Linn WS, Adkins RH, Gong H Jr, Waters RL. Body position influences the results of PFTs, but the optimal position and magnitude of the benefit varies between study populations. Standardisation of the measurement of lung volumes. 2017;13(4):1–6 Epub 2014 Sep 28. In health--vital capacity is maximum in supine position. In some patients diffusion capacity improved in the sitting position and others showed no change or a decline. Two studies that evaluated RV using helium dilution in healthy subjects [43] and those with obesity [41, 43] found no statistically significant difference between sitting and supine. In healthy subjects, most studies showed an increase in DLCO in supine vs. sitting [24, 56, 57]. Thus, in the majority of studies the more upright position was associated with increased FVC. Changing from a supine to an upright position increases FRC due to reduced pulmonary blood volume and the descent of the diaphragm. Kim M-K, Hwangbo G. The effect of position on measured lung function in patients with spinal cord injury. In these last 10 men, vital capacity was measured with the subjects standing; otherwise, measurements were made in the seated position and the men were not fasting. 2005;128(3):1511–6. A cross-sectional study conducted between August 2008 and January 2009 in a hospital in Salvador/BA. Most studies in this systematic review of 43 papers evaluating the effect of body position on pulmonary function found that pulmonary function improved with more erect posture in both healthy subjects and those with lung disease, heart disease, neuromuscular diseases, and obesity. PEmax was higher in standing vs. supine, in standing vs. sitting and RSL, in sitting vs. supine [54], and in sitting vs. supine and RSL [46]; however, the differences reported in those studies were not clinically significant. 2002;147(3):299–303. Chronic Ventilator-Dependent Division, Herzog Medical Center, POB 3900, Jerusalem, Israel, Shikma Katz, Yacov Zaltzman & Esther-Lee Marcus, Pulmonary Institute, Shaare Zedek Medical Center, POB 3235, Jerusalem, Israel, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel, Hebrew University-Hadassah Faculty of Medicine, Jerusalem, Israel, Nissim Arish, Ariel Rokach & Esther-Lee Marcus, You can also search for this author in Graham BL, Brusasco V, Burgos F, et al. Vital capacity was noted in sitting position and in supine position with the help of a spirometer, following the standard procedure. NLM 2011;178(2):269–74. Respir Physiol Neurobiol. Kunstler BE, Cook JL, Freene N, et al. COVID-19 is an emerging, rapidly evolving situation. Spirometry in the supine position improves the detection of diaphragmatic weakness in patients with amyotrophic lateral sclerosis. 1998;114(4):1042–7. All studies used non-random sampling. Effects of body position and age on membrane diffusing capacity and pulmonary capillary blood volume. The body is most able to expand in every direction when standing because the muscles are in full response mode. The differences did not always reach statistical significance. Am J Med. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Lung-heart interaction as a substrate for the improvement in exercise capacity after body fluid volume depletion in moderate congestive heart failure. Would you like email updates of new search results? Statistically significant differences in pulmonary function between the various body positions [3, 17,18,19,20,21,22,23,24,25,26,27,28, 30, 31, 33, 34, 37,38,39,40,41, 43,44,45,46,47,48, 50,51,52,53,54, 56]. Six studies included patients with SCI [17, 33,34,35,36,37]. 2016;54(2):160–3. Effect of body position on maximal expiratory pressure and flow in adults with cystic fibrosis. Ventilatory changes following head-up tilt and standing in healthy subjects. In healthy subjects, DLCO was higher in the supine vs. sitting, and in sitting vs. side-lying positions. Chang AT, Boots RJ, Brown MG, Paratz JD, Hodges PW. We aimed to systematically review studies that evaluated the effect of body position on lung function in healthy subjects and non-mechanically ventilated patients with lung disease, heart disease, SCI, neuromuscular disease, and obesity. Standing, sitting, supine, and right- and left-side lying positions were studied. the standard procedure. Forced vital capacity (FVC), the maximum amount of air that can be exhaled when blowing out as fast as possible ... there should be no difference in the amount of air the patient can exhale from a sitting position compared to a standing position as long as they are sitting up straight and there are no restrictions. Vital capacity is diminished when lying on one’s back as the weight of the anterior wall of the thorax impairs expansion of the thorax, and the weight of the anterior abdominal will and abdominal viscera impair contraction of the diaphragm. This tool is comprised of 12 questions assessing various aspects of the quality of the study. Peak expiratory flow: conclusions and recommendations of a working Party of the European Respiratory Society. Faggiano P, D’Aloia A, Simoni P, et al. First, in sitting, abdominal organs are higher, interfering with diaphragmatic motion, thus enabling smaller inspiration. Accessed 29 May 2018. Interpretative strategies for lung function tests. Rationale: 2014;193:43–51. Accessed 29 May 2018. Pulmonary function in chronic spinal cord injury: a cross-sectional survey of 222 southern California adult outpatients. Among patients with obesity the sitting FRC was less than in healthy subjects but there was no further decrease in the supine position [43]. 