Influence Of Arm Position Research Articles

Influence of arm position on the first pass success rates of ultrasound-guided infraclavicular axillary vein cannulation in spontaneously breathing patients: A randomised clinical trial.

Significant collapsibility during spontaneous respiration, deeper location, and smaller vein size are key challenging factors to safe infraclavicular axillary vein cannulation. Arm abduction reduces collapsibility, but interventional data supporting this observation is lacking. This study investigates the effect of neutral and abducted arm position on the first pass success rate of infraclavicular axillary vein cannulation in spontaneously breathing patients. One hundred and twelve patients were randomly assigned to two arm positions, neutral or abducted by 90° at the shoulder joint. Under ultrasound guidance, the infraclavicular axillary vein was cannulated using an in-plane approach. The primary outcome was the first pass success rate of guidewire placement in the infraclavicular axillary vein. The secondary outcome measures were the number of attempts for successful cannulation, failure rate, and catheter tip malposition. Fifty-two patients in the neutral arm and fifty-six patients in the arm abduction group were compared according to the intention to treat analysis. The abducted arm position was associated with a higher first pass success rate (RR = 3.39, 95% CI = 1.47-7.85; p = 0.004) with fewer attempts (p = 0.005), lower failure rate (RR = 1.37, 95% CI = 1.16-1.61; p = 0.000) and lower catheter tip malposition (1.5 vs 15.8%; p = 0.012) when compared to the neutral arm position. Abducted arm position resulted in a significantly higher first pass success rate with a lower failure rate and catheter tip malposition during ultrasound-guided infraclavicular axillary vein cannulation in spontaneously breathing patients.

The influence of arm positions on abdominal image quality of whole-body computed tomography in trauma: systematic review

PurposeWhole-body computed tomography (WBCT) is the standard diagnostic method for evaluating polytrauma patients. When patients are unable to elevate their arms, the arms are placed along the body, which affects the image quality negatively. Aim of this systematic review is to evaluate the influence of below the shoulder arm positions on image quality of WBCT.MethodsLiterature in PubMed and Scopus databases was systematically searched. Results of the papers were stratified into 4 categories: arms elevated, 1 arm up 1 arm down, arms ventrally supported, arms along the body. A qualitative analysis was performed on subjective image quality and a quantitative analysis on objective quality (image noise).ResultsEight studies were included with 1421 participants. Various studies reported significantly higher quality scores with arms elevated, compared to arms along the body. Significant differences in objective image quality were found between the arms elevated and the arms ventrally on support group. The arms ventrally supported group had a significantly higher image quality than the arms along the body group. A statistically significant difference was found in objective image quality between the 1 arm up 1 arm down and arms along the body group. No preferential below the shoulders position could be identified.ConclusionPositioning the arms alongside the body results in a poor image quality. Placing the arms on a pillow ventrally to the chest improves image quality. Interestingly, asymmetrical arm positioning has potential to improve the image quality for patients that are unable to elevate the arms.

Influence of arm position and respiration technique during liver examinations on the detectability of mammary lesions.

During liver computed tomography (CT), scanning is performed with the raised arm position and an inhalation technique. However, for liver magnetic resonance imaging (MRI), the arms are placed at the sides of the body and an exhalation technique is used. This study was aimed at evaluating the effect that the patient's arm position and respiration technique had on the ability to detect mammary glands in the scan range to discover unexpected mammary lesions during the liver MRI examination. Liver MRI and CT images were compared for 337 female patients. More than half of the mammary glands were included in 97.3% of MRI, but in 4.7% of CT. No mammary lesions were found during CT, whereas seven were found during MRI. The mammary lesions are more likely to be detected when the patient places her arms at the sides of the body and uses the exhalation technique during liver MRI.

Diffusion Tensor Imaging of Rotator Cuff: Influence of Arm Position

Diffusion tensor imaging (DTI) of skeletal muscles has been reported as capable to characterize physiological properties, tissue microstructure and architectural organization. However, the DTI indices may vary with the contractile state of the muscles, and in the rotator cuff muscles, a change in forearm position can result in variation of the DTI indices. The purpose of this study was to examine the influence of forearm position on the major DTI indices of the rotator cuff muscles. The DTI of right rotator cuff was acquired under the neutral position and external and internal rotation of the forearm in nine healthy volunteers. Fractional anisotropy (FA) and mean diffusivity (MD) of each muscle were calculated and compared among the three forearm positions. FA and MD were significantly different between external and internal rotation in infraspinatus, teres minor and subscapularis (p<0.05). We considered that this difference was due to the change in cross-sectional area of muscle fibers based on their contractile state. That is, when the muscle is contracted, its cross-sectional area is increased and the muscle fiber density in the short axis direction becomes less. This causes a change in FA and MD due to increase in λ2 and λ3 through increased diffusion of intercellular water in the short axis direction. In conclusion, the DTI indices of the rotator cuff muscles are affected by the forearm position.

