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      Surface electromyography in orofacial and cervical musculature in mouth breathing children: an integrative literature review Translated title: Eletromiografia de superfície em musculatura orofacial e cervical de crianças respiradoras orais: revisão integrativa da literatura

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          Abstract

          ABSTRACT Purpose: to review, in an integrative manner, studies using surface electromyography in the orofacial and cervical musculature in mouth breathing children aged from three to 11 years and 11 months old. Methods: the survey was conducted in national and international databases, from 1998 to 2018, in Portuguese, English and Spanish. Review articles, dissertations, book chapters, case studies and editorials were excluded. Results: 86 articles were found, 14 of which met the inclusion criteria. Most of these studies used surface electromyography to assess and describe the muscle condition of the mouth breathing population. Only one study addressed the influence of myofunctional speech therapy and two studies included physical therapy treatment, using electromyographic evaluation before and after the intervention. Given the main categories of analysis, the discussion was based on the year, state of publication and journal, sample size, scientific methodology, muscles assessed, assessment protocols used and the results of the publications. Conclusions: surface electromyography has been used mainly in the initial assessment of orofacial and postural myofunctional changes caused by mouth breathing and not as a therapeutic biofeedback, thus, it is important to conduct longitudinal studies using this instrument in mouth breathers.

          Translated abstract

          RESUMO Objetivo: revisar, de maneira integrativa, estudos que utilizaram a eletromiografia de superfície (EMGs) em musculatura orofacial e cervical de crianças respiradoras orais da faixa etária dos três aos 11 anos e 11 meses de idade. Métodos: a busca foi realizada em bases de dados nacionais e internacionais, entre 1998 a 2018, nos três idiomas português, inglês e espanhol. Foram excluídos os artigos de revisão, as dissertações, os capítulos de livros, os estudos de caso e os editoriais. Resultados: foram encontrados 86 artigos, e desses, 14 atendiam aos critérios de inclusão. A maioria desses estudos utilizaram a EMGs para avaliação e descrição da condição muscular da população de respiração oral. Apenas um estudo abordou a influência da terapia fonoaudiológica miofuncional e dois realizaram o tratamento fisioterápico utilizando a avaliação eletromiográfica antes e após a intervenção. A discussão foi construída em torno do ano, estado de publicação e periódico, tamanho da amostra, metodologia científica, músculos avaliados, protocolos de avaliação utilizados e os resultados contidos nas publicações, considerando que estas são as principais categorias de análise. Conclusões: constata-se que a EMGs tem sido utilizada, principalmente, na avaliação inicial das alterações miofuncionais orofaciais e posturais causadas pela respiração oral e não como biofeedback terapêutico, sendo importante a condução de estudos longitudinais utilizando tal instrumento em respiradores orais.

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          Most cited references33

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          Protocol of orofacial myofunctional evaluation with scores.

          In the literature there is no validated instrument for the clinical evaluation of the orofacial myofunctional condition of children that will permit the examiner to express numerically his perception of the characteristics and behaviors observed. The proposal of this study is to describe a protocol for the evaluation of children aged 6-12 years in order to establish relations between the orofacial myofunctional conditions and numerical scales. The protocol validity, reliability of the examiners and agreement between them was analyzed. Eighty children aged 6-12 years participated in the study. All were evaluated and 30 were selected at random for the analyses (age range: 72-149 months, mean=103.3, S.D.=23.57). Individuals with and without orofacial myofunctional disorders were included. The examiners were two speech therapists properly calibrated in orofacial myofunctional evaluation. Two protocols were constructed. One, based on traditional models, was called traditional orofacial myofunctional evaluation (TOME), and the other, with the addition of numerical scales, was called orofacial myofunctional evaluation with scores (OMES). The clinical conditions included were: appearance, posture and mobility of lips, tongue, cheeks and jaws, respiration, mastication and deglutition. Statistical analysis was performed using the split-half reliability method. Means, standard deviations and the Spearman correlation coefficient were also calculated. There was a statistically significant correlation between the evaluations of 30 children assessed with the TOME and OMES protocols (r=0.85, p<0.01). The reliability between protocols was 0.92. The test-retest reliability of the OMES instrument was 0.99 and the correlation was 0.98. Reliability between examiners 1 and 2 using the OMES protocol was 0.99, and the correlation was 0.98 (p<0.01). The OMES protocol proved to be a valid and reliable instrument for orofacial myofunctional evaluation, permitting the grading of orofacial myofunctional conditions within the limits of the selected items.
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            Mouth breathing in allergic children: its relationship to dentofacial development.

            While there are many claims that abnormal breathing patterns alter facial growth, there are limited controlled data to confirm this. We evaluated forty-five North American Caucasians of both sexes, ranging in age from 6 to 12 years. Thirty chronically allergic mouth-breathing subjects were selected from a pediatric allergy practice, and fifteen nonallergic nose breathers were selected from a general pediatric practice. Each subject underwent an intraoral clinical examination and a cephalometric radiograph analysis. Various skeletal and dental relationships were evaluated for statistical differences related to mode of breathing and age. The upper anterior facial height and the total anterior facial height were significantly larger in the mouth breathers. Angular relationships of the sella-nasion, palatal, and occlusal planes to the mandibular plane were greater in the mouth breathers, and their gonial angles were larger. The mouth breathers' maxillae and mandibles were more retrognathic. Palatal height was higher, and overjet was greater in the mouth breathers. Maxillary intermolar width was narrower in the mouth breathers and was associated with a higher prevalence of posterior cross-bite. Over all, mouth breathers had longer faces with narrower maxillae and retrognathic jaws. This supports previous claims that nasal airway obstruction is associated with aberrant facial growth. Longitudinal studies are needed to evaluate the effectiveness of early intervention in preventing these growth alterations.
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              Efficacy of physical therapy on cervical muscle activity and on body posture in school-age mouth breathing children.

              The mouth breathing resulting from nasal obstruction has been highly incident, mostly as a consequence of allergic rhinitis. In children, such condition is more concerned because it causes alteration during their development, which may generate deformities.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                rcefac
                Revista CEFAC
                Rev. CEFAC
                ABRAMO Associação Brasileira de Motricidade Orofacial (São Paulo, SP, Brazil )
                1516-1846
                1982-0216
                2020
                : 22
                : 1
                : e19318
                Affiliations
                [2] Campinas São Paulo orgnameUniversidade Estadual de Campinas orgdiv1Faculdade de Ciência Médicas orgdiv2Programa de Pós-Graduação em Saúde, Interdisciplinaridade e Reabilitação Brazil
                [1] Campinas São Paulo orgnameUniversidade Estadual de Campinas orgdiv1Faculdade de Ciência Médicas orgdiv2Programa de Pós-Graduação Brazil
                Article
                S1516-18462020000100603 S1516-1846(20)02200100603
                10.1590/1982-0216/202022119318
                cbc41997-2918-4459-b250-21a1611a0e3e

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 29 October 2019
                : 22 February 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 40, Pages: 0
                Product

                SciELO Brazil

                Categories
                Review Articles

                Eletromiografia de Superfície,Respiração Bucal,Criança, Pré Escolar,Surface Electromyography,Mouth Breathing,Children,Preschool

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