Thoracic Mobility, Posture, Functional Capacity, and Respiratory Rate in Children Playing Wind Instruments

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.

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."

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.

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