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PubMedDate not supplied

Effect of position (semirecumbent versus supine) on postoperative oxygenation in markedly obese subjects.

In 22 markedly obese, otherwise healthy, women studied postoperatively on each of days 1 through 3 after intra-abdominal operation, the effect of position change on arterial oxygenation was assessed. There was a statistically significant decrease in PaO2, an increase in A-aDO2 and a simultaneous modest reduction in PaCO2 with the assumption of the supine position on postoperative days 1 and 2, but not positional difference demonstrable in any studied variable by day 3. This report suggests that during the first 48 hours after abdominal surgery in obese patients, assumption and maintenance of the semirecumbent posture is a valuable therapeutic modality to improve arterial oxygenation.

Abdomen↗
PubMed2003

Evaluation of the peak torque, total work, average power of flexor-estensor and prono-supinator muscles of the elbow in baseball players.

The Authors, after a short analysis on biomechanics of the elbow during throwing in baseball, show the movements of the elbow during the different phases of the throw and the stabilizing action of the ulnar collateral ligament, flexor-pronator muscles of the wrist, anconeus and brachial triceps muscles. Aim of this study is the evaluation of the peak torque, total work and average power of the flexor-extensor and pronator-supinator muscles of the elbows in professional baseball players. Isokinetic test data show that a mayor peak torque in flexo-extension at power and resistance test in the pitchers compared to the strikers. Whereas the strikers show a higher peak torque in pronation at the resistance test. This may happen because during a baseball match the ball is hit many times by the bat and the pronator muscle of the wrist are notably stimulated and reinforced.

Adult↗
PubMedDate not supplied

[Attitude of the paralytic supination of the forearm in children. Surgical treatment in 19 cases].

Nineteen cases of paralytic supination contracture have been surgically treated in children and teenagers. Three successive stages are described - 1) reducible deformity 2) contractures of soft tissues and 3) skeletal deformities. Surgical treatment aimed to improve the patient cosmetically and functionally. Ideally, the condition should be corrected early, during the first stage. The results of the Zancolli procedure of section of the interosseous membrane and rerouteing of the biceps in 11 cases were all satisfactory. Osteotomy of one or both bones could be used in association in cases with fixed deformity.

Adolescent↗
PubMed2005

Activation of selected frontal trunk and extremities muscles during rolling from supine to side lying in healthy subjects and in post-stroke hemiparetic patients.

The purpose of this work was to get insight into the role of frontal trunk and proximal extremity muscles in rolling from supine to side lying. Participants were seventeen hemiparetic patients and 14 healthy subjects. Electromyographic (EMG) activity of the Sternocleidomasoid (ScM), Pectoralis Major (PM), External Oblique (ExO) and Rectus Femoris (RF) muscle pairs was recorded during rolling performance. Analysis included the establishment of EMG response times and magnitudes. For all muscles, initiation of EMG activity was delayed in the patients as compared with the controls. Among the healthy subjects, EMG activity level of the SCM was more enhanced on the mobile than on the stable body side, while activation level of the PM muscle was larger on the stable body side. In the hemiparetic group, the SCM demonstrated similar results as the controls yet, PM activity on the paretic side was lower than on the non-paretic side regardless of rolling direction. The difference in activation level between the corresponding ExO and RF muscles showed inconsistency among the healthy subjects, whereas in the hemipareic group the muscles on the paretic side never displayed higher activation levels than on the non-paretic side. In conclusion, rolling sideways in hemiparetic subjects is characterized by a normal relationship between activation levels of the SCM muscles while the relationship between the corresponding PM, ExO and RF muscles is hampered due to reduced activation level of the muscles on the paretic body side.

Aged↗
PubMed1993

1992 Student Writing Contest-1st Runner-up: A Comparison of Thermotherapy and Cryotherapy in Enhancing Supine, Extended-leg, Hip Flexion.

