The performance of Cardio Pulmonary Resuscitation (CPR) chest compressions on a patient provide critical blood flow and oxygen delivery to the heart and brain. The objective of this study was to establish the relationship between the rate of muscle fatigue and chest compression performance. It was hypothesized that if performance of chest compressions cause fatigue after five minutes, then the rate of muscle fatigue will be indicated through surface electromyography (sEMG) measurements. Four participants (M=2, F=2) volunteered to perform chest compressions on a CPR mannequin. sEMG electrodes were placed on the participants’ dominant limb anterior deltoid muscle to capture muscle activity while performing chest compressions. Each participant completed four sets of CPR chest compressions with a two minute rest period between sets. Data was analyzed through the iWrox LabScribe™ software. The absolute interval, root mean square, and minimum and maximum amplitudes for each signal were collected for data analysis. The mean amplitude percent decline was calculated for each set of chest compressions in three-minute intervals for each participant. Examination of the rate of decline between subjects, indicating muscle fatigue was evident. The hypothesis was therefore accepted; there was convincing muscle fatigue shown through sEMG measurements while CPR chest compressions were performed. If the study was to be replicated, the author recommends that the study involve more participants to confirm the established data

Necco, Katelyn

English

Valparaiso University

Valparaiso University ValpoScholar Symposium on Undergraduate Research and Creative Expression (SOURCE) Office of Sponsored and Undergraduate Research Spring 5-1-2020 Muscle Fatigue During Cardiopulmonary Resuscitation Chest Compressions Katelyn Necco katelyn.necco@valpo.edu Follow this and additional works at: https://scholar.valpo.edu/cus Recommended Citation Necco, Katelyn, "Muscle Fatigue During Cardiopulmonary Resuscitation Chest Compressions" (2020). Symposium on Undergraduate Research and Creative Expression (SOURCE). 865. https://scholar.valpo.edu/cus/865 This Poster Presentation is brought to you for free and open access by the Office of Sponsored and Undergraduate Research at ValpoScholar. It has been accepted for inclusion in Symposium on Undergraduate Research and Creative Expression (SOURCE) by an authorized administrator of ValpoScholar. For more information, please contact a ValpoScholar staff member at scholar@valpo.edu. The performance of cardiopulmonary resuscitation (CPR) chest compressions on a patient provides critical blood flow and oxygen delivery to the heart and brain1. The objective of this study was to establish the relationship between the rate of muscle fatigue and chest compression performance. The hypothesis stated that if performance of chest compressions cause fatigue after two minutes, then the rate of muscle fatigue will be indicated through surface electromyography (sEMG) measurements. Four participants (M=2, F=2) volunteered to perform chest compressions on a CPR mannequin. sEMG electrodes were placed on the dominant limb anterior deltoid muscle to capture muscle activity while performing chest compressions. Each participant completed 4 sets of CPR chest compressions with a 2-minute rest period between sets. Data was analyzed through the iWroxLabScribe™ software. The root mean square and maximum amplitudes for each signal were collected for data analysis. The mean percent decline was calculated for each set of chest compressions in 3-minute intervals for each participant. The mean percent decline was found to be 17.19% across all participants. Examination of the rate of decline between subjects, indicated the presence of muscle fatigue. The hypothesis was therefore accepted; muscle fatigue was shown through sEMG measurements while CPR chest compressions were performed. IntroductionResults cont.Valparaiso University Department of  