Distinguishing Fowler's and Semi-Fowler's Patient Postures Within Continuous-Wave Functional Near-Infrared...

Background/Objectives: Lightweight and portable functional near-infrared spectroscopy (fNIRS) systems enable neuromonitoring in clinical environments such as operating rooms. Patient posture is known to influence physiology, behavior, and brain activity, and may affect fNIRS measurements. However, the effects of some postures commonly used in clinical care-such as Fowler's and semi-Fowler's-remain largely unexamined in fNIRS research. Methods: We conducted a singular study in a mock operating room exploring the effects of five postures-standing, upright sitting, Fowler's, semi-Fowler's, and supine-on fNIRS data during resting-state conditions and under various auditory stimuli. We collected hemodynamic data and extracted the characteristic hemodynamic response function (HRF) at each posture in response to the presented auditory stimulus and the amplitude of the resting-state signal. Results: For the auditory task condition, we found that posture had no statistically significant impact on the amplitude of the global HRF for Fowler's and semi-Fowler's postures. We also found no significant relationships across different postures when analyzing the amplitude of the global resting-state signal; however, binning of frequency-dependent postural effects revealed statistically significant differences between Fowler's and semi-Fowler's postures at low frequencies (f < 0.09 Hz). Conclusions: Our results suggest posture effects need not require complex data processing pipelines or data segmentation efforts on an auditory task-induced condition or on the general analysis of the global resting signal; however, not all reclined postures are equivalent, and we recommend that researchers report the angle of reclination measurements for seated data collection sessions for improved reliability and data context.