Many patients with a cerebral injury cannot move independently. Every year, 45,000 new stroke patients are affected in such a way. They have to be repositioned at regular intervals for a long period of time in order to prevent pressure ulcers that may develop as a result of patients’ physical immobility. Heidrun Pickenbrock et al., in a topical original article in Deutsches Ärzteblatt International (Dtsch Arztebl Int 2015; 112: 35-42), compare two positioning methods for immobile patients. They found that lying in the so called neutral position is more comfortable for affected patients, and that mobility of hips and shoulders is improved compared with when the conventional method is used.
In the study, more than 218 immobile patients with a brain injury were placed in a conventional position or the neutral position for two hours. The positions differ primarily in terms of the load placed on certain body sections. In the neutral position, the body parts are aligned in order to prevent overextension and shortening of muscles and tendons. A survey among participating patients showed that the neutral position is experienced as more comfortable than the conventional position. Furthermore, a study of passive mobility showed that the hip and shoulder joints were more mobile after patients had been placed in the neutral position than after conventional positioning.