Jéssica Danielle Medeiros da Fonsêca1,2,3, Vanessa Regiane Resqueti1,2,3, Kadja Benício1,2,3, Valéria Soraya de Farias Sales4, Luciana Fontes Silva da Cunha Lima5, Andrea Aliverti6, Antonio Sarmento1,2,3, Guilherme Augusto de Freitas Fregonezi7,2,3. 1. PneumoCardioVascular Lab, Hospital Universitário Onofre Lopes, Natal, Rio Grande do Norte, Brazil. 2. Empresa Brasileira de Serviços Hospitalares and Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil. 3. Laboratório de Inovação Tecnológica em Reabilitação, Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil. 4. Departamento de Análises Clínicas e Toxicológicas, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil. 5. Departamento de Cirurgia, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil. 6. Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy. 7. PneumoCardioVascular Lab, Hospital Universitário Onofre Lopes, Natal, Rio Grande do Norte, Brazil. fregonezi.guilherme@gmail.com.
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.
RCT Entities:
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.
Authors: Jéssica Danielle Medeiros da Fonsêca; Andrea Aliverti; Kadja Benício; Valéria Soraya de Farias Sales; Luciana Fontes Silva da Cunha Lima; Vanessa Regiane Resqueti; Guilherme Augusto de Freitas Fregonezi Journal: ERJ Open Res Date: 2022-05-09