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Vol.3 , No. 2, Publication Date: Apr. 21, 2016, Page: 23-29
 and Forced Expiratory Volume (FEV1) at each position were scored relative to individual predicted values, and compared using ANOVA for both main and interactive positioning effects. Results: As expected, head rotation alone caused decrements in both subject FVC and FEV1, while changes in torso angle exhibited a small influence on subject FEV1 alone. No significant interaction between torso angle and head rotation was revealed, suggesting that the effects of head rotation were uniform across all torso angles examined. The combined effects of both torso flexion and head rotation closely matched those predicted by additive combination of their independent effects, suggesting that their interaction is linear, and non-synergistic. Conclusion: While torso flexion and head rotation exhibit only modest effects on pulmonary function in healthy subjects, their combined effects are additive, and mutually consistent. As such, attention must be paid to both torso flexion and head rotation during patient care for subjects whose ventilatory performance is most crucial.&picture=http://www.aascit.org/aascit/decorators/img/journal/908.jpg)
| [1] | Zachary J. Ankney, Department of Biology, Indiana University of Pennsylvania, Indiana, PA, U.S.A. |
| [2] | Katalin Komjati, Department of Biology, Indiana University of Pennsylvania, Indiana, PA, U.S.A. |
| [3] | Paul M. Nealen, Department of Biology, Indiana University of Pennsylvania, Indiana, PA, U.S.A. |
Study Aim: Patient position during care has significant implications for patient pulmonary performance, such that standard guidelines exhibit for consideration of bedded patient torso angle in order to ensure sufficient pulmonary function. It is known that both torso flexion and head rotation independently impair exhalation performance, but their combined effects have not been examined, despite the fact that bed-ridden subjects routinely experience both simultaneously. Methods: To assess the magnitude and form of interaction that torso angle and head rotation exert on patient pulmonary performance, we used spirometry to measure exhalation function in healthy young adults in combinations of torso and head positions designed to mimic the positioning of bedridden patients. Subject maximal values for both Forced Vital Capacity (FVC) and Forced Expiratory Volume (FEV1) at each position were scored relative to individual predicted values, and compared using ANOVA for both main and interactive positioning effects. Results: As expected, head rotation alone caused decrements in both subject FVC and FEV1, while changes in torso angle exhibited a small influence on subject FEV1 alone. No significant interaction between torso angle and head rotation was revealed, suggesting that the effects of head rotation were uniform across all torso angles examined. The combined effects of both torso flexion and head rotation closely matched those predicted by additive combination of their independent effects, suggesting that their interaction is linear, and non-synergistic. Conclusion: While torso flexion and head rotation exhibit only modest effects on pulmonary function in healthy subjects, their combined effects are additive, and mutually consistent. As such, attention must be paid to both torso flexion and head rotation during patient care for subjects whose ventilatory performance is most crucial.
Keywords
Spirometry, Patient Positioning, Head Rotation, Torso Angle, Forced Vital Capacity (FVC), Forced Expiratory Volume (FEV)
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