KinesiologyKatelyn Necco; Kelly Helm PhD Rate of Muscle Fatigue During Cardiopulmonary Resuscitation Chest CompressionsSetting• Fitness Lab at a small Midwest university; Spring 2020Participants• 4 (M=2,F=2) volunteers experienced with CPR chest compression performanceProcedures• sEMG electrodes placed on participants’ dominant anterior deltoid• Performance of 2-minute chest compressions with 2-minute rest, repeated 3 times• Root mean square and minimum and maximum amplitude of muscle activation analyzed• Mean amplitude percent decline calculated Conclusions This study provides data on the rate of muscle fatigue during CPR chest compression performance. Percent decline of 17.19% across all participants was found and therefore, it is concluded that performance of chest compressions does cause muscle fatigue after several minutes. This conclusion was supported by the calculated percent decline of muscle activation which was seen through the collected sEMG measurements. Therefore, the hypothesis of this study that if performance of chest compressions cause fatigue after several minutes, then the rate of muscle fatigue will be indicated through sEMG measurements, is accepted. Future research could examine differences in muscle fatigue in varying muscle groups.ResultsI would like to greatly thank Dr. Helm with the help she provided while I formed, planned, and performed my study. Additionally, I would like to extend my utmost thanks to my participants, JD, Connor, Mackenzy, and Sydney, for volunteering their time and effort towards my study. Lastly, I would like to thank Terrance Wade from the statistics department for providing support with analysis of the collected data in my study.Figure 1Participants performing CPR chest compressionsAcknowledgementsFigure 2 Condensed last 4th set of chest compressions References1. American Heart Association. (n.d).  Retrieved from cpr.heart.org2. Cobo-Vázquez, C., De Blas, G., García-Canas, P., Del Carmen Gasco-García, M., (2018). Electrophysiology of muscle fatigue in cardiopulmonary resuscitation on manikin model. Anesthesia Progress, 65(1), 30–37. doi:10.2344/anpr-65-01-063. Finsterer, J. (2012). Biomarkers of peripheral muscle fatigue during exercise. BMC musculoskeletal disorders, 13(1), 218.AbstractMuscles become fatigued because performing CPR is a physically demanding task. The AHA currently recommends, if resources are available, to switch rescuers every 2-minutes while performing CPR so that adequate chest compressions are maintained.1 EMG research supports the recommendation of switching every 2-minutes as studies  show muscle fatigue occurs in rescuers at 2-minutes.2 Exercise-induced muscle fatigue can develop under a maximal and sub-maximal intensity exercise. Performing chest compressions for 2-minutes is considered an anaerobic exercise that induces muscle fatigue..3 This study was designed to investigate the relationship between muscle fatigue and performance of chest compressions. The muscle targeted was the anterior deltoid on the dominant arm of the participant. Figure 3Processed last 30 s. 4th set of chest compressions Table 1Mean muscle activation across all four 2-min. trialsRMS Maximum Amplitudes (mV)n 1 2 3 4 1 2 3 44 0.15 0.25 0.16 0.2 0.82 1.55 0.91 0.99MethodsTable 2Percent rate of decline across all participantsn 1 2 3 4 x̄4 21.93 13.98 6.13 26.72 17.19Table 1 indicates the decline of the root mean square which further indicate the decrease in muscle activation. The individual maximum amplitudes of each participant vary within each trial and do not confirm a rate of decline. The information in Table 2 displays that each participant demonstrated a decrease in muscle activation in the dominant anterior deltoid through the first and last maximum amplitudes. Table 2 also presents the average percent decline of muscle activation across all participants of 17.19%. The sEMG data collected therefore indicated a decrease in muscle activation across all participants. 

