学童期の口呼吸児の呼吸・姿勢適応と自己認知の関連性とQOLの関連性

Association between respiratory and postural adaptations and self-perception of school-aged children with mouth breathing in relation to their quality of life.

抄録

目的:

口呼吸と鼻呼吸に関連する呼吸・姿勢の適応を調査し、口呼吸者の自己認識とQOLとの関連を評価すること。

OBJECTIVE: To investigate the respiratory and postural adaptations associated with mouth and nasal breathing and to evaluate the associations of such adaptations in mouth breathers' self-perceived quality of life.

方法:

7歳から14歳の小学生の口呼吸者（初期116名、最終48名）および鼻呼吸者（初期131名、最終24名）を対象とした横断的研究である。両群とも，胸郭検査による胸郭の拡大，臨床評価と写真測量による呼吸様式と付属筋の使用，および柔軟性試験を行った．その後、口呼吸の患者にはQOLアンケートに回答してもらった。統計学的検定統計学的検定：カイ二乗、オッズ比、Mann-Whitney、二項検定を適用し、次にロジスティック回帰を行った。

METHOD: Cross-sectional study with mouth breathers (initial n=116 and final n=48) and nasal breathers (initial n=131 and final n=24) from elementary school, aged between 7 and 14 years. Chest expansion, using cirtometry, the breathing pattern and the use of accessory muscles, by means of clinical evaluations and photogrammetry, and flexibility tests were evaluated in both groups. Subsequently, the mouth breathers were asked to complete the quality of life questionnaire. Statistical tests: Chi-square, odds ratio, Mann-Whitney, and binomial tests were first applied followed by logistic regressions.

結果:

胸式呼吸（p=0.04）、補助筋の使用（p=0.03）、柔軟性の低下（p=0.001）は、鼻式呼吸者と比較して口式呼吸者である可能性を増加させた。また、肩の非対称性は、静かな眠りをもたらす可能性を減少させ（p=0.05）、遊びやランニングで咳をしたり疲れたりする可能性を増加させる（p=0.008）ことが示された。最後に、前方頭位は、夜間に目が覚める可能性を減少させ（p=0.04）、息切れを経験する可能性を減少させる（p=0.05）ことが示された。

RESULTS: Thoracic breathing (p=0.04), using of accessory muscles (p=0.03) and reductions in flexibility (p=0.001) increased the chances of an individual being a mouth breather when compared to nasal breathers. Subsequently, using of accessory muscles decreased the chances of snoring among mouth breathers (p=0.03); the presence of shoulder asymmetry reduced the chances of experiencing quiet sleep (p=0.05) and increased the chances of coughing or being tired when playing or running (p=0.008). Finally, forward head position reduced the chances of waking up at night (p=0.04) and experiencing shortness of breath (p=0.05).

結論:

呼吸と姿勢の適応は、口呼吸を継続させる可能性を増加させた。さらに，これらの適応は，口呼吸者の自己認識するQOLと関連する可能性がある．

CONCLUSIONS: Respiratory and postural adaptations increased the chances of individuals persisting with mouth breathing. Additionally, these adaptations could be associated with mouth breathers' self-perceived quality of life.