Ventral Decubitus Position Research Articles

Effects of combined muscle power and endurance training with different volumes on functional and hemodynamic parameters in previously trained older adults.

To promote optimal neuromuscular and cardiovascular gains in older adults, it seems crucial to investigate the effects of different combined training volumes in this population. Thus, the present study aimed to compare the effects of combined muscle power training (MPT) and endurance training (ET) with different volumes on functional and hemodynamic parameters in previously trained older adults. Twenty-five older adults were randomly assigned to either the lower-volume group (LVG; n = 13) or the higher-volume group (HVG; n = 12). In the LVG, participants performed 1 set of 6 repetitions for each exercise, followed by 10min of walking exercise. In the HVG, participants performed 2 sets of 6 repetitions for each exercise, followed by 20min of walking exercise. Lift from the ventral decubitus position (LPDV), timed up-and-go (TUG), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were assessed before and after 8weeks. Significant increases in LPDV test occurred in both groups after 8weeks (p < 0.05). Additionally, significant improvements in TUG performance occurred in both groups from week 0 to week 8 (p < 0.05). However, no significant changes were observed between groups in functional parameters (p > 0.05). SBP and DBP remain unchanged (p > 0.05) in both groups over the experimental period. These findings indicate that lower-volume and higher-volume of combined MPT and ET promoted improvements in functional parameters. This study has an important practical application, as it indicates that regardless of the volume (lower or higher), comparable improvements are observed in functional parameters in previously trained older adults.

Phase Angle Is Moderately Associated With Muscle Quality and Functional Capacity, Independent of Age and Body Composition in Older Women.

There is a growing body of evidence indicating that phase angle (PhA) can be used as an indicator of nutritional status, disease prognosis, and mortality risk; however, it is still unknown whether PhA can be used as an explanator of functional capacity and muscle quality in older women. The main purpose of this cross-sectional study was to explore whether PhA is associated with muscle quality and functional capacity in older women, regardless of total and regional body composition. A total of 125 older women-66.7 (4.7) years; 65.6 (10.9) kg body mass; 156.1 (5.2) cm height; 26.9 (4.0) kg/m body mass index-participated in this study. Anthropometric, PhA, body composition (whole-body dual-energy x-ray absorptiometry) and muscle quality (defined as total muscular strength per kilogram of appendicular lean soft tissue) were measured. The functional capacity was assessed by 4 tests: 10-m walk test, rising from sitting position, rising from ventral decubitus position, and rising from a chair and walking around the house. The summing z-scores for the 4 tests was used as a continuous functional capacity score. Linear regression analysis was conducted to test whether PhA is related to the dependent variables (muscle quality and functional capacity), after adjusting for potential covariates. The PhA presented a small-to-moderate relationship with muscle quality (r = 0.27; P < .01) and functional capacity (r = 0.31; P < .01), respectively. These relationships remained significant after adjustment for age, lower limb lean soft tissue, and total fat mass for muscle quality (β= 0.55; P < .01) and functional capacity (β= 1.38; P < .01). Our findings suggest that healthy elderly women with higher values of PhA have a better muscle quality and functionality, regardless of age and body composition.

Effects of a four-exercise resistance training protocol on functional parameters in sedentary elderly women

Aging is related to negative changes in muscle strength and consequent impairment in daily activities. A number of studies have demonstrated that resistance training (RT) is promising for disease prevention and rehabilitation in this population. The objective of the present study was to investigate the effects of a four-exercise RT protocol on the functional parameters of sedentary elderly women. The study sample consisted of 29 elderly women (aged 68.4 ± 5.2 years). Before and after 10 weeks of RT, the following evaluations were performed: 10-m walking, standing up from the sitting position five times, standing up from the sitting position for 30 s, standing up from the ventral decubitus position, standing up from a chair and walking inside the house, and dressing and undress a t-shirt. RT was performed for 10 weeks (2 times per week with a rest interval of 48 h between each session). The protocol consisted of performing leg press at 45°, seated row, leg curl and bench press alternated by segment, performed with a 2-min rest interval between sets and exercises. Significant improvements were found for the following tests: 10-m walking (6.5 ± 1.2 vs. 5.8 ± 1.1 s; p = 0.001), standing up from the sitting position (8.6 ± 2.3 vs. 6.9 ± 1.4 s; p = 0.001), 30-s chair-stand (19.5 ± 5.0 vs. 23.8 ± 5.3 repetitions; p = 0.001), dressing and undressing a t-shirt (9.7 ± 1.8 vs. 9.0 ± 1.9 s; p = 0.025), standing up from the ventral decubitus position (3.6 ± 1.0 vs. 3.3 ± 0.9 s; p = 0.003) of elderly. The four-exercise RT protocol was effective in improving functional parameters in the present study sample.

