Association between respiratory and postural adaptations and self-perception of school-aged children with mouth breathing in relation to their quality of life

Abstract

Objective: To investigate the respiratory and postural adaptations associated with mouth and nasal breathing and to evaluate the associations of such adaptations in mouth breathers' self-perceived quality of life. Method:Cross-sectional study with mouth breathers (initial n=116 and final n=48) and nasal breathers (initial n=131 and final n=24) from elementary school, aged between 7 and 14 years. Chest expansion, using cirtometry, the breathing pattern and the use of accessory muscles, by means of clinical evaluations and photogrammetry, and flexibility tests were evaluated in both groups. Subsequently, the mouth breathers were asked to complete the quality of life questionnaire. Statistical tests: Chi-square, odds ratio, Mann-Whitney, and binomial tests were first applied followed by logistic regressions. Results:Thoracic breathing (p=0.04), using of accessory muscles (p=0.03) and reductions in flexibility (p=0.001) increased the chances of an individual being a mouth breather when compared to nasal breathers. Subsequently, using of accessory muscles decreased the chances of snoring among mouth breathers (p=0.03); the presence of shoulder asymmetry reduced the chances of experiencing quiet sleep (p=0.05) and increased the chances of coughing or being tired when playing or running (p=0.008). Finally, forward head position reduced the chances of waking up at night (p=0.04) and experiencing shortness of breath (p=0.05). Conclusions:Respiratory and postural adaptations increased the chances of individuals persisting with mouth breathing. Additionally, these adaptations could be associated with mouth breathers' self-perceived quality of life.

Effect of Holistic Gymnastics in the Flexibility of Girls Between 10 and 12 Years

“…The "fingertip-to-floor" (FTF) test 23,24 is performed with the knees extended and the trunk flexed forward, aiming at the approximation of the fingertips to the floor, and it evaluates the flexibility of the lumbar spine and pelvis. This test was validated and considered reliable for both research (therapeutic trials) and clinical practice 24 .…”

Body posture and pulmonary function in mouth and nose breathing children: cross-sectional study

“…On the other hand, a number of studies have associated postural changes, primarily forward head posture, to mouth breathing (2,3,4,26). In a study by Okuro et al (2), head posture was most affected by mouth breathing, acting as a satisfactory compensatory mechanism to maintain respiratory muscle strength, irrespective of breathing mode.…”

“…including prolonged sitting and extended use of computers and smartphones (26,30,31). Sedrez et al (24) used panoramic radiographs to investigate the risk factors associated with postural-structural changes in the spine of children and adolescents.…”

Variables associated with mouth breathing diagnosis in children based on a multidisciplinary assessment

“…Postural measurements, evaluated by a physiotherapist, showed no association with MB diagnosis. Nevertheless, despite no association being observed, it should be highlighted that postural changes, mainly in the craniocervical region, represent important clinical aspects for an MB therapeutic approach, given that respiratory and postural adaptations may increase the chance of mouth breathing persistence (16) . Postural adaptations are also considered a compensatory mechanism to assist the breathing function (30) .…”

“…Participants underwent speech therapy, otorhinolaryngologic (OTRL), dental and physiotherapy assessments. Breathing mode was defined by the agreement of three conditions: parent report (1,4) and OTRL (16) and speech therapist (1,4) assessments, without taking into account orofacial and postural features. The following aspects were considered for mouth breathing categorization: report of open mouth throughout the majority of the day, open mouth at night, nocturnal drooling or snoring for more than six months and breathing through the mouth, confirmed by speech therapist and OTRL examinations.…”