OBJETIVO: Avaliar a postura de escolares do ensino público fundamental e diferenciar as alterações que fazem parte do crescimento normal das compensatórias. MÉTODOS: Trata-se de um estudo analítico, descritivo, de corte transversal, no qual se realizou avaliação postural em escolares de primeira a quarta série de uma escola pública da cidade de Jaguariúna, situada no interior do Estado de São Paulo. Cada aluno foi avaliado nos planos coronal-anterior, coronal-posterior e sagital, utilizando-se o método de Kendall como referência de alinhamento postural normal. RESULTADOS: A avaliação postural de 247 escolares (131 masculinos e 116 femininos) identificou a seguinte incidência de alterações: desnível (50,2%) e protrusão de ombro (39,7%), escápula alada (40,5%), aumento do ângulo valgo de joelho (29,6%), inclinação (21,5%) e anteroversão pélvica (19%), hiperextensão de joelho (19%), rotação de fêmur (12,9%), protrusão (11,7%) e inclinação cervical (15,4%), cifose torácica (9,7%) e hiperlordose lombar (26,3%). CONCLUSÕES: Houve elevada incidência de escápula alada, desnível e protrusão de ombro, aumento do ângulo valgo de joelho e hiperlordose lombar, consideradas normais durante o desenvolvimento da criança. As inclinações e a protrusão cervical, alterações que necessitam de intervenção precoce, também foram identificadas.
Objective: To investigate associations between mouth breathing (MBr), nose breathing (NBr) and body posture classification and clinical variables in children and adolescents, by comparing patients with mouth breathing syndrome with a control group of similar age. Methods:This was an observational, analytical, controlled, crosssectional study conducted at a university hospital. Children aged 5 years or more were recruited to one of two groups: healthy controls (NBr) or an MBr group. The MBr group comprised patients with a diagnosis of mouth breathing syndrome confirmed by clinical examination by a physician plus nasal endoscopy. The control group comprised healthy volunteers of the same age, with NBr confirmed by medical examination. All participants underwent postural assessment. Data were analyzed using the MannWhitney nonparametric test, the chi-square test and Fisher's exact test, to a significance level of 0.05%. Results:A total of 306 MBr and 124 NBr were enrolled. Mouth breathers were more likely to be male (p = 0.0002), have more frequent and more severe nasal obstruction and larger tonsils (p = 0.0001) than NBr. Mouth breathers also exhibited higher incidence rates of allergic rhinitis (p = 0.0001), of thoracic respiratory pattern (p = 0.0001), high-arched palate (p = 0.0001) and unfavorable postural classifications (p = 0.0001) with relation to the control group. Postural classification scores were directly proportional to nasal obstruction (p = 0.0001) and male sex (p = 0.0008).Conclusions: Postural problems were significantly more common among children in the group with mouth breathing syndrome, highlighting the need for early interdisciplinary treatment of this syndrome. J Pediatr (Rio J). 2011;87(4):357-363:Mouth breathing, child, adenoids, tonsils, rhinitis, prevalence. ResumoObjetivo: Verificar a associação do tipo respiratório oral (RO) e nasal (RN) e da classificação da postura corporal em variáveis clínicas de crianças e adolescentes com a síndrome do respirador oral, em relação a um grupo-controle de mesma faixa etária.Métodos: Estudo analítico do tipo observacional e transversal, com grupo-controle, realizado em hospital universitário. Foram incluídas crianças maiores de 5 anos, distribuídas em dois grupos: controle saudável (RN) e grupo RO. O grupo RO incluiu pacientes com diagnóstico de síndrome do respirador oral confirmado por exame clínico médico e nasofibroscopia. Participaram do grupo-controle voluntários saudá-veis da mesma faixa etária, cujo tipo RN foi confirmado por avaliação médica. Todos os participantes foram submetidos à avaliação postural. Para análise dos dados, foram utilizados os testes: não paramétrico de Mann-Whitney, qui-quadrado e exato de Fisher, considerando-se nível de significância de 0,05%. Artigo originAl 0021-7557/11/87- Não foram declarados conflitos de interesse associados à publicação deste artigo.Como citar este artigo: Conti PB, Sakano E, Ribeiro MA, Schivinski CI, Ribeiro JD. Assessment of the body posture of mouth-breathing children and adolescents.
In a visuo-motor pointing task, the accuracy of response was measured in situations which differ in the visual information available and the speed of execution of movement. Results confirm the role of visual cues received from self-produced movement in the control of the trajectory of a limb. Furthermore, it can be shown that a structured visual background is important in the treatment of sensory data concerned with the movement and in target localization. This effect is absent in rapidly executed pointing response.
