Purpose[edit | edit source]
The diaphragm is the primary muscle of respiration, when it is functioning normally it produces observable breathing mechanics of abdominal motion, anterior-superior chest expansion, and lateral rib expansion, commonly referred to as “diaphragmatic breathing”.
The Hi-Lo Test is used in the assessment of breathing pattern dysfunction, by the observation of abdominal excursion and anterior-posterior chest expansion.
Technique[edit | edit source]
The patient is instructed to place one hand on their chest and the other on their abdomen and breathe normally. Movement in the upper chest and abdomen is observed.
The patients who functionally breathe display visible abdominal expansion movement and no visible superior migration of the thoracic cage.
The test can be done in different positions according to the patient. From supine, sitting or standing.
One study at 2019 looked into the effect of different positions on Hi-Lo test results, it found that as postural demand increased from sitting to standing, frequency of functional breathing decreased, due to increased demand on the diaphragm. Which suggests that Hi-Lo test should be performed from different positions to determine whether the diaphragm is able to respond to increased postural demands.
Evidence[edit | edit source]
One study compared Hi-Lo test with MARM (Manual Assessment of Respiratory Motion), it found that less experienced practitioners with only a small amount of practice and training can use the MARM and Hi Lo with similar levels of accuracy to experienced practitioners.
References[edit | edit source]
- Horris H, Anderson BE, Bay RC, Bliven KC. Clinical breathing mechanics differ based on test and position. Journal of Sport Rehabilitation. 2019 Aug 1;28(6):635-9.
- coachkeats. Basic Table Assessments 101 Hi-Lo Breathing Test w/Keats S. Available from: https://www.youtube.com/watch?v=yjLl5NINUEk [last accessed 9/5/2023]
- Courtney, R., Cohen, M. and Reece, J., 2009. Comparison of the Manual Assessment of Respiratory Motion (MARM) and the Hi Lo Breathing Assessment in determining a simulated breathing pattern. International Journal of Osteopathic Medicine, 12(3), pp.86-91.