced stage. On the other hand, over-treatment is also to be
expected.
Nowadays, methods of pulmonary function testing are available which do not
require active cooperation.

Information on feasibility of spirometry, impulse oscillometry and body
plethysmography in adults with mild and moderate intellectual disabilities.

Non-invasive observational feasibility pilot study.

This pilot concerns a non-invasive observational study. The studied methods are
internationally accepted for clinical diagnosis.
The burden consists of time (1 hour), taking the afternoon off, travelling to
the hospital, and the unknown situation, which can be felt as threatening. We
know from earlier studies, that pulmonary function testing based on normal
breathing is usually not experienced as threatening, if the situation is
explained in a quiet way, whereas spriometry using an incentive was met with
enthusiasm by most participants. Practicing with the mouthpiece at home will
advance security and improve cooperation. There is no systematic information on
the application of body plethysmography. Sitting in a closed glass cabin might
be felt as threatening. The involved pulmonary function test assistant has
applied this test as part of regular diagnostics in some persons with
intellectual disabilities. Acceptation was varying.