Eighteen healthy subjects (13 females and 5 males) were pretested and posttested under two treatment conditions in order to compare the effects of cryotherapy and thermotherapy on supine, extended-leg, hip flexion measurements. Cryotherapy treatments consisted of crushed ice bags secured to the posterior thigh for 20 minutes. On a separate day, thermotherapy treatment of moist heat pads were applied to the posterior thigh for 20 minutes. For pretest and posttest measurements, the subject's extended leg was taken to the end feel of passive hip flexion as maximum range of motion was assessed using a goniometer. Both cryotherapy and thermotherapy significantly improved immediate range of motion; however, there were no differences between the two treatment conditions. These results suggest that athletes wishing to obtain maximum range of motion immediately after treatment may select either ice or heat modalities. Individual conditions and preferences can be used to dictate treatment selection.

Journal Article↗
PubMed2001

Movement characteristics of persons with prader-willi syndrome rising from supine.

PURPOSE: The purposes of this study were to: 1) determine if previously published descriptors of the supine to stand rising task in healthy individuals could be applied to the movements of persons with Prader-Willi Syndrome (PWS); and 2) assess upper extremity (UE), axial region (AX), and lower extremity (LE) movements among subjects with PWS compared with controls. METHODS: Nine subjects with PWS (seven-36 years of age) and matched controls were videotaped performing 10 rising trials. The UE, AX, and LE movements were classified using published descriptors. Occurrence frequencies of movement patterns, duration of movement, and the relationships among body region movement score, BMI, and age were determined. RESULTS: Subjects with PWS utilized developmentally less advanced asymmetrical rising patterns, took longer to rise, and demonstrated less within subject variability than controls. CONCLUSIONS: Categorical descriptors, with minor modifications, can be used to describe rising movements in persons with PWS. Knowledge of successful rising patterns may assist PTs when examining or planning intervention strategies for teaching the rising task.

Journal Article↗
PubMed1991

[The supinator fat line--its visualization and validity].

Based on 259 lateral x-ray films of the elbows of healthy subjects, the typical forms of the fat plane overlying the supinator muscle were determined. The forms of this plane in 121 patients who had suffered bony lesions in the elbow joint region were juxtaposed to these x-ray images. Measurements of the proximal distance between the fat plane and the extended tangent of the anterior humeral cortex layer revealed that distances of more than 13 mm in children and of more than 18 mm in adults are highly suspicious of a fracture. The good visualisation of the fat plane by means of various imaging methods is appropriately demonstrated.

Adipose Tissue↗
PubMed1990

[Syncope caused by paroxysmal atrial fibrillation and flutter: diagnostic usefulness of electrophysiological studies in the erect and supine positions].

In this study, we verified if the induction of atrial fibrillation/flutter, during the electrophysiological study, could be useful for the evaluation of syncope of unknown origin. Of 292 patients who underwent an electrophysiological study for unexplained symptoms, we selected 15 patients (5.1%) affected by syncope and pre-syncope. In these, the induction of atrial fibrillation (14 patients) or flutter (1 patient) just at the onset caused, the reproduction of the spontaneous symptoms. No other cause could be identified. These patients were affected by: 1) syncope or pre-syncope without electrocardiographic documentation of paroxysmal atrial fibrillation/flutter 2) syncope or presyncope and documented asymptomatic episodes of paroxysmal atrial fibrillation/flutter. Palpitations closely preceded or followed the syncope in 11/15 patients. Symptom reproduction was obtained in the supine position in 3 patients (heart rate 180 +/- 82 beat/min, systolic blood pressure 53 +/- 6 mmHg) and in the upright position in 12 patients (heart rate 177 +/- 24, systolic blood pressure 65 +/- 18 mmHg). The arrhythmia was induced by incremental atrial pacing or premature atrial beats in 3 cases, ramp in 3 cases and burst--mean rate 339 +/- 48 beat/min--in 9 cases. The arrhythmia lasted for a period of time ranging from a minimum of 1 mm to a maximum of 24 hours (median 1 hour). During sinus rhythm, an abnormal vasodepressor reflex (with a systolic blood pressure fall greater than or equal to 50 mmHg) could be induced in 7/9 patients by carotid sinus massage or 60 degrees tilt test.(ABSTRACT TRUNCATED AT 250 WORDS)

Atrial Fibrillation↗
PubMed1990

Reproducibility and accuracy of pulmonary artery pressure measurement in supine and lateral positions.

