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PubMed1993

Distal radio-ulnar ligament motion during supination and pronation.

The dorsal and palmar distal radio-ulnar ligaments (DRUL) play an important role in the stability of the distal radio-ulnar joint (DRUJ). Various authorities, however, hold opposite opinions regarding DRUL motion during DRUJ pronation and supination, thus implying opposite techniques for reconstruction of the unstable DRUJ. With the hypothesis that relative displacement would increase in the dorsal DRUL during pronation and would increase in the palmar DRUL during supination, measurements were made of the relative DRUL displacement with a Hall-effect displacement transducer during DRUJ pronation and supination in six fresh cadaver wrists. The hypothesis was confirmed that the dorsal radio-ulnar ligament undergoes relative displacement during pronation, while the palmar radio-ulnar ligament undergoes relative displacement during supination.

Aged↗
PubMed2006

When supine is better than upright: evidence from postural effects in extinction patients.

There is no clear consensus on the specific effects of gravitational inputs on the manifestations of neglect and extinction. While some studies provided evidence that neglect patients improved their performance in supine position, other studies supported instead the notion that the manipulation of body posture has no effect on neglect and extinction. To investigate the effects of the postural manipulation of the entire body in space on visual extinction, a total of 24 right- and left-brain-damaged patients (with or without signs of visual extinction) and 8 healthy control subjects were tested in a visual detection task in two different gravitational conditions: upright and supine. Two dependent variables were considered: accuracy and speed of response. The results were clear-cut. Changing body posture had only a mild effect on the performance of healthy controls and non-extinction patients, but it clearly modulated the performance of extinction patients. In fact, extinction patients markedly improved their performance on contralesional stimuli in supine position in terms of both accuracy and speed of response. This suggests that the reduction of gravitational inputs obtained by placing patients in supine position results in a significant amelioration of visual extinction.

Aged↗
PubMed2005

What indices quantify regional myocardial function during supine bicycle in healthy subject: natural strain and strain rate?

BACKGROUND: Evaluation and quantification of regional myocardial function remain a challenge for imaging techniques in stress test. Strain and strain rate can be calculated from velocity gradients in time and space. This new technique has been developed to allow quantifiable stress echocardiography. The aim of this study was to define normal regional strain rate and strain values for both radial and deformation longitudinal myocardial deformation during supine bicycle. METHODS: Real-time color Doppler myocardial velocities were acquired as data superimposed on an underlying two-dimensional (2D) grey-scale image at a frame rate > 150/s, a depth of 16 cm, and a sector angle of 60 degrees in 18 healthy volunteers, mean age 34+/-7 years (25-43 years). During acquisition, a complete cardiac cycle of each view was acquired at rest and during supine bicycle (from 25 W to maximal charge). Maximal systolic velocity, strain rate, and strain were processed offline for both radial (basal posterior wall segment) and longitudinal (septum, lateral, inferior, anterior walls) function. For analysis, each wall was divided into three segments (basal, mid, apical). All the velocity and SR/S values were averaged over three consecutive cycles. RESULTS: During exercise, heart rate and systolic blood pressure increased significantly from rest to peak stress (69+/-14 vs. 152+/-7 beats/min, p < 0.0001 and 118+/-9 vs. 178+/-28 mm Hg, p < 0.001). For the Lax view, both the mean velocity and mean strain rate increased significantly between rest and peak exercise, respectively, for the velocity and for the strain rate. Similarly is said for the Sax view. In contrast, the systolic strain response was biphasic during exercise, basal, mid, and apical segments of walls showed a significant increase of velocity in each workload step. The resting base-apex velocity gradient observed at rest remained in all walls throughout supine bicycle. The mean peak systolic SR data were homogeneous throughout in all segments analysed at rest. This homogeneity remained at peak exercise. The SR increased significantly between rest and peak exercise, respectively, p < 0.0117. The segmental systolic strain response was biphasic. CONCLUSION: This study demonstrated that strain rate imaging may represent a new and interesting method for quantifying regional myocardial function during supine bicycle, which appears to be less influenced by tethering than Doppler tissue imaging. Further studies are needed to determine whether this approach will be clinically useful.

Adult↗
PubMed2005

Erector spinae and quadratus lumborum muscle endurance tests and supine leg-length alignment asymmetry: an observational study.

