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Conventional versus neutral positioning in central neurological disease: a multicenter randomized controlled trial
Heidrun Pickenbrock1, Vera U Ludwig, Antonia Zapf
1Movement Disorders Section, Department of Neurology, Hannover Medical School, Hannover, Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Department of Medical Statistics, University Medical Center Göttingen.
Positioning severely immobilized patients using the neutral (LiN) method significantly improved hip and shoulder mobility and patient comfort compared to conventional (CON) positioning. Further research is needed to explore long-term benefits.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Clinical Trials
Background:
- Severe immobility in brain-lesioned patients requires long-term therapeutic positioning.
- Limited scientific evidence exists on the efficacy of different patient positioning methods.
- This study investigates positioning in neutral (LiN) versus conventional (CON) methods.
Purpose of the Study:
- To compare the effects of conventional positioning (CON) with positioning in neutral (LiN) for severely immobilized patients.
- To evaluate the impact of different positioning methods on passive range of motion (PROM) and patient comfort.
Main Methods:
- A prospective, multicenter, randomized controlled trial involving 218 non-ambulatory patients.
- Patients were randomly assigned to either LiN or CON positioning for two hours.
- Primary endpoint: change in passive range of motion (PROM) of hip joints; Secondary endpoints: PROM of shoulder joints and patient comfort.
Main Results:
- LiN positioning resulted in significantly better PROM for hips (12.84° increase) and shoulders (flexion 11.85°, external rotation 7.08° increase) compared to CON.
- Patient comfort was significantly higher in the LiN group (81% good comfort) versus the CON group (38% good comfort).
- All differences were statistically significant (p<0.001).
Conclusions:
- Two-hour positioning in neutral (LiN) improves passive mobility and comfort in severely immobilized patients compared to conventional positioning.
- Further studies are warranted to assess long-term benefits of LiN, including rehabilitation, quality of life, pressure sore prevention, and nursing care.
- LiN positioning presents a promising alternative for managing immobilized patients.
