PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Supination”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed2003

Prognostic implications of combined prone and supine acquisitions in patients with equivocal or abnormal supine myocardial perfusion SPECT.

UNLABELLED: Although acquisition of (99m)Tc-sestamibi myocardial perfusion SPECT (MPS) with the patient in the prone position is commonly used to minimize attenuation artifacts, the impact of combined prone and supine imaging on the prognostic evaluation of coronary artery disease (CAD) has not been determined. The prognostic implications of MPS obtained in both prone and supine positions in patients with perfusion defects on supine MPS were evaluated. METHODS: We studied 3,834 patients who were monitored for 24.2 +/- 6.0 mo after rest (201)Tl/stress (99m)Tc-sestamibi MPS acquired during 1994-1995, when prone acquisition was performed only in patients with inferior wall perfusion defects that might represent attenuation or motion artifact. RESULTS: During follow-up, there were 132 hard events (cardiac death or myocardial infarction) and 375 total events (hard events or late myocardial revascularization). Overall, patients who underwent prone and supine acquisitions had similar characteristics to those who underwent supine-only imaging, with the exception of being more commonly male. In multivariable analysis, there were similar independent predictors for hard events and total events; the type of acquisition (prone and supine or supine-only) was not a significant predictor of either of these outcome events. After risk adjustment, the predicted event rates were nearly identical for patients undergoing prone and supine compared with supine-only studies. Both observed and predicted hard event rates of patients with normal prone and supine versus supine-only imaging were very low (observed, 0.7%/y and 0.5%/y, respectively; predicted, 1.5% over 24 mo for both). There was no reduction in the higher rates of events associated with abnormal scan results with the combination of prone and supine imaging. CONCLUSION: Patients with inferior wall defects on supine MPS that are not present on prone MPS have a low risk of subsequent cardiac events, similar to that of patients with normal supine-only studies.

Adenosine↗
PubMed1983

Comparison of supine and erect bicycle exercise electrocardiography in coronary heart disease: accentuation of exercise-induced ischemic ST depression by supine posture.

Exercise-induced electrocardiographic ST depression was compared during supine and erect graded bicycle exercise in 43 patients with chest pain but no prior myocardial infarct; all had greater than or equal to 1 mm of ST depression during either erect or supine exercise; 16 had multivessel, 24 had 1-vessel and 3 had no coronary artery disease. Supine exercise used 4 minutes/stage and erect exercise used either 4 minutes or 3 minutes/stage with identical graded work loads for both postures. Chest pain occurred in 31 patients during erect and in 29 during supine exercise. ST depression was greater than or equal to 1 mm in 28 patients during erect exercise and in all 43 during supine exercise (p less than 0.001); mean maximal ST depression was 1.3 +/- 0.2 mm during erect and 2.6 +/- 0.2 mm during supine exercise (p less than 0.001). Maximal work load was higher during erect than supine exercise (745 +/- 32 versus 678 +/- 32 kpm/min; p less than 0.001). The accentuation of ST depression by supine posture was not attributable to the changes in heart rate, rate-pressure product or mean blood pressure during supine versus erect exercise. In the 10 patients who had 2 erect bicycle tests using work load durations of 3 and 4 minutes, the maximal ST depression was not significantly different (erect 3 minutes 1.3 +/- 0.5 mm and erect 4 minutes 1.4 +/- 0.4 mm).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

[A biomechanical analysis of pronation-supination of the forearm using magnetic resonance imaging: dynamic changes of the interosseous membrane of the forearm during pronation-supination].

