PTOTOtherJournal of physical therapy science2020

The effects of a defecation posture, supported by the upper limbs, on respiratory function.

Daisuke Tashiro, Masami Nakahara, Eiji Kitajima and 1 others

PMID 32425350

WHAT IT FOUND

Arm-supported forward-leaning posture on a toilet seat produced larger breath volumes and higher comfort ratings than upright or unsupported forward-leaning postures in 73 healthy young adults.

Key findings

01The arm-supported forward-leaning posture had greater vital capacity and forced vital capacity than the upright and forward-leaning postures.

02The arm-supported forward-leaning posture was ranked most comfortable and had the highest numerical comfort rating.

03Tidal volume, forced expiratory volume in one second, FEV1%, and maximal inspiratory pressure did not differ significantly among the postures.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

The study tested 73 healthy adults with a mean age of 21.2 years, not older adults or people with respiratory disease, so the results may not apply to patients who are physically burdened by defecation. The outcomes were lung-function measurements and subjective comfort taken in seated postures, not actual bowel movements, straining effort, dyspnea, fatigue, or constipation relief. Many respiratory measures and comfort scales were compared, and the paper does not identify a single primary outcome. The arm-supported posture combined a forward lean with elbow support, so the handrail alone cannot be separated from the posture. The authors state that they did not investigate other possible reasons for comfort, such as respiratory function and posture-maintaining muscles.

Declared interests

The work was supported by JSPS KAKENHI Grant Number JP19K19879. The authors declared no relevant conflicts of interest.

The easy way to misread this

Do not conclude that a toilet handrail alone will reduce breathlessness or help older adults during defecation. The tested posture combined a forward lean with elbow support, and the study measured lung function and comfort in 73 healthy young adults, not actual defecation symptoms in elderly or respiratory patients.

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