Impact of Physical Therapy Program in Mouthbreathing Children After Adenotonsillectomy: Randomized Clinical Trial.

Although oral breathing children be studied by otolaryngologists, allergists, orthodontists, speech therapists and physiotherapists and the prevalence of mouth breathing range from 26.6% to 53.3% in Brazilian studies, physical, medical and social problems arising from the Mouth Breathing Syndrome(MB) are still not recognized as a public health problem. Behavioral changes in sleep quality and craniofacial development and consequently the quality of life after surgical, orthodontic and multidisciplinary approach to the MB children are known.However, little is known about the effectiveness of early physical therapy intervention, whereas postural abnormalities characteristic of mouth breathing children are relevant and that the postural pattern adopted may persist into adulthood.

SPECIFIC OBJECTIVES

1. Compare linear measurements of elevation, scapular abduction and depression among MB children in preoperative and postoperative adenotonsillectomy.
2. Compare the angular measurements of upper / lower rotation, external / internal rotation, anterior / posterior tilt of the scapula and thoracic kyphosis, protrusion and retraction of the head and shoulders of protrusion and retraction group of MB children preoperative and postoperative adenotonsillectomy 3. Evaluate the impact of physical therapy intervention postoperatively.

STUDY DESIGN: Cohort cross-sectional PARTICIPANTS: The sample size calculation was based on the results of Correa et al (2008) , who report similar to the effects of intervention proposed in this study.45 children will be recruited from the Clinic of MOUTH BREATHING (ARO) of the Federal University of Minas Gerais (UFMG). To ensure adequate statistical power in case of loss to follow-up will be considered sample of 55 children.

ELIGIBILITY CRITERIA: 45 both male and female mouthbreathing children belonging to any racial group aged 4-10 years completed INCLUSION CRITERIA: diagnosis of upper airway obstruction by endoscopy (pharyngeal tonsil occupying 80% or more of the nasopharynx and / or palatine tonsils 3 or 4 ), history of oral route of access and loss of passive lip seal, display good understanding and whose family can signing the consent form approved by the Ethics Committee of the Federal University of Minas Gerais (COEP ).