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The aim of this study is to evaluate thoracic mobility, posture, functional capacity, and respiratory rate in children aged 8-14 years who play wind instruments and to compare these findings with those of their peers who do not play wind instruments. In line with this primary objective, the study seeks to comprehensively investigate the potential biomechanical and physiological adaptations associated with playing wind instruments in the context of childhood music education, with a particular focus on chest wall mobility, postural alignment, respiratory efficiency, and functional capacity.
The novelty of this study lies in being the first to adopt a holistic perspective to examine the effects of wind instrument playing on the postural and cardiorespiratory systems during the sensitive developmental period of 8-14 years, which is known to be highly responsive to biomechanical adaptations. By addressing this understudied age group, the study aims to fill an important gap in the existing literature.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Wind Instrument Group (WIG) | This study includes healthy children aged 8-14 years who are in primary and middle school and play wind instruments. Healthy children aged 8-14 years who have regularly played the flute or melodica for at least one year (Musician Group). | ||
| Non-Wind Instrument Group (NWIG) | The control group will consist of age-matched children who do not play any wind instruments. |
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| Measure | Description | Time Frame |
|---|---|---|
| Thoracic Mobility Assessment | Thoracic mobility will be assessed using chest circumference measurements obtained with a tape measure. Children will be instructed to perform maximal inspiration and maximal expiration while in a seated position. Measurements will be taken at the axillary, epigastric, and subcostal levels. Each measurement will be repeated three times, and the mean value will be recorded. Thoracic expansion will be calculated as the difference between inspiratory and expiratory chest circumferences. This method has been described as a reliable and clinically feasible approach for evaluating thoracic mobility in children. Cruz-Montecinos et al. reported high inter-rater reliability for chest circumference measurements obtained with a tape measure in pediatric populations. Similarly, Sharma and Parashar demonstrated that thoracic expansion measurements in school-aged children show high reproducibility and can provide reference values for healthy children. | Both groups will be assessed once. There will be no intervention. All participants' measurements will be completed by May 2026. |
| Measure | Description | Time Frame |
|---|---|---|
| Postural Assessment | Postural analysis in this study will be performed using the New York Posture Rating Scale.This assessment method divides the body into thirteen distinct regions according to anatomical alignment, allowing posture to be evaluated in both the anterior (frontal) and lateral (sagittal) planes. Each body region is scored using a five-point Likert scale. Accordingly, a score of one indicates marked postural impairment (severe deviation), three represents moderate posture, and five indicates ideal postural alignment. The total score ranges from 13 to 65, with higher scores reflecting better postural alignment. Based on the overall score, posture quality is categorized according to standardized criteria: scores of 45 or above are classified as "very good," 40-44 as "good," 30-39 as "moderate," 20-29 as "poor," and 19 or below as "very poor." |
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Inclusion Criteria:
Exclusion Criteria:
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This study is planned to include healthy children aged 8-14 years who attend primary and middle school and either play or do not play wind instruments. Healthy volunteer children aged 8-14 years from schools in TekirdaÄŸ, who either play wind instruments or do not play wind instruments (e.g., those playing string instruments) as part of compulsory music education, will be recruited. Participants will be divided into two groups: those who play wind instruments and those who do not. The musician group will consist of healthy children aged 8-14 years who have been regularly playing the flute or melodica for at least one year, whereas the control group will comprise age-matched children who do not play any wind instruments.
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| Name | Affiliation | Role |
|---|---|---|
| Aslı Yeral | Yeditepe University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Yeditepe University | Istanbul | Ataşehir | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 8065862 | Background | Rusconi F, Castagneto M, Gagliardi L, Leo G, Pellegatta A, Porta N, Razon S, Braga M. Reference values for respiratory rate in the first 3 years of life. Pediatrics. 1994 Sep;94(3):350-5. | |
| Background | 10. Rajakumari, D. L., & Alagesan, S. (2012). Survey of posture using New York postural rating scale-Impact of corrective and aerobic exercise on posture and physiological variables. International Journal of Innovative Research and Development, 1(10), 151-160. | ||
| 17463419 |
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Participants' data will be used for scientific study and will not be shared with third parties and organizations.
