The metabolic cost of maintaining five fixed body positions
McCarthy, Rosemary T.
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It was the purpose of this study to evaluate the metabolic cost of maintaining 5 fixed body positions commonly employed for patients in hospital beds. In conjunction with the study or metabolic cost observations were also made of the effects or position on selected circulatory and respiratory responses. These included heart rate, respiratory rate, minute ventilation, tidal volume, vital capacity and oxygen pulse. The positions studied were: (1) supine, flat in bed with a small pillow under the head and shoulders; (2) prone, flat in bed on abdomen with a small-pillow under the shoulders and head, head turned to the side; (3) left lateral, flat in bed on left side with the right leg flexed and a small pillow under the head; (4) right lateral, flat in bed on right side with the left leg flexed and a small pillow under the head; (5) sitting, on back with the head or the bed elevated 30°, the root or the bed flat and a small pillow under the head and shoulders. Five subjects were selected for homogeneity as to height, weight, age, sex, and general physical condition. Each or the 5 subjects was studied in the 5 positions, by the methods or open circuit indirect calorimetry, a total or 5 times. All gas samples were analyzed in duplicate on the Scholander 0.5 cc. Micro Analyzer. The order and sequence of positions was randomized by a 5x5 Latin Square design and the subjects were assigned to a particular Latin Square plan randomly. The data were analyzed by the technique of Analysis of Variance and Considered significant at the 5% level and highly significant at the 1% level. The null hypothesis is that no difference exists in the metabolic cost of maintaining the 5 fixed positions. The subjects were young women between the ages of 20 to 29. All were in good health; menstrual history was essentially normal; none was active in sports activity. Prior to acceptance as a subject the individaal was interviewed and a Health-Activity history obtained. At that time she received preliminary instructions in the experimental procedure. The study was carried out in a screened off portion of a teaching laboratory on days when classes were not in session. This laboratory is away from the main activity centers of the building and a portable radio was used to provide a soft musical background to further minimize traffic noise. The data collection period extended from March to June, 1967. During this time the temperature or the laboratory was maintained between 22-23°C. to prevent chilling of the subjects. Analysis of variance tests confirmed a significant difference between individuals (P < O.O1) for all parameters not including energy cost when expressed as kilocalories/ meter^2/minute where the difference was not significant. No significant differences ware exhibited between positions except in heart rate. Heart rate displayed a difference between positions significant at the 5% level (P(0.05). Further analysis by means of the "Duncan Test for Multiple Comparisons" showed this difference to be due to differences between the supine and sitting and between the left lateral and sitting position. Minute ventilation was significantly lower in the supine and right lateral positions than the other three positions tested. In keeping with these findings it was necessary to accept the null hypothesis that no differences exist in the metabolic cost of maintaining the 5 fixed positions studied. Generalization of the data is limited by the size of the sample.
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