Utility of a Non-Exercise VO_2max Prediction Model for Designing Ramp Test Protocols

Abstract

This study investigated the validity of determining the final work rates of cycling and walking ramp-incremented maximal cardiopulmonary exercise tests (CPETs) using a non-exercise model to predict maximal oxygen uptake VO_2max and the American College of Sports Medicine ACSM’s metabolic equations. The validity of using this methodology to elicit the recommended test duration of between 8 and 12 min was then evaluated. First, 83 subjects visited the laboratory once to perform a cycling (n=49) or walking (n=34) CPET to investigate the validity of the methodology. Second, 25 subjects (cycling group: n=13; walking group: n=12) performed a CPET on 2 separate days to test the reliability of CPET outcomes. Observed VO_2max was 1.0 ml·kg⁻¹·min⁻¹ lower than predicted in the cycling CPET (P=0.001) and 1.4 ml·kg⁻¹·min⁻¹ lower in the walking CPET (P=0.001). Only one of the 133 conducted CPETs was outside the test duration range of 8–12 min. Test-retest reliability was high for all CPET outcomes, with intraclass correlation coefficients of 0.90 to 0.99. In conclusion, the non-exercise model is a valid and reliable method for establishing the final work rate of cycling and walking CPETs for eliciting test durations of between 8 and 12 min.

Key words

cycling - walking - cardiopulmonary exercise testing - ergometry - physical fitness - reproducibility

• References

• 1 ACSM . ACSM’s guidelines for exercise testing and prescription. 8^th ed Baltimore: Lippincott Williams & Wilkins; 2009
• 2 Cunha FA, Catalao RP, Midgley AW, Gurgel J, Porto F, Farinatti PT. Do the speeds defined by the American College of Sports Medicine metabolic equation for running produce target energy expenditures during isocaloric exercise bouts?. Eur J Appl Physiol 2012; 112: 3019-3026
• 3 Cunha FA, Farinatti Pde T, Midgley AW. Methodological and practical application issues in exercise prescription using the heart rate reserve and oxygen uptake reserve methods. J Sci Med Sport 2011; 14: 46-57
• 4 Cunha FA, Midgley AW, Monteiro WD, Campos FK, Farinatti PT. The relationship between oxygen uptake reserve and heart rate reserve is affected by intensity and duration during aerobic exercise at constant work rate. Appl Physiol Nutr Metab 2011; 36: 839-847
• 5 Cunha FA, Midgley AW, Monteiro WD, Farinatti PT. Influence of cardiopulmonary exercise testing protocol and resting VO(2) assessment on %HR(max), %HRR, %VO(2max) and %VO(2)R relationships. Int J Sports Med 2010; 31: 319-326
• 6 Cunha FA, Montenegro RA, Midgley AW, Vasconcellos F, Soares PP, Farinatti P. Influence of exercise modality on agreement between gas exchange and heart rate variability thresholds. Braz J Med Biol Res 2014; 47: 706-714
• 7 da Silva SC, Monteiro WD, Cunha FA, Myers J, Farinatti PT. Determination of best criteria to determine final and Initial speeds within ramp exercise testing protocols. Pulm Med 2012; 2012: 542402
• 8 Fletcher GF, Ades PA, Kligfield P, Arena R, Balady GJ, Bittner VA, Coke LA, Fleg JL, Forman DE, Gerber TC, Gulati M, Madan K, Rhodes J, Thompson PD, Williams MA. Exercise standards for testing and training: a scientific statement from the American Heart Association. Circulation 2013; 128: 873-934
• 9 Gibbons RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher GF, Froelicher VF, Mark DB, McCallister BD, Mooss AN, O’Reilly MG, Winters Jr WL, Antman EM, Alpert JS, Faxon DP, Fuster V, Gregoratos G, Hiratzka LF, Jacobs AK, Russell RO, Smith Jr SC. ACC/AHA 2002 guideline update for exercise testing: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). Circulation 2002; 106: 1883-1892
• 10 Harriss DJ, Atkinson G. Ethical standards in sport and exercise science research: 2014 update. Int J Sports Med 34: 1025-1028
• 11 Howley ET, Bassett Jr DR, Welch HG. Criteria for maximal oxygen uptake: review and commentary. Med Sci Sports Exerc 1995; 27: 1292-1301
• 12 Maeder M, Wolber T, Atefy R, Gadza M, Ammann P, Myers J, Rickli H. Impact of the exercise mode on exercise capacity: bicycle testing revisited. Chest 2005; 128: 2804-2811
• 13 Maeder M, Wolber T, Atefy R, Gadza M, Ammann P, Myers J, Rickli H. A nomogram to select the optimal treadmill ramp protocol in subjects with high exercise capacity: validation and comparison with the Bruce protocol. J Cardiopulm Rehabil 2006; 26: 16-23
• 14 Maranhão Neto GdA, Leon ACMPd, Farinatti PdTV . Cross-cultural equivalence of three scales used to estimate cardiorespiratory fitness in the elderly. Cad Saúde Pública 2008; 24: 2499-2510
• 15 Maranhão Neto GdA, Lourenço PMC, Farinatti PdTV . Prediction of aerobic fitness without stress testing and applicability to epidemiological studies: a systematic review. Cad Saúde Pública 2004; 20: 48-56
• 16 Matthews CE, Heil DP, Freedson PS, Pastides H. Classification of cardiorespiratory fitness without exercise testing. Med Sci Sports Exerc 1999; 31: 486-493
• 17 Midgley AW, Bentley DJ, Luttikholt H, McNaughton LR, Millet GP. Challenging a dogma of exercise physiology: does an incremental exercise test for valid VO 2 max determination really need to last between 8 and 12 minutes?. Sports Med 2008; 38: 441-447
• 18 Midgley AW, McNaughton LR, Carroll S. Effect of the VO2 time-averaging interval on the reproducibility of VO2max in healthy athletic subjects. Clin Physiol Funct Imaging 2007; 27: 122-125
• 19 Midgley AW, McNaughton LR, Carroll S. Reproducibility of time at