Postural Techniques Research Articles

Cephalic version by postural management for breech presentation.

It is possible that maternal posture may influence fetal position. Many postural techniques have been used to promote cephalic version. The objective of this review was to assess the effects of postural management of breech presentation on measures of pregnancy outcome. The Cochrane Pregnancy and Childbirth trials register and Controlled Trials Register were searched. Date of last search: February 1999. Randomised and quasi-randomised trials comparing postural management with pelvic elevation for breech presentation, with a control group. Eligibility and trial quality were assessed by both reviewers. Three studies involving a total of 192 women were included. Postural management was associated with a non-significant trend towards fewer non-cephalic births (relative risk 0.90, 95% confidence interval 0. 73 to 1.12). No differences were detected for caesarean sections or Apgar scores below seven at one minute. There is not enough evidence to evaluate the use of postural management for breech presentation.

Assessing musculoskeletal back pain during pregnancy

Low back pain (LBP) affects between 50% and 90% of women who are pregnant. The many etiologies of LBP include hormonal, mechanical, postural, and vascular influences. It is unclear whether the cause of LBP is a single entity or multifactorial. When diagnosing LBP, it is important to rule out other medical causes such as pre-term labor and/or urinary tract infections. The patient's history and physical examination can isolate the cause of LBP as musculoskeletal most of the time. The patients can then be divided into treatment groups based on the severity of their symptoms. A flow chart is provided that divides patients into three main groups and treatment options for these groups. One of the most effective means of preventing LBP during pregnancy is early education. Research has shown that patients who received education during pregnancy have less severe backache. Thus, it is important to discuss with the patient at the first prenatal visit appropriate prevention tools. This article provides diagrams demonstrating proper postural techniques for saving patients' backs from the pain and aggravation of LBP during pregnancy.

Effect of posture strategies on preventing aspiration

The purpose of this study was to determine the effect of postural change on preventing aspiration, and the types of swallowing disorder that were influenced by posture. Ninety-five patients that were examined by aspiration of barium during videofluoroscopic examination of oropharyngeal swallow assumed one of four postures (chin down, head rotation, chin down + head rotation, and head back to chin down). Postural strategies were successful in eliminating aspiration in 68(72%) of the 95 patients. Twenty five of the 68 patients, however, needed an additional change in bolus volume to eliminate aspiration. Effective postures eliminating aspiration were chin down for 43 patients, head rotation for 10 patients, chin down + head rotation for 12 patients, and head back to chin down for 3 patients. The successes rates of posture changes for each swallowing abnormality were 76% for reduced tongue base retraction, 74% for delay in triggering pharyngeal swallow, 74% for reduced laryngeal elevation, 73% for laryngeal paralysis, 68% for inefficient oral transit, and in 57% for cricopharyngeal dysfunction. Among individuals with cricopharyngeal dysfunction or with than three swallowing motility problems, the frequency of unsuccessful swallow despite postural change was significantly higher than that of successful swallow. These results indicated that the posture strategies in addition to control of bolus volume could prevent aspiration in more than 70% of patients, but the efficacy of posture techniques differed with the different types of swallowing disorder identified as causing the aspiration, and suggested that the posture strategies were less beneficial in individuals with cricopharyngeal dysfunction or exhibiting multiple swallowing disorders.

Effects of postural change on aspiration in head and neck surgical patients

This study was designed to define the effects of postural change on liquid aspiration during videofluorographic examination of oropharyngeal swallow in head and neck surgical patients. Thirty-two patients were given two swallows of five different amounts of liquid barium as tolerated. When aspiration occurred, the patient's head and/or body position was changed, new posture being determined by the swallowing disorder identified as the cause of the aspiration. Postural techniques were successful in eliminating aspiration on at least one volume of liquid in 81% of these patients. Patients in all surgical groups were able to use postures with equal success. A variety of positions were used in each type of surgical patient, indicating that these patients exhibited a variety of swallowing problems. Results emphasize the importance of introducing postural techniques during the radiographic study of oropharyngeal swallow to facilitate safe oral intake of liquids.

Noninvasive approaches to deglutitive aspiration.

Etiologies for aspiration are described. Noninvasive procedures to eliminate aspiration are outlined including postural techniques, variations in bolus volume, viscosity, taste and temperature, methods to enhance oral sensation, swallow maneuvers and exercise programs to improve neuromotor control for swallow. Specific disorders for which each procedure is appropriate are defined.

A test of a common assumption regarding the use of antenatal training during labour.

The nature and purpose of antenatal classes are reviewed briefly, together with the common assumption that women given antenatal training to cope with their labour pains do all in fact make use of the breathing and postural techniques which have been taught in the classes when they come to labour itself. This assumption was tested by obtaining reports of the use of such techniques from sixty primiparous mothers after their labours. The results showed that the majority of these women did use their coping techniques at the onset of contractions, but as labour progressed toward delivery fewer and fewer mothers did so, less than a third practising any kind of coping techniques by the time they were in the second stage of labour. Of the more than two thirds remaining, a very substantial number could be accounted for by the mothers who had epidural analgesia, but, even allowing for this, more than half of the 'non-epidural' mothers failed to make use of their postural and breathing techniques during the second stage of labour. These findings suggest that it should no longer be assumed that all women taught to cope with labour pains by learning postural and breathing techniques in antenatal classes will necessarily be able to use them throughout labour itself.

An approach to the problem of intestinal gas in diagnostic radiology.

The causes of troublesome non-pathological gastrointestinal collections of gas or air in diagnostic radiology are discussed. Methods of prevention and treatment are suggested. These are simple postural techniques capable of being carried out by any experienced radiographer under radiological supervision. They involve no expensive drugs and in fact reduce the overall cost of examinations by eliminating wastage of film and of opaque media and loss of time.