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Research ArticleOriginal Research

Effects of Inspiratory Load on Chest Wall Kinematics, Breathing Pattern, and Respiratory Muscle Activity of Mouth-Breathing Children

Jéssica Danielle Medeiros da Fonsêca, Vanessa Regiane Resqueti, Kadja Benício, Valéria Soraya de Farias Sales, Luciana Fontes Silva da Cunha Lima, Andrea Aliverti, Antonio Sarmento and Guilherme Augusto de Freitas Fregonezi
Respiratory Care September 2020, 65 (9) 1285-1294; DOI: https://doi.org/10.4187/respcare.06908
Jéssica Danielle Medeiros da Fonsêca
PneumoCardioVascular Lab, Hospital Universitário Onofre Lopes, Natal, Rio Grande do Norte, Brazil.
Empresa Brasileira de Serviços Hospitalares and Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
Laboratório de Inovação Tecnológica em Reabilitação, Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
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Vanessa Regiane Resqueti
PneumoCardioVascular Lab, Hospital Universitário Onofre Lopes, Natal, Rio Grande do Norte, Brazil.
Empresa Brasileira de Serviços Hospitalares and Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
Laboratório de Inovação Tecnológica em Reabilitação, Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
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Kadja Benício
PneumoCardioVascular Lab, Hospital Universitário Onofre Lopes, Natal, Rio Grande do Norte, Brazil.
Empresa Brasileira de Serviços Hospitalares and Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
Laboratório de Inovação Tecnológica em Reabilitação, Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
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Valéria Soraya de Farias Sales
Departamento de Análises Clínicas e Toxicológicas, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
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Luciana Fontes Silva da Cunha Lima
Departamento de Cirurgia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
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Andrea Aliverti
Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy.
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Antonio Sarmento
PneumoCardioVascular Lab, Hospital Universitário Onofre Lopes, Natal, Rio Grande do Norte, Brazil.
Empresa Brasileira de Serviços Hospitalares and Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
Laboratório de Inovação Tecnológica em Reabilitação, Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
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Guilherme Augusto de Freitas Fregonezi
PneumoCardioVascular Lab, Hospital Universitário Onofre Lopes, Natal, Rio Grande do Norte, Brazil.
Empresa Brasileira de Serviços Hospitalares and Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
Laboratório de Inovação Tecnológica em Reabilitação, Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
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Abstract

BACKGROUND: We sought to evaluate the acute effects of different inspiratory loads using nasal and oral interfaces on the volumes of the chest wall and its compartments, breathing pattern, and respiratory muscle activation in children with mouth-breathing syndrome.

METHODS: Children with mouth-breathing syndrome were randomized into 2 groups, one with an inspiratory load intensity 20% of maximum inspiratory pressure (n = 14), and the other with an inspiratory load intensity 40% of maximum inspiratory pressure (n = 15). The chest wall volumes and electromyography of sternocleidomastoid, rectus abdominis, scalene, and internal intercostal muscles were used to analyze respiration against the 2 load intensities and using 2 interfaces (ie, nasal and oral).

RESULTS: A total of 72 children with mouth-breathing syndrome were recruited, and 29 were evaluated in this study. The use of inspiratory load promoted improvement in the components of the breathing pattern: breathing frequency (P = .039), inspiratory time (P = .03), and total respiratory time (P = .043); and increases in tidal volume (P < .001), end-inspiratory volume (P < .001), and electrical activity of scalene muscles and sternocleidomastoid muscles (P < .001) when compared to quiet breathing. The load imposed via a nasal interface versus an oral interface provided an increase in tidal volume (P = .030), end-inspiratory volume (P = .02), and electrical activity of scalene muscles (P < .001) and sternocleidomastoid muscles (P = .02).

CONCLUSIONS: The use of acute inspiratory loads improved the breathing pattern and increased lung volume and electrical activity of inspiratory muscles. This work brings new perspective to the investigation of using nasal interfaces during the application of inspiratory loads. The nasal interface was more effective compared to the oral interface commonly used in clinical practice.

  • respiratory muscles
  • mouth breathing
  • children
  • electromyography
  • plethysmography

Footnotes

  • Correspondence: Guilherme Augusto de Freitas Fregonezi PhD, PneumoCardioVascular Lab Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Campus Universitário, Caixa-postal 1524, Lagoa Nova, CEP 59072970, Natal, RN, Brazil. E-mail: fregonezi.guilherme{at}gmail.com
  • The study received financial support from the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), PGCI CAPES 054/2014 - 23038.007514/2014-78 and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) process: 400316/2012-9. Guilherme Augusto de Freitas Fregonezi received a grant from CNPq number 312876/2018-1, and Vanessa Resqueti received a grant from CNPq number 315580/2018-6.

  • Copyright © 2020 by Daedalus Enterprises
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Respiratory Care: 65 (9)
Respiratory Care
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1 Sep 2020
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Effects of Inspiratory Load on Chest Wall Kinematics, Breathing Pattern, and Respiratory Muscle Activity of Mouth-Breathing Children
Jéssica Danielle Medeiros da Fonsêca, Vanessa Regiane Resqueti, Kadja Benício, Valéria Soraya de Farias Sales, Luciana Fontes Silva da Cunha Lima, Andrea Aliverti, Antonio Sarmento, Guilherme Augusto de Freitas Fregonezi
Respiratory Care Sep 2020, 65 (9) 1285-1294; DOI: 10.4187/respcare.06908

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Effects of Inspiratory Load on Chest Wall Kinematics, Breathing Pattern, and Respiratory Muscle Activity of Mouth-Breathing Children
Jéssica Danielle Medeiros da Fonsêca, Vanessa Regiane Resqueti, Kadja Benício, Valéria Soraya de Farias Sales, Luciana Fontes Silva da Cunha Lima, Andrea Aliverti, Antonio Sarmento, Guilherme Augusto de Freitas Fregonezi
Respiratory Care Sep 2020, 65 (9) 1285-1294; DOI: 10.4187/respcare.06908
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Keywords

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  • electromyography
  • plethysmography

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