OBJECTIVE: To determine if there is an association between supine leg-length alignment (LLA) asymmetry and the endurance of the erector spinae (ES) and quadratus lumborum (QL) muscles. METHODS: Forty-seven subjects (21 women; average age, 36 years old) were tested for ES endurance using the Biering-Sorensen (B-S) test, and 69 (31 women; average age, 34.5 years) were tested for QL endurance. Subjects were examined for supine LLA and tested for ES and QL muscle endurance. The muscle endurance times were compared against those who did and did not demonstrate LLA asymmetry and the side of the "short leg." RESULTS: In the B-S test, volunteers with LLA asymmetry (n = 27) had a mean endurance time of 89.7 seconds (SD, 43.3), and the no-LLA asymmetry group (n = 20) had a mean endurance time of 161.5 seconds (SD, 57.1), a significant difference (P < .001). In the QL test, after correction for the effects of sex and exercise, those with a right "short leg" (n = 22) had a right QL endurance time of 25.9 seconds (SE, 4.2) and a left QL endurance time of 34.7 seconds (SE, 4.3). The right QL endurance time was significantly different from those subjects with balanced legs (P = .001). Those with a left "short leg" (n = 20) had a left QL endurance time of 28.6 seconds (SE, 4.7) and a right QL endurance time of 38.1 seconds (SE, 4.5). Both QL endurance times were significantly different from those with balanced leg-length (P = .002 and .016, respectively). CONCLUSION: This study suggests that, using the B-S test, the group of volunteers who demonstrated a commonly used sign of subluxation/joint dysfunction, supine LLA asymmetry, had a decreased endurance times over those who did not. The QL endurance tests showed that the QL muscle ipsilateral to the supine short leg had significantly decreased endurance times over the same-side QL fatigue times in the no leg-length asymmetry group.

Adult↗
PubMed2007

Reproduction of the lumbar lordosis: a comparison of standing radiographs versus supine magnetic resonance imaging obtained with straightened lower extremities.

OBJECTIVE: This study investigates whether it is possible to reproduce the lumbar lordosis in the upright position during magnetic resonance imaging (MRI) by positioning the patient supine with straightened lower extremities and investigates intra- and interexaminer reliability of measurements of the lumbar lordosis on radiographs and MRI. METHODS: This was an observational study, which included an intra- and interexaminer reliability study. The lumbar lordosis was measured digitally on radiographs taken from 22 patients in an upright standing position, and 22 MRI scans of the same patients lying supine with straightened lower extremities. These measurements were compared statistically. Intra- and interexaminer reliability was calculated applying the Bland and Altman method. RESULTS: The lumbar lordosis in the standing position was reproduced in the straightened supine position with a median deviation of 3 degrees . Intra- and interexaminer reliability was better for MRI than for radiographs. The mean differences were close to 0, especially for interexaminer reliability during MRI. On radiographs, there was a higher agreement on interexaminer than on intra-examiner reliability. CONCLUSION: The findings of this study show that lumbar lordosis in the upright position can be reproduced by positioning the patient supine with straightened lower extremities.

Female↗
PubMed1995

Physiologic responses of cardiac patients to supine, recumbent, and upright cycle ergometry.

Physiological responses were compared in nine stable male cardiac patients (mean +/- standard error (SE): age, 68.3 +/- 8.1 years; height, 172.7 +/- 3.9cm; weight, 72.8 +/- 14.5kg) during stationary cycling in the supine, recumbent, and upright positions. A discontinuous exercise protocol was performed in which each stage included 3 minutes of exercise and 1 minute of recovery. Each subject's workload started at 150kgm.min-1 and increased by 150kgm.min-1 per stage until volitional fatigue. Testing sessions were randomized and performed 1 week apart. Subjects continued their normal medication regimen. All subjects were participants in a community-based cardiac rehabilitation program. Dependent variables were assessed at two different intensities; submaximal (300kgm.min +/- 1) and maximal. A two-way repeated measures ANOVA found no significant differences in systolic blood pressure (SBP), diastolic blood pressure (DBP), minute ventilation (VE), respiratory exchange ratio (R), rate pressure product (RPP), and rating of perceived exertion (RPE) at submaximal (300kgm.min +/- 1) and maximal exercise efforts. Heart rate (HR) was significantly lower (p < or = .05) in the supine position compared with either the upright or recumbent positions during the submaximal workload. In addition, oxygen uptake (VO2) was significantly lower in the supine position at the submaximal workload (p < or = .05) compared with both upright and recumbent. No difference in HR or VO2 was observed at maximal exercise. Regressions of HR on VO2 showed similar slopes and intercepts for supine, recumbent, and upright ergometry.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1983

Comparative plasma catecholamine and hemodynamic responses to handgrip, cold pressor and supine bicycle exercise testing in normal subjects.

