MIPS and MEPS
Also known as Maximal Inspiratory Pressure (MIP) and Maximal Expiratory Pressure (MEP)
At A Glance
- MIP and MEP tests measure the strength of your breathing muscles.
- They are different from spirometry, which measures air volume and flow rather than muscle strength.
- Your doctor may order this test if you have unexplained breathlessness, a weak cough, or a condition that can affect muscle strength.
- The test is quick, non-invasive, and does not involve needles or radiation.
- Not sure why you have been referred? Read this article to understand what the test involves and what your results mean.
What are MIP and MEP tests?
MIP and MEP tests are respiratory tests conducted by specialists and offered at Manse Medical in Ballarat, Sunshine, and Warrnambool. They measure how strongly your breathing muscles can generate pressure, both when breathing in and when breathing out. MIP stands for Maximal Inspiratory Pressure, and MEP stands for Maximal Expiratory Pressure.
MIP is a global measure of inspiratory muscle strength, primarily assessing the diaphragm. It measures the maximum pressure you can generate when inhaling against resistance, reflecting the strength of your diaphragm and the muscles between your ribs, and helps evaluate for ventilatory failure and lung disease.
The MEP test measures the maximum pressure you can create when exhaling forcefully, reflecting the strength of your abdominal and chest wall muscles.
How does a MIP and MEP test work?
The MIP and MEP tests use our standard testing equipment to measure the air pressure your breathing muscles can generate. You breathe through a mouthpiece connected to the equipment, and the pressure from each effort is recorded. A nose clip is worn throughout to prevent air from escaping through the nose.
MEP: Breathing in
breathe in as deeply as you can, then blow out as forcefully as possible into the mouthpiece.
MIP: Breathing out
Breathe out as fully as you can, then inhale as hard and fast as possible into the mouthpiece for at least one second.
Each manoeuvre is repeated several times to ensure consistent, reliable results. The test is effort-dependent, meaning your results reflect the effort you apply — your respiratory technician will coach you through each step to help you get the most accurate reading.
A referral is required for this test. You can download a referral here.
This test typically takes 45- 60 minutes.
Results are shared with your referring doctor within 1-2 business days.
Why would your doctor order a MIP or MEP test?
Your GP or specialist may refer you for MIP and MEP testing if you have:
- Unexplained breathlessness, particularly when lying flat
- A weak or ineffective cough
- Breathing difficulties that are not fully explained by spirometry results
- Fatigue that worsens with physical activity
- A condition known to affect muscle strength
MIP and MEP testing are commonly used for people with:
- COPD (chronic obstructive pulmonary disease)
- Motor neurone disease (MND)
- Muscular dystrophy and other neuromuscular conditions
- Diaphragm weakness or dysfunction
- Myasthenia gravis
- Post-COVID breathlessness (long COVID)
- Sleep apnoea
Understanding your MIP and MEP test
- Medical documents: Bring your referral letter and any other documents or test results that may be important for the specialist to consider.
- Clothing: Wear comfortable, loose-fitting clothing that does not restrict your chest or abdomen
- Medications: Ask your specialist if you can continue your existing medications. Please note that if the test is ordered alongside spirometry or bronchodilator testing, you may be asked to pause certain inhalers.
- Special considerations: Let your technician know if you have experienced recent chest pain, recent eye or abdominal surgery, or any condition that may affect your ability to perform a forceful breathing effort
- Food and drink: Avoid eating a large meal within 2 hours of the test and do not drink alcohol at least 4 hours beforehand
- Smoking: Do not smoke on the day of the test
- Exercise: Do not engage in heavy exercise at least 1 hour before the test
- The test is not painful
- Each effort requires a short burst of maximal force, similar to blowing up a balloon as hard as you can
- Mild lightheadedness afterwards is common and settles quickly
- Rest time is given between each effort
- The full appointment, including preparation and rest breaks, typically takes 15 to 30 minutes
Your results show how strong your breathing muscles are, measured in cmH₂O (centimetres of water pressure). Think of it like a grip strength test, but for your lungs. Your specialist will compare your results against established reference values for people of your age, sex, and height.
A result below the expected range may suggest your breathing muscles are not generating as much pressure as anticipated. This does not automatically mean something is seriously wrong as your specialist will always interpret your results alongside your symptoms, medical history, and other lung function tests, never in isolation.
The test helps your specialist understand whether your symptoms are related to lung disease, muscle weakness, or both, which directly shapes what treatment you are offered.
Commonly Asked Questions
If you are currently unwell with a respiratory illness such as a cold, flu, or chest infection, it is best to contact the clinic before your appointment. Active illness can affect your ability to perform the breathing manoeuvres to your full capacity, which may mean your results do not accurately reflect your true muscle strength. In some cases, the clinic may recommend rescheduling until you have recovered.
Yes, a few things can affect the quality or reliability of results:
- Effort – the test is effort-dependent, so results that are inconsistent between attempts may need to be repeated until three reliable readings are obtained
- Air leaks – a poor seal around the mouthpiece (which can be affected by dentures, facial hair, or muscle weakness around the mouth) can lead to inaccurate pressure readings
- Recent illness – a current respiratory infection may reduce your ability to generate maximum effort
- Pain or recent surgery – recent chest, abdominal, or eye surgery may limit how forcefully you can breathe, and your technician should be informed beforehand
Your respiratory technician will assess the consistency of the results on the day and repeat efforts as needed to ensure accuracy.
Yes, MIPs and MEPs are available for bulk billing to eligible patients at our Sunshine practice.
All Respiratory Tests
Clinic locations
MIP and MEP testing is available at our Ballarat, Sunshine and Warrnambool clinics.
View all locations →Bulk billing at Sunshine
MIP and MEP testing may be bulk billed for eligible patients at our Sunshine clinic.
Learn more about billing →Do you have a referral for this test?
We can help you book an appointment. Click here or call 1300 626 730