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Preliminary Study of The Periodic Limb Movement Disorder Following Nasal CPAP : Is It Associated With Supine-Sleeping Position? (지속적 양압술과 수면중 주기적 사지운동 장애의 관계에 대한 예비적 연구 : 앙와위가 주기적 사지운동 장애와 관련되는가?)

  • Yang, Chang-Kook;Clerk, Alex A
    • Sleep Medicine and Psychophysiology
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    • v.4 no.2
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    • pp.164-171
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    • 1997
  • Introduction : Periodic limb movement disorder (PLMD) is shown to common in patients with OSA and may become evident or worsened when treated with nasal continuous positive airway pressure (CPAP). Whether this is due to im proved sleep continuity. adverse nocturnal body positioning, uncovered by CPAP, or due to the CPAP stimulus is still debat-ed. We hypothesized that the increase in PLM activity following CPAP is associated with more supine-sleeping tendencies when being treated with CPAP. In the present work, we compared differences in the PLMD index (PLMI) and sleeping position of patients with sleep disordered breathing before and after CPAP treatment. Method : We studied 16 patients (mean age 46 yr, 9M, 7F) with OSA (11 patients) or UARS (5 patients) who either had PLMD on initial polysomnogram (baseline PSG) or on nasal CPAP trial (CPAP PSG). All periodic leg movements were scored on anterior tibialis EMG during sleep according to standard criteria (net duration; 0.5-5.0 seconds, intervals; 4-90 seconds. 4 consecutive movements). Paired t-tests compared PLMD index (PLMI), PLMD-related arousal index (PLMD-ArI), respiratory disturbance index (RDI), and supine sleeping position spent with baseline PSG and CPAP PSG. Results : Ten patients (63%) on baseline PSG and fifteen patients (94%) on CPAP PSG had documented PLMD ($PLMI{\ge}5$) respectively with significant increase on CPAP PSG(p<0.05). Ten patients showed the emergence (6/10 patients) or substantial worsening (4/10 patients) of PLMD during CPAP trial. Mean CPAP pressure was $7.6{\pm}1.8\;cmH_2O$. PLMI tended to increase from baseline PSG to CPAP PSG, and significantly increase when excluding 2 outlier (baseline PSG, $19.0{\pm}25.8/hr$ vs CPAP PSG, $29.9{\pm}12.5/hr$, p<0.1). PLMD-ArI showed no significant change, but a significant decrease was detected when excluding 2 outlier (p<0.1). There was no significant sleeping positional difference (supine vs non-supine) on baseline PSG, but significantly more supine position (supine vs non-supine, p<0.05) on CPAP PSG. There was no significant difference in PLMI during supine-sleeping and nonsupine-sleeping position on both of baseline PSG and CPAP PSG. There was also no significant difference in PLMI during supine-sleeping position between baseline PSG and CPAP PSG. With nasal CPAP, there was a highly significant reduction in the RDI (baseline PSG, $14.1{\pm}21.3/hr$ vs CPAP PSG, $2.7{\pm}3.9/hr$, p<0.05). Conclusion : This preliminary data confirms previous findings that CPAP is a very effective treatment for OSA, and that PLMD is developed or worsened with treatment by CPAP. This data also indicates that supine-sleeping position is more common when being treated with CPAP. However, there was no clear evidence that supine position is the causal factor of increased PLMD with CPAP. It is, however, suggested that the relative movement limitation induced by CPAP treatment could be a contributory factor of PLMD.

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The Comparison of Sleep Characteristics According to the Sleep Positions in Healthy Newborns (정상 신생아의 체위에 따른 수면양상 및 행동변화 비교)

  • Lee Ae Ran;Ahn Hae Young;Lee Jong Soon
    • Child Health Nursing Research
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    • v.5 no.3
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    • pp.281-291
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    • 1999
  • The purpose of this study was to compare the sleep characteristics between the prone and the supine position in healthy newborns. The 48 newborns were observed in the prone position and the supine position respectively on the 2nd day after birth. The data were collected from January to May, 1999. The state of a newborn was classified and categorized to 6 states (deep sleep. light sleep, drowsy, quiet alert, active alert, crying) by Barnard. The movements of eyes, face and extremities, pulse and arterial oxygen were observed and recorded continuously from the start of sleep after feeding until the time of being woken for the next feeding by a trained nurse The data was analyzed by using paired t-test. The results of this study were as follows; 1. There was no significant difference in the length of sleeping time between the prone and the supine position. 2. There was no significant difference in the length and frequencies of each states(deep sleep, light sleep, drowsy, quiet alert, active alert, crying) between the prone and the supine position But the frequency of light sleep in the supine position was significantly higher than that of the prone position. 3 There was no significant difference In the numbers or eyes movements between the prone and the supine sleep position. But the amount of facial and extremity movement in the supine position was significantly higher than those in the prone position 4. There was no significant difference in the arterial oxygen content between the prone and the supine sleep position. 5. There was no significant difference in the heart rates between the prone and the supine sleep position. The above results indicated that the newborns in the prone Position moved less and slept deeper than those in the supine position. though there was no difference in the length of sleep or arterial oxygen content between the prone and the supine sleep Position. But. Nurses and mothers should consider the relationship between the sleep Position and SIDS suggested by previous researches. The infant's 'awakening' during sleep is a normal process and rather valuable because it can provide an opportunity to promote a stronger relationship between mother and baby. So, It is suggested that the supine sleep position is better than the prone sleep position for infants.

