Effects of dorsal and lateral decubitus on peak expiratory flow in healthy subjects

Gianinis, Heloisa H.; Antunes, Bianca O.; Passarelli, Rita C. V.; Souza, Hugo Celso Dutra de; Gastaldi, Ada Clarice

doi:10.1590/s1413-35552012005000116

Cited by 12 publications

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References 21 publications

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“…PEF in different body positions was evaluated in 13 studies [ 3 , 22 – 24 , 31 , 33 , 45 – 51 ]. Eight studies evaluated only healthy adults [ 3 , 22 – 24 , 45 , 48 , 50 , 51 ], three evaluated healthy subjects and patients with COPD or asthma [ 31 , 46 , 49 ], one included adult cystic fibrosis patients [ 47 ], and one included subjects with SCI [ 33 ]. Nine studies that compared standing or sitting positions vs. supine or RSL and LSL found higher PEF in standing and sitting [ 3 , 22 – 24 , 31 , 45 – 48 ].…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies evaluated only healthy adults [ 3 , 22 – 24 , 45 , 48 , 50 , 51 ], three evaluated healthy subjects and patients with COPD or asthma [ 31 , 46 , 49 ], one included adult cystic fibrosis patients [ 47 ], and one included subjects with SCI [ 33 ]. Nine studies that compared standing or sitting positions vs. supine or RSL and LSL found higher PEF in standing and sitting [ 3 , 22 – 24 , 31 , 45 – 48 ]. Three of six studies comparing the standing and sitting positions found higher PEF in standing [ 46 , 50 , 51 ] and one reported higher PEF in sitting [ 22 ].…”

Section: Resultsmentioning

confidence: 99%

“…PEF, PEmax, and PImax were found to increase in upright positions in healthy subjects [ 3 , 23 , 24 , 46 , 48 , 50 , 51 ] and in those with lung diseases [ 31 , 46 , 47 ]. This may be related to changes in lung volumes with positions.…”

Section: Discussionmentioning

confidence: 99%

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The effect of body position on pulmonary function: a systematic review

et al. 2018

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BackgroundPulmonary function tests (PFTs) are routinely performed in the upright position due to measurement devices and patient comfort. This systematic review investigated the influence of body position on lung function in healthy persons and specific patient groups.MethodsA search to identify English-language papers published from 1/1998–12/2017 was conducted using MEDLINE and Google Scholar with key words: body position, lung function, lung mechanics, lung volume, position change, positioning, posture, pulmonary function testing, sitting, standing, supine, ventilation, and ventilatory change. Studies that were quasi-experimental, pre-post intervention; compared ≥2 positions, including sitting or standing; and assessed lung function in non-mechanically ventilated subjects aged ≥18 years were included. Primary outcome measures were forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC, FEV1/FVC), vital capacity (VC), functional residual capacity (FRC), maximal expiratory pressure (PEmax), maximal inspiratory pressure (PImax), peak expiratory flow (PEF), total lung capacity (TLC), residual volume (RV), and diffusing capacity of the lungs for carbon monoxide (DLCO). Standing, sitting, supine, and right- and left-side lying positions were studied.ResultsForty-three studies met inclusion criteria. The study populations included healthy subjects (29 studies), lung disease (nine), heart disease (four), spinal cord injury (SCI, seven), neuromuscular diseases (three), and obesity (four). In most studies involving healthy subjects or patients with lung, heart, neuromuscular disease, or obesity, FEV1, FVC, FRC, PEmax, PImax, and/or PEF values were higher in more erect positions. For subjects with tetraplegic SCI, FVC and FEV1 were higher in supine vs. sitting. In healthy subjects, DLCO was higher in the supine vs. sitting, and in sitting vs. side-lying positions. In patients with chronic heart failure, the effect of position on DLCO varied.ConclusionsBody position influences the results of PFTs, but the optimal position and magnitude of the benefit varies between study populations. PFTs are routinely performed in the sitting position. We recommend the supine position should be considered in addition to sitting for PFTs in patients with SCI and neuromuscular disease. When treating patients with heart, lung, SCI, neuromuscular disease, or obesity, one should take into consideration that pulmonary physiology and function are influenced by body position.Electronic supplementary materialThe online version of this article (10.1186/s12890-018-0723-4) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The effect of body position on pulmonary function: a systematic review

et al. 2018

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“…Gianinis et al (18) compared the Peak Expiratory Flow (PEF) by spirometry in 30 young and healthy individuals in sitting position, SP, RLD and LLD. It has been proven statistically significant differences in sitting position, SP and RLD.…”

