Document Detail

The effect of body position on maximal expiratory pressure and flow.
MedLine Citation:
PMID:  12047207     Owner:  NLM     Status:  MEDLINE    
Positioning combined with coughing and huffing is frequently used to promote secretion clearance. Maximum expiratory pressure (MEP) and peak expiratory flow rate (PEFR) have been used as surrogate measures of cough and huff strength. This study investigated the effect of body position on MEP and PEFR. Repeated measures of MEP and PEFR were performed across seven randomised positions (standing, chair sitting, sitting in bed with backrest vertical, sitting in bed with backrest at 45 degrees, supine, side lying, and side lying with head down tilt 20 degrees) on 25 adults with normal respiratory function (NRF) and 11 adults with chronic airflow limitation (CAL). For the NRF group, MEP in standing (143+/-10cmH2O, mean+/-SEM) was significantly higher than MEP in chair sitting (133+/-10cmH2O) which in turn was significantly higher than in the remaining positions. The MEP in head down tilt (108+/-9cmH2O) was significantly lower than in all other positions. The PEFR in standing (571+/-24L/min) was significantly higher and head down tilt (486+/-23L/min) was significantly lower than in all other positions. For the CAL group, MEP in standing (134+/-18cmH2O) was significantly higher, while in head down tilt (96+/-15cmH2O) was significantly lower, than in most other positions. For the CAL group, PEFR in standing (284+/-40ml/sec) was significantly higher, while in head down tilt (219+/-38ml/sec) was significantly lower, than in most other positions. Body position has a significant effect on MEP and PEFR in NRF and CAL subjects, with the lowest values in the head down position. Thus, to maximise the strength of expiratory manoeuvres during treatments that use the head down position, patients should be encouraged to adopt a more upright position when coughing or huffing.
Charbel Badr; Mark R Elkins; Elizabeth R Ellis
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  The Australian journal of physiotherapy     Volume:  48     ISSN:  0004-9514     ISO Abbreviation:  Aust J Physiother     Publication Date:  2002  
Date Detail:
Created Date:  2002-06-05     Completed Date:  2002-09-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370615     Medline TA:  Aust J Physiother     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  95-102     Citation Subset:  IM    
School of Physiotherapy, The University of Sydney, Sydney, NSW, Australia.
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MeSH Terms
Airway Obstruction / diagnosis*,  physiopathology
Analysis of Variance
Case-Control Studies
Cohort Studies
Maximal Expiratory Flow Rate
Middle Aged
Peak Expiratory Flow Rate
Posture / physiology*
Pulmonary Gas Exchange / physiology*
Reference Values
Respiratory Function Tests
Respiratory Mechanics
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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