Serial hemodynamic and plasma catecholamine responses were compared among 10 healthy men (27 +/- 3 years) (+/- 1 standard deviation) during symptom-limited handgrip (33% maximal voluntary contraction for 4.4 +/- 1.8 minutes), cold pressor testing (6 minutes) and symptom-limited supine bicycle exercise (22 +/- 5 minutes). Plasma catecholamine concentrations were measured by radioenzymatic assays: ejection fraction and changes in cardiac volumes were assessed by equilibrium radionuclide angiography. During maximal supine exercise, plasma norepinephrine and epinephrine concentrations increased three to six times more than during either symptom-limited handgrip or cold pressor testing. Additionally, increases in heart rate, systolic blood pressure, rate-pressure product, stroke volume, ejection fraction and cardiac output were significantly greater during bicycle exercise than during the other two tests. A decrease in ejection fraction of 0.05 units or more was common in young normal subjects during the first 2 minutes of cold pressor testing (6 of 10 subjects) or at symptom-limited handgrip (3 of 10), but never occurred during maximal supine bicycle exercise. The magnitude of hemodynamic changes with maximal supine bicycle exercise was greater, more consistent and associated with much higher sympathetic nervous system activation, making this a potentially more useful diagnostic stress than either handgrip exercise or cold pressor testing.

Adult↗
PubMed1994

Upright and supine cephalometric evaluation of obstructive sleep apnea syndrome and snoring subjects.

Specific craniofacial characteristics are reported to occur with obstructive sleep apnea syndrome (OSAS). The purpose of this study was to determine whether craniofacial morphology differs between subjects with OSAS and heavy snorers, and to investigate how change in posture from upright to lying down affects the upper airway passage. Lateral head radiographs of ten persons diagnosed with OSAS(AHI > 50) and ten snorers matched for age, height and weight without any history of daytime sleepiness, doctor-diagnosed OSAS, and no evidence of significant desaturation on overnight oximetry were obtained in both upright seated and awake supine positions. The posterior superior pharyngeal space in both the OSAS and snorers was reduced when changing from upright to supine posture (p < or = 0.05). Significant differences in cranial base alignment, ramus width relative to the middle-cranial fossa, position of the maxilla relative to the cranial base in the seated position (P < or = 0.01) were noted between subjects with OSAS and subjects with snoring and less severe apnea. In addition, differences in the posterior superior pharyngeal space, tongue length, tongue to intermaxillary area ratio and hyoid position (p < or = 0.05) were demonstrated both in the upright and in the supine positions (p < or = 0.05) in the OSAS compared to the snoring group. These results suggest that anatomic factors may predispose some snorers to develop OSAS. Measurements made from awake supine position lateral head radiographs revealed no additional differences between OSAS and snoring subjects when compared to measurements made on radiographs taken in the upright position.

Cephalometry↗
PubMed1981

Comparative echocardiographic examinations in sitting and supine position at rest and during dynamic exercise.

Echocardiograms of 12 healthy male subjects in the supine and sitting positions were obtained. The end-diastolic (EDD) and end-systolic (ESD) diameters of the left ventricle were measured, and the stroke volume was calculated as the cube of the diameter. A significantly (P less than 0.001) smaller stroke volume was found in the sitting rest position (67.1 ml) compared to the supine rest position (92.3 ml). During dynamic exercise, the stroke volume increase in the sitting position (29.7%) was considerably higher than in the supine position (13%). The shortening fraction showed no difference in the sitting and supine positions at rest and during dynamic exercise. The results demonstrate good agreement between the echocardiographic method and other noninvasive procedures.

Adult↗
PubMed1994

The effects of pressure and shear on skin microcirculation in elderly stroke patients lying in supine or semi-recumbent positions.

