Pal Arvind Kumar, Tiwari Sunita, Verma Dileep Kumar
Junior Resident, Department of Physiology, King George's Medical University, Lucknow, Uttar Pradesh, India.
Professor, Department of Physiology, King George's Medical University, Lucknow, Uttar Pradesh, India.
J Clin Diagn Res. 2017 May;11(5):CC08-CC10. doi: 10.7860/JCDR/2017/25202.9828. Epub 2017 May 1.
The change in body position can alter pulmonary functions parameters, therefore it is important to understand the physiological basis of these alteration. Ideally, spirometry is done in sitting position until the subject is unable to do so. Hospitalized patients often assume recumbent body positions irrespective of underlying pathology. Hence, need arises to find out best recumbent body positions for the benefit of these patients to make breathing comfortable for them.
The aim of this study was to find out whether the change from the supine position to crook lying and Fowler's position (45° dorsal elevation) causes change in spirometric parameters.
The present work was carried out at Department of Physiology, King George's Medical University, Lucknow. A total 131 apparently healthy individuals were enrolled in this cross-sectional study. Lung function was assessed using a PC-based spirometer according to American Thoracic Society guideline in the supine, crook lying and Fowler's position (45° dorsal elevation).
The study consisted of 131 subjects (male 66%, female 34%), with mean age of 20.15±2.71 years and BMI 21.20±3.28 Kg/m. Repeated measures ANOVA with post hoc Bonferroni test was used to compare the mean values between each body position. Compared with the other two positions, Fowler's position showed significantly (p<0.05) higher values for FVC, FEV, PEF, FEF.
Recumbent body position influences spirometric parameters in young healthy subjects. We demonstrated that spirometric values are higher in the Fowler's position than in the supine or crook lying position. The results of this study will help in the selection of the best alternative position for the spirometry in bed ridden patients.
身体姿势的改变会改变肺功能参数，因此了解这些改变的生理基础很重要。理想情况下，肺活量测定应在坐姿下进行，直到受试者无法保持该姿势。住院患者通常无论潜在病情如何都会采取卧位。因此，有必要找出对这些患者有益的最佳卧位，以使他们呼吸舒适。
本研究的目的是确定从仰卧位变为屈膝卧位和福勒氏位（背部抬高45°）是否会导致肺活量测定参数发生变化。
本研究在勒克瑙乔治国王医科大学的生理学系进行。共有131名看似健康的个体参与了这项横断面研究。根据美国胸科学会指南，使用基于电脑的肺活量计在仰卧位、屈膝卧位和福勒氏位（背部抬高45°）评估肺功能。
该研究包括131名受试者（男性占66%，女性占34%），平均年龄为20.15±2.71岁，体重指数为21.20±3.28kg/m²。采用重复测量方差分析及事后邦费罗尼检验来比较每个体位之间的平均值。与其他两个体位相比，福勒氏位的用力肺活量（FVC）、第一秒用力呼气容积（FEV）、呼气峰值流速（PEF）、用力呼气流量（FEF）值显著更高（p<0.05）。
卧位会影响年轻健康受试者的肺活量测定参数。我们证明，福勒氏位的肺活量测定值高于仰卧位或屈膝卧位。本研究结果将有助于为卧床患者选择肺活量测定的最佳替代体位。