A magnetic resonance (MR) study was performed using a 0.5 tesla system to investigate the behavior of the interosseous membrane of the forearm during pronation-supination and to evaluate the influence of pronation-supination loading in the neutral position. The right forearm was examined in twenty volunteers at the proximal fourth part, middle part and distal fourth part of the forearm. Slices were examined at maximum pronation, 45 degrees pronation, neutral, 45 degrees supination and at maximum supination. A 0.1 Nm torque in both rotational directions was added in the neutral position. The MR image of the interosseous membrane of the forearm was a thin line with low contrast in the neutral position. The tendinous portion and membranous portions of the interosseous membrane could be differentiated. At maximum pronation and at maximum supination, the interosseous membrane was flexed, caused mainly by the relaxation in the membranous portion. The radius shifted slightly volarly to the ulna at maximum pronation, caused by the incongruity of the distal radioulnar joint. The radius shifted dorsally with pronation loading, and shifted volarly with supination loading. The inelasticity of the membranous portion of the interosseous membrane may be responsible for pronation-supination contracture, while rotational loading may be a cause of the distal radioulnar joint dislocation. These studies suggest that this technique is useful for further in vivo studies of kinesiology.

Adult↗
PubMed1985

M-mode echocardiography in supine and standing position in control subjects and patients with auscultatory evidence of mitral valve prolapse but negative supine echocardiography: does sensitivity improve?

Approximately 10-20% of patients with auscultatory evidence of mitral valve prolapse (MVP) have "false negative" echocardiograms. Pharmacological maneuvers do not significantly improve the sensitivity and may cause side effects. It is well known that auscultatory features of MVP change and not uncommonly can be heard only in the standing position. Therefore M-mode echo was performed in both supine and standing positions in 10 normal control subjects and 25 patients of comparable age and sex who had auscultatory evidence of MVP but negative echo in supine position. All 10 control subjects had normal echo in both supine and standing positions. No instance of false positive MVP was noted. Of the 25 patients with "false negative" supine echo, 5 showed evidence of MVP (3 pansystolic and 2 late systolic) in standing position. Based on these results the following conclusions were reached. In normal individuals the MVE remains uninfluenced by change in posture. There is modest (20%) improvement in sensitivity of detecting MVP when M-mode echo is performed in standing position in addition to supine position. Change in posture is preferable to the use of pharmacological maneuver to improve the sensitivity of detecting MVP because it is physiological, devoid of any cost, and does not produce side effects. M-mode echo in standing position or two-dimensional echo in supine position can be used to confirm the diagnosis of MVP in those patients who have "false negative" and/or nondiagnostic supine echo in the presence of auscultatory features of midsystolic click and mid- or late-systolic murmurs.

Adult↗
PubMed2000

A clinical trial investigating the possible effect of the supine cervical rotatory manipulation and the supine lateral break manipulation in the treatment of mechanical neck pain: a pilot study.

OBJECTIVE: To evaluate the possible effect of the supine cervical rotary manipulation and the supine lateral break manipulation in the treatment of mechanical neck pain, according to subjective and objective clinical findings. BACKGROUND: Delivering a supine lateral break manipulation to the ipsilateral side of an inflamed facet joint(s) that exhibits a lateral flexion fixation may result in pain and/or discomfort to the patient. Thus the proposed alternative is a supine cervical rotary manipulation delivered on the ipsilateral side or a supine lateral break manipulation delivered on the contralateral side of the relevant joint(s). DESIGN: Randomized, comparative clinical trial. SUBJECTS: Two groups of 15 subjects diagnosed with mechanical neck pain. INTERVENTION: The diagnosis of mechanical neck pain and the identification of lateral flexion fixations in the cervical spine were made with conventional clinical evaluation, including motion palpation. Group A received a cervical rotary manipulation(s) on the ipsilateral side of the lateral flexion fixation(s), while group B received a supine lateral break manipulation(s) on the contralateral side of the lateral flexion fixation(s). Subjects received a maximum of 10 treatments over a 4-week treatment period. OUTCOME MEASURES: Both treatment groups were assessed with subjective (Numerical Pain Rating Scale 101, McGill Short-Form Pain Questionnaire and the Canadian Memorial Chiropractic College Neck Disability Index) and objective (cervical range of motion goniometer and algometer) measurement parameters at the initial consultation (before any treatment), the final consultation, and at a 1-month follow-up consultation. Statistical analysis was conducted at a 95% confidence level (alpha =.05) with the non-parametric 2-tailed Wilcoxon signed ranks test, the Mann-Whitney U test, and descriptive statistics. Two-tailed power analysis was conducted after the fact, where a confidence level of 80% (beta =.20) was considered satisfactory. RESULTS: Intragroup analysis indicated a significant difference between the initial consultation data and the final consultation data for the subjective data, indicating an effect. Analysis of the objective data did not reveal any significant difference. Intergroup analysis did not reveal any significant difference between the 2 groups when comparing the data of the initial consultation and the final consultation, indicating that both treatments had a similar or equal effect. Power analysis was not satisfactory for most data, indicating the possibility of many Type II errors. CONCLUSION AND RECOMMENDATIONS: Statistically, the results suggested that both treatments had an effect but that neither group showed a benefit over the other. However, because of the unsatisfactory power of the study, conclusions are to be drawn with caution. Clinical significance supported the statistical outcomes where it was suggested that both treatments had an effect and that neither treatment had a greater effect. A larger sample size and the inclusion of a placebo group is recommended to reveal true treatment outcomes and trends.

