Assessment of the body posture of mouth-breathing children and adolescents

Abstract

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.

Implicações da respiração oral na função pulmonar e músculos respiratórios

“…This fact could lead to the development of thoracic deformities, such as elevation of last ribs, upper displacement of thoracic cage and increased lumbar lordosis 2 . Nasal obstruction can lead to decreased olfactory stimuli, increased pulmonary hyperresponsiveness and nasal congestion 5,7 . Therefore, the upper airway obstruction can bring as consequence mouth breathing, impaired ventilation and chest expansion, subsequently resulting in developmental disorders of the thoracic cage.…”

“…Mouth Breathing Syndrome is defined as a set of signs and symptoms that may be completely or incompletely present in subjects who, for several reasons, replace the correct pattern of nasal breathing by an oral or mixed pattern 4 for mor than six months 5 . Among these signs and symptoms are included daytime sleepiness, headache, agitation and nocturnal enuresis, frequent fatigue, poor appetite, bruxism, school problems and even learning deficits and behavioral problems 6 .…”

Deficits in working memory, reading comprehension and arithmetic skills in children with mouth breathing syndrome: analytical cross-sectional study

“…3,4 The main causes are allergic rhinitis, palatine and/or pharyngeal tonsil hypertrophy, and septal deviation. 3,4 Chronic mouth breathing may have several consequences, such as dentofacial morphological and orofacial myofunctional adaptations, [5][6][7] along with changes to body posture, 3,4,[8][9][10][11] pulmonary function, 10 auditory processing and voice. [12][13][14][15] In some cases, mouth breathing is associated with sleep-related obstructive breathing disorders, with important behavioral and cognitive impacts such as daytime tiredness, sleepiness, poor concentration and attention, and such children may often present learning difficulties and low academic achievement.…”

Efeitos do método isostretching na função respiratória e postura de respiradores bucal

“…Outras alterações posturais podem advir da anteriorização da cabeça, como a protrusão dos ombros; a elevação e a abdução das escápulas; a depressão da região torácica; a hiperextensão dos joelhos; os pés planos e desequilíbrios musculares 8,9 . Essas compensações podem ser explicadas pelo fato de nossos músculos serem organizados anatômica e funcionalmente relacionados por meio de cadeias musculares e agirem sinergicamente com o objetivo de manter o equilíbrio postural 3,8,10 .…”