Objectives: The aim of this study was to evaluate the acute effects of different inspiratory loads and different interfaces on the breathing pattern and activity of the respiratory muscles. Methods: Twenty healthy adults were recruited and assigned to two groups (20% and 40% of the Maximal Inspiratory Pressure) by way of randomized crossover allocation. Subjects were evaluated during quiet breathing, breathing against inspiratory load, and recovery. The measurements were repeated using two different interfaces (nasal and oral). Chest wall volumes and respiratory muscle activity were assessed with optoelectronic plethysmography and surface electromyography, respectively. Results: During the application of inspiratory load, significant changes were observed in the respiratory rate (p < 0.04), inspiratory time (p < 0.02), minute ventilation (p < 0.04), tidal volume (p < 0.01), end-inspiratory volume (p < 0.04), end-expiratory volume (p < 0.03), and in the activity of the scalene, sternocleiomastoid, and parasternal portion of the intercostal muscles (RMS values, p < 0.01) when compared to quiet breathing, regardless of the load level or the interface applied. Inspiratory load application yielded significant differences between using nasal and oral interfaces with an increase in the tidal volume (p < 0.01), end-inspiratory volume (p < 0.01), and electrical activity of the scalene and sternocleiomastoid muscles (p < 0.01) seen with using the nasal interface. Conclusion: The addition of an inspiratory load has a significant effect on the breathing pattern and respiratory muscle electrical activity, and the effects are greater when the nasal interface is applied.

/pdf/acute-effects-of-inspiratory-loads-and-interfaces-on-569ptqrj6s.pdf

Acute Effects of Inspiratory Loads and Interfaces on Breathing Pattern and Activity of Respiratory Muscles in Healthy Subjects.

Purpose: Purpose: To compare the use of the Glatzel mirror and peak nasal inspiratory flow in the evaluation of mouth-breathing participants and to analyze the correlation between these instruments. Methods: Sixty-four children were evaluated  —  32 mouth breathers and 32 nasal breathers; the children were aged 4 to 12 years. The mouth breathers were subdivided according to the cause of obstruction by a multidisciplinary team. The Glatzel mirror and peak nasal inspiratory flow were used in both groups to evaluate patency and nasal airflow. Data were then subjected for statistical analysis. Results: The Glatzel mirror allowed us to differentiate the breathing mode considering gender, age, weight, height, and body mass index, but it did not help in identifying the cause of mouth breathing. The peak nasal inspiratory flow did not allow differentiation of the breathing mode and identification of the cause of mouth breathing. In our sample, there was no correlation between the instruments used. Conclusion: The Glatzel mirror was reliable in identifying participants with and without nasal obstruction, although it was not possible to differentiate subgroups of mouth breathers using this instrument. The peak nasal inspiratory flow showed differences only between nasal breathers and surgical mouth breathers. Low correlation was found between these two instruments.

http://scielo.br/pdf/codas/v25n3/en_08.pdf

Mouth breathing evaluation: use of Glatzel mirror and peak nasal inspiratory flow Avaliação do respirador oral: uso do espelho de Glatzel e do peak nasal inspiratory flow

Os fonoaudiologos que atuam no campo da Motricidade Orofacial atendem com frequencia, pacientes com obstrucao nasal; entretanto, nem sempre o acesso ao profissional responsavel pelo diagnostico otorrinolaringologico e facil. O Peak Nasal Inspiratory Flow e um instrumento barato, de facil manuseio, amplamente citado na literatura internacional, que tem por objetivo avaliar a patencia nasal. O objetivo do presente estudo foi realizar uma revisao da literatura acerca do Peak Nasal Inspiratory Flow, fornecendo subsidios para reflexoes acerca de seu emprego nos disturbios miofuncionais orofaciais e cervicais. Para tanto, foi realizada uma revisao da literatura nas bases de dados Medline, Cochrane Library, LILACS e SciELO empregando-se os descritores peak, inspiratory, nasal e flow. O Peak Nasal Inspiratory Flow mostrou-se uma tecnica simples, barata, validada e com boa reprodutibilidade. Parece, portanto, tratar-se de um instrumento util para avaliacao da patencia nasal, apesar de algumas limitacoes, fornecendo dados complementares ao diagnostico miofuncional orofacial e cervical. Entretanto, estudos clinicos precisam ser conduzidos para que se comprove ou refute a hipotese.

/pdf/peak-nasal-inspiratory-flow-a-possible-instrument-in-rvb73f42yk.pdf

Peak nasal inspiratory flow: a possible instrument in orofacial myology?

