The Korean Journal of Emergency Medical Services (한국응급구조학회지)

The Korea Society of Emergency Medical Services (한국응급구조학회)
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Analysis of trunk angle and muscle activation during chest compression in 119 EMTs

가슴압박시 구급대원의 체간 각도와 근활성도 분석

  • Shin, Dong-Min (Dept. of Paramedic Science, Korea National University of Transportation) ;
  • Lee, Chang-Sub (Se-Jong Metropolitan Autonomous City Fire Headquarter) ;
  • Kim, Seung-Yong (Dept. of Management Information System, Korea National University of Transportation) ;
  • Kim, Chang-Kook (Dept. of Global Sport Studies, Korea University) ;
  • Hong, Eun-Jeong (Dept. of Industry-Academic Cooperation Foundation, Korea National University of Transportation) ;
  • Lee, Young-Chul (Dept. of Sport and Leisure Studies, Graduate School, Korea University) ;
  • Choi, Ga-Ram (Dept. of Sport and Leisure Studies, Graduate School, Korea University) ;
  • Kim, Gyoung-Yong (Dept. of Emergency Medical Rehabilitation Graduate School, Gangwon National University) ;
  • Jang, Mun-Sun (Dept. of Emergency medical technology, Sunlin College) ;
  • Kim, Jeong-Hee (Dept. of Industry-Academic Cooperation Foundation, Korea National University of Transportation) ;
  • Han, Boong-Ki (Dept. of Emergency Medical Technology, ChungBuk Health & Science University) ;
  • Lee, Jong-Kun (Dept. of Sports, YoungDong University) ;
  • Tak, Yang-Ju (Dept. of Paramedic Science, Korea National University of Transportation)
  • 신동민 (국립한국교통대학교 응급구조학과) ;
  • 이창섭 (세종특별자치시 소방본부) ;
  • 김승용 (국립한국교통대학교 경영정보학과) ;
  • 김창국 (고려대학교 국제스포츠학부) ;
  • 홍은정 (국립한국교통대학교 산학협력단) ;
  • 이영철 (고려대학교 일반대학원 사회체육학과) ;
  • 최가람 (고려대학교 일반대학원 사회체육학과) ;
  • 김경용 (강원대학교 일반대학원 응급의료재활학과) ;
  • 장문순 (선린대학교 응급구조과) ;
  • 김정희 (국립한국교통대학교 산학협력단) ;
  • 한붕기 (충북보건과학대학교 응급구조과) ;
  • 이종근 (영동대학교 스포츠학부) ;
  • 탁양주 (국립한국교통대학교 응급구조학과)
  • Received : 2014.10.25
  • Accepted : 2014.12.24
  • Published : 2014.12.31
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Abstract

Purpose: We aimed to investigate trunk angle and muscle activation of the extremity and back to evaluate the effect of chest compression on work-related musculoskeletal disorders in 119 emergency medical technicians (EMTs). Methods: Eighteen 119 EMTs performed 2-minute chest compression without interruption on a cardiopulmonary resuscitation manikin, during which we measured changes in the trunk and shoulder joint angles, muscle activation (triceps brachii, biceps brachii, erector spinae, gluteus maximus, pectoralis major, rectus abdominis, and rectus femoris) and chest compression accuracy. Results: The decrease in trunk angle by trunk muscle activation was the highest in event 2, the major direction of chest compression. Both shoulder joint angles had no significant difference. Muscle activation of the triceps brachii (p < .01), biceps brachii (p < .05), rectus abdominis (p < .05) and rectus femoris (p < .01) significantly increased during the compression phase compared with the decompression phase, with the rectus femoris showing an increase of 19%. Muscle activation of the erector spinae significantly increased in the decompression phase compared with the compression phase (p < .01). Conclusion: 119 EMTs mainly use the triceps brachii, biceps brachii and pectoralis major muscles during chest compression.

