Walk test and school performance in mouth-breathing children

Abstract

In recent decades, many studies on mouth breathing (MB) have been published; however, little is known about many aspects of this syndrome, including severity, impact on physical and academic performances.

Objective: Compare the physical performance in a six minutes walk test (6MWT) and the academic performance of MB and nasal-breathing (NB) children and adolescents.

Method: This is a descriptive, cross-sectional, and prospective study with MB and NB children submitted to the 6MWT and scholar performance assessment.

Results: We included 156 children, 87 girls (60 NB and 27 MB) and 69 boys (44 NB and 25 MB). Variables were analyzed during the 6MWT: heart rate (HR), respiratory rate, oxygen saturation, distance walked in six minutes and modified Borg scale. All the variables studied were statistically different between groups NB and MB, with the exception of school performance and HR in 6MWT.

Conclusion: MB affects physical performance and not the academic performance, we noticed a changed pattern in the 6MWT in the MB group. Since the MBs in our study were classified as non-severe, other studies comparing the academic performance variables and 6MWT are needed to better understand the process of physical and academic performances in MB children.

Figure 1

Modified Borg Scale. Levels of dyspnea.

Figure 2

Cardiac and respiratory rates. A. HR in the different groups analyzed (NB and MB) during the first and second 6MWT carried out. For each 6MWT, we have the HR initial and final values. There were no significant differences between the analyzed groups (NB and MB), nor between the tests 1 and 2. HR was higher after the six-minute walk in the first test (* p < 0.0001) and in the second test (^#p < 0.0001) regardless if the group was NB or MB. The significance level adopted for the analysis was 0.05. B. RR in the different groups analyzed (NB and MB) during the first and second 6MWT carried out. For each 6MWT we describe the RR initial and final values. In the second test, the MB group had higher RR than the NB (* p = 0.0011). The MB in the second 6MWT held in comparison to the first, had a higher RR (^#p = 0.0038). In the comparison between the beginning and the end of the 6MWT, regardless of the NB and MB groups, in both tests there was a higher value for the RR (test 1: ^¥p = 0.0011 and test 2: ¶p = 0.0011). The level of significance adopted for the analysis was 0.05. HR: Heart rate; RR: Respiratory rate; MB: Mouth-breathing; NB: Nasal-breathing; SpO₂: Oxygen peripheral saturation; 6MWT: 6-minute walk test.

Figure 3

Oxygen peripherical saturation. SpO₂ in the different groups analyzed (B and MB) during the first and second 6MWT. For each 6MWT we describe the SpO₂ initial and final values. In the second test, the SpO2 was higher in the NB group when compared to MBs. * p = 0.0175. The significance level adopted for the analysis was 0.05. MB: Mouth-breathing; NB: Nasal-breathing; SpO₂: Oxygen peripheral saturation; 6MWT: 6-minute walk test.

Figure 4

Comparison with the Modified Borg Scale. The MBS in the different groups analyzed (NB and MB) during the first and the second 6MWT. For each 6MWT we describe the initial and final values of the MBS. In comparing tests 1 and 2 in the NB group, the MBS value was higher in test 2 (* p = 0.0005). In test 2, the MB group had the higher MBS when compared to the NB individuals at the end of the 6MWT (^#p = 0.0088). Regardless of the group analyzed (NB or MB), there was an increase in the MBS value in test 1 (^¥p = 0.0005) and test 2 (^¶p = 0.0005). The level of significance adopted for the analyses was 0.05. MB: Mouth-breathing; NB: Nasal-breathing; MBS: Modified Borg Scale; 6MWT: 6-minute walk test.

Figure 5

Analysis of the distance traveled in six minutes in the walk test A: Distance traveled in the first 6MWT, comparing the MB group (550.67 ± 72.22) with the NB group (667.14 ± 88.97). Student-t test. The level of significance adopted for the analysis was 0.05, (T = -7.902), p < 0.0001). B: Distance traveled in the second 6MWT, comparing the MB group (543.40 ± 79.40) with the NB group (667.13 ± 90.67). Student-t test. The level of significance adopted for the analyses was 0.05. MB: Mouth-breathing; NB: Nasal-breathing; 6MWT: 6-minute walk test.