The influence of therapeutic body positions on hemodynamics and respiration in adults with and without obesity

Abstract

The primary objective of this research was to investigate the impact of therapeutic body positions on hemodynamic and respiratory responses in adults with and without abdominal obesity. This research comprises three studies: 1) a systematic review and meta-analyses to investigate the influence of various body positions on hemodynamic and respiratory variables in healthy adults; 2) a study on hemodynamic responses during therapeutic body positions in adults with and without abdominal obesity; 3) a study on respiratory responses during therapeutic body positions, comparing obese and non-obese adults. The results from the systematic review revealed that different positions elicit distinct hemodynamic and respiratory responses. The evidence indicated that the supine position had the greatest impact on hemodynamic variables, while 70-degree head-up tilt and standing positions had the most significant influence on respiratory variables. The second and third studies examined 52 male volunteers, comprising 26 individuals with normal weight and 26 with abdominal obesity. Each participant underwent 40 minutes in various therapeutic body positions, including Fowler's, right lateral, left lateral, supine, and prone positions, respectively. The results of the second study in both groups suggest that the supine position emerged as the most favorable for hemodynamic responses, with the exception of blood pressure, for which the right lateral position proved optimal. The study strongly discourages the use of the prone position due to its potential negative impact on hemodynamics, which may be even more pronounced in individuals with abdominal obesity. Later, when examining the respiratory response in the third study, in both groups, the prone position was the most effective for improving ventilation and oxygenation, followed by Fowler's position for ventilation, while the right lateral position ranked second in oxygenation. The results demonstrate that each position leads to varying physiological responses, both positive and negative. These findings are valuable for choosing appropriate postures for patients in both groups to maximize treatment benefits while avoiding postures that may exacerbate symptoms.