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 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.

http://rc.rcjournal.com/content/respcare/early/2020/04/07/respcare.06908.full-text.pdf

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

Introducao: O Sistema Estomatognatico (SE) e composto por diferentes estruturas que, controladas pelo Sistema Nervoso Central, desempenham funcoes de succao, de mastigacao, de degluticao, de fala e de respiracao. Tais estruturas agem de forma conjunta, de tal maneira que qualquer modificacao anatomica ou funcional especifica pode levar a um desequilibrio generalizado, ocasionando alteracoes. Estas alteracoes tem sido objeto de estudos, dos quais se pode depreender que elas estao originalmente relacionadas a alguns fatores, dentre outros, as doencas do trato respiratorio. Pouco se conhece das alteracoes do SE em pacientes com asma. Objetivos: Comparar as funcoes orofaciais (mastigacao, degluticao e fala) e o modo respiratorio em criancas asmaticas e em criancas saudaveis. Metodos: Participaram do estudo 54 criancas com idade entre sete anos e dez anos completos, de ambos os generos. Vinte e sete delas compuseram o grupo experimental e foram subdivididas em dois niveis de gravidade de asma: grupo I - intermitente e persistente leve e grupo II - persistente moderada e grave. Vinte e sete criancas saudaveis fizeram parte do grupo controle (grupo III). Para anamnese e avaliacao fonoaudiologica foi utilizado o protocolo de avaliacao miofuncional orofacial adaptado de Marchesan (2003). A adaptacao constituiu-se na realizacao parcial da parte funcional, excluindo-se o componente estrutural, ja que este nao fazia parte do objetivo do presente estudo. Resultados: Dos relatos sobre a mastigacao, a degluticao, a fala e o modo respiratorio, os resultados encontrados foram estatisticamente semelhantes nos dois grupos de asmaticos. Em contrapartida, os resultados de avaliacao clinica fonoaudiologica identificaram alteracoes nas funcoes orofaciais e no modo respiratorio, com resultados estatisticamente significantes, entre os tres grupos estudados. As alteracoes encontradas nao demonstraram relacao com a gravidade de asma, quando analisadas as funcoes orofaciais de mastigacao, de degluticao e de fala, visto que o maior indice de alteracoes foi encontrado no grupo I, ou seja, no grupo de asmaticos leves. Contudo, na avaliacao do modo respiratorio, quanto maior a gravidade de asma, maior a presenca de respiracao oronasal. Conclusoes: Independente do nivel de gravidade, os asmaticos apresentaram padroes alterados de mastigacao, de degluticao, de fala e a depender do nivel de gravidade, do modo respiratorio. 
Abstract

http://repositorio.unicamp.br/jspui/bitstream/REPOSIP/309987/1/Castro_MarianaSanJorgede_M.pdf

Avaliação das funções orofacias do sistema estomatognático e do modo respiratório nos níveis de gravidade de asma em crianças

The Oral Breathing Syndrome consists in a set of signals and symptoms presented by people who breaths partially or totally through the mouth. This alteration in the respiratory pattern may cause modifications in all body dynamics, which may cause reduction in ventilatory muscle strength (VMS) and, consequently, reduction of the respiratory flows, being this reduction also explained by the obstruction that provokes the syndrome. The aim of this work was to evaluate if a program based on Ventilatory Muscular Training (VMT) and Nasal Breathing Training (NBT) makes it possible an improvement in the VMS and in the nasal inspiratory flow. Were participants of this study 8 children from 5 to 12 years-old with medical diagnosis of Oral Breathing Syndrome (OBS), who were submitted to evaluation, which consisted in: anamnesis, physical examination, evaluation of the RMS, Peak of Nasal Inspiratory Flow (PNIF) test and postural evaluation. The training program consisted of 15 sessions, in which the children made RMT in the Nasomanometro and NBT concomitantly with the RMT, as well as through activities that stimulated the nasal breathing. After the training, a reevaluation was done. The results were submitted to the non-parametric test Wilcoxon (p<0,05) and was observed significant increase in the maximal inspiratory and expiratory pressures, in the maximal inspiratory and expiratory nasal pressures and in the PNIF, which means that the execution of VMT and NBT improved RMS and respiratory nasal flow in these children.

/pdf/treinamento-muscular-e-da-respiracao-nasal-em-criancas-2jbh6bytaj.pdf

TREINAMENTO MUSCULAR E DA RESPIRAÇÃO NASAL EM CRIANÇAS RESPIRADORAS ORAIS Respiratory muscular training and nasal breathing training in oral breathers children

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TREINAMENTO MUSCULAR E DA RESPIRAÇÃO NASAL EM CRIANÇAS RESPIRADORAS ORAIS Respiratory muscular training and nasal breathing training in oral breathers children