PL-LBA-2164

M. Deshmukh¹, I. Madhani¹, T. Palekar¹

¹Dr. D. Y. Patil Vidyapeeth, Dr. D. Y. Patil College of Physiotherapy, Pune, India

Background: Mouth Breathing (MB) and forward head posture (FHP) are correlated with each other and remain undiagnosed or neglected, especially in pediatric population. FHP is a functional response among Mouth Breathing children to facilitate air entry through the mouth due to nasal obstruction. The forward head projection increases airflow through the mouth by triggering postural alterations that reduces respiratory performance. These changes tend to worsen with advancing age. With age, especially in adolescents, postural malalignments worsens in order to compensate for a decrease in lung volumes, leading to increase in head projection. This vicious cycle land up into postural malalignments, muscular imbalance, breathing pattern disorders (BPD) etc. in later stage of life. Though, very little evidence is available in the area of BPD, early detection and correction of MB becomes an important aspect to avoid future consequences. Hence the study is proposed to examine the effect of Papworth Breathing Re-correction Technique combined with postural correction exercises in adolescents having FHP and MB.

Purpose: Papworth breathing technique is a series of diaphragmatic breathing and relaxation exercises emphasising on nose breathing. To determine this effect on mouth breathing adolescents, a study is conducted comprising papworth breathing technique and postural correction exercises to assess and correct FHP, MB ,and Respiratory parameters like Breath Holding Test (BHT) at Total Lung Capacity (TLC) & Functional Residual Capacity (FRC) and chest expansion.

Methods: In this single-blinded, randomized, controlled trial, 120 participants between the age group of 14 and 16 years were involved, including both genders. Screening for FHP through measurement of cranio-vertebral angle (CVA) and MB using mirror test and water holding test respectively was done. Selected 70 Participants with FHP and MB were divided into two groups using computerized randomization. Group A received Papworth breathing technique along with postural correction exercises and Group B received postural correction exercises only. Both the groups were intervened three times a week for two consecutive weeks. Pre and post assessment of outcome measures like FHP through CVA, MB through water holding and mirror test, Pulmonary Function Test (FEV1 & FVC), BHT at TLC and FRC, and chest expansion were carried out.

Results: After checking the normality using Shapiro-Wilk Test, Paired t test and unpaired t test was applied for within the group and between the group comparison respectively. Group A showed significant improvement (p<0.005) for CVA, BHT at TLC and FRC, FEV1, FVC and chest expansion. Whereas group B showed significant improvement (p<0.005) in CVA, FEV1, FVC, only. Significant statistical changes (p<0.005) were observed in chest expansion, BHT at TLC and FRC for between the group comparison.

Conclusions: From the present study, we conclude that Papworth breathing technique is effective in improving FHP, pulmonary function test (FEV1 and FVC), BHT at FRC and TLC, and chest expansion when compared to postural correction exercises alone.

Implications: The Papworth breathing technique can be incorporated into the physiotherapy regimen to reduce the negative consequences of FHP and MB in later stages of life, along with early diagnosis.

Funding acknowledgements: None

Keywords:
Forward Head Posture
Mouth Breathing
Papworth Breathing Technique

Topics:
Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? Yes

Institution: Dr. D. Y. Patil College of Physiotherapy Pune. Maharashtra, India.

Committee: Institutional Ethics Committee.

Ethics number: DYPCPT/IEC/33/2022