Muscle Fatigue During Cardiopulmonary Resuscitation Chest Compressions

ValpoScholar

Valparaiso University 
ValpoScholar 
Symposium on Undergraduate Research and 
Creative Expression (SOURCE) 
Office of Sponsored and Undergraduate 
Research 
Spring 5-1-2020 
Muscle Fatigue During Cardiopulmonary Resuscitation Chest 
Compressions 
Katelyn Necco 
katelyn.necco@valpo.edu 
Follow this and additional works at: https://scholar.valpo.edu/cus 
Recommended Citation 
Necco, Katelyn, "Muscle Fatigue During Cardiopulmonary Resuscitation Chest Compressions" (2020). 
Symposium on Undergraduate Research and Creative Expression (SOURCE). 865. 
https://scholar.valpo.edu/cus/865 
This Poster Presentation is brought to you for free and open access by the Office of Sponsored and Undergraduate 
Research at ValpoScholar. It has been accepted for inclusion in Symposium on Undergraduate Research and 
Creative Expression (SOURCE) by an authorized administrator of ValpoScholar. For more information, please 
contact a ValpoScholar staff member at scholar@valpo.edu. 
The performance of cardiopulmonary resuscitation (CPR) chest 
compressions on a patient provides critical blood flow and oxygen 
delivery to the heart and brain1. The objective of this study was to 
establish the relationship between the rate of muscle fatigue and chest 
compression performance. The hypothesis stated that if performance of 
chest compressions cause fatigue after two minutes, then the rate of 
muscle fatigue will be indicated through surface electromyography 
(sEMG) measurements. Four participants (M=2, F=2) volunteered to 
perform chest compressions on a CPR mannequin. sEMG electrodes 
were placed on the dominant limb anterior deltoid muscle to capture 
muscle activity while performing chest compressions. Each participant 
completed 4 sets of CPR chest compressions with a 2-minute rest 
period between sets. Data was analyzed through the iWrox
LabScribe™ software. The root mean square and maximum amplitudes 
for each signal were collected for data analysis. The mean percent 
decline was calculated for each set of chest compressions in 3-minute 
intervals for each participant. The mean percent decline was found to 
be 17.19% across all participants. Examination of the rate of decline 
between subjects, indicated the presence of muscle fatigue. The 
hypothesis was therefore accepted; muscle fatigue was shown through 
sEMG measurements while CPR chest compressions were performed. 
Introduction
Results cont.
Valparaiso University Department of  Kinesiology
Katelyn Necco; Kelly Helm PhD 
Rate of Muscle Fatigue During 
Cardiopulmonary Resuscitation Chest Compressions
Setting
• Fitness Lab at a small Midwest university; Spring 2020
Participants
• 4 (M=2,F=2) volunteers experienced with CPR chest compression 
performance
Procedures
• sEMG electrodes placed on participants’ dominant anterior 
deltoid
• Performance of 2-minute chest compressions with 2-minute 
rest, repeated 3 times
• Root mean square and minimum and maximum amplitude of 
muscle activation analyzed
• Mean amplitude percent decline calculated 
Conclusions 
This study provides data on the rate of muscle fatigue during 
CPR chest compression performance. Percent decline of 17.19% 
across all participants was found and therefore, it is concluded that 
performance of chest compressions does cause muscle fatigue after 
several minutes. This conclusion was supported by the calculated 
percent decline of muscle activation which was seen through the 
collected sEMG measurements. Therefore, the hypothesis of this 
study that if performance of chest compressions cause fatigue after 
several minutes, then the rate of muscle fatigue will be indicated 
through sEMG measurements, is accepted. Future research could 
examine differences in muscle fatigue in varying muscle groups.
Results
I would like to greatly thank Dr. Helm with the help she provided while I formed, planned, and 
performed my study. Additionally, I would like to extend my utmost thanks to my participants, JD, 
Connor, Mackenzy, and Sydney, for volunteering their time and effort towards my study. Lastly, I would 
like to thank Terrance Wade from the statistics department for providing support with analysis of the 
collected data in my study.
Figure 1
Participants performing CPR chest compressions
Acknowledgements
Figure 2 
Condensed last 4th set of chest compressions 
References
1. American Heart Association. (n.d).  Retrieved from cpr.heart.org
2. Cobo-Vázquez, C., De Blas, G., García-Canas, P., Del Carmen Gasco-García, M., (2018). Electrophysiology of muscle fatigue in cardiopulmonary 
resuscitation on manikin model. Anesthesia Progress, 65(1), 30–37. doi:10.2344/anpr-65-01-06
3. Finsterer, J. (2012). Biomarkers of peripheral muscle fatigue during exercise. BMC musculoskeletal disorders, 13(1), 218.
Abstract
Muscles become fatigued because performing CPR is a physically 
demanding task. The AHA currently recommends, if resources are 
available, to switch rescuers every 2-minutes while performing CPR so 
that adequate chest compressions are maintained.1 EMG research 
supports the recommendation of switching every 2-minutes as studies  
show muscle fatigue occurs in rescuers at 2-minutes.2 Exercise-induced 
muscle fatigue can develop under a maximal and sub-maximal intensity 
exercise. Performing chest compressions for 2-minutes is considered an 
anaerobic exercise that induces muscle fatigue..3 This study was 
designed to investigate the relationship between muscle fatigue and 
performance of chest compressions. The muscle targeted was the 
anterior deltoid on the dominant arm of the participant. 
Figure 3
Processed last 30 s. 4th set of chest compressions 
Table 1
Mean muscle activation across all four 2-min. trials
RMS Maximum Amplitudes (mV)
n 1 2 3 4 1 2 3 4
4 0.15 0.25 0.16 0.2 0.82 1.55 0.91 0.99
Methods
Table 2
Percent rate of decline across all participants
n 1 2 3 4 x̄
4 21.93 13.98 6.13 26.72 17.19
Table 1 indicates the decline of the root mean square which 
further indicate the decrease in muscle activation. The individual 
maximum amplitudes of each participant vary within each trial 
and do not confirm a rate of decline. The information in Table 2 
displays that each participant demonstrated a decrease in muscle 
activation in the dominant anterior deltoid through the first and 
last maximum amplitudes. Table 2 also presents the average 
percent decline of muscle activation across all participants of 
17.19%. The sEMG data collected therefore indicated a decrease 
in muscle activation across all participants. 


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Muscle Fatigue During Cardiopulmonary Resuscitation Chest Compressions

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