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Effect of Changing positions on aged circulation (체위 변화가 노인들의 순환에 미치는 영향에 관한 연구)

  • Hong K.P.;Lee S.H.;Eun Y.;Kang H.Y.
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.2 no.2
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    • pp.239-251
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    • 1995
  • The prevalence of postural hypotension among over 65 year old men is 10-30%. The postural hypotension commonly causes the discomfort such as dizziness, irritability or fainting spell, and for the result it diminishes the quality of the life of aged. Therefore the assessment and intervention of postural hypotension during changing position is very important. The purpose of this study is to investigate the effect of changing position from supine to standing upright, from supine through left lateral to standing upright, from supine through sitting to standing upright of aged. The results obtained are as follows : 1. The average systolic blood pressure of normotension group is $132.68{\pm}16.04mmHg$ at supine position. The average diastolic blood pressure of normotension group is $80.72{\pm}9.82mmHg$ at supine position. The average systolic blood pressure of hypertension group is $153.92{\pm}20.12mmHg$ at supine position. The average diastolic blood pressure of hypertension group is $93.74{\pm}15.53mmHg$ at supine position. 2. There is no significant difference of blood pressure after three different procedures as mentioned above from supine to standing upright. 3. The prevalence of postural hypotension at standing upright is 13.5% which is 18.8% of the hypertension group and 9.4% of the normotension group. There is statistical difference of the prevalence of postural hypotension between hypertension group and normotension group.

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A Study on the Effects of Position Change on the Liver Shape on Radioisotope Scan (간(肝)스캔상(上) 체위변동(體位變動)에 따른 간형태(肝形態) 변화(變化)에 대(對)한 고찰(考察))

  • Hong, Kee-Suk;Choi, Du-Hyok;Yang, Young-Tae;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.16 no.1
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    • pp.49-54
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    • 1982
  • For this study, the authors obtained and examined anterior views of the liver and spleen in two different positions, upright and supine, of 39 normal subjects and 20 patients with hepaticpathology by means of $^{99m}Tc-colloid$ and gamma camera. This examination confirms the following findings. In general, it is shown, left lobe of the liver in upright position becomes longer in height than in supine position, while the distance between lateral margin of the liver and that of the spleen becomes father in with in supine position than in upright position. The upper margin of liver moves more downward in upright position than in supine. It is noticeable that as for 5 cases with severe chronic liver disease, there is minimal alteration of the liver shape between in two positions. The comparison of the both positions for the better liver scan shows the following finding. Prominent caudate and/or left lobe are marked in the upright position in 16 cases out of the total 59, while none is found in the supine. The false cold area in lower part of the liver disappears in 7 cases in the upright position, while only one shows the disappeance of the false cold area in the supine. Left liver margin due to close contact of spleen is blurred in 3 cases in the upright position. In total 23 cases out of 59 support that the upright position is better for the liver scan, while only 4 cases support the supine position is better. These findings support two assumptions. One is that upright view can bo expected more improved resoluton than supine view for liver scan. Second is that minimal change of the liver shape in both views indicate the serious abnormality in the liver.