Section: Discussionmentioning

confidence: 99%

Comparison of ventilatory restriction in techniques of respiratory physiotherapy and changes of position

et al. 2015

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Introduction: Body position affects the respiratory mechanics and could be favorable to pulmonary function when combined with respiratory physiotherapy. Objective: Was to compare the ventilatory restriction in respiratory therapy techniques and changes of position. Method: For analysis of lung volume was measured Slow Vital Capacity (SVC) in university students in the positions: sitting, dorsal decubitus (DD), DD with application of maneuver thoracic blockade of the right hemithorax and right lateral decubitus (RLD). In all maneuvers were instructed to perform an inspiration to total lung capacity and slow exhalation to residual volume. Results: It was evaluated 26 subjects with a mean age of 25,5 ± 11 years and mean body mass index of 25 ± 4 kg/m2. The values obtained from SVC sitting, DD, DD with blockade and DLD were respectively 3,5 ± 1,5 liters (87,7 ± 26,8%); 2,9 ± 1,4 liters (75,0 ± 26,5%); 3,0 ± 1,4 liters (75,2 ± 26,2%); 3,5 ± 1,6 liters (88,3 ± 29,4%). Using the SVC in a sitting position as compared, there was no statistical difference in DD (p = 0,024) and DD with position blockade (p = 0,036). There was no significant difference in the DLD (p = 0,459) position. Conclusion: Can conclude that the positions DD and DD with blockade reduced lung volume, whereas DLD position showed no significant difference when compared to sitting position, suggesting that this position is an option favorable position for respiratory therapy.

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“…A avaliação pré-operatória utiliza testes funcionais que possuem papel chave no diagnóstico e determinação da gravidade do distúrbio respiratório e na determinação da melhor conduta ao paciente com afecções pulmonares, sendo capazes de quantificar as alterações observadas nos pacientes e traduzirem sua real condição física e pulmonar (GIANINIS et al, 2013).…”

Section: Cirurgia Cardíaca E Avaliação Pré-operatóriaunclassified

Avaliação da fragilidade em indivíduos submetidos à cirurgia cardíaca

Bottura¹

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Frailty syndrome, defined as the reduction of energy reserve and resistance to stressors, associated with late indication of some surgical procedures, results in a higher occurrence of risk situations for the patients with heart disease, with a greater predisposition to the development of postoperative complications, which are related to an increase in cases of hospital readmission and high length of stay. In order to improve postoperative management and our assessment of severity, prevention and risk stratification, preoperative physiotherapy uses functional tests that translate the patient's actual physical and pulmonary condition, allowing the identification of potentially risk factors. As a way of evaluating the prevalence of frailty in population for cardiac surgery, the association of functional tests with frailty, and peri and postoperative morbidity and mortality, we evaluated the candidates for cardiac surgery according to five criteria proposed by Fried: loss of weight, depression, low handgrip strength, low level of physical activity and reduction of walking speed, as well as lung capacity (manovacuometry, ventilometry and peak flow), effort tolerance (6MWT) and cognitive function (MMSE). After surgery, information was collected regarding the surgical procedure and postoperative recovery and then, subjects were divided into two groups: fragile and nonfragile and subdivided according to the age group in the elderly and not elderly. We evaluated 100 individuals, being 59 valvopaths and 41 coronary disease; 13% were considered nonfragile, 70% pre-fragile and 17% fragile; the maximum inspiratory pressure was significantly lower in the fragile individuals (52 ± 21 vs 75 ± 33 in non-fragile, p = 0.044), as well as the handgrip strength (31 ± 11 vs. 22 ± 8, p = 0.007); 11 patients died after the procedure (7.2% non-fragile versus 29.4% fragile individuals; p = 0.019). From the results found, we can conclude that the prevalence of frailty in cardiac surgery patients was high, even among individuals not considered elderly, and, in addition, fragile individuals had lower handgrip strength, lower vital capacity and lower inspiratory pressures and expiratory rates than those observed in non-fragile patients, as well as higher in-hospital mortality.

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Effects of dorsal and lateral decubitus on peak expiratory flow in healthy subjects

Cited by 12 publications

References 21 publications

The effect of body position on pulmonary function: a systematic review

The effect of body position on pulmonary function: a systematic review

Comparison of ventilatory restriction in techniques of respiratory physiotherapy and changes of position

Avaliação da fragilidade em indivíduos submetidos à cirurgia cardíaca

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