Adolescent↗
PubMed2005

Comparability of the standing and supine standard electrocardiograms and standing sitting and supine stress electrocardiograms.

The aim of this study was to evaluate whether change in the patients' position during the electrocardiogram (ECG) recording alters the various components of the ECG curve. Concerns whether ECGs in medically compromised patients recorded in a sitting position should be considered "standard" tracings and whether ECGs recorded in the supine and standing positions and ECGs recorded in different positions in the Exercise Laboratory are interchangeable provided the impetus for this study. The ECG was recorded in the supine and standing positions in 10 patients using standard electrode placement and in the sitting, standing, and supine positions in 16 patients using the Mason-Likar electrode system. Comparisons of sums of P waves and QRS complexes of various combinations of ECG leads from recordings in different positions and amplitudes of Q, R, and S waves of all 12 ECG leads revealed stability in the standard and stress ECGs, although few statistically significant but minor changes were noted in some comparisons, which, however, could not be expected to have any diagnostic significance. Comparison of standard ECGs recorded in patients in the supine and standing positions and stress ECGs recorded in the sitting, standing, and supine positions are interchangeable; this should allay concerns about recording the standard ECG in unconventional positions and may facilitate and make more cost-effective ECG recording in busy outpatient clinic environments.

Electrocardiography↗
PubMed2004

Short-term spectral analysis of heart rate variability during supine-standing-supine test in patients with paroxysmal atrial fibrillation.

The aim of the study was to assess the sympathovagal balance in group of 27 patients without significant structural heart disease after an attack of atrial fibrillation. The investigation was performed using spectral analysis of heart rate variability during examination under conditions of different orthostatic loads in single phases, called the supine-standing- supine test. The findings were compared with a group of healthy persons. These revealed a significantly decreased total spectral power (430.7 vs 1558.0 ms(2) supine1; 477.6 vs 1042,5 ms(2) standing; 567.5 vs 1948.5 ms(2) supine2), and spectral power of the high frequency spectral component (140.8 vs 619.3 ms(2) supine1; 96.2 vs 203.3 ms(2) standing; 186.3 vs 739.4 ms(2) supine2) in the studied group of patients in comparison with the control group.

Adult↗
PubMed2004

A randomized trial of supine vs. prone positioning in patients undergoing escalated dose conformal radiotherapy for prostate cancer.