Respiratory EMG Activity between Subjects with Costo-diaphragmatic, Upper Costal or Mixed Breathing Type

This study aimed to compare the electromyographic (EMG) activity among participants with costo-diaphragmatic, mixed or upper costal breathing type. Forty male were classified according to their breathing type into three groups: costo-diaphragmatic, upper costal and mixed breathing type. EMG activity of diaphragm (DIA), external intercostal (EIC), sternocleidomastoid (SCM) and latissimus dorsi (LAT) muscles was recorded in the dorsal, left lateral and ventral decubitus positions, during the following tasks: 1) quiet breathing, 2) speaking, 3) swallowing, and 4) sustained maximal inspiration. DIA activity was higher in upper costal than in costo-diaphragmatic breathing in all tasks and body positions; was higher in mixed than in costo-diaphragmatic breathing in all tasks in the dorsal and ventral decubitus positions and only in task 4 in the left lateral decubitus position; was similar between upper costal and mixed breathing in all tasks and body positions. EIC activity was significantly higher in mixed than costodiaphragmatic breathing in all tasks in the dorsal decubitus position and only in task 4 in the left lateral decubitus position. SCM activity did not show significant differences. LAT activity was only higher in upper costal than costodiaphragmatic breathing in task 4 in the dorsal decubitus position, in tasks 1, 2 and 4 in the left lateral decubitus position, and in tasks 2, 3 and 4 in the ventral decubitus position. EMG activity of the DIA was the only muscle that allows to differentiate between upper costal or mixed breathing than costo-diaphragmatic in all tasks in the dorsal and ventral decubitus positions.

Effects of resistance training, tai chi chuan and mat pilates on multiple health variables in postmenopausal women

Objective: To compare the effect of two concurrent training methods on the muscle strength, functional autonomy, cardiorespiratory capacity and quality of life (QoL) of postmenopausal women. Material and methods: Thirty-eight volunteers were allocated to two groups: Resistance Training (RT)+Tai Chi Chuan (TC) (n=16), and RT+Mat Pilates (MP) (n=12). For the RT+TC group, RT was linearly periodized twice a week, alternating weekly with TC. In the RT+MP group, RT was non-linearly periodized and alternated with MP in five sessions a week over a period of 16 weeks. Results: Intragroup improvement in QoL was observed for the physical health of RT+MP. The Cooper test showed improvement in the prediction test for both groups. Functional autonomy improved in the following: rising from a ventral decubitus position, rising from a sitting position, walking 10 meters, putting on and taking off a t-shirt (PTTs) and the GDLAM index (GI) in the RT+MP group. For RT+TC, PTTs and GI improved. With respect to strength, there was intragroup improvement in the RT+MP group for all upper limb exercises, knee flexion and 45o leg press. On the other hand, the RT+TC group showed improvements in high shoulder adduction, elbow extension, low shoulder adduction, pec deck pectorals and 45o leg press. Intergroup analysis showed better results in the 10mW test for RT+MP. Conclusion: Both methods showed significant improvements in functional autonomy and muscle strength, as well as maintenance of QoL and cardiorespiratory capacity. Intergroup analysis indicated better results with the RT+MP program.

Maternal Knowledge and Unsafe Baby Sleep Position: A Cross-Sectional Survey in Southern Brazil.

