A physical therapist is treating a patient with a left cerebrovascular accident and right lower-extremity paresis who also has a history of gastroesophageal reflux disease. During therapeutic exercises, which position should be avoided?

A physical therapist is treating a patient with a left cerebrovascular accident and right lower-extremity paresis who also has a history of gastroesophageal reflux disease. During therapeutic exercises, which position should be avoided?

• A. Standing
• B. Sitting upright at 90°
• C. Supine
• D. Sitting semi-upright at 45°

Answer: (C)

When a patient has GERD, keeping activity in upright positions helps gravity keep stomach contents from refluxing into the esophagus. Lying flat (supine) removes that gravitational aid, so reflux is more likely and the risk of aspiration increases—especially important in a patient with stroke who may have impaired swallow and airway protection. In therapy, standing or sitting upright (90°) or semi-upright (around 45°) positions are safer during exercises because they minimize reflux and support safer swallowing and breathing. That makes the supine position the one to avoid.

When a patient has GERD, keeping activity in upright positions helps gravity keep stomach contents from refluxing into the esophagus. Lying flat (supine) removes that gravitational aid, so reflux is more likely and the risk of aspiration increases—especially important in a patient with stroke who may have impaired swallow and airway protection. In therapy, standing or sitting upright (90°) or semi-upright (around 45°) positions are safer during exercises because they minimize reflux and support safer swallowing and breathing. That makes the supine position the one to avoid.