BACKGROUND AND PURPOSE: The optimal treatment position for patients receiving radical radiation therapy for prostate cancer has been a source of controversy. To resolve this issue, we conducted a randomized trial to evaluate the effects of supine and prone positioning on organ motion, positioning errors, and dose to critical organs during escalated dose conformal irradiation for localized prostate cancer and patient and therapist satisfaction with setup technique. PATIENTS AND METHODS: Twenty eight patients were randomized to commence treatment immobilized in the supine or prone position and were subsequently changed to the alternate positioning for the latter half of their treatment. Patients underwent CT simulation and conformal radiotherapy planning and treatment in both positions. The clinical target volume encompassed the prostate gland. Alternate day lateral port films were compared to corresponding simulator radiographs to measure the isocentre positioning errors (IPE). Prostate motion (PM) and total positioning error (TPE) were measured from the same films by the displacements of three implanted fiducial markers. Dose volume histograms (DVHs) for the two treatment positions were compared at the 95, 80 and 50% dose (D%) levels. The patients and radiation therapists completed weekly questionnaires regarding patient comfort and ease of setup. RESULTS: Seven patients, who started in the supine position, subsequently refused prone position and received their whole treatment supine. Small bowel in the treatment volume, not present in the supine position, prevented one patient from being treated prone. PM in anterior posterior direction was statistically significantly less in the supine position (P<0.05). There was no significant difference in superior inferior PM for the two treatment positions. No statistically significant difference between supine and prone positioning was observed in isocentre positioning error (IPE) or total positioning error (TPE) due to a policy of daily pre-treatment correction. However, more pre-treatment corrections were required for patients in the prone position. The DVH analysis demonstrated larger volumes of the bladder wall, rectal wall and small bowel within the D95, D80 and D50% when comparing the planning target volumes (PTVs) actually treated for prone positioning. When the prone PTV was expanded to account for the greater PM encountered in that position, a statistically significant difference (P<0.007) was observed in favour of the supine position at all dose levels. In the prone position, four patients had small bowel within the 60 Gray (Gy) isodose and in the supine position, no patients had small bowel in the 60 or 38Gy volumes. Supine position was significantly more comfortable for the patients and setup was significantly easier for the radiation therapists. The median patient comfort score was 0.79 (Standard deviation (SD) 0.03) supine and 0.45 (SD 0.05) prone (P<0.001) The therapist convenience of setup was 0.80 (SD 0.016) supine and 0.54 (SD 0.025) prone (P<0.005). No statistically significant difference was seen for the other parameters studied. CONCLUSIONS: We demonstrated significantly less PM in the supine treatment position. There was no difference for either treatment position in IPE or TPE, however, more pre-treatment corrections were required in the prone position. Prone position required a larger PTV with resulting increased dose to critical organs. There were statistically significant improvements at all dose levels for small bowel, rectal wall and bladder wall doses in the supine position once corrections were made for differences in organ motion. Linear analogue scores of patient comfort and radiation therapist convenience demonstrated statistically significant improvement in favour of the supine position. Supine positioning has been adopted as the standard for conformal prostatic irradiation at our centre.

Aged↗
PubMed2001

Control of acceleration during sudden ankle supination in people with unstable ankles.

STUDY DESIGN: Comparative study of differences in functional control during ankle supination in the standing position in matched stable and unstable ankles (ex post facto design). OBJECTIVES: To document acceleration and deceleration during ankle supination in the standing position and to determine differences in control of supination perturbation between stable and unstable ankles. BACKGROUND: Repetitive ankle sprain can be explained by mechanical instability only in a minority of cases. Exercise therapy for ankle instability is based on clinical experience. Joint stability has not yet been measured in dynamic situations that are similar to the situations leading to a traumatic sprain. The process of motor control during accelerating ankle supination has not been adequately addressed in the literature. METHODS AND MEASURES: Patients with complaints of ankle instability (16 unstable ankles) and nonimpaired controls (18 stable ankles) were examined (N = 17 subjects, 10 women and 7 men). The average age was 23.7 +/- 5.0 years (range, 20-41 y). Control of supination speed was studied during 50 degrees of ankle supination in the standing position using accelerometry (total supination time and deceleration times) and electromyography (latency time). Timing of motor response was estimated by measuring electromechanical delay. RESULTS: The presence of an early, sudden, and presumably passive slowdown of ankle supination in the standing position was observed. Peroneal muscle motor response was detected before the end of the supination. Unstable ankles showed significantly shorter total supination time (109.3 ms versus 124.1 ms) and significantly longer latency time (58.9 ms versus 47.7 ms). CONCLUSIONS: Functional control in unstable ankles is less efficient in decelerating the ankle during the supination test procedures used in our study. Our conclusions are based on significantly faster total supination and significantly slower electromyogram response in unstable ankles. The results support the hypothesis that both decelerating the total supination movement during balance disturbance and enhancing the speed of evertor activation through exercise can be specific therapy goals.