Keywords

References

  1. Chaffin DF, Andrsson GB Jr, Martin BJ. Occupational biomechanics. 3rd ed. New York: John Wiley & Sons Inc, 1999. 9.
  2. National Emergency Management Agency. Statistical yearbook. Available at: http://www.nema.go.kr/nema_cms_iba/show_nema/board/board9s/list.jsp?tab_no=2&c_relation=39&check_the_num=142&check_the_code=5&check_up_num=165, 2008.
  3. Joo JM. A study on job stress and musculoskeletal symptoms of 119 rescuers. Unpublished master's thesis, Aju University 2011, Suwon, Korea.
  4. Kim DS, Moon MK, Kim KS. A survey of musculoskeletal symptoms & risk factors for the 119 emergency medical services (EMS) activities. J Ergon Soc Korea 2010; 29(2):211-6. https://doi.org/10.5143/JESK.2010.29.2.211
  5. Jones AY, Lee RY. Rescuer's position and energy consumption, spinal kinetics and effectiveness of simulated cardiac compression. Am J Crit Care 2008;17(5):417-25.
  6. Ochoa FJ, Ramalle-Gomara E, Lisa V, Saralegui I. The effect of rescuer fatigue on the quality of chest compressions. Resuscitation 1998;37(3):149-52. https://doi.org/10.1016/S0300-9572(98)00057-4
  7. McCarthy P. Take the pain out of CPR training. RN 1995;58(6):17-20.
  8. Chi CH, Tsou JY, Su FC. Effects of rescuer position on the kinematics of cardiopulmonary resuscitation(CPR) and the force of delivered compressions. Resuscitation 2008;76(1):69-75. https://doi.org/10.1016/j.resuscitation.2007.06.007
  9. Dolan P, Adams MA. Repetitive lifting task fatigue the back muscle and increase the bending moment acting on the lumbar spine. J Biomech 1998;31(8):713-21. https://doi.org/10.1016/S0021-9290(98)00086-4
  10. Solomonow M, Zhou BH, Baratta RV, Lu Y, Harris M. Biomechanics of increased exposure to lumbar injury caused by cyclic loading: Part 1. Loss of reflexive muscular stabilization. Spine 1999;24(23):2426-34. https://doi.org/10.1097/00007632-199912010-00003
  11. Greingor JL. Quality of cardiac massage with ratio compression-ventilation 5/1 and 15/2. Resuscitation 2002;55(3):263-7. https://doi.org/10.1016/S0300-9572(02)00237-X
  12. Parekh JN. Effect of age and cardiopulmonary resuscitation(CPR) techniques on characteristics of muscle fatigue in females trained in CPR administration. Unpublished master's thesis, University of Texas 2007, Austin, USA.
  13. Ashton A, McCluskey A, Gwinnutt CL, Keenan AM. Effect of rescuer fatigue on performance of continuous external chest compression over 3 min. Resuscitation 2002; 55(2):151-5. https://doi.org/10.1016/S0300-9572(02)00168-5
  14. Tsou JY, Su FC, Tsao PC, Hong MY, Cheng SC, Chang HW, et al. Electromyography activity of selected trunk muscles during cardiopulmonary resuscitation. Am J Emerg Med 2014;32(3):216-20. https://doi.org/10.1016/j.ajem.2013.10.044
  15. De Luca CJ. Use of the surface EMG signal for performance evaluation of back muscles. Muscle Nerve 1993;16(2):210-6. https://doi.org/10.1002/mus.880160216
  16. Oddsson LI, De Luca CJ. Activation imbalances in lumbar spine muscles in the presence of chronic low back pain. J Appl Physiol 2003;94(4):1410-20. https://doi.org/10.1152/japplphysiol.01183.2001
  17. Nishiyama C, Iwami T, Kawamura T, Ando M, Yonemoto N, Hiraide A, et al. Quality of chest compression during continuous CPR; compression between chest compressiononly CPR and conventional CPR. Resuscitation 2010;81(9):1152-5. https://doi.org/10.1016/j.resuscitation.2010.05.008
  18. Cram JR, Kasman GS, Holtz J. Holtz Introduction to surface electromyography. 1st ed. Maryland, Aspen: Jones & Bartlett Publishers, 1998. 231.
  19. Raez MB, Hussain MS, Mohd-Yasin. Techniques of EMG signal analysis: Detection, preocessing, classification and application. Bio Proced Online 2006;8(1):11-35. https://doi.org/10.1251/bpo115
  20. Ekstrom RA, Donatelli RA, Carp KC. Electromyographic analysis of core trunk, hip and thigh muscles during 9 rehabilitation exercises. J Orthop Sports Phys Ther 2007;37(12):754-62. https://doi.org/10.2519/jospt.2007.2471
  21. Queiroz BC, Cagliari MF, Amorim CF, Sacco IC. Muscle activation during four pilates core stability exercises in quadruped position. Arch Phys Med Rehabil 2010; 91(1):86-92. https://doi.org/10.1016/j.apmr.2009.09.016
  22. McGill SM, Karpowicz A. Exercises for spine stabilization: Motion/motor patterns, stability progressions, and clinical technique. Arc Phys Med Rehabil 2009;90(1):118-26. https://doi.org/10.1016/j.apmr.2008.06.026
  23. Arokoski JP, Valta T, Airaksinen O, Kankaanpaa M. Back and abdominal muscle function during stabilization exercises. Arch Phys Med Rehabil 2001;82(8):1089-98. https://doi.org/10.1053/apmr.2001.23819
  24. Bejia I, Younes M, Jamila HB, Khalfallah T, Ben Salem K, Touzi M, et al. Prevalence and factors associated to low back pain among hospital staff. Joint Bone Spine 2005;72(3):254-9. https://doi.org/10.1016/j.jbspin.2004.06.001
  25. Tsou JY, Chi CH, Hsu RM, Wu HF, Su FC. Mechanical loading of the low back during cardiopulmonary resuscitation. Resuscitation 2009;80(10):1181-6. https://doi.org/10.1016/j.resuscitation.2009.06.025
  26. Hong EJ. Biomechanical analysis of trunk of EMT's during abdominal drawing-in CPR. Unpublished Doctor dissertation, Daegu university 2014, Daegu, Korea.
  27. Jones AY, Lee RY. Cardiopulmonary resuscitation and back injury in ambulance officers. Int Arch Occup Environ Health 2005;78(4):332-6. https://doi.org/10.1007/s00420-004-0577-3
  28. Foo NP, Chang JH, Lin HJ, Guo HR. Rescuer fatigue and cardiopulmonary resuscitation positions: A randomized controlled crossover trial. Resuscitation 2010; 81(5):579-84. https://doi.org/10.1016/j.resuscitation.2010.02.006