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The Effect of Body Position on Arterial Oxygen Saturation in Acute Stroke

^a The Stroke Association's Therapy Research Unit, Hope Hospital, Salford, UK
^b Robert Barnes Medical Unit, Manchester Royal Infirmary, Manchester, UK
^c The University of Manchester Medical Statistics Unit, University of Manchester, UK.

Hilary J. Chatterton, The Stroke Association\|[apos ]\|s Therapy Research Unit, Department of Geriatric Medicine, Hope Hospital, Eccles Old Road, Salford M6 8HD, England E-mail: Hilary{at}physio.cmht.nwest.nhs.uk.

William B. Ershler, MD

Background. Evidence suggests that respiratory function is impaired poststroke. Body position is known to influence respiratory function in normal subjects and those with respiratory pathologies. Its effect on respiratory function after stroke has received little attention. However, one study suggests that some positions used in clinical practice may adversely influence respiratory function. This study therefore aimed to identify resting positions that maintain arterial oxygen saturation (SaO₂) at optimal levels, changes in SaO₂ during time spent in the test position, and differences in SaO₂ among the positions investigated.

Method. A within-subject, two-center clinical study was made. Patients in the first 72 hours following mild to moderately severe stroke were allocated a randomized sequence of four positions. One hour was spent in each position. SaO₂ was recorded each minute by pulse oximetry with a finger probe. Mean values for the hour were calculated.

Results. Mean arterial oxygen saturation values for all patients were >90% for the hour spent in each test position for all patients. There were no changes in arterial oxygen saturation across the hour spent in the test positions (repeated- measures analysis of variance). No differences in arterial oxygen saturation were identified among positions (analysis of covariance).

Discussion. The saturation levels recorded corresponded to those observed in studies of normal elderly persons. The positions tested may be recommended for use in clinical practice to maintain arterial oxygen saturation in patients in the first 72 hours following mild to moderately severe stroke.