Position And Pulmonary Function: An Investigation Into The Effect Of Body Position On Pulmonary Function In Healthy Adults.

ABSTRACT Background and Purpose: Physiotherapy is an integral part of rehabilitation for patients in the intensive care unit (ICU) and positioning is a primary treatment technique utilized by physiotherapists to optimize pulmonary function. The introduction of electric profiling beds (EPBs) has been a major advancement in the ICU setting and allows patients to achieve seated and semi-seated postures earlier in recovery. This is proposed to help reduce ICU stay, help prevent the negative effects of recumbency, and enhance functional recovery. Unfortunately, there is currently no evidence to support the use of EPBs as a positioning aid. This study aims to create a base level of evidence to support the use of EPBs in clinical practice by investigating the effect of chair sitting, EPB sitting, and supine body positions on pulmonary function in healthy individuals. Methods: Twenty healthy subjects participated in this study. Pulmonary function measures of forced vital capacity (FVC), forced expiratory volume in one sec (FEV 1 ) and FEV 1 /FVC ratio were measured using a Vitalograph Compact II spirometer across three test positions (chair sitting, EPB sitting, and supine). Standardised spirometry guidelines were followed. Results were obtained and statistically analysed using SPSS 19.0. A repeated Measures Analysis of Variance (ANOVA) was performed in conjunction with a series of paired t-tests to determine significant differences. Results: Results of 19 subjects were analysed and computed as mean values +/- standard deviations. Differences were calculated as a percent change in mean values of FVC, FEV 1 , and FEV 1 /FVC ratio to help describe these results. Generally speaking, the chair sitting position showed the highest values across spirometric parameters, followed by EPB sitting, then the supine position. Not all differences were deemed to be significantly different. FEV 1 /FVC ratio was not significantly different between chair sitting and EPB sitting, while FVC was not significantly different between EPB sitting and the supine position. Conclusions: The results of this study suggest that positions obtained using EPBs do have a significant effect on pulmonary function measures. The results further suggest, that EPB sitting is superior to supine, but inferior to chair sitting for promoting pulmonary function, and may in some causes results in a mildly restrictive deficit. While this information is useful in the guidance of future research, generalisation to a clinical population is limited, and further research into the use of EPBs in clinical populations is recommended.msc_physpreunpub1663_ethesesunpu