Acceleration↗
PubMedDate not supplied

A supination splint worn distal to the elbow: a radiographic, electromyographic, and retrospective report.

The purposes of this study were to 1) describe a dynamic supination splint that does not cross the humeroulnar and humeroradial joints, allowing flexion and extension of the elbow; 2) provide retrospective data on effectiveness of this splint in patients with limited supination; and 3) provide data from radiography and electromyography (EMG) that document this splint's ability to provide a passive supination force. Eleven subjects treated for various elbow and/or wrist fractures leading to losses of forearm supination significantly increased their passive range of motion (PROM) from 34.0 degrees at the initial visit to 82.3 degrees at discharge and active range of motion (AROM) from 27.0 degrees to 72.3 degrees. Radiographic images of the radius and ulna were identical in maximal voluntary supination and resting in the splint. Surface EMG was used to measure supinator muscle activity at rest, passively supinated while wearing the splint, and during a maximal isometric supination effort (without splint). Average supinator EMG activity was 7.9 mV at rest, 7.8 mV in the splint, and 68.0 mV with maximal isometric contraction. Results indicate the supination splint is clinically effective in increasing supination PROM. EMG data and radiographs indicate that the splint passively positions the forearm in supination even though the proximal margin of the splint does not cross the elbow.

Adult↗
PubMed1998

Treatment success with a mandibular advancement device is related to supine-dependent sleep apnea.

STUDY OBJECTIVE: To evaluate the effect of a mandibular advancement device in patients with supine-dependent sleep apnea and patients with non-supine-dependent sleep apnea. DESIGN: Prospective study. SETTING: Department of Respiratory Medicine, University Hospital, Umeå, Sweden. PATIENTS: Twenty-six patients with obstructive sleep apnea. INTERVENTION: Individually fabricated and adjusted mandibular advancement devices. MEASUREMENTS: Overnight polysomnographic sleep recordings with and without the device. Supine-dependent sleep apnea was defined when the supine apnea-hypopnea index was > or = 10, together with a lateral apnea-hypopnea index of < 10. Non-supine-dependent sleep apnea was considered when the lateral apnea-hypopnea index was > or = 10. RESULTS: In 12 patients with supine-dependent sleep apnea, the device reduced the supine apnea-hypopnea index from a median of 41 (range, 16 to 70) to 5.9 (range, 0.0 to 15) (p < 0.01). In 14 patients with non-supine-dependent sleep apnea, the treatment reduced the supine apnea-hypopnea index from 44 (range, 1.8 to 73) to 21 (range, 6.3 to 60) (p < 0.05) and the lateral apnea-hypopnea index from 21 (range, 12 to 70) to 4.5 (range, 0.0 to 31) (p < 0.01). The odds ratio for a successful apnea reduction to an apnea-hypopnea index of < 10 in both the supine and the lateral positions was 30 for supine-dependent sleep apnea adjusted for age, obesity, mandibular advancement, and mandibular opening (p < 0.01). CONCLUSION: Successful apnea reduction with a mandibular advancement device is highly related to supine-dependent sleep apnea.

Adult↗
PubMed2006

Uterine blood flow during supine rest and exercise after 28 weeks of gestation.