The reproducibility and accuracy of pulmonary artery (PA) pressures in supine versus side-lying positions were compared in two groups of intensive care unit (ICU) patients. Side-lying measurements were reproducible, accurate, and clinically acceptable for surgical ICU patients, but not for medical ICU patients. The inconsistency was partly explained by the reference points used for transducer releveling in lateral positions. Surgical ICU used the fourth intercostal space and dependent midaxillary line; medical ICU used the fourth intercostal space and sternum. Reversing the leveling procedure in each ICU reduced surgical unit accuracy to an unacceptable level; medical unit accuracy was increased but was still too low for clinical acceptance. Further research is needed to identify appropriate anatomic reference points for transducer releveling in the side-lying position and to clarify which patient groups may be safely monitored by using this position.

Blood Pressure Determination↗
PubMed1989

Torsional strength of the ankle in vitro. The supination-external-rotation injury.

Nineteen fresh-frozen anatomic specimens of the ankle were mounted in an experimental test device with the foot in supination. Torque versus rotation curves were recorded as each foot was rotated externally to failure. The mean failure torque was 45.3 Nm, the mean rotation to failure was 41.4 degrees, and the mean energy absorbed to failure was 10.6 Nm. Twelve specimens failed by fracture of the fibula, five by failure of lateral ligaments with no fibular fracture, one by a subtalar dislocation, and one by fracture of the calcaneous through a fixation screw hole. There were no statistically significant differences in torque or energy to failure between those specimens that failed by fibular fracture and those with ligamentous failure alone. Rotation to failure was 6 degrees greater in the ligamentous failure group. Ankles with less initial rotatory laxity tended to fail at higher torque levels. The mean ankle fracture torque measured in this study is similar to previously reported mean ligamentous failure torque for the knee flexed to 20 degrees and rotated externally to failure. In a prior in vivo study, approximately 10 Nm of external foot torque and 20 degrees of foot rotation could be tolerated prior to the initiation of pain. The present study indicates that these in vivo pain threshold levels represent approximately 50% of the rotation to failure and 25% of the torque to failure.

Ankle Injuries↗
PubMed1985

Effects of intravenous anesthesia on VA/Q distribution: a study performed during ventilation with air and with 50% oxygen, supine and in the lateral position.

Distribution of ventilation and perfusion in relation to ventilation-perfusion ratio (VA/Q) were studied in 14 patients, with a mean age of 59 yr, before elective lung surgery, in the supine position when awake, during intravenous anesthesia and mechanical ventilation with air, after increasing the fraction of inspired oxygen (FIO2) to 0.5, and in the lateral position. Before anesthesia, small inert gas shunts and perfusion of low VA/Q regions, indicating some degree of VA/Q mismatch, were observed in several patients. After induction, FIO2 = 0.21, the major changes were a significant decrease in cardiac output and an increase in log SD for perfusion from 0.77 +/- 0.45 (SD) to 1.13 +/- 0.50 (SD), while the shunt remained low at 1% of cardiac output and arterial oxygen tension (PaO2) was unchanged. An increase to FIO2 = 0.5 induced only small changes with a shunt of 2.5% of cardiac output. In the lateral position, the shunt was 4.0% and increases in ventilation to high VA/Q regions were observed. The lack of marked changes in the VA/Q distribution after induction either could be a result of only minor alterations in the distribution of ventilation and perfusion or an effective vascular response to alveolar hypoxia (hypoxic pulmonary vasoconstriction, HPV).

Adult↗
PubMed1978

Haemodynamic effects of isosorbide dinitrate in patients with congestive cardiac failure at rest and during submaximal supine exercise.

Eight patients with chronic congestive cardiac failure secondary to ischaemic heart disease performed submaximal supine exercise before and after 5 mg sublingual isosorbide dinitrate (ISDN) at the time of cardiac catheterisation. Exercise before ISDN produced a poor response in left ventricular performance. After ISDN this response was significantly improved. Compared with the control exercise period cardiac index (CI) increased from mean 2.9 to 3.5 l/mn/m2 (p = less than 0.0025), stroke volume index (SVI) from mean 24 to 29 ml/m2 (p = less than 0.0005) and left ventricular stroke work index (LVSWI) from mean 22 to 28 g-m/m2 (p = less than 0.0025). Although ISDN reduced LVEDP significantly at rest, there were associated small but significant falls in CI, SVI and LVSWI. The improvement in exercise cardiac index was related to the ejection fraction, or the ejection fraction of the contractile section where a left ventricular aneurysm was present. ISDN may be effective in improving exercise tolerance in ambulant patients with chronic congestive cardiac failure.

