DEAR EDITOR,
We would like to thank the authors for their interest in our study1 and for their thoughtful comments regarding the influence of ethnicity on the normative data (ND) for maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). We appreciate the opportunity to address their insights and clarify our study’s scope and limitations.
As noted, our study aimed to establish normative values for MIP and MEP specific to the Turkish population, taking into consideration key factors like age, gender, and anthropometric characteristics. We acknowledge that ethnicity can indeed play a role in respiratory muscle strength.2 However, due to limited data and the challenges in defining clear ethnic categories within Türkiye, we chose not to stratify our sample based on ethnicity.
Türkiye’s population is indeed diverse, with multiple ethnic groups including Turks, Kurds, Arabs, and other minorities, as mentioned by the authors. Due to the nature of Turkish society, individuals may identify with multiple ethnic backgrounds simultaneously, such as Arab and Circassian. Comparable studies have been conducted in countries with complex demographic compositions, such as Türkiye.3-10 For instance, studies conducted in Brazil11 and Germany,10 which illustrate this approach. In Brazil—a country with a diverse population including White, mixed-race, Black, Asian, and Indigenous groups—ethnic categorization was deliberately avoided, mirroring the methodology in our study. This approach reflects a nuanced understanding of ethnic identity that recognizes the limitations of rigid classifications within diverse populations. Nonetheless, establishing ethnic-specific normative values for respiratory parameters would require a larger, more segmented sample size and more detailed data on ethnic backgrounds, which were beyond the scope and resources of our current study.
We agree that future research could further refine normative values by incorporating ethnicity, if feasible. This could provide even more tailored references for clinical and research applications. However, we believe that our study offers valuable and applicable ND that can aid healthcare practitioners and researchers in assessing respiratory muscle strength among the Turkish population.
Thank you for your valuable feedback. We hope that our response clarifies the considerations and limitations inherent in our methodology.
