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Some elderly patients experience difficulty when attempting to use pressurized metered-dose inhalers (pMDIs) due to reduced finger muscle strength. However, no studies have investigated the finger muscle strength required for pMDI actuation. Therefore, we created a modified pMDI pinch gauge and examined the finger muscle strength in elderly asthmatic patients with and without the use of a pMDI assist device to push the canister. We measured the finger muscle strength (N) required to spray pMDI formulations (Adoair , Alvesco , Flutiform ,