Influence of arm position during infraclavicular subclavian vein catheterization in coronary artery bypass graft surgery.

Introduction: Percutaneous subclavian vein catheterization via infraclavicular approach is one of the most widely used cannulation techniques for inserting catheters into a central vein. The aim of this study was to evaluate influence of arm position during infraclavicular subclavian vein catheterization with landmark-based technique in coronary artery bypass graft (CABG) surgery. Methods: Between September 2017 and June 2018, this prospective randomized clinical trial was performed in 320 patients. The patients were randomly assigned to the Neutral group (the arms kept by the side) or Abduction group (the arm was abducted to 90°). The success and complication rates were compared in the two groups. The data were analyzed using SPSS software. Results: In the first attempt of subclavian vein cannulation, the success rate had no significant difference between the two groups (P = 0.185). In the second attempt of catheterization, the success rate in Abduction group (40.5%) was lower than Neutral group (81.2%). The overall success rate in two attempts were (84.4%) in the Abduction group and (96.2%) in the Neutral group. There was a significant difference between two groups in the second and overall success rates (P = 0.0001). In 34 (10.6%) patients, subclavian artery puncture occurred, 30 (18.8%) in the Abduction group and 4 (2.5%) in the Neutral group. There was a significant difference between two groups (P = 0.0001). Pneumothorax was occurred in 15 (9.4%) in the Abduction group and 3 (1.9%) in the Neutral group. There was also a significant difference between two groups (P = 0.004). The differences in other complications on two groups were statistically insignificant. Conclusion: Compared with Abduction group, the Neutral group resulted in higher success rate and fewer subclavian artery puncture and pneumothorax. The incidences of other complications were similar on both groups.

Long-range tactile masking occurs in the postural body schema.

Long-range tactile masking has been reported between mirror symmetric body locations. This suggests a general principle of contralateral inhibition between corresponding points on each side of the body that may serve to enhance distinguishing touches on the two halves of the body. Do such effects occur before or after posture is added to the body schema? Here, we address this question by exploring the effect of arm position on long-range tactile masking. The influence of arm position was investigated using different positions of both the test and masking arms. Tactile sensitivity was measured on one forearm, while vibrotactile-masking stimulation was applied to the opposite arm or to a control site on the shoulder. No difference was found in sensitivity when test arm position was varied. Physical contact between the arms significantly increased the effectiveness of a masking stimulus applied to the other arm. Long-range masking between the arms was strongest when the arms were held parallel to each other and was abolished if the position of either the test arm or the masking arm was moved from this position. Modulation of the effectiveness of masking by the position of both the test and masking arms suggests that these effects occur after posture information is added to the body's representation in the brain.

Influence of arm position on ultrasound visibility of the axillary brachial plexus.

Contemporary axillary brachial plexus block is performed by separate injections targeting radial, median, ulnar and musculocutaneous nerve. These nerves are arranged around the axillary artery, making ultrasound visualisation sometimes challenging. In particular, the radial nerve can be difficult to localise deep to the artery. The primary aim of this study was to investigate which arm position optimises the visibility of the radial nerve. Secondary aims were the visibility and position of the other nerves during varying arm positions. A prospective observational study. University teaching hospital, November 2012. Twenty volunteers, recruited by an advertisement on the Department's bulletin board. Inclusion criterion age more than 18 years. refusal of ultrasound examination, restricted shoulder movement, local infection, BMI greater than 30 kg m⁻². One anaesthesiologist performed bilateral ultrasound examinations of the axillary brachial plexus on 20 volunteers. Each arm was placed in different positions [shoulder (S) 90° or 180° abduction, elbow (E) 0° or 90° extension] and scans were performed proximally in the axilla, and additionally 5 cm distally to this point [proximal (P) vs. distal (D)], resulting in eight different scans stored for off-line analysis performed by two blinded anaesthesiologists. For radial, median, ulnar and musculocutaneous nerve, visibility was assessed on a six-point visibility scale. Distances and angles of the nerves relative to the axillary artery and distances relative to the skin were measured. No significant differences between arm positions were found in the visibility score of radial (P = 0.359) and musculocutaneous nerves (P = 0.073). Visibility of the median nerve was improved in positions S90°/E0°/D and S180°/E0°/P (P = 0.02). The ulnar nerve was more visible in position S180°/E 0°/P and D (P = 0.007). The greatest distance between artery and radial nerve was 7.4 ± 4.7 mm at an angle of 120 ± 14° in position S180°/E 0°/D. The visibility of the radial nerve was not improved by varying positions of the arm. S180°/E0° provided the best overall visibility and accessibility of nerves. https://www.toetsingonline.nl/to/ccmo_search.nsf/Searchform?OpenForm Identifier: NL42116.018.12.

