Positioning can improve oxygen transport and lung function in patients with cardiopulmonary dysfunction. Different positions like supine, side lying, and prone affect lung volumes and ventilation in different areas of the lungs. The supine position decreases lung capacity but improves ventilation distribution, while side lying improves ventilation in the dependent lung. Prone positioning increases lung capacity and decreases airway closure. Head down and forward leaning positions can relieve dyspnea. Upright positioning augments drug effects and improves ventilation-perfusion matching. Mobilization provides both acute benefits like increased ventilation and oxygen transport, as well as chronic benefits including increased exercise capacity and decreased cardiac workload.

1. Effect of Positioning Shaswat Shaswat

2. It is a non invasive physiotherapy intervention that can augment arterial oxygenation so that invasive, mechanical and pharmacological forms of respiratory support can be postponed, reduced or avoided . Shaswat Shaswat

3. Clinically Significant Effects To improve oxygen transport in acute, post - acute and chronic stages of cardiopulmonary dysfunction. To prevent the negative effects of restricted mobility . Shaswat Shaswat

4. Different positions Supine lying Side lying Prone lying Head down tilt position Lean forward position Upside down position Upright position Shaswat Shaswat

5. Zones of the Lungs Zone 1 Zone 2 Zone 3 Shaswat Shaswat

6. Effect of Different Positions Shaswat Shaswat

7. Supine Position Position of Diaphragms - Cephalad Alters the chest wall configuration Intrathoracic pressure Central shift of blood volume Decrease lung compliance Increase airway resistance Increase pre and after load on ® heart Shaswat Increase WOB and airway closure Shaswat

8. Reduced FRC Shaswat Shaswat

9. Normal breathing Shaswat Shaswat

10. Breathing at low lung volumes Shaswat Shaswat

11. Collection of secretion Shaswat Shaswat

12. Diameter of the airway Shaswat Shaswat

13. Benefits Distribution of V/Q BUT Associated with Decrease FRC Decrease VC Increase area of dependent lung Increase closure of airways Shaswat Shaswat

14. Side Lying Shaswat Shaswat

15. Side Lying Position Dependent hemi diaphragm is highest ever and non dependent diaphragm is the lowest ever. Effects on the dependent lung Low lung volume and compliance Largest excursion of diaphragm More ventilation  Good V/Q ratio Shaswat Shaswat

16. Unilateral Lung pathology Bilateral lung pathology Shaswat Shaswat

17. Prone Lying Improves lung compliance Stabilize anterior chest wall Increase diaphragmatic excursion Increase TV, FRC Decrease airway closure Prone ABDOMEN FREE position SEMI PRONE position Shaswat Shaswat

18. Head down Tilt Position Position of diaphragm Advantages Dyspnea Accessory muscle use Reduce Upper chest breathing pattern Lung pathology to basal zones Disadvantages Shaswat Shaswat

19. Lean Forward position Position of diaphragm WOB Effect on dyspnea Shaswat Shaswat

20. Position Down Upside Shaswat Shaswat

21. Upright Position V/Q ratio Lung volumes and capacities Diameter of airways (Airway closure) Compression of heart and lung Sympathetic nervous system Augment the effects of potent sympathomimetic agents such that dosage of drugs can be reduced. Shaswat Shaswat

22. Other Effects Postural Drainage Technique Inhibits Bacterial Colonization Redistribute Compression forces acting on the diaphragm, myocardium. Shaswat Shaswat

23. Drainage from Kidney Shaswat Shaswat

24. Increase arousal state Shaswat Shaswat

25. Progression Shaswat Shaswat

26. Effect of Mobilization Acute effects Chronic effects Shaswat

27. Acute Effect Increase TV Increase breathing frequency Increase CO, SV, HR, BP Increase coronary and peripheral muscle perfusion Increase O2 binding in blood Increase O2 dissociation and extraction at tissue level. Shaswat

28. Decrease pulmonary complications Decrease bed sores Decrease contractures Coughing is facilitated Decrease WOB Decrease work of heart Shaswat

29. Chronic Effects Increase capacity for gas exchange Decrease WOB, MV, Breathing frequency Increase O2 extraction capacity Decrease work of heart, HR, BP, CO Shaswat

30. Prevent negative effect of restricted mobility Decrease airway closure Decrease secretion pooling Alters preload and afterload Lymphatic drainage. Shaswat

31. THANK YOU Shaswat Shaswat