Evaluation of upper body muscle activity during cardiopulmonary resuscitation performance in simulated microgravity

Performance of efficient single-person cardiopulmonary resuscitation (CPR) is vital to maintain cardiac and cerebral perfusion during the 2-4 min it takes for deployment of advanced life support during a space mission. The aim of the present study was to investigate potential differences in upper body muscle activity during CPR performance at terrestrial gravity (+1Gz) and in simulated microgravity (μG). Muscle activity of the triceps brachii, erector spinae, rectus abdominis and pectoralis major was measured via superficial electromyography in 20 healthy male volunteers. Four sets of 30 external chest compressions (ECCs) were performed on a mannequin. Microgravity was simulated using a body suspension device and harness; the Evetts-Russomano (ER) method was adopted for CPR performance in simulated microgravity. Heart rate and perceived exertion via Borg scores were also measured. While a significantly lower depth of ECCs was observed in simulated microgravity, compared with +1Gz, it was still within the target range of 40-50 mm. There was a 7.7% decrease of the mean (±SEM) ECC depth from 48 ± 0.3 mm at +1Gz, to 44.3 ± 0.5 mm during microgravity simulation (p < 0.001). No significant difference in number or rate of compressions was found between the two conditions. Heart rate displayed a significantly larger increase during CPR in simulated microgravity than at +1Gz, the former presenting a mean (±SEM) of 23.6 ± 2.91 bpm and the latter, 76.6 ± 3.8 bpm (p < 0.001). Borg scores were 70% higher post-microgravity compressions (17 ± 1) than post +1Gz compressions (10 ± 1) (p < 0.001). Intermuscular comparisons showed the triceps brachii to have significantly lower muscle activity than each of the other three tested muscles, in both +1Gz and microgravity. As shown by greater Borg scores and heart rate increases, CPR performance in simulated microgravity is more fatiguing than at +1Gz. Nevertheless, no significant difference in muscle activity between conditions was found, a result that is favourable for astronauts, given the inevitable muscular and cardiovascular deconditioning that occurs during space travel.