Impact of Cardiopulmonary Resuscitation Health Care Workers' Physical Health Parameters on Cardiopulmonary Resuscitation Performance Quality in Simulated Manikin-Based Settings—A Systematic Review

Objectives: The physical fitness of health care workers also influences the quality of cardiopulmonary resuscitation (CPR). With the recent conceptualization of "pit-crew" in hospitals to ensure sustained, seamless, high-quality CPR, the physical fitness parameters of CPR health care workers that affect CPR quality must be systematically studied. This systematic review aimed to synthesize findings from the current literature on the physical health parameters of CPR health care workers that are essential to ensuring high-quality CPR. Methods: PubMed, Scopus, and the Cochrane databases were reviewed to identify relevant articles published in English from inception to February 2025. Studies were included if they reported any physical health parameter of CPR health care workers and their association with high-quality CPR, including chest compression rate, depth, timing, or overall CPR quality. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool by 2 independent reviewers. Results: After screening of 11,895 articles, 22 studies published between 2002 and 2024 were included, with 2492 CPR participants in manikin studies. Age, gender, height, weight, body mass index, physical exercise frequency, handgrip or upper-body strength, anaerobic power, maximum heart rate during CPR, muscle strength, fatigue or endurance, body composition, and ventilation threshold were various parameters that were found to be significantly associated with high-quality CPR. Due to differences in the presentation of physical fitness parameters across the studies, a meta-analysis could not be carried out as planned. Conclusion: Physical health and fitness parameters of CPR health care workers are crucial to ensure high-quality CPR. Achieving adequate depth and sustained frequency of chest compressions requires both strength and endurance among CPR health care workers.