Effect of body position on foot and ankle volume in healthy subjects

Abstract

Physical therapy treatments for and evaluation of lower limb swelling are usually performed in supine lying position. However, the limb is usually treated or assessed in the dependent position, i.e. sitting or standing. The purpose of this study was to determine the possible confounding effect of subject positioning on foot and ankle volume. Sixty healthy individuals were randomly positioned into motionless standing, sitting or supine lying for 30 min. Volumetric measurements of the dominant leg were taken with a foot and ankle volumeter before and after 30 min of positioning. A significant difference between the three groups for foot and ankle volume change (F(2,53) = 35.41, P<0.001) was found. A post-hoc Tukey HSD test revealed that the difference was statistically significant between sitting and standing as well as supine lying and standing (P<0.001). No statistical significance was found between sitting and supine lying (P = 0.90). Standing caused the greatest increase in foot and ankle volume followed by sitting then supine lying. The results indicate that treating or assessing a limb with the subject in a sitting position would not be significantly different from a subject who is positioned in supine lying. However, it is not known whether the height and the distance from the heart to the feet were comparable between the groups, and so it is recommended that, where possible, treatment and assessment of lower leg swelling should be undertaken with the leg in a non-dependent position and definitely not in standing.

Measurement of lower-leg volume change by quantitative computed tomography

“…Glycogen level varies during the day in response to physical activity and the energy-restoring process. Plasma volume is known to increase in an upright posture as compared to a horizontal posture (11). A corresponding change in muscle attenuation was not detected.…”

Effect of Spironolactone and Amiloride on Thiazolidinedione-Induced Fluid Retention in South Indian Patients with Type 2 Diabetes

“…Plasma aldosterone levels were measured by radioimmunoassay using a Cobas e411 analyzer (Roche, Japan) at baseline and 24 weeks. Foot and ankle volume was measured in the dominant leg with the patient in the seated position by an ankle volumeter (Sammons Preston, Bowlingbroke, IL) using the water displacement technique (17).…”

An Experimental In Vivo Model to Characterize “Heavy Legs” Symptom in Topical Formulations

“…LDF is commonly used to assess local vascular conditions in a wide variety of pathologies from peripheral vascular disease [8] to diabetes [14, 15] or the Raynaud's syndrome [17, 18, 22]. LDF's dynamical assessment during limb postural changes proved to be very useful [8, 22], providing an interesting amount of information related with the local vascular function, especially regarding the veno-arterial reflex, although with different experimental approaches [8, 18, 22, 23].…”

“…LDF's dynamical assessment during limb postural changes proved to be very useful [8, 22], providing an interesting amount of information related with the local vascular function, especially regarding the veno-arterial reflex, although with different experimental approaches [8, 18, 22, 23]. In healthy subjects, a modification of posture from lying to standing involved an increase in the precapillary resistance of the foot's skin microcirculation, leading to an increase in local blood flow [20].…”

“…When the leg is lowered from supine, a decrease on the red cell flux was described [20]. Changing from supine to seated reportedly evoked a reduction in the lower limb blood volume [22]. More recently, an increase of the foot's blood flow by elevation of the leg (180° regarding the thigh) from seating was described [19].…”