OBJECTIVE: To test the null hypothesis that, after 28 weeks of gestation, uterine blood flow during supine rest and supine exercise is no different than uterine blood flow at left-lateral rest. DESIGN: In vivo experimental study in pregnant women. SETTING: Department of Obstetrics, MetroHealth Medical Center, Cleveland, OH, USA. POPULATION: Fourteen, physically active, late-pregnant women who continued supine exercise throughout gestation. METHODS: Studies were carried out between 29 and 38 weeks of gestation. Maternal blood pressure, maternal heart rate, and ultrasound estimates of volume blood flow in the right ascending branch of the uterine artery were obtained serially at rest in the left-lateral position, at rest in the supine position, during and immediately after 10 minutes of supine exercise, and again at rest in the left-lateral position. Exercise sessions included alternating 60- to 90-second periods of abdominal crunches and leg exercise at moderate/high intensity (Borg's rating of perceived exertion 14 +/- 1). MAIN OUTCOME MEASURES: Blood pressure, heart rate, and uterine artery volume flow. RESULTS: Data are presented as the mean +/- SD. Maternal heart rate and blood pressure were unchanged at supine rest but increased during supine exercise (heart rate increased from 76 +/- 9 to 98 +/- 12 beats per minute, mean arterial pressure increased from 81 +/- 6 to 102 +/- 12 mmHg). Volume flow fell from 410 +/- 93 to 267 +/- 73 cc/minute after 5 minutes of supine rest and then, during supine exercise, increased to 355 +/- 125 cc/minute. Uterine artery luminal diameter and blood flow correlated directly with tissue weights at birth (r(2) values between 0.32 and 0.59). CONCLUSIONS: In physically active women, uterine blood flow decreases during both supine rest and supine exercise but the decrease in the former is twice that seen in the latter.

Adult↗
PubMed2003

Effects of gravity on lung diffusing capacity and cardiac output in prone and supine humans.

Both in normal subjects exposed to hypergravity and in patients with acute respiratory distress syndrome, there are increased hydrostatic pressure gradients down the lung. Also, both conditions show an impaired arterial oxygenation, which is less severe in the prone than in the supine posture. The aim of this study was to use hypergravity to further investigate the mechanisms behind the differences in arterial oxygenation between the prone and the supine posture. Ten healthy subjects were studied in a human centrifuge while exposed to 1 and 5 times normal gravity (1 G, 5 G) in the anterioposterior (supine) and posterioanterior (prone) direction. They performed one rebreathing maneuver after approximately 5 min at each G level and posture. Lung diffusing capacity decreased in hypergravity compared with 1 G (ANOVA, P = 0.002); it decreased by 46% in the supine posture compared with 25% in the prone (P = 0.01 for supine vs. prone). At the same time, functional residual capacity decreased by 33 and 23%, respectively (P < 0.001 for supine vs. prone), and cardiac output by 40 and 31% (P = 0.007 for supine vs. prone), despite an increase in heart rate of 16 and 28% (P < 0.001 for supine vs. prone), respectively. The finding of a more impaired diffusing capacity in the supine posture compared with the prone at 5 G supports our previous observations of more severe arterial hypoxemia in the supine posture during hypergravity. A reduced pulmonary-capillary blood flow and a reduced estimated alveolar volume can explain most of the reduction in diffusing capacity when supine.

Acceleration↗
PubMed1997

Restriction of foot supination by ankle braces in sudden fall situations.

OBJECTIVE: To investigate the restriction of foot supination in different shoe orthotic combinations for unexpected ankle turns. DESIGN: A supination platform was used to experimentally induce sudden ankle turns. BACKGROUND: This study expanded on previous investigations of the effectiveness of different ankle braces and the influence of shoe material on foot supination. METHODS: For 21 male subjects pressure distribution data, achilles tendon angle, and supination velocity were collected. A comparison between a shoe with cut upper material and an intact shoe was done to show the influence of upper material on supination. The effectiveness of four different orthotics inside of an intact shoe were tested in comparison to the same shoe without ankle brace. Additionally, subjects rated their perceived supination movement of the foot. RESULTS: Between experimental conditions no large differences for the pressure distribution patterns were found. Three of the ankle braces reduced foot supination as well as supination velocities. More than two times lower supination values were measured for a footwear condition in which the upper material was cut away. Already during the free-fall most ankle braces caused a substantial reduction of foot inversion. CONCLUSION: The experiments demonstrated the influence of the upper material of a shoe and different orthotics on foot supination. Biomechanical measurements are necessary because of limited capabilities of subjects in detecting subtalar angular motions. RELEVANCE: This study investigated the effectiveness of different shoe conditions and ankle braces under experimental conditions that simulated unexpected ankle turns, the most frequent causes of sport injuries. The results of the study provide insights into which factors influence the amount of foot supination during unexpected ankle turns.

Journal Article↗