Body position and cardio-respiratory variables in older people

Abstract

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.

Effect of supine versus sitting position on noninvasive assessment of aortic pressure waveform: a randomized cross-over study

“…13,14,16,19 Yet, three other randomized studies found nonsignificant differences in SBP between body positions. 15,17,18 Similarly, in line with the present findings, DBP is more likely to be lower in the supine position (five out of seven randomized studies [13][14][15][16][17][18][19] ), a finding that is also consistent in most of the non-randomized studies. 20,21,24,25,29,30 Regarding MBP, one randomized 18 and two non-randomized studies 25,29 suggest that it is higher in the sitting position whereas another non-randomized study reported higher MBP in the supine position; 22 the rest of the studies do not provide data for MBP.…”

“…A series of studies [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] have shown that body posture affects bBP values. In most recommendations [31][32][33][34] as well as in most clinical trials and daily clinical practice, the sitting position for bBP measurement is most commonly applied.…”

The effect of Schroth’s three-dimensional exercises in combination with respiratory muscle exercise on Cobb’s angle and pulmonary function in patients with idiopathic scoliosis

“…Also, the intergroup analysis has shown that there were significant differences in PEF between before and after the exercise. Changes in posture may affect cardiovascular, digestive, respiratory, and musculoskeletal systems and should therefore be considered as important in medical management and physical therapy [14]. Correction and respiratory therapy should be performed because scoliosis patients have weakened respiratory muscles due to curvature of the thoracic spine, which reduces cardiopulmonary function [15].…”

Ergonomic approach for pillow concept design

“…For this topic, Gordon et al (2011) reported that lateral positions produce significantly lower diastolic, systolic, and mean arterial blood pressure than does the supine position. Furthermore, Leung et al (2003) pointed out that patients with congestive heart failure avoid the left lateral position during sleep to prevent discomfort from an enlarged apical heart.…”

“…Many methods have been used to improve sleep quality including sleep hygiene education and behavioral therapy Kaku et al, 2012), doing a short afternoon nap (Kaida et al, 2012), using a suitable pillow with appropriate support to reduce neck and shoulder pain (Lavin et al, 1997), and keep in a certain sleep positions (Gordon et al, 2011;Leung et al, 2003). For this topic, Gordon et al (2011) reported that lateral positions produce significantly lower diastolic, systolic, and mean arterial blood pressure than does the supine position.…”