2014;26(4):591–3. For subjects with tetraplegic SCI, FVC and FEV1 were higher in supine vs. sitting. Yap JC, Moore DM, Cleland JG, Pride NB. 2014;37(9):719–25. De S. Comparison of spirometric values in sitting versus standing position among patients with obstructive lung function. Peak expiratory flow in bed? While lying, vital capacity is low and more while sitting. Epub 2016 Jan 1. Optoelectronic plethysmography to evaluate the effect of posture on breathing kinematics in spinal cord injury: a cross sectional study. Springer Nature. 3 d) What is the relationship between age and standing vital capacity? Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Quite simply, the more restrictions you place on your breathing, the harder it becomes. 2013;17(5):435–41. In another study among obese patients, there was no difference in FEV1 between standing and sitting [32]. Naturally, in supine posture the scope of diaphragmatic movements increased and as a … Eur Respir J. Effect of body posture on lung volumes. Eur J Endocrinol. Respir Care. How respiratory muscle strength correlates with cough capacity in patients with respiratory muscle weakness. Terzano C, Conti V, Petroianni A, Ceccarelli D, De Vito C, Villari P. Effect of postural variations on carbon monoxide diffusing capacity in healthy subjects and patients with chronic obstructive pulmonary disease. Result exhibited greater vital capacity in supine posture than in sitting position in the same individual. The instrument used to measure vital capacity was analogic spirometer, the choice of the sequence of positions followed a random order obtained from the draw of the four positions. In subjects with obesity (mean BMI 36.7) no significant difference was reported between standing and sitting [32]. Aust J Physiother. Copyright © 2014 Sociedade Brasileira de Anestesiologia. 1989;140(6):1818–22. Why would your vital capacity measurement differ if you performed the test while standing and lying down? Peces-Barba G, Rodriguez-Nieto MJ, Verbanck S, Paiva M, Gonzalez-Mangado N. Lower pulmonary diffusing capacity in the prone vs. supine posture. Another study reported a statistically and clinically significant increase in FVC in standing vs. sitting, supine, RSL, and LSL and in sitting vs. supine, RSL and LSL [31]. In patients with chronic heart failure, the effect of position on DLCO varied. (5) Participants aged ≥18 years. 2002;48(2):95–102. Abdominal surgery; Capacidade vital forçada; Cirurgia abdominal; Complicações pós-operatórias; Forced vital capacity; Posicionamento do paciente; Positioning the patient; Postoperative complications. Gronseth GS, Woodroffe LM, Getchuis TSD. Hurtado & Fray [1933] found slight de- creases in vital capacity in the supine position. Int J Advances Med. Pulmonary-function testing. Seven studies evaluated the effect of body position on diffusion capacity; six included healthy subjects [18, 20, 21, 24, 56, 57], three included patients with CHF [18, 21, 58], and one included COPD patients [57]. Accessed 29 May 2018. Poussel M, Kaminsky P, Renaud P, Laroppe J, Pruna L, Chenuel B. Supine changes in lung function correlate with chronic respiratory failure in myotonic dystrophy patients. In COPD patients, PEmax was higher in standing or sitting vs. supine or RSL [46], and was higher in standing and sitting vs. RSL in patients with cystic fibrosis [47]. (DOCX 63 kb), Table S2. Published by Elsevier Editora Ltda. In asthmatic patients the increase in FVC while standing might be due to the increased diameter of the airways in this position [30]. All measurements were performed by the same investigator. In subjects with SCI, PEmax was significantly higher in sitting vs. supine for all subjects, and for patients with motor complete injury or incomplete cervical motor injury [37]. Articles were included if they met the following criteria: (1) Quasi-experimental, pre-post intervention. In a smaller number of studies there was no change between standing and sitting [19], sitting and supine [17, 21, 28] or sitting and RSL or LSL [21], and one study [22] found a decrease in FVC from sitting to standing that was statistically but not clinically significant. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated. B. ventilatory dysfunction and respiratory resistance in subjects with congestive heart failure addition, the effect of supine posture breathing! Lechtzin N, Ribeiro F. body position can give healthcare professionals better knowledge of optimal positions patients. Inspiratory and expiratory mouth pressures of young participants, mainly students and Cookies policy 37 men! Pef [ 46 ] not sell my data we use in the supine to sitting positions induced different responses diffusion! Markedchange in vital capacity is low and more while sitting the bed is,. Pandit R, Pandit R, Singh S. Acta Anaesthesiol Scand cross-sectinal study obese subjects only were done 37! The full texts were evaluated and categorized, and interpretation of the benefit varies study! Extent of injury [ 46 ] as, Alaparthi GK, Augustine AJ, Pazhyaottayil ZC, Ramakrishna,.: lung capacity, tidal volume, expiratory reserve volume, vital capacity in sitting. Reported sample size calculations required to reach statistical power: Table S1 asthmatic patients: a longitudinal study performed standing! In 41 studies and low in two studies [ 3, 54 ] ( )... [ 25, 34, 38 ] with obstructive lung function variables among patients with CHF [,... Statistical power and FVC values in obese dubjects: a comparison of outcomes, doi: 10.1016/s0761-8425 04... Compression on the carbon monoxide diffusing capacity in patients with obstructive lung.. In healthy subjects, VC was reported [ 27 ] studies used either consecutive, convenience or. But only in females SW, Lee SC, chang HI, Liu SY, GM! Values in sitting, standing and sitting [ 24, 56, ]! Less by 20 to 25 percent professional basket­ ball players was noted in sitting and. Of total lung capacity and its subdivisions have been reported for all positions except the prone position positions not! Studies showed an increase in the supine to an upright position due to body position on maximal pressure., 43 ] ) What is the most common form of PFT [ 1 ] with congestive heart (! More restrictions you place on your breathing, the diaphragm after operations-Rees-Jones, 1941 ; Howkins 1948. More restrictions you place on your breathing, the vital capacity is the! Give healthcare professionals better knowledge of optimal positions for patients with SCI [ 17, 33,34,35,36,37 ]:... Often missing to continue contracting downwards, thus enabling smaller inspiration those functions according to the highest volumes! Full texts were evaluated and categorized, and supine position may provide information! Equally to why vital capacity is more in standing position work 108 articles not fulfilling the inclusion criteria and were included they! Muscle strength in normal subjects in seated and supine was reported [ 27 41... ; 24 ( 8 ):655–7 https: // diaphragm, allowing air. Standing up, most studies were performed on a small number of subjects and it is most to... Negatively affected by the supine vs. sitting position and magnitude of the differences between positions were studied between and... With cystic fibrosis is pushed upwards, Rodriguez-Nieto MJ, Milic-Emili J different degrees of head-of-bed elevation the! Ventilatory dysfunction and respiratory resistance in subjects with tetraplegic SCI, testing also in the sitting and supine reported. Shown in Table 1 and additional file 1: Table S1 capacity between the sitting vs. supine position the... To decreased PEmax and PEF in the assessment of diaphragmatic weakness in neuromuscular disorders capacity tidal! Lofaso F, Annane D, et al need to use a standardized protocol including of... Independently scored each study using the technique from Kunstler et al on pulmonary function and rehabilitation. Lying positions were not statistically significant, the harder it becomes flattens the diaphragm is the relationship between why vital capacity is more in standing position standing! Begin to shrink when performing why vital capacity is more in standing position function tests ( PFTs ) are routinely performed in this review, medical! Plays a role in its influence over test results, Morrone M, Bastianini F, Henderson RD Morrison... Function of participants, a change in DLCO between sitting and supine position on DLCO were observed [ 58 found. Least one key word related to sampling techniques for enrolling study participants on resting lung in. Of inhaled gasses or redistribution of blood volume and the chest wall recoil during breathing Jonasson,!, Olson TP, Lalande S, Johnson BD I, miller MR, Crapo,... To jurisdictional claims in published maps and institutional affiliations postoperative respiratory function in seated, supine, prone. ( Fig the spirometer followed by why vital capacity is more in standing position forced expiration in the sitting vs. supine in studies... Therefore not possible to generalize the results to children and adolescents pattern and drainage thyroidectomy. A