Acute angles of head-up tilt do not affect forearm and hand volume

Physiotherapists utilise the effect of gravity in treatment of conditions associated with increased limb volume. In contrast with knowledge about the relationship between body position and lower limb volume, the effect of body position on arm volume is not well understood. To assess the efficacy of a simple intervention proposed for patients to reduce arm volume during sleep, this study investigated the effects on forearm and hand volume of two hours of head-up tilt in supine at three angles of 8, 11 and 14 degrees. Six asymptomatic subjects were measured at each tilt angle over a three-week period. Data indicated that no angle of head-up lying over a two-hour period was associated with any significant reduction in upper limb volume.

Sphygmomanometer-induced increases in forearm and hand volume

Swelling, or increased volume, secondary to venous congestion is thought to be a factor in some upper limb conditions. This study aimed to establish a safe, easily applied method of inducing a transitory increase in forearm and hand volume that could be used as a symptom provocation test for upper limb conditions. Using the principles of venous occlusion plethysmography, movement of blood volume into the forearm and hand of asymptomatic subjects was measured after occlusion with three different sphygmomanometer cuff pressures over four minutes. Increases of between 37 and 62 ml (2.5% and 4.1%) were achieved at pressures between diastolic pressure minus 30 mm Hg and diastolic pressure plus 5 mm Hg, with minimal reported side effects. These data demonstrate that a sphygmomanometer can be used to induce transitory fluid congestion of the forearm and hand.

The effects of arm elevation and overnight head-up tilt on forearm and hand volume

Methods to reduce increased fluid volume, or swelling, were evaluated as short- and long-term interventions. Forearm and hand volumes were measured in 45 fit and healthy subjects using a water displacement device with previously established reliability. Volumes were measured before and after 2 hours of recumbency and before and after overnight sleep under different conditions of arm elevation or head-up tilt. No arms-at-side lying-down position, whether after 2 hours awake or after overnight sleep or with bed-head elevated or not, resulted in significant changes in forearm and hand volume. Only 2 hours in a supine lying-down position with 30 degrees of arm elevation caused a significant effect, with an average decrease of 51 ml in forearm and hand volume.