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Studies on vital capacity in a smoker (흡연자의 폐활량에 관한 조사)

  • Hong, Wan-Sung;Kim, Gi-Won
    • The Journal of Korean Physical Therapy
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    • v.13 no.2
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    • pp.347-357
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    • 2001
  • It is well known that there is an adverse effect of long-term cigarette smoking on pulmonary function. Therefor we attempted to consider the vital capacity for position changes in a smokers and non-smokers. The pulmonary functions on sitting and supine positions were measured in 28 young healthy students fer the change of vital capacity. Forced expiratory flow-volume curve were performed sitting position and supine position and smoking. The results were summarized as follows; 1) The spirometric values(VC, FVC, FEV$_{1}$) were progressively decreased from sitting position to 30minutes after supine position in a non-smoking group(p<.05). 2) The VC, FVC. FEV$_{1}$, FEF25 ${\sim}$ 75% were decreased from sitting position to 30minutes after supine position in a smoking group(p< .01). The PEF and FEF25% were decreased from supine position to after smoking(p< .05). 3) non-smoking group and smoking group not showed significant change(p> .05). But the spirometric values were more decreased nonsmokers than smokers.

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Analysis of Intra-abdominal Pressure Changes on Daily Activities for Ambulatory Bladder function monitoring (Ambulatory 방광기능 모니터링을 위한 일상 생활 중 복강 내압의 변화 분석)

  • Song, C.G.;Kim, G.S.;Yang, Y.G.;Seo, J.H.
    • Proceedings of the KIEE Conference
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    • 2003.11c
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    • pp.943-945
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    • 2003
  • This study is to evaluate the change of intra-abdominal pressure related with intravesical and intrarectal pressure in patients with spinal cord injury according to daily activities and postural changes which make the abdominal pressure elevated. The intravesical and the intrarectal pressures were obtained during patient's speech, sneeze, cough, valsalva and various postural changes with supine to decubitus, derubitus to supine, supine to sit, and sit to supine according to empty and full bladders, respectively. The order of higher intravesical and intrarectal pressure rise during various maneuvers were valsalva, sneeze, supine to sit and cough, respectively. Higher correlation coefficient between the intrvesical and intrarectal pressures were noted during cough, sneeze, valsalva and supine to sit in empty bladder than full one. These results demonstrated that the intravesical and intrarectal pressures were influenced by daily activities and postural changes of increasing the intra-abdominal pressure. The intrarectal pressures according to daily activities such as cough, sneeze, valsalva and postural change were significantly related with intravesical pressures.

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The Effect of Arm Extension Patterns of PNF on Muscle Activity of Opposite Lower Extremity (고유수용성신경근촉진법의 팔 폄 패턴이 반대편 다리의 근활성도에 미치는 영향)

  • Kim, Hee-Gwon;Kim, Gyeon;Choi, Jae-Won;Chung, Hyun-Ae
    • PNF and Movement
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    • v.12 no.1
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    • pp.7-12
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    • 2014
  • Purpose: The purpose of this study is to analyze the effect of the arm extension pattern of proprioceptive exercise program on the muscle activity of the opposite lower extremity. Methods: In this study, electromyogram MP150(Biopac system, USA) was applied to 20 healthy male subjects. Arm extension-adduction-internal rotation pattern was applied within initial, mid and end range in sling position and supine position for measurement. And the effect on the activity of rectus femoris and tibialis anterior muscle of the opposite lower extremity was compared and analyzed. Results: The results of this study were summarized as follows: First, there was a statistically significant difference of the activity of the tibialis anterior muscle within the Initial range in sling position and supine position(P<0.05). Second, there was a statistically significant difference of the activity of the tibialis anterior muscle within the end range in sling position and supine position(P<0.05). Conclusion: Rectus femoris and tibialis anterior muscles shows the higher activity in the supine position than in the sling position. Therefore, the supine position is more appropriate than the sling position to make irradiation on lower extremity muscle with the extension pattern.

Comparing Dynamic Control Ratio and Lower Extremity Muscle Activity during Eccentric Hamstring Exercises

  • Dae-Woo Jeong;Du-Jin Park
    • PNF and Movement
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    • v.21 no.3
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    • pp.291-298
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    • 2023
  • Purpose: This study aimed to suggest an effective exercise for treating anterior cruciate ligament (ACL) and hamstring injuries based on the dynamic control ratio (DCR) for the hamstring and quadriceps during eccentric hamstring exercises. Methods: Twenty-four healthy participants participated in this study. The participants performed three eccentric hamstring exercises, including the Nordic exercise, the supine leg curl, and single-leg deadlifts. During the eccentric hamstring exercises, the vastus medialis oblique (VMO), vastus lateralis (VL), biceps femoris (BF), and semitendinosus (ST) were measured using surface electromyography. Results: The DCR was significantly lower during the supine leg curl and single-leg deadlift than during the Nordic exercise (p < 0.05). The activity of the VMO and VL was significantly greater during the supine leg curl than during the Nordic exercise and the single-leg deadlift (p < 0.05). VL activity was significantly higher during the single-leg deadlift than during the Nordic exercise (p < 0.05). ST activity was significantly higher during the supine leg curl and Nordic exercise than during the single-leg deadlift (p < 0.05). BF activity was significantly higher during the supine leg curl than during the Nordic exercise and single-leg deadlift (p < 0.05). Finally, the BF showed significantly higher activity during the Nordic exercise compared to during the single-leg deadlift (p < 0.05). Conclusion: Based on the DCR ratio and quadriceps activity, the supine leg curl should be introduced early in rehabilitation for ACL injuries.