Objective: To evaluate submaximal exercise tolerance and respiratory muscle strength in relation to forward head posture (FHP) and respiratory mode in children, comparing mouth-breathing (MB) children with nasal-breathing (NB) children. Methods: This was a controlled, analytical cross-sectional study involving children in the 8-12 year age bracket with a clinical otorhinolaryngology diagnosis of MB, recruited between October of 2010 and January of 2011 from the Mouth Breather Clinic at the State University of Campinas Hospital de Clínicas, located in the city of Campinas, Brazil. The exclusion criteria were obesity, asthma, chronic respiratory diseases, heart disease, and neurological or orthopedic disorders. All of the participants underwent postural assessment and the six-minute walk test (6MWT), together with determination of MIP and MEP. Results: Of the 92 children in the study, 30 presented with MB and 62 presented with NB. In the MB group, the differences between those with moderate or severe FHP and those with normal head posture, in terms of the mean MIP, MEP and six-minute walk distance (6MWD), were not significant (p = 0.079, p = 0.622, and p = 0.957, respectively). In the NB group, the mean values of MIP and MEP were higher in the children with moderate FHP than in those with normal head posture (p = 0.003 and p = 0.004, respectively). The mean MIP, MEP, and 6MWD were lower in the MB group than in the NB group. Values of MIP and MEP were highest in the children with moderate FHP. Conclusions: Respiratory biomechanics and exercise capacity were negatively affected by MB. The presence of moderate FHP acted as a compensatory mechanism in order to improve respiratory muscle function.Keywords: Mouth breathing; Posture; Exercise tolerance; Respiratory mechanics. ResumoObjetivo: Avaliar a tolerância ao exercício submáximo e a força muscular respiratória em relação à anteriorização da cabeça (AC) e ao tipo respiratório em crianças com respiração bucal (RB) ou nasal (RN). Métodos: Estudo analítico transversal com um grupo controle no qual foram incluídas crianças de 8 a 12 anos com diagnóstico clínico otorrinolaringológico de RB, recrutadas do Ambulatório do Respirador Bucal do Hospital de Clínicas da Universidade Estadual de Campinas, Campinas (SP), entre outubro de 2010 e janeiro de 2011. Os critérios de exclusão foram obesidade, asma, doenças respiratórias crônicas, cardiopatias e distúrbios neurológicos ou ortopédicos. Todos os participantes foram submetidos a avaliação postural, teste de caminhada de seis minutos (TC6) e determinação de PImáx e PEmáx. Resultados: Das 92 crianças do estudo, 30 tinham RB e 62 tinham RN. No grupo RB, não houve diferenças nas médias de PImáx, PEmáx e distância percorrida pelo TC6 (DTC6) entre o grupo com AC classificada como grave ou moderada e aquele com AC normal (p = 0,622; p = 0,957; e p = 0,079, respectivamente). No grupo RN, as médias de PImáx e PEmáx foram maiores no grupo com AC moderada do que naquele com AC normal (p = 0,003 e p = 0,004, respectivamente). Os...
MB affects physical performance and not the academic performance, we noticed a changed pattern in the 6MWT in the MB group. Since the MBs in our study were classified as non-severe, other studies comparing the academic performance variables and 6MWT are needed to better understand the process of physical and academic performances in MB children.
Objectives: To assess the impact of increased thoracic kyphosis on pulmonary function and functional capacity in children and adolescents with cystic fibrosis (CF) and to verify the influence of disease severity, age and nutritional status on this deformity.Method: This was a cross-sectional, analytical study conducted at a university hospital. It included CF patients with confirmed diagnosis and without pulmonary exacerbation. The sample was submitted to postural assessment, spirometry (FEV 1 , FVC and FEV 1 /FVC) and 6-minute walk test distance (6-MWT distance). Data were analyzed using the Mann Whitney test, Spearman correlation and logistic regression.Results: Forty-two patients were enrolled, 61.9% presented increase of thoracic kyphosis. There was no difference in values of FEV 1 , FVC, FEV 1 /FVC and 6-MWT distance between the groups with or without thoracic kyphosis (p = 0.407; p = 0.756; p = 0.415; p = 0.294). In the group without alteration, patients with more disease severity had a mean FEV 1 of 74.1±21.9% and FVC of 79.8±18.7% while in those of lesser severity higher values were found (95.6±12.2% and 97.6±13.2%, respectively) (p = 0.027 and p = 0.027). The presence of kyphosis was correlated with age (p = 0.048) but not with severity (p = 0.151) and body mass index (p = 0.088). Conclusions:There was a high prevalence of increased thoracic kyphosis in children and adolescents with CF. The deformity did not affect pulmonary function and functional capacity and there was no relationship with disease severity. Regardless of posture, worsening of disease severity determined worsening of pulmonary function.J Pediatr (Rio J). 2012;88(4):310-6: Posture, cystic fibrosis, pulmonary function. ResumoObjetivos: Avaliar a repercussão do aumento da cifose torácica na função pulmonar e na capacidade funcional de crianças e adolescentes com fibrose cística e verificar a influência da gravidade da doença, idade e aspectos nutricionais sobre essa deformidade.Método: Estudo analítico de corte transversal, realizado em um hospital universitário. Incluiu fibrocísticos com diagnóstico confirmado e fora de exacerbação pulmonar. A amostra foi submetida à avaliação postural, registro de parâmetros espirométricos -volume expiratório forçado no primeiro segundo (VEF 1 ), capacidade vital forçada (CVF) e VEF 1 /CVF -e da distância percorrida pelo teste de caminhada de 6 minutos. Para análise dos dados, utilizou-se teste de Mann-Whitney, correlação de Spearman e regressão logística, considerando-se nível de significância de 5%. Resultados:No total, 42 pacientes foram incluídos, e 61,9% apresentaram aumento da cifose torácica. Não houve diferença nos valores de VEF 1 , CVF, VEF 1 /CVF e distância percorrida pelo teste de caminhada de 6 minutos entre os grupos com e sem cifose torácica (p = 0,407; p = 0,756; p = 0,415; p = 0,294). No grupo sem alteração postural, fibrocísticos mais graves apresentaram média de VEF 1 de 74,1±21,9% e CVF de 79,8±18,7%, enquanto naqueles de menor gravidade foram verificados valores superiores...
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