Breathing pattern and muscle activity using different inspiratory resistance devices in children with mouth breathing syndrome

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