The Effect Of Body Positions On Diaphragmatic Excursion And Thickness In Stroke Patients With Tracheotomy By Ultrasound

Objective: To investigate the effect of three positions on diaphragmatic excursion and thickness in patients with stroke tracheotomy based on electric standing up bed.Methods: This study was a cross-sectional experiment.The 40 stroke patients with tracheotomy treated in Department of Rehabilitation Medicine of The Second People’s Hospital of Shenzhen from August 2021 to October 2021 were selected as the subjects,including 21 males and 19 females.All tests were performed within 2 hours after meals.Avoid overeating or consuming caffeinated or alcoholic beverages,and avoid strenuous rehabilitation training.First of all,the subjects were placed in supine position on the electric standing up bed for 10 minutes.The chest,hip and knee were fixed with restraint straps,the lower limbs were straightened,and the pedals were placed flat on both feet.Then,the subjects were placed in three upright 0°,30° and 60° positions by electric standing up bed in random order.In each position,after the subjects’ breathing was stable,the diaphragmatic excursion during calm breathing and diaphragmatic thickness at calm end expiratory were measured by ultrasound by the same experienced investigator.During the test,blood pressure,heart rate and oxygen saturation were monitored in real time in each position to ensure safety.SPSS25.0 software was used for statistical analysis of all data,and P < 0.05 was considered as statistically significant difference.Results:(1)Comparison of three positions: the diaphragmatic excursion and thickness of stroke patients with tracheotomy increased with the increase of the angle of electric standing up bed,and there were significant statistical differences between the two angles(P<0.05).(2)Gender comparison: at 30° and 60° upright positions,male patients had significantly higher diaphragmatic excursion and thickness than female patients(P<0.05);In addition,the changes of diaphragmatic excursion and diaphragmatic thickness in male patients were more obvious than those in female patients under three tilt angles(P<0.05).(3)Comparison of course of disease: there were no significant differences in diaphragmatic excursion and thickness between the subacute and chronic stage of stroke patients with tracheotomy(P>0.05).Conclusion: Electric standing up bed can effectively improve the diaphragmatic excursion and thickness of stroke patients with tracheotomy,and male stroke patients with tracheotomy have higher diaphragmatic excursion and thickness than female stroke patients.Therefore,the electric standing up bed in the upright 60° position can improve the excursion and thickness of the diaphragmatic in stroke patients with tracheotomy,which has important clinical application value.