Body position change and its effect on hemodynamic and metabolic status

Jones, Alice; Dean, Elizabeth

doi:10.1016/j.hrtlng.2004.04.004

Cited by 71 publications

(77 citation statements)

References 21 publications

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“…This finding is in agreement with Ryan who reported the same finding in healthy young adults [3]. In contrast Jones & Dean reported significantly lower HR in HS than RSL and in LSL than RSL [4]. Older people recorded the lowest mean value for DBP & SBP in RSL whereas in the young age group this occurred in LSL [4].…”

Section: Discussionsupporting

confidence: 91%

“…[ Table 2 about here] Whilst significantly lower HR in relation to body position has been reported in young [4] and middle aged adults [6] this was not found in older people. As well this study found no significant difference in the HR of older people when comparing LSL and RSL.…”

Section: Discussionmentioning

confidence: 93%

“…Before testing, participants did not to undertake any unusual activity for 24 hours and on the day of testing refrained from caffeinated beverages, unusual exercise, heavy meals, and undue stress prior to the data collection session [4]. All measurements were undertaken in the Physiotherapy Clinic at James Cook University.…”

Section: Methodsmentioning

confidence: 99%

“…Reported findings related to body position and cardio-respiratory factors have varied for healthy, young adults [3][4][5] and one study has investigated these factors in a middle aged group [6].…”

Section: Introductionmentioning

confidence: 99%

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Body position and cardio-respiratory variables in older people

Gordon

Jones

Sealey

et al. 2011

Archives of Gerontology and Geriatrics

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Background: Older people are placed in different body positions for medical, nursing and physiotherapy intervention.Objective: To investigate the effect of body position on cardio-respiratory variables in active older people.Design: Experimental laboratory study.Setting: Research was undertaken at the James Cook University, Physiotherapy Clinic.Subjects: Twenty-six active people aged 60 years and over.Methods: Heart rate, systolic and diastolic blood pressure and oxygen saturation were measured every two minutes over a ten minute period in five standardized positions, sitting, right side lying, left side lying, supine and supine with the head 20 degrees below the level of the body. Rate pressure product and mean arterial pressure were calculated. Smoking history, medication use, health conditions and activity level were recorded. Height, weight and body fat were measured.Results: Left and right side lying produced significantly lower diastolic and systolic blood pressure, rate pressure product and mean arterial pressure than supine with the head down. Older, healthy people have decreased forced vital capacity and forced expiratory volume after one second in side lying when compared to sitting [16]. Further healthy, seated older subjects 3 (>65 years) have significant impairment of ventilation distribution to dependent lung zones [17]. Body position and cardio-respiratory variables in older peopleOlder people exhibit significant increased preference for the right side sleep position [18]. This has been postulated to be due to age related alterations in cardiovascular function [18] or compression from other structures causing reduction in ventricular distensibility [19].This study investigates the effect of five standardised body positions on cardio-respiratory variables in a group of healthy, older people. Comparisons are made to previously reported findings for young and middle aged healthy people. MethodologyThe method of this observational study largely replicates Jones & Dean [4]. It is described here for the convenience of the reader and to identify alterations for this study.Participants were recruited from four Probus clubs (a community organisation for people aged over 60 years) in Townsville, Australia. Human research ethics approval was provided by James Cook University and signed informed consent was gained prior to participation.Participants were eligible to participate if they were over 60 years of age. A screening questionnaire (see Appendix 1 in the supplementary data on the journal website) was completed by participants to identify the presence of any physical or medical condition which would prevent participants from comfortably adopting each position included in the study for 20 minutes.Information regarding smoking history, usual exercise level, medication use, medical history and recent illness was also collected.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 93%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Body position and cardio-respiratory variables in older people

Gordon

Jones

Sealey

et al. 2011

Archives of Gerontology and Geriatrics

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“…This is in line with another study showing a 9% higher HR in the sitting than in the supine position. 10 Nonetheless, the increase in HR during sitting versus lying is small (þ7 beats/ min), and was not associated with a significant increase in REE. Similarly, despite no differences in REE between the two postures, our results indicate a small but statistically lower RQ while sitting compared to lying.…”

Section: Discussionmentioning

confidence: 85%

Sitting comfortably versus lying down: Is there really a difference in energy expenditure?

Miles-Chan¹,

Sarafian²,

Montani³

et al. 2014

Clinical Nutrition

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Background & aims: Energy expenditure (EE) during sitting is widely assumed to be higher than that while lying down, but supporting evidence is equivocal. Despite this, resting EE in the sitting position is often used as a proxy for basal metabolic rate. Here we investigate whether EE differs in the comfortable seated position compared to supine (lying) position. Methods: EE and respiratory quotient (RQ) were measured (by ventilated hood indirect calorimetry) in 19 healthy subjects (9 men, 10 women) after an overnight fast. Supine measurements were made using a comfortable clinical tilting table and sitting measurements made using an adjustable, ergonomic car seat adapted for the hood system. After about 30 min of rest in either position, metabolic monitoring was conducted until stabilization of EE for at least 15 min in each posture. Results: EE in the sitting position was not significantly different compared to supine (<2% difference). By contrast, heart rate was higher by 7 beats/min (p < 0.05). RQ was slightly but significantly decreased during sitting compared to lying (p < 0.05), with no change in breathing rate. Conclusions: This study suggests that the ventilated hood calorimetry system for assessment of REE after an overnight fast in a comfortable sitting position can be used as a good proxy of the basal metabolic rate. It also underscores the applicability of the ventilated hood system to measurements of resting EE in the sitting posture which, compared to supine posture, may be more acceptable/convenient to the subject/ patient participating in postprandial metabolic studies lasting several hours.

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Lateral positioning for critically ill adult patients

Hewitt

Bucknall

Faraone

2016

Cochrane Database of Systematic Reviews

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Review authors could provide no clinical practice recommendations based on the findings of included studies. Available research could not eliminate the uncertainty surrounding benefits and/or risks associated with lateral positioning of critically ill adult patients. Research gaps include the effectiveness of lateral positioning compared with semi recumbent positioning for mechanically ventilated patients, lateral positioning compared with prone positioning for acute respiratory distress syndrome (ARDS) and less frequent changes in body position. We recommend that future research be undertaken to address whether the routine practice of repositioning patients on their side benefits all, some or few critically ill patients.

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Body position change and its effect on hemodynamic and metabolic status

Cited by 71 publications

References 21 publications

Body position and cardio-respiratory variables in older people

Body position and cardio-respiratory variables in older people

Sitting comfortably versus lying down: Is there really a difference in energy expenditure?

Lateral positioning for critically ill adult patients

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