The effects of external pressure and shear on the skin microcirculation over the sacral area, which is known as a high risk area for pressure sore formation, were studied in 30 elderly patients. The skin blood cell flux (SBF) was measured using the laser Doppler technique, with the patient first at rest in lateral position, then lying for 30 minutes in supine or semi-recumbent 45 degrees position, and finally in lateral position. Elderly high-risk patients (G2), most of them more than two years post-stroke, had a lower body mass index and a reduced sacral skin-fold compared with non-risk patients (G1). The SBF in G2 decreased 28% in supine and 14% in 45 degrees position, whereas the SBF in G1 increased 35% in supine and 13% in 45 degrees position. Spontaneous movements up to seven times per 30 minutes were registered, even during sleep, and were evident by direct observation of the recorded charts as a temporary SBF increase. The risk for skin ischaemic damage over the sacral area of elderly risk patients was evident in both positions, especially with the patients lying in supine position. When increasing the upper body slope in G2 from horizontal to 45 degrees, an inability to recover a satisfactory blood supply after the ischaemic insult was found. Discomfort from compressive and shear forces initiates changes in posture, even in elderly patients prone to tissue breakdown. Occasional relief of pressure was in most patients followed by temporary increase in skin blood flow with concomitant temperature increase. This most probably protected them from developing skin lesions.

Aged↗
PubMed1992

Effects of amiodarone on erect and supine exercise haemodynamics and exercise capacity in patients with hypertrophic cardiomyopathy.

Hypertrophic cardiomyopathy (HCM) is a primary heart muscle disease associated with a high incidence of sudden death. Amiodarone is of benefit in those patients with a high risk profile for sudden death. Amiodarone has also been reported to improve symptoms dramatically in some patients with HCM but to cause functional deterioration in others. In the acute phase of oral amiodarone therapy there are few discernable changes in cardiovascular haemodynamics and the mechanisms of any beneficial effects on symptoms remain unclear. To determine the effect of amiodarone on exercise responses we measured haemodynamic indices in 10 patients during maximal supine- and symptom-limited erect treadmill exercise before and 6 weeks after amiodarone therapy. Following amiodarone therapy there was a significant reduction in resting and peak heart rate during erect exercise (76 +/- 13 vs 97 +/- 19 b.min-1; P = 0.001 and 114 +/- 26 vs 146 +/- 21 b.min-1; P = 0.001 respectively). Despite increases in peak pulmonary and systemic artery pressures with amiodarone therapy there was no difference in the peak left ventricular filling pressure or maximum cardiac output achieved. Similarly, during supine exercise the resting and peak heart rates were less following the 6 weeks amiodarone therapy. Comparison of supine and erect exercise haemodynamic indices demonstrated higher peak LV filling and higher peak systolic and pulmonary artery pressures during supine than during erect exercise (29 +/- 10 vs 25 +/- 12; P less than 0.04; 151 +/- 42 vs 126 +/- 48; P = 0.01 and 66 +/- 27 vs 62 +/- 21; P = 0.08 respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1977

Cervical traction. A comparison of sitting and supine positions.

Eight students were studied todetermine the position which provided the greatest amount of posterior intervertebral separation during a cervical traction treatment. A standard angle of 45 degrees with traction apparatus set at zero, 14 Kg (30 pounds), and 18 Kg (40 pounds) were used in both sitting and supine positions. Measurements of posterior intervertebral separation taken from lateral roentgenograms of the C4-C7 vertebrae revealed greater separation in the supine positions. The results suggested that the supine position was more beneficial in treatment of the cervical spine with traction. The investigators concluded that the increased separation in the supine position was related to the patient's increased comfort and relaxation.

Adult↗
PubMed1992

Rib hump and supine angle as prognostic factors for mild scoliosis.

A retrospective study was conducted on 262 patients with minor idiopathic scoliosis, having supine angles of less than 30 degrees and rib humps of less than 30 mm at the first examination. The initial radiographic measurement of the Cobb supine angle and rib hump height, recorded during a bending test performed on subjects in a sitting position, was correlated with the rate of scoliosis progression. Scoliosis progression was estimated graphically from an angle diagram established by monitoring untreated patients for 7 months to several years, depending on the rate of progression before treatment. More than 95% of the patients with initial supine angles of more than 17 degrees or rib humps greater than 11 mm suffered from progressive scoliosis. The importance of the size of the supine angle, rib-hump height, scoliotic pattern, and state of maturation for the progression rate are analyzed. Knowledge of these parameters can be used to make individual prognoses for approximately 95% of these subjects.

Adolescent↗
PubMed2006

Standing versus supine radiographs in RSA evaluation of femoral head penetration.