Administration, Oral↗
PubMed1979

Cardiovascular dynamics after acute and long-term alpha- and beta-adrenoceptor blockade at rest, supine and standing, and during exercise.

1 After acute intravenous administration labetalol reduced mean values for BP, total peripheral resistance, heart rate and cardiac output. All changes were more pronounced during bicycle exercise. 2 After a mean duration of 20 months' treatment with oral labetalol the haemodynamic findings were broadly similar except for a more marked reduction in the total peripheral resistance and cardiac output had returned to pretreatment level due to an increased stroke volume which had counter balanced the reduction in heart rate. These changes occurred at rest, in the erect position and during exercise but the reductions in BP and peripheral resistance were most marked during exercise. 3 Left ventricular filling pressures and stroke volume/filling pressure ratios were not significantly altered after intravenous labetalol compared with pretreatment values. 4 Systolic BP x heart rate product was lowered particularly during exercise after both intravenous and oral labetalol. 5 After long-term oral labetalol, the most striking haemodynamic change was in the elevated resting stroke volume supine and standing.

Adrenergic alpha-Antagonists↗
PubMed1979

Effect of supine and prone positions on arterial oxygen tension in the preterm infant.

To determine the optimal position for the preterm infant, arterial oxygen tension (Pao2) was monitored in 16 preterm infants by the transcutaneous method with the infants in both supine and prone positions. When the infants were prone, Pao2 rose by a mean of 7.4 mm Hg (P less than .001), an increase of 15%. In those infants with residual cardiopulmonary disease a 25% increase was noted. The higher Pao2 in the prone position was accompanied by a significant decrease in the amount of time the chest wall moved asynchronously. This improved oxygenation in the prone position appears to be the result of enhanced ventilation/perfusion ratios and not merely secondary to an alteration in sleep state with positioning of the infant. These findings may have important implications in the management of preterm infants, requiring neonatal intensive care.

Arteries↗
PubMed1979

Comparison of the liver's respiratory motion in the supine and upright positions: concise communication.

The effect of the upright position, compared with the supine position, in reducing respiratory motion during liver scintigraphy has been measured in a group of 51 randomly selected patients. Little improvement in spatial resolution can be expected from simply standing the patient upright, and analog motion correction is recommended as much more effective in minimizing respiratory motion artifacts in liver scintigraphy.

Humans↗
PubMed1983

Noninvasive echo-Doppler duplex measurements of common femoral artery blood flow variables during supine exercise and post-occlusive reactive hyperemia.

Noninvasive dynamic measurements of common femoral artery blood flow (CFBF) and stroke volume (CFSV) during supine exercise (SE) and staged post-occlusive reactive hyperemia (PORH) in normal subjects using an echo-Doppler duplex scanner (DS) would provide baseline hemodynamic data in the study of the peripheral circulation in resting, stressed, and diseased conditions. Heart rate (HR), CFBF, and CFSV were determined at rest (R), after 5 minutes of SE on an ergometer (30 rpm) at 30, 60, 90-watt loads and after a 3-minute recovery. The same variables were also calculated after periods of 2-, 5-, and 10-minute thigh occlusions (greater than 240 mm Hg cuff pressure). Measurements of spatial average blood velocities and lumen diameters were used to calculate CFBF. Ankle pressure (AP) and brachial pressure (BP) were determined, and the ratio of systolic AP to systolic BP, the ankle index (AI), was calculated. As in vitro validation of the DS method was accomplished using a hydraulic model of CFBF (r = 0.98). Mean values for maximal CFBF following SE and PORH were 0.81 and 1.53 l/min, respectively. With SE, increases in CFBF and CFSV and decreases in AI were significantly (p less than .05) only at 60- and 90-watt loads. Increases in CFBF and CFSV and decreases in AP and AI were significantly different (p less than .05) from rest for the three occlusion durations and show a linear trend. This study suggests that the DS method can noninvasively and quantitatively measure CFBF and CFSV at rest following SE and during PORH.

Adult↗