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| ID | Term |
|---|---|
| D012120 | Respiration Disorders |
| ID | Term |
|---|---|
| D012140 | Respiratory Tract Diseases |
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| Both groups will be assessed once. There will be no intervention. All participants' measurements will be completed by May 2026. |
| Functional Capacity Assessment | Functiona capacity will be evaluated using the Six-Minute Walk Test (6MWT). The test will be conducted in a 30-meter flat corridor in accordance with the standardized protocol established by the American Thoracic Society. Participants will be instructed to walk as fast as possible at their own pace for six minutes. Before the test, children will be informed that they may rest if they experience excessive shortness of breath, and that any resting time will be included within the total test duration. Heart rate and oxygen saturation will be measured and recorded using a finger pulse oximeter before and immediately after the test. To encourage and motivate participants, the standardized phrase "You are doing very well" will be given every minute during the test. At the end of the test, the total distance walked in six minutes will be calculated and recorded in meters. The feasibility, reliability, and reference values of the 6MWT in children have been well documented. | Both groups will be assessed once. There will be no intervention. All participants' measurements will be completed by May 2026. |
| Respiratory Rate Assessment | Respiratory rate will be assessed by observation while participants are in a resting position and in a quiet environment. During the measurement, children will be instructed not to speak and to breathe normally. The number of respirations per minute will be recorded by observing chest wall movements over a one-minute period. The measurement will be repeated twice, and the mean value will be used for analysis. The observational counting method has been described as one of the most commonly used, simple, and reliable techniques for assessing respiratory rate in clinical settings. Beck et al. reported high measurement reliability of this method in pediatric populations. Furthermore, Rusconi et al. emphasized that establishing age-specific reference values for respiratory rate contributes to the standardization of clinical assessments. Therefore, the observational counting method was preferred for the evaluation of respiratory rate in the present study | Both groups will be assessed once. There will be no intervention. All participants' measurements will be completed by May 2026. |
| Background |
| Li AM, Yin J, Au JT, So HK, Tsang T, Wong E, Fok TF, Ng PC. Standard reference for the six-minute-walk test in healthy children aged 7 to 16 years. Am J Respir Crit Care Med. 2007 Jul 15;176(2):174-80. doi: 10.1164/rccm.200607-883OC. Epub 2007 Apr 26. |
| Background | 8. Hatziagorou, E., Kousta, A., Hristara-Papadopoulou, A., et al. (2018). Pulmonary function in young wind instrument players. European Respiratory Journal, 52(Suppl 62), PA4575. |
| 38337641 | Background | Giontella A, Tagetti A, Bonafini S, Marcon D, Cattazzo F, Bresadola I, Antoniazzi F, Gaudino R, Cavarzere P, Montagnana M, Pietrobelli A, Maffeis C, Minuz P, Fava C. Comparison of Performance in the Six-Minute Walk Test (6MWT) between Overweight/Obese and Normal-Weight Children and Association with Haemodynamic Parameters: A Cross-Sectional Study in Four Primary Schools. Nutrients. 2024 Jan 25;16(3):356. doi: 10.3390/nu16030356. |
| Background | 6. Cruz-Montecinos, C., Mandiola, E., & Soto, J. (2017). Reliability of chest wall expansion measurements in children using a measuring tape method. Pediatric Physical Therapy, 29(2), 120-126. |
| 38713736 | Background | Kim BS, Kim H, Kim JY. Effects of a choral program combining wind instrument performance and breathing training on respiratory function, stress, and quality of life in adolescents: A randomized controlled trial. PLoS One. 2024 May 7;19(5):e0276568. doi: 10.1371/journal.pone.0276568. eCollection 2024. |
| Background | 4. Beynon, C., Holman, S., & McKenzie, M. (2020). Postural demands of playing musical instruments in childhood and adolescence: A systematic review. Physiotherapy Theory and Practice, 36(10), 1073-1085 |
| Background | 3. Beck, J. R., Sethi, J. M., & Tanner, J. L. (2016). Reliability of respiratory rate measurement in children by visual observation. Pediatric Pulmonology, 51(9), 915-920. |
| Background | 2. Antoniadou, M., Michaelidis, V., & Tsara, V. (2012). Lung function in wind instrument players. Pneumon, 25(2), 180-183. |
| 12091180 | Result | ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002 Jul 1;166(1):111-7. doi: 10.1164/ajrccm.166.1.at1102. No abstract available. |