Evaluation of polyethylene acetabular component wear in total hip arthroplasties commonly is performed using serial radiographs of the hip by measuring the change in the location of the center of the femoral head in relation to the acetabular component. Of the different methods currently used for this purpose, radiostereometric analysis (RSA) is considered the most accurate and precise. In all such radiographic studies, it is assumed the femoral head is seated into the deepest portion of the acetabular component during all radiographic examinations. Although most radiographs used for wear measurements are taken with the patient supine, we questioned whether standing radiographs, with substantial joint load, are better suited for these measurements. We evaluated two groups of patients having total hip arthroplasty who had radiostereometric radiographs taken in supine and standing positions. The average femoral head penetration that occurred between the 6-month and 2-year time interval was measured with radiographs taken in the standing or supine position. We found no difference between the average total femoral head penetration when using supine or standing radiographs.

Arthrography↗
PubMed2006

Positional MRI changes in supine versus sitting postures in patients with degenerative lumbar spine.

INTRODUCTION: Back pain is associated with a degree of alteration in the alignment and movement of the lumbar spine. The purpose of this study is to investigate how the degree of lumbar segmental degeneration affects sagittal changes in the lumbar spine as it shifts from the supine to the sitting (load-bearing) posture. MATERIALS AND METHODS: Thirty patients with chronic low back pain were enrolled (14 male and 16 female patients); mean age 44.5 years. Their lumbar spines were initially investigated by conventional supine magnetic resonance imaging (MRI) followed later by positional MRI in the seated posture. Of the 150 discs studied, 87 were classified as healthy grade 1, 16 as grade 2, 34 as grade 3, and 13 as grade 4. RESULTS: As the lumbar spine was loaded from the supine to the sitting position, the end-plate angles were decreased significantly as the degeneration was increased. There were also significant changes in the anterior and middle disc heights between the supine and the sitting postures irrespective of the degree of degeneration. The overall lumbar lordosis did not significantly change between the two postures. CONCLUSIONS: We have found that the changes in the segmental motion were related to the degree of degeneration. With positional MRI, we were able to demonstrate changes in healthy and degenerative discs in the weight-bearing position. More similar studies are needed to understand the complex kinematics of the lumbar spine.

Adult↗
PubMed2003

The relationship between awake positioning and motor performance among infants who slept supine.

PURPOSE: The purpose of this study was to describe the gross motor development of infants who slept supine and spent different amounts of time in the prone position when awake. METHOD: Thirty infants who were six months old and slept supine were evaluated using the Alberta Infant Motor Scale (AIMS) and then divided into two groups: prone (n = 16) and no prone (n = 14) based on the number of times per day they were placed in prone position while awake. RESULTS: The prone group scored higher than the no prone group on the AIMS total scores (U = 36, p = 0.004), total percentile scores (U = 42, p = 0.003), and prone subscale scores (U = 25, p < 0.001). CONCLUSIONS: Gross motor performance as measured by the AIMS was more advanced in infants who slept supine and had been placed in the prone position when awake than in infants who slept supine but had limited or no experience in the prone position while awake. The influence of awake positioning needs to be considered when interpreting the developmental motor performance of infants who are six months old.

Journal Article↗
PubMed1985

Supine and sitting maximal workload difference and response to long-term enalapril therapy in congestive heart failure.

Maximal workloads in supine and sitting bicycle stress tests were compared in 12 patients with congestive heart failure during long-term therapy with the vasodilator enalapril. The response to the therapy was observed with the supine and sitting bicycle stress tests and gated equilibrium ventriculography. The maximal workload was 68 W in the supine position and 84 W in the sitting position; the mean difference was 15 W. The difference was highly significant (P less than 0.001). Both the supine and sitting workloads were significantly higher (P less than 0.02 and P less than 0.05) in the enalapril group than in the placebo group. The findings in the gated equilibrium ventriculography were not significantly different between the two groups.

Aged↗
PubMed1984

Pleural effusion. Use of the semi-supine position for radiographic detection.

Chest radiographs of 100 routinely examined patients were evaluated to study the effectiveness of the oblique semi-supine position when attempting to identify pleural effusion. Comparisons were made to images obtained with the patient in the lateral decubitus position. Radiography was performed without noticeable discomfort for 62 patients in the lateral decubitus position and for 97 patients in the oblique semi-supine position. The visualization of free pleural fluid was not affected by the different body positions, but demonstration of encapsulated fluid was superior in views obtained with the patient in the oblique semi-supine posture. For most individuals with suspected pleural effusion, the oblique semi-supine position is preferable to the lateral decubitus position.

Adolescent↗