Influence of Arm Position and Lung Volume on the Center of Buoyancy of Competitive Swimmers

Influence of Arm Position and Lung Volume on the Center of Buoyancy of Competitive Swimmers

Motor actions in retrieval of valenced information: II. Boundary conditions for motor congruence effects.

We report an experiment on the influence of arm positions on the generation of valenced information. Participants were induced to perform either approach (arm flexion) or avoidance (arm extension) behavior while generating names of persons. One half of the participants had to indicate whether they had positive, negative or neutral attitudes towards these persons during retrieval (evaluation group), the other half had to indicate their attitudes after retrieval (nonevaluation group). Participants retrieved significantly more negative than positive names under arm extension but more positive than negative names under arm flexion. This motor congruence effect, however, was only obtained for the evaluation group. The data show that an evaluative context is necessary to produce the effect in retrieval.

Effect of arm position on the effectiveness of perivascular axillary nerve block

The influence of arm position on the effectiveness of perivascular axillary nerve block with a catheter was assessed prospectively in two groups of patients. Ninety patients were allocated randomly to receive 1% mepivacaine with adrenaline 40 ml with the arm either adducted or abducted. Radiographs were taken in 12 additional patients; six in each group immediately after injection of 2% mepivacaine 20 ml mixed with contrast agent 20 ml. There were no statistically significant differences in onset time, spread of analgesia, motor block or success rate between the two groups. Proximal flow of the local anaesthetic-contrast agent mixture was neither facilitated by arm adduction nor was it necessary for the development of a successful block.

The influence of arm position and cardiac output on bolus clearance from the arm.

The importance of arm position and cardiac output on the clearance of a bolus injection from the arm was assessed in 63 patients using technetium-99m. Injections were made in the left arm which was either adducted, abducted or adducted with the forearm flexed over the lower chest. The clearance of isotope was assessed by measuring the amount of radioactivity remaining in the arm at 10 s intervals and calculating it as a fraction of the injected dose. The clearance of Tc-99m was significantly faster and more complete from the abducted arm than from the adducted arm. There was no correlation between clearance and cardiac output.

The influence of arm position on the pinch grip strength of female dentists in standing and sitting positions

The objective of this study was to measure and compare hand pinch grip forces in standing and sitting postures for a group of 77 healthy female dentists of 25 to 55 years old. The equipment used consisted of a gripping device with strain gauges, a measuring device and a printer. The results can be described as follows. With respect to absolute values the hand pinch forces are higher when the subject is standing with her arm supported, than when she is sitting. In the standing position the measured forces were maximum when the forearm was at 60° angle towards the frontal position, while in the sitting position the pinch grip forces were maximum with the forearm vertical (90°) with respect to the frontal position. The above data can be used to design the dentist's working area.

Influence of Arm Position on Measurement of Blood Pressure

Influence of Arm Position on Measurement of Blood Pressure

Influence of arm position on measurement of blood pressure.

A series of measurements of blood pressure in normotensive and hypertensive subjects showed that measurements made with a sphygmomanometer with the arm dependent by the side were consistently higher than those made with the arm horizontal at heart level. The mean difference in a group of 90 hypertensive outpatients was 11/12 mm Hg. Failure to appreciate the importance of arm position may lead to erroneous measurements of blood pressure. This has important implications for clinical practice and research.

Influence of arm position on thoracic injuries in side impact

Influence of arm position on thoracic injuries in side impact