Date of Award


Degree Name

MS in Kinesiology




College of Science and Mathematics


Steven C. Davis

Advisor Department


Advisor College

College of Science and Mathematics


The standard first aid for a heart attack resulting in cardiopulmonary arrest is effective cardiopulmonary resuscitation (CPR). Chest compressions are most commonly performed on a flat surface with the rescuer kneeling next to the victim with one hand on top of the other on the sternum and elbows straight. This technique of being on the ground may be challenging for those without the mobility and strength to get up and down from the ground. In 2005, the American Heart Association (AHA) Guidelines listed “pedal”, or heel, compression as an acceptable alternative to standard chest compressions (Trenkamp & Perez, 2015). That same year, the recommended depth of a compression increased from 3.8 cm to 5.0 cm (Trenkamp & Perez, 2015). To attain such a depth, extra force and strength arerequired. The heel method may be especially reasonable for those rescuers who cannot attain the floor and those who do not have the cardiovascular or muscular strength to perform traditional chest compressions.

The purpose of this study was to evaluate the effects of performance of hands only (HO) versus the combination (CO) of hands only plus pedal CPR on the electrocardiogram, including heart rate and heart rhythm.

The subjects utilized in this investigation were six men and nine women between 56 and 71 years of age from San Luis Obispo County in California. Subjects underwent two trials with at least a 15 hour rest period in between but no more than one week. Subjects were randomly assigned to either the Combination (CO) trial or the Hands Only (HO) trial. When they came back for their second trial, they did the trial that they did not do the first time.

On average, participants were able to sustain the combination of HO plus pedal CPR longer (9.47 minutes) than they were able to perform standard HO CPR (9.02 minutes) but this difference was not statistically significant (p=0.16). Mean maximum heart rate was 133 ± 23.7 bpm during the CO trial and 125.4 ± 21.9 bpm during the HO trial (p=0.12). Mean percentage of the HR reserve was 75.1% during the CO trial and 61.1% during the HO trial (p=0.09). Mean RPE was not significantly different between CO and HO trials (p=0.2124), nor between genders (p=0.42090). However, for both trials combined the mean RPE was significantly greater at 5 minutes of CPR (4.45 ± 0.53) than at 2 minutes of CPR (3.38 ± 0.31), (p

It may take time for individuals to accept pedal CPR as a viable resuscitation method. With the majority of sudden cardiac arrests occurring in the home among older adults in society, it is important to recognize that pedal CPR is an acceptable method and that a rescuer may have this choice if they either need a break from standard CPR or if they can not attain the ground.

Included in

Cardiology Commons