Thai physiotherapists’ performance of manual chest wall percussion on an artificial lung: frequency, force, and fatigue perception
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Abstract
Manual chest wall percussion (MP) is a conventional chest physical therapy that aims to assist airway clearance. Various frequencies and forces of MP are widely used in current practice. However, MP low frequency, highest frequency, and repeatability have not been explored. Moreover, the relationship between MP force and flow oscillation amplitude (FOA) has not been reported. Our objective is to explore the performance of physiotherapists in performing MP at three frequencies (routine, low, and highest) and repeatability of MP in the artificial lung and explore the relationship between MP force and FOA. Physiotherapists with cardiopulmonary practice experience performed MP at three frequencies: routine, low, and highest. Each physiotherapist performed MP on the artificial lung at each frequency for five minutes, on two different days. We measured the frequency and force of MP, the physiotherapist’s fatigue, and the flow and pressure from the artificial lung during percussion. Forty-four participants were recruited for this study. The routine, low, and highest frequencies were 5.4 ± 0.6 Hz, 3.9 ± 0.9 Hz, and 6.5 ± 0.8 Hz, respectively. The force in the dominant hand at the routine, low, and highest frequencies was 5.2 ± 1.2 kg, 4.4 ± 1.4 kg, and 5.9 ± 1.8 kg, respectively. The force in the non-dominant hand at the routine, low, and highest frequencies was 3.8 ± 1.1 kg, 3.3 ± 1.1 kg, and 4.3 ± 1.4 kg, respectively. The average 5-minute upper body fatigue scores for the routine, low, and highest frequencies were 2.5 (range 0.0–5.5), 1.6 (range 0.0–5.6), and 4.1 (range 0.2–8.5), respectively Additionally, the highest and low frequencies show great repeatability (r = 0.90, p-value < 0.001, r = 0.86, p-value < 0.001, respectively), although the routine frequency only showed moderate repeatability (r = 0.69, p-value < 0.001). The positive relationship between dominance and non-dominance in MP force and FOA were met (r = 0.85, p-value < 0.001 for the dominant hand and r = 0.76, p-value < 0.001 for the non-dominant hand). In conclusion, the possible MP frequency in clinical practices was 3.9 to 6.5 Hz with force 3.3 to 5.2 kg. MP force direct effect on FOA. Based on fatigue perception and repeatability results, we recommend using MP for 3–5 minutes per session.
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