Comparison between Group I in Which Non-Supine Apnea-Hypopnea Index ≥5 and Group II in Which Non-Supine Apnea-Hypopnea Index<5 in Patients with Positional Sleep Apnea (체위성 폐쇄성 수면무호흡증 환자에서 비앙와위 무호흡-저호흡 지수가 5 이상과 5 미만인 집단간의 비교)

  • Park, Won Il;Jung, Hye Won;Joo, Joon Bum;Cho, Ju Eun;Kim, Jong Yang
    • Sleep Medicine and Psychophysiology
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    • v.20 no.1
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    • pp.31-34
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    • 2013
  • Objectives: The aim of this study was to evaluate the differences in patients with positional dependent sleep apnea according to their non-supine apnea-hypopnea index (AHI, ${\geq}5$ vs. <5). Methods: 92 patients with positional sleep apnea were evaluated. The patients were divided into two groups : group I was non-supine AHI having ${\geq}5$ ; group II was non-supine AHI having less than 5. Statistical analysis was performed to find the difference between two groups. Results: In 92 patients, the number of group I patients was 11 (12%) and the number of group II patients was 81 (88%). In the severe AHI group, percentage of group I was dominated (70%) and showing a significant difference compared with the mild and moderate AHI groups (p<.05). In the severe body mass index (BMI) group, percentage of group I was dominated (54.5%) and showing a significant difference compared with of the mild and moderate BMI groups (p<.05). The percentage of group I was significantly higher than group II (p<.05) in the AHI, supine AHI, non-supine AHI and snore time. Conclusions: In patients with positional sleep apnea, severe OSA and high BMI are more common in patients with non-supine AHI${\geq}5$ than non-supine AHI<5.

The effect of posture on the human thermoregulatory response (인체의 자세가 체온조절에 미치는 영향)

  • Shim, Hyun Sup;Choi, Jeong Wha
    • Journal of the Korean Society of Clothing and Textiles
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    • v.17 no.3
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    • pp.415-427
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    • 1993
  • The purpose of this study was to evaluate the thermoregulatory responses to postures under different environmental conditions and to obtain the basal information for standard clothing weight, indoor climates, and working condition. Two adult female (22.5yrs, 46kg) were participated in this study. The experimental conditions were divided into three groups ; 1) comfort($27{\pm}1^{\circ}C$, $60{\pm}10%$), 2) hot($34{\pm}1^{\circ}C$, $60{\pm}10%$), and 3) cold($21{\pm}1^{\circ}C$, $50{\pm}10%$) condition. The postures performed were as follows; standing, sitting on the chair, sitting on the floor, and supine on the floor. At each condition, subjective sensations, 12 points skin temperature, rectal temperature, total and local sweat rate, pulse rates, blood pressure, skin blood flow rate were measured. The results were as follows : 1. Rectal temperature was high significant among groups in order of supine, sitting on the floor, sitting on the chair, standing posture(p<0.01). 2. Skin temperature was high in part of contact with the surface of the floor or wall and the effect of posture was greater in peripheral temperature than torso temperature. Sitting on the chair and sitting on the floor posture showed higher peripheral temperature than standing and supine posture. And peripheral temperature was lower in supine posture than any other postures. 3. Total and local sweat rate were decreased in order of standing, sitting on the chair, sitting on the floor, supine posture. 4. Pulse rate and disastolic blood pressure were higher in standing posture than supine posture, and there was significant difference between two postures(p<0.001). 5. Blood flow rate of thigh was high in sitting on the chair and sitting on the floor posture and low in standing posture. Blood flow rate of leg was low in standing posture significantly(p<0.01). 6. In comfort and hot condition, temperature sensation and comfort sensation were higher in standing posture and lower in supine posture than any other postures. In cold condition, temperature sensation was lower and comfort sensation was higher in standing and supine posture than any other postures. And supine posture was appeared positive in hot condition and negative in cold condition. From this study, we confirmed the effects of posture on human thermoregulatory responses. Results indicate that even under same conditions and clothing weight, the insulation of clothing will be different to postures.

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