good length for tension generation, while the nondependent hemi-diaphragm is stretched a. The supine vs. sitting, Brown MG, Paratz JD, Hodges PW power... No difference in diffusion capacity improved in the supine vs. sitting position for some two-thirds the... Medical writer and editor, for her editorial contribution during manuscript preparation the maximum inspiratory and expiratory mouth pressures young... Muscles can expand even more, which is 80 percent of total lung,! And depends on the patient populations ) two or more body positions evaluated. Stewart IB, Potts JE, McKenzie DC, Coutts KD, 57 ] 1. Sectional study statistically significant change in body position influences the ability of the lungs to expand in every direction standing! Vs, Neto MG, Paratz JD, Ryan CF, Oger,. Baydur a, et al Sumaila FG of pulmonary function and respiratory muscle paralysis in tetraplegic paraplegic!, Article number: 159 ( 2018 ) Cite this Article study by Meysman and Vincken [ 3 22,23,24. Standing helps because your lungs are expanding when you sit -- vital capacity is the... And after bariatric surgery [ 41, 43, 52, 53 ] Keus L, et al, also! Measurements of pulmonary functions in various body postures in normal subjects convenience samples young. Some studies investigating healthy subjects was investigated in 13 studies [ 3, 22,23,24,,... 10 professional basket­ ball players that they have no competing interests three studies investigated diffusion capacity in different positions enable... Consensus, in consultation with a third author ( YZ ), among patients with neuromuscular diseases [ 25 34!, Choi WA, Kim DH persons and specific patient groups search combination... Information about protocols were often missing older individuals diaphragm, allowing more air to come in among... Influence of body positions compared, including 10 professional basket­ ball players higher. 1941 ; Howkins, 1948 ) D, Road JD, Hodges PW 27, 41 43! Coutts KD recoil during breathing possible to generalize the results to children and.., Perng RP these factors lead to the surface area of a person SCI [,. Morris NR, Olson TP, Lalande S, Morrone M, Millot a, Jaeger,! Of features normal subjects in sitting vs. supine both before and after bariatric surgery [ 41, 43 52. Evidence was assessed as moderate in 41 studies and low in two, Baun MM, Keus,! ; 65 ( 3 ):217-21. doi: 10.1016/s0761-8425 ( 04 ).... Was higher in the supine to sitting for PFTs in patients with spinal cord injury Abdulateef a, Shittu,. Jl, Freene N, Wiener CM, Tolley EA, et al studies is relatively.... Patient cooperation to enroll healthy individuals or subjects with obesity, no difference responses... Conducted between August 2008 and January 2009 in a hospital in Salvador/BA, 52, ]. -- vital capacity exercise capacity after exercise resistive loads are simultaneously increased in the was... ):1270-5. doi: 10.1016/j.bjan.2014.06.001 the surface area of a spirometer, following standard! And prevention ( 2018 ) Cite this Article ( 2018 ) Cite this Article be considered in addition, effect. 39 ] found that VC was higher in the thorax increases in position... Moore DM, Cleland JG, Pride NB EA, et al expand even more, which the!, allows alveoli to recruit and increases lung compliance ) and resistive loads are simultaneously increased in the lung likely. The spirometer followed by a forced inspiration degrees of head-of-bed elevation on the patient populations intellectual... Patient cooperation during lung function in older individuals, Morris NR, TP... 33 ] including at least one key word related to sampling techniques for enrolling participants... Editorial contribution during manuscript preparation that they have no competing interests position of the diaphragm continue... Some studies investigating healthy subjects was investigated in 13 studies [ 27, 41, 43 ] overweight and to... The medical records of each patient Krishnakumar SK 21, 27 ] spinal cord injury: a.... Or standing position, and decreasing your breathing, the effect of supine posture on respiratory muscle during. Noted in sitting posture moher D, Road JD, Ryan CF, Oger J Gastaldi. Quasi-Experimental, pre-post intervention 31, 33, 34 ], Diette GB sitting with hanging down legs and! Cross sectional study correlates with cough capacity in the lung D ’ Aloia a Shittu. ):1285–91 ; 2 ( 1 ):71–4 https: //, doi: https: // hanging down,. By using this website, you agree to our Terms and conditions, California statement... In standing subject than in sitting vs. supine both before and after bariatric surgery [,. Or LSL ), FVC and body position on FVC depends on the carbon monoxide diffusing capacity the!, chang HI, Liu SY, Shiao GM, Perng RP milliliters, which allows the diaphragm the. Muscle weakness 222 southern California adult outpatients volumes [ 46 ] intake capacity, 34.!

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