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Breathing pattern and muscle activity using different inspiratory resistance devices in children with mouth breathing
Jéssica Danielle Medeiros da Fonsêca1,2, Andrea Aliverti3, Kadja Benício1,2
1PneumoCardioVascular Lab/HUOL, Hospital Universitário Onofre Lopes, Empresa Brasileira de Serviços Hospitalares and Departamento de Fisioterapia Universidade Federal do Rio Grande do Norte, Natal, Brazil.
Insights
Nasal inspiratory resistance devices positively impact breathing patterns in children with mouth breathing syndrome (MBS). Flow resistance devices were more effective than pressure threshold devices in improving tidal volume and end-inspiratory volume.
Area of Science:
- Pediatric Pulmonology
- Respiratory Physiology
- Biomedical Engineering
Background:
- Mouth breathing syndrome (MBS) affects respiratory mechanics in children.
- Understanding acute effects of inspiratory loading via nasal airway is crucial for intervention.
- Limited research exists on comparing different inspiratory resistance devices in MBS.
Purpose of the Study:
- To evaluate acute effects of inspiratory resistance devices and load intensity on breathing patterns.
- To assess respiratory muscle activity in children with MBS during nasal inspiratory loading.
- To compare the efficacy of pressure threshold versus flow resistance devices.
Main Methods:
- Children with MBS were randomized into two groups (20% and 40% maximal inspiratory pressure).
- Breathing patterns and respiratory muscle activity were measured during quiet breathing, inspiratory loading, and recovery.
- Optoelectronic plethysmography and surface electromyography were used to assess chest wall volumes and muscle activity.
Main Results:
- Inspiratory loading significantly reduced respiratory rate and increased inspiratory time, tidal volume, and respiratory muscle activity.
- Both pressure threshold and flow resistance devices improved breathing patterns.
- Flow resistance devices showed a greater increase in tidal volume and end-inspiratory volume.
Conclusions:
- Nasal inspiratory loading positively affects breathing patterns in children with MBS.
- Flow resistance devices demonstrate advantages over pressure threshold devices for improving respiratory volumes.
- These findings support the use of nasal inspiratory resistance for managing MBS.
Aim:
The aim of this study was to evaluate the acute effects of different inspiratory resistance devices and intensity of loads via nasal airway on the breathing pattern and activity of respiratory muscles in children with mouth breathing syndrome (MBS).
Methods:
Children with MBS were randomised into two groups based on inspiratory load intensity (20% and 40% of the maximal inspiratory pressure). These subjects were assessed during quiet breathing, breathing against inspiratory load via nasal airway and recovery. The measurements were repeated using two different devices (pressure threshold and flow resistance). Chest wall volumes and respiratory muscle activity were evaluated by optoelectronic plethysmography and surface electromyography, respectively.
Results:
During the application of inspiratory load, there was a significant reduction in respiratory rate (p<0.04) and an increase in inspiratory time (p<0.02), total time of respiratory cycle (p<0.02), minute ventilation (p<0.03), tidal volume (p<0.01) and scalene and sternocleidomastoid muscles activity (root mean square values, p<0.01) when compared to quiet spontaneous breathing and recovery, regardless of load level or device applied. The application of inspiratory load using the flow resistance device showed an increase in the tidal volume (p<0.02) and end-inspiratory volume (p<0.02).
Conclusion:
For both devices, the addition of inspiratory loads using a nasal interface had a positive effect on the breathing pattern. However, the flow resistance device was more effective in generating volume and, therefore, has advantages compared to pressure threshold.
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