Comparison of Different Methods of Obtaining Orthostatic Vital Signs

Lance, Robyn; Link, Mary E.; Padua, Magdalena; Clavell, Liccy E.; Johnson, G; Knebel, Ann R.

doi:10.1177/10547730022158708

Cited by 14 publications

(11 citation statements)

References 21 publications

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“…Orthostatic challenges, such as position changes, are used frequently to assess a range of sympathetic and parasympathetic responses (Lance et al, 2000). Changing from a recumbent to a standing position results in a reduction of cardiac output and is counteracted by tachycardia after 10 seconds to maintain mean arterial pressure (DeBroer, Karemaker, & Strackee, 1987;Savard & Stonehouse, 1995).…”

Section: Cardiac Rate Responsementioning

confidence: 99%

Cardiac Response Rate Variability in Physically Abused Women of Childbearing Age

Rice

Records

2006

Biological Research For Nursing

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Physical abuse directly affects maternal and fetal/infant health, with documented reports of higher rates of pregnancy termination, neonatal death, and lower birth weights. Although the Centers for Disease Control and Prevention recommend repeated interviews of women of childbearing age to screen for abuse, the paper-and-pencil instruments available for such screening are adversely affected by the hesitancy of women to disclose physical abuse. Biophysical measures of physiological stress adaptations may hold potential for identifying physically abused childbearing women. This pilot investigation used a Latin square design to assess the effects of physically abusive trauma on the cardiac rate response of three clinical groups and one control group of childbearing-age women. Participants were screened using the Childbearing Health Questionnaire. Cardiac response rates were measured during a standardized orthostatic challenge using a Tanito cardiac rate response monitor. Forty participants participated with an average age of 27. Multiple analyses of variance revealed that there were significant differences between cardiac rate responses at the 5-min interval. Post hoc testing using Dunnett's t indicated that only the abused pregnant women had significantly higher cardiac responses to orthostatic challenges; differences were apparent at the 5-min testing period. The findings suggest that physical abuse may alter the vasovagal response beyond the attenuation associated with pregnancy. These findings support further testing with larger samples to identify vasovagal changes in abused pregnant women.

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Section: Cardiac Rate Responsementioning

confidence: 99%

Cardiac Response Rate Variability in Physically Abused Women of Childbearing Age

Rice

Records

2006

Biological Research For Nursing

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“…2003) there is some evidence to suggest that they may be manifested earlier. The largest drops in SBP in non‐bed rest populations have been found to occur immediately (Lance et al. 2000, Youde et al.…”

Section: Discussionmentioning

confidence: 99%

“…The largest drops in SBP in non-bed rest populations have been found to occur immediately (Lance et al 2000, Youde et al 2002, at one minute (Gehrking et al 2005), and within three minutes (Gibbons & Freeman 2006) upon resuming upright posture. The largest drop in DBP has been found to occur at 45 seconds upon resuming upright standing (Maurer et al 2004); a similar time period has been identified for maximal increase in HR (Melby et al 2007).…”

Section: Discussionmentioning

confidence: 99%

The relationship between bed rest and sitting orthostatic intolerance in adults residing in chronic care facilities

Fox

Sidani²,

Brooks³

2010

J of Nursing and Healthcare

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fox mt, sidani s & brooks d (2010) Journal of Nursing and Healthcare of Chronic Illness2, 187–196 The relationship between bed rest and sitting orthostatic intolerance in adults residing in chronic care facilities Aim. To examine the relationship between orthostatic intolerance and bed rest as it was used by/with 65 adults residing in chronic care facilities. Background. The evidence on the relationship between bed rest and orthostatic intolerance has been obtained from aerospace studies conducted in highly controlled laboratory settings, and is regarded as having high internal validity. In the studies, prolonged and continuous bed rest, administered in a horizontal or negative tilt body position, had a major effect on orthostatic intolerance in young adults. However, the applicability of the findings to the conditions of the real world of practice is questionable. Methods. Participants were recruited over the period of April 2005 to August 2006. A naturalistic cohort design was used. The cohorts represented different doses of bed rest that were naturally occurring. Comparisons were made between patients who had no bed rest (comparative dose group, n = 20), two to four days (moderate dose, n = 23) and five to seven days of bed rest (high dose, n = 22) during a one‐week monitoring period. Orthostatic intolerance was measured by orthostatic vital signs and a self‐report scale. Bed rest dose was measured by the total number of days spent in bed during one week. Results. Post hoc comparisons, using Bonferroni adjustments, indicated significant differences in adjusted means on self‐reported orthostatic intolerance between the comparative and high (CI: −4·12, −0·85; p < 0·001), and the moderate and high (CI: 0·35, 3·56, p < 0·01) bed rest dose cohorts. No group differences were found on orthostatic vital signs. Conclusions. A moderate dose of bed rest with intermittent exposure to upright posture may protect against subjective orthostatic intolerance in patients who are unable to tolerate being out of bed every day. Future research may examine the effects of reducing bed rest days on orthostatic intolerance in individuals with high doses of five to seven days of bed rest.

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“…They measured vital signs following one minute, five minutes and 20 minutes of rest and found that "the augmentation of the BP and HR response is small when the period of rest is increased from five to 20 minutes, it seems adequate to perform this test after at least five minutes of supine rest" (Harkel, Lieshout, Lieshout, & Wieling, 1990, p. 152). However, Lance et al (2009) found that 10 minutes of rest was required for accurate measurement of orthostatic vital signs. It should be noted that both studies by Harkel et al and Lance et al were conducted on small samples of 10 and 34 (respectively) of young, healthy, normotensive subjects.…”

Section: Supinementioning

confidence: 98%

“…A review of definitions from the literature indicates that the assessment parameter labeled as orthostatic vital signs can be summarized by its: physiological variables, measurement method, and purpose. The physiological variables include blood pressure, heart rate, and stroke index (Durukan et al, 2009;Fuchs & Jaffe, 1987;Horam & Roscelli, 1992;KoziolMcLain et al, 1991;Levitt et al, 1992;Witting & Gallagher, 2003), as well as symptoms of dizziness or lightheadedness (Lance et al, 2009;Sarasin et al, 2002). Stated purposes of orthostatic vital signs assessment include identification of hypovolemia (both dehydration and blood loss) and treatment efficacy of pharmacological agents for neurological conditions.…”

Section: Summary Of Definitionsmentioning

confidence: 99%