Differences in Muscle Activity of the Upper Extremities During Respiratory Assistance Techniques between Experienced and Inexperienced Physiotherapists - Observational Study

Purpose: To compare upper extremity muscle activity and tidal volume during the breathing assist technique between experienced and inexperienced respiratory physiotherapists.

Methods: Nine physiotherapists with more than 10 years of experience in respiratory physiotherapy (experienced physiotherapists) and ten physical therapists with less than 1 year of experience in respiratory physiotherapy (inexperienced physiotherapists) participated in this study. A healthy adult male received the breathing assist technique while wearing an eye mask. The tidal volume at rest was calculated from the average value of the 1-minute resting breaths measured using an expiratory gas analyzer. In addition, the tidal volume during the breathing assist technique was measured six times, and the tidal volume during respiratory assistance was calculated from the average value. The measurement sites for muscle activity were the anterior deltoid, middle deltoid, posterior deltoid, biceps brachii, triceps brachii, flexor carpi radialis, flexor carpi ulnaris and opponens pollicis muscles of the upper limb from the caregiver side to the distal side.

Results: The tidal volume measured for the experienced participants tended to be higher than that for the inexperienced physiotherapists. According to the average electromyography values, experienced physiotherapists had significantly higher activity in the anterior deltoid and posterior deltoid muscles, while inexperienced physiotherapists showed activity in the biceps brachii and flexor carpi ulnaris muscles that was significantly higher compared to the experienced participants (p<0.05).

Discussion: In this study, experienced physiotherapists showed greater muscle activity related to shoulder joint movement, whereas inexperienced physiotherapists showed greater muscle activity related to elbow and wrist joint movements. Therefore, it is reasonable to assume that the experienced physiotherapists tried to assist breathing with the whole trunk and upper limbs, while the inexperienced physiotherapists tried to use only the upper limbs and hands.

Key words: Manual breathing assist, Muscle activity, Tidal volume.