Objective to evaluate women's knowledge about the best baby sleeping position and to identify factors associated with a greater probability of putting infants to sleep in an unsafe position, in Rio Grande, Southern Brazil. Method This is a cross-sectional population-based study that included all women who bore children in 2013 in this municipality. A single, standardized questionnaire was given within 48h after delivery in the only two local maternity hospitals. The outcome was that women reported the lateral and the ventral decubitus as the best sleeping positions for babies. A Chi square test was used for proportions and Poisson regression was used with robust variance adjustment in the multivariate analysis. The prevalence ratio was the measure of effect used. Results We included 2624 women in this study. Of these, 82.1% (95% CI 80.6-83.6) stated that the baby should sleep in the lateral or ventral decubitus positions. 76.4% reported having acquired this knowledge from their mothers and 34.7% were willing to adopt the correct (supine) sleeping position for their child if recommended by doctors. The adjusted analysis showed that the lower the schooling of the mothers and the greater the number of people per bedroom and number of children, the greater the probability of women choosing an unsafe baby sleeping position. Conclusions for Practice This study showed that the percentage of women who are unaware of the correct baby sleeping position is very high, that doctors should be convinced to recommend the supine baby sleeping position, and that campaigns on this subject should also include grandparents as a priority intervention group.

Effects of positioning on the ventral and right lateral decubitus positions in the sleep and wake states of preterm infants: a randomized clinical trial

Effects of positioning on the ventral and right lateral decubitus positions in the sleep and wake states of preterm infants: a randomized clinical trial

Early Physical Therapy Intervention in Infant Hip Dysplasia

The hip dysplasia represents a dysplasic syndrome, characterized by anomalies of articular and periarticular structures, and, as concerns the biomecanic part, reveals the hip instability, capsular laxity, and abnormal acetabulum. An important percent of our country's new-born children suffer from hip dysplasia, and most of their parents don’t know that the role of the physical therapist in this disorder's recovery is as important as the role of the physician. The research hypothesis: By precocious physical therapy intervention, individually applied and structured in accordance with the identified deficit, the nurseling's hip functionality increases and the risks of ulterior complications are eliminated. The action viewed a group of seven newborn babies, immediately after the diagnosis settlement, beginning with the physical therapy intervention. First, the newborn was evaluated, then the physical therapy intervention was structured in accordance with the initial results, which revealed the functional diagnosis. The number of sessions were 3 per week; they were realized by the physical therapist; andin the other days the patient exercised at home. As shown in the tests which were used in the initial evaluation, we can affirm that the newborns, at the end of the therapy, presented a qualitative spontaneous motility, in accordance with the stadium of development specific to the chronological age. Motility was symmetrical on both hips and pelvis in ventral and dorsal decubitus, the weight centre in ventral decubitus position being lowered, to xiphoid appendix, a fact that proves a greater stability of hips, but also an adequate support on forearms. Analysing the child's evolution, it can be seen that the effects of physical therapy weren’t just locale, but they formed a complex of beneficial factors, which contributed to a general muscular equilibration, a fact that was reflected by a general development specific to the chronological age, qualitatively. The parent is the key-element as concerns the identification of the functional limits, since the first days, but also in the ulterior intervention, becoming a member of the work-team, besides the doctor and the physical therapist.

Functional autonomy, bone mineral density (BMD) and serum osteocalcin levels in older female participants of an aquatic exercise program (AAG)

The aim of the present study was to evaluate the effects of an AAG on BMD, osteocalcin and functional autonomy in older women. The sample consisted of eighty-two post-menopausal women with low BMD, randomly divided into two groups: the Aquatic Aerobics Group [AAG; n=42; age: 66.8±4.2years], submitted to two weekly sessions over eight months, and the Control Group (GC; n=42; age: 66.9±3.2years), which did not participate in regular exercise. BMD was measured by Dual Energy X-ray Absorptiometry [DXA] of the lumbar and femur, and serum osteocalcin was measured using electrochemiluminescence. A functional autonomy assessment protocol (GDLAM, 2004) was also applied. Statistical analyses used were repeated measures ANOVA and Tukey's post hoc tests. The results showed a significant improvement in tests following the GDLAM protocol: 10 meters walk (10mw) –p=0.003; rising from a ventral decubitus position (RVDP) – Δ%=0.78, p<0.001; rising from a chair and moving around the house (RCMH) –p<0.001 and autonomy index (AI) –p=0.007, with more favorable results observed in the AAG when compared to the CG. The AAG achieved the best results for BMD; however, no inter or intragroup statistical differences were recorded for total femur –p=0.975 and lumbar L2–L4p=0.597. For serum osteocalcin, intra and intergroup statistical differences of p=0.042 and p=0.027 were observed in the AAG, respectively. This demonstrates that an eight-month aquatic aerobic exercise program can improve functional autonomy and osteocalcin levels, although training did not improve lumbar and total femur BMD in the older women.

Positional Headaches in a Young Brazilian Woman

A 26-year-old Brazil-born woman was hospitalized because of severe headaches that increased in severity when she moved her head. T2-fluid attenuated inversion recovery magnetic resonance imaging showed a cystic-like lesion in the right occipital horn of the lateral ventricle (Figure 1 ). Repeat magnetic resonance imaging of a ventral decubitus position showed that the free-floating cyst shifted anteriolaterally to the base of the lateral ventricle (Figure 2 ) and partially occluded the interventricular foramen (Figure 3). Enzyme-linked immunosorbent assay identified IgG against Taenia solium cysticercosis in cerebrospinal fluid and serum samples. Figure 1. T2-fluid attenuated inversion recovery magnetic resonance imaging (transverse section) of the patient, showing a free-floating Taenia solium cyst (arrow) in the right occipital horn of the lateral ventricle (supine position). Figure 2. Repeat T2-fluid attenuated inversion recovery magnetic resonance imaging of the patient in a prone position, showing a Taenia solium cyst (arrowhead) shifting anteriolaterally to the base of the lateral ventricle. Figure 3. T1-magnetic resonance imaging (sagittal section) of the patient, showing a Taenia solium cyst (*) partially occluding the third ventricle. She underwent uneventful neuroendoscopic removal of a 1.3-cm cyst (Figure 4) that was histologically compatible with a T. solium larval stage infection. Positional headaches, a characteristic feature of spontaneous intracranial hypotension, cluster headaches, and various brain tumors such as colloid cysts, are commonly self-reported by patients with intraventricular neurocysticercosis. Infections with this parasite result in partial and temporary cerebrospinal fluid obstruction of the ventricular system.1 Neuroendoscopic removal has been performed in persons with intraventricular neurocysticercosis and shows minimal perioperative complications,2 such as in our patient. Figure 4. Larval stage of Taenia solium removed from the right lateral ventricle of the patient by neuroendoscopic surgery.

Functional autonomy of elderly women enrolled in a physical activity program

The present study aimed to determine the effects of a physical activity program on the functional autonomy of elderly women. The sample was divided into an experimental group (EG; n = 20; 68.51 ± 5.02 years; BMI = 27.01 ± 4.35) submitted to a physical activity program, and a control group (CG; n = 20; 67.01 ± 3.51 years; BMI = 26.71 ± 5.74). Functional autonomy was assessed using tests from the GDLAM autonomy protocol: 10 meter walk test (10MW), rising from a sitting position (RSP), rising from a ventral decubitus position (RVDP), rising from a chair and moving around the house (RCMH) and putting on and taking off a t-shirt (PTT), after which the autonomy index (AI) was calculated. In the EG, ANOVA showed significant reductions in execution times for the RSP (∆ = -3.92 s; p = 0.0001), RCMH (∆ = -9.61 s; p = 0.0001), 10MW (∆ = -0.94 s; p = 0.038) and RVDP (∆ = -1.15 s; p = 0.036) tests, as well as the AI (∆ = -6.27; p = 0.0001). This was not observed in the CG. Intergroup comparisons demonstrated that execution times for the RSP (∆% = -36.63; p = 0.0001), RCMH (∆% = -20.27; p = 0.0001), 10mW (∆% = -12.54; p = 0.002) and RVDP (∆% = -25.10; p = 0.005) tests and the AI (∆% = -21.37; p = 0.0001) of the EG were shorter than those of the CG. These results indicate that elderly subjects in the EG showed improved performance in activities of daily living after engaging in physical exercise.

The role of Abraham’s VY flap in the treatment of neglected Achilles tendon rupture

Neglected rupture of the Achilles tendon presents a difficult surgical problem because of the retraction of the tendon and consequent loss of its substance. The objective of this study was to evaluate the role of Abraham’s VY tendinous flap in the treatment of such Achilles tendon ruptures. This retrospective study performed over 4 years, from July 2005 to July 2009, examines 16 cases of neglected calcaneal tendon rupture. The mean age of the patients, aged between 30 and 54, was 40 years. The injuries were mainly linked to sporting activity (12 cases). The mean delay between the initial injury and medical treatment was 10 weeks, with a range of 4 to 16 weeks. The diagnosis of rupture was always made entirely on clinical grounds. Surgery was performed in the ventral decubitus position, using a medial para-Achilles tendon approach. The mean loss of substance was estimated at 6 cms, with a range of 5 to 10 cms. The mobilisation of the VY flap facilitated the closure of the gap. In all cases, reinforcement was performed using the tendon of the plantaris muscle. After surgery a non-weight-bearing plaster cast was applied for 6 weeks (in equinus for the first 3 weeks; ankle at right-angles for the last 3 weeks). Thereafter, functional rehabilitation was commenced. Results were assessed according to the clinical and functional criteria. The overall results were excellent in 2 cases (12.5%), good in 12 (75%) and poor in 2 (12.5%). The treatment of neglected rupture of the Achilles tendon is difficult because of the associated substantial loss of tendon substance. However, the involvement of Abraham’s VY flap produces encouraging functional results.

Fortalecimiento muscular, nivel de fuerza muscular y autonomía funcional en una población de mujeres mayores

Introduction This study aimed to evaluate the effects of muscular strengthening on the level of muscular strength in the neurogenic and myogenic phases and functional autonomy in a population of healthy, sedentary, elderly women. Material and methods The sample was composed of 40 women, randomly divided into an experimental group (n=20; 65.62±5.36 years) and a control group (n=20; 71.45±5.72). A protocol of one repetition maximum (1 RM) was employed to evaluate muscular strength and the battery of tests included in the protocol of the Latin American Development Group for Maturity was used to evaluate functional autonomy. For the statistical analysis, the following tests were used: Kruskal-Wallis (experimental group in relation to three moments) followed by Dunn's multiple comparison test; Student's t-test for dependent samples (control group in relation to two moments) and the Mann-Whitney and Student's t-test for independent samples for Δ% (inter-group comparison). Results The results in the experimental group showed a significant increase in the myogenic phase in comparison with the pre-test (p-values: knee extension =0.0001; right knee flexion and left knee flexion=0.0001; straight supine=0.0001; triceps curl=0.0001. Functional autonomy tests showed significant improvements in the experimental group: neurogenic phase (p-values: general autonomy index=0.0089; walking 10 meters=0.0106; standing from a sitting position =0.0005; standing from a ventral decubitus position =0.0061; standing from a sitting position and walking around the house =0.0072; putting on and taking off a shirt =0.0104) and the myogenic phase (p-values: general autonomy index=0.0001; walking 10 meters=0.0005; standing from a sitting position =0.0000; standing from a ventral decubitus position =0.004; standing from a sitting position and walking around the house =0.0059; putting on and taking off a shirt =0.0003). Conclusions Thus, strength training only showed statistically significant differences in the myogenic phase; statistically significant reductions were also found in the time needed to perform functional autonomy tests in the neurogenic phase.

Effects of a program of physical activity on the autonomy level of elderly participants in the program of the family health

Introduction: The objective of this study was to verify the effects of a program of physical activity on the autonomy level of elderly participants of the Program of Family Health. Materials and Methods: The sample was composed by seniors of both sexes, being divided in an experimental group (GE), with mean age of 68.66±5.93 years (n=35), and a control group (GC), with mean age of 69.80±8.05 years (n=35). The functional autonomy was evaluated by the battery of tests of the Group of Latin-American Development for the Maturity (GDLAM), composed of: to walk 10m (C10m), to get up of the seating position (LPS), to get up of the ventral decubitus position (LPDV), to get up of the chair and to move around in the house (LCLC) and the test of to dress and to remove a shirt (VTC). Results: In the pre-test, a weak value of functional autonomy was observed in all the tests, in GE and in GC. After the intervention, it could be noticed in the results of GE a weak value in the LPS test, regular in the LCLC and IG tests and strong in the LPDV, C10m and VTC tests. Discussion: The elderly participants, after the accomplishment of the program of physical activity, obtained improvement in their level of functional autonomy, echoing in a smaller diffi culty for the accomplishment of the activities of the daily life.

PERFORATION OF SIGMOID COLON AFTER EXTRACORPOREAL LITHOTRIPSY

A 32-year-old white man presented with an 8 mm. renoureteral calculus on the left side. He was placed in the ventral decubitus position and underwent ESWL with 3,000, 7 kV. shock waves. The patient had symptoms of nephritic colic on the left side and on day 5 after ESWL he complained of indistinct pain in the left iliac fossa along with 6 episodes of diarrhea in 24 hours. Symptoms improved after receiving analgesics but on day 7 significant clinical worsening was characterized by signs of septicemia and an acute abdomen. An x-ray of the abdomen revealed pneumoperitoneum with the right diaphragmatic cupula and bilateral disappearance of the psoas muscle line (fig. 1). With the diagnostic hypothesis of perforative acute abdomen due to the use of antiinflammatory drugs the patient underwent laparotomy. The surgical finding was diffise pustular peritonitis and a blocked 1 cm. perforation in the distal sigmoid colon in the mesocolic margin. No diverticulum or foreign body was identified in the colon or in the cavity. In the distal urethral projection an intense organized inflammatory process was identified. The patient elected resection of the perforated intestinal segment following terminal colostomy of the sigmoid, rectal stump closure, washing of the abdominal cavity and broad-spectrum antibiotic therapy (fig. 2). On pathological examination a perforative process was observed in a segment of the sigmoid with infiltrating polymor

Effects of ventilation in ventral decubitus position on respiratory mechanics in adult respiratory distress syndrome.

To assess the potential benefits of a period of ventilation in ventral decubitus (VD) on oxygenation and respiratory mechanics in the adult respiratory distress syndrome (ARDS). In a stable condition during baseline ventilation in dorsal decubitus (DD), after 15 min of ventilation in VD and after 10 min of restored DD, the following parameters were studied: arterial blood gas tension, haemodynamics and static respiratory compliance (Crs), evaluated with the rapid airway occlusion technique. The study was completed in the intensive care units of university hospitals as part of the management of the patients studied. Twelve patients (7 males, 5 females, mean age 51.8 +/- 16.6 years) suffering from ARDS of different aetiologies. Before and during each evaluation, the patients were kept under stable haemodynamic and metabolic conditions. The ventilatory setting was kept constant. All the patients were sedated, paralysed and mechanically ventilated. A statistically significant increase in the ratio between the arterial partial pressure of oxygen and fractional inspired oxygen (p < 0.01) was observed between the baseline conditions (mean 123.9 +/- 22.6) and VD (mean 153.0 +/- 16.9), while no statistical significant was noted between baseline conditions and after 10 min of restored DD (mean 141.1 +/- 19.7). A significant increase in Crs (p < 0.001) was observed between baseline conditions (mean 42 +/- 10.1) and VD (mean 48.8 +/- 9.6) and between baseline conditions and restored DD (mean 44.7 +/- 10.6). Two patients were considered nonresponders. All the patients were haemodynamically stable. No side effects were noted. We observed an increase in oxygenation and Crs when the patients were turned from the supine to the prone position with the upper thorax and pelvis supported.