Research Article| Volume 11, ISSUE 3, P180-190, July 1998

Download started.


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

      This paper is only available as a PDF. To read, Please Download here.


      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° of arm elevation caused a significant effect, with an average decrease of 51 ml in forearm and hand volume.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Hand Therapy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Casley-Smith JR
        • Morgan RG
        • Piller NR
        Treatment of lymphedema of the arms and legs with 5,6-benzo-[α]-pyrone.
        New Engl J Med. 1993; 329: 1158-1163
        • Hazarika EZ
        • Knight MT
        • Frazer-Moodie A
        The effects of intermittent pneumatic compression on the hand after fasciectomy.
        Hand. 1979; 11: 309-314
        • Ause-Elleas KL
        • Richard R
        • Miller SF
        • Finley Jr, RK
        The effect of mechanical compression on chronic hand edema after burn injury: a preliminary report.
        J Burn Care Rehabil. 1994; 15: 29-33
        • Evans P
        The healing process at a cellular level: a review.
        Physiotherapy. 1980; 66: 256-259
        • Tobin MB
        • Lacey HJ
        • Meyer L
        • Mortimer PS
        The psychological morbidity of breast cancer-related arm swelling: psychological morbidity of lymphoedema.
        Cancer. 1993; 72: 3248-3252
        • Griffin JW
        • Newsome LS
        • Stralka SW
        • Wright PE
        Reduction of chronic posttraumatic hand edema: a comparison of high-voltage pulsed current, intermittent pneumatic compression, and placebo treatments.
        Phys Ther. 1990; 70: 279-286
        • Swedborg I
        Voluminometric estimation of the degree of lymphedema and its therapy by pneumatic compression.
        Scand J Rehabil Med. 1977; 9: 131-135
        • Boris M
        • Weindorf S
        • Lasinski B
        • Boris G
        Lymphedema reduction by noninvasive complex lymphedema therapy.
        Oncology. 1994; 8: 95-106
        • Morgan RG
        • Casley-Smith JR
        • Mason MR
        • Casley-Smith JR
        Complex physical therapy for the lymphoedematous arm.
        J Hand Surg. 1992; 17B: 437-441
        • Nicholas JS
        The swollen hand.
        Physiotherapy. 1977; 63: 285-286
        • Thurston AJ
        • Krause BL
        The possible role of venous congestion in carpal tunnel syndrome.
        J Bone Joint Surg. 1998; 13B: 397-399
        • Matalon SV
        • Farhi LE
        Cardiopulmonary readjustments in passive tilt.
        J Appl Physiol. 1979; 47: 503-507
        • Warren PJ
        • Hardiman PJ
        • Woolf VJ
        Limb exsanguination, I. The arm: effect of angle of elevation and arterial compression.
        Ann R Coll Surg Engl. 1992; 74: 320-322
        • Sims D
        Effects of ankle positioning on ankle edema.
        J Orthop Sports Phys Ther. 1986; 8: 30-33
        • Warren PJ
        • Hardiman PJ
        • Woolf VJ
        Limb exsanguination, II. The leg: effect of angle of elevation.
        Ann R Coll Surg Engl. 1992; 74: 323-325
        • Folkow B
        • Neil E
        Circulation. Oxford University Press, New York1973
        • Buckey JC
        • Peshok RM
        • Blomqvist CG
        Deep venous contribution to blood volume change in the human leg.
        Am J Cardiol. 1988; 62: 449-453
        • Ludbrook J
        Regulation of arterial blood flow, pressure and resistance in the systemic circulation.
        in: Schwartz CJ Weithessen NT Wolf SW Structure and Function of the Circulation. Plenum Press, New York1980: 587-630
        • Boland R
        • Adams R
        Development and evaluation of a precision forearm and hand volumeter and measuring cylinder.
        J Hand Ther. 1996; 9: 349-358
        • Smith JJ
        • Hughes CC
        • Ptacin MJ
        • Barney JA
        • Tristani FE
        • Ebert TJ
        The effect of age on hemodynamic response to graded postural stress in normal men.
        J Gerontol. 1987; 42: 406-411
        • Kapoor WN
        • Smith MA
        • Miller NL
        Upright tilt testing in evaluating syncope: a comprehensive literature review.
        Am J Med. 1994; 97: 78-88
        • Rushmer RF
        Cardiovascular Dynamics. 4th ed. WB Saunders, Philadelphia, Pa1976: 217-245
        • Ten Harkel AD
        • Van Lieshout JJ
        • Wieling W
        Treatment of orthostatic hypotension with sleeping in the head up tilt position alone and in combination with fludrocortisone.
        J Intern Med. 1992; 232: 139-145
        • Lampson R
        Quantitative study of vasoconstriction induced by smoking.
        JAMAa. 1935; 104: 1963
        • Jozsa L
        • Renner A
        • Santha E
        The effect of tourniquet ischaemia on intact tenotomized and motor nerve injured human hand muscles.
        Hand. 1980; 12: 235-240
        • Hutchinson DT
        • McClinton MA
        Upper extremity tourniquet tolerance.
        J Hand Surg. 1993; 18A: 206-210
        • Woodcock JP
        Theory and practice of blood flow measurement. Butterworths, London1975: 166-189
        • Harrison M
        Effects of thermal stress and exercise on blood volume in humans.
        Physiol Rev. 1985; 65: 149-209
        • Winer B
        Statistical Principles in Experimental Design. 2nd ed. McGraw-Hill, New York1971
        • Lassiter TE
        • Malone TE
        • Garrett WG
        Injury to the lateral ligaments of the ankle.
        Orthop Clin North Am. 1989; 20: 629-640
        • Abdel-Salam A
        • Eyres KS
        Effects of tourniquet during total knee arthroplasty: a prospective randomised trial.
        J Bone Joint Surg. 1995; 77B: 250-253
        • Huber KH
        • Weicker H
        • Jost J
        • Daikeler R
        • Kunz B
        • Kunz C
        Humeral regulation of the orthostatic reaction.
        Int J Sports Med. 1988; 9: 103-112
        • Hansen KW
        • Pedersen MM
        • Christiansen JS
        • Mogensen CE
        Night blood pressure and cigarette smoking: disparate association in healthy subjects and diabetic patients.
        Blood Press. 1994; 3: 381-388
        • Millar-Craig MW
        • Bishop CN
        • Raftery EB
        Circadian variation of blood pressure.
        Lancet. 1978; 1: 795-797
        • Chen C-H
        • Ting C-T
        • Lin S-J
        • et al.
        Relation between diurnal variation of blood pressure and left ventricular mass in a Chinese population.
        Am J Cardiol. 1995; 75: 1239-1243
        • Rowell LR
        Human Circulation Regulation During Physical Stress. Oxford University Press, New York1986: 137-173
        • Wilson-MacDonald J
        • Caughey MA
        • Myers DB
        Diurnal variation in nerve conduction, hand volume and grip strength in the carpal tunnel syndrome.
        Br Med J. 1984; 289: 1042
        • Engler S
        • Sweat R
        Volumetric arm measurements: technique and results.
        Am Surg. 1962; 28: 465-468
        • van Velze CA
        • Kluever I
        • Van Der Merwe CA
        • Mennen U
        The difference in volume of dominant and non dominant hands.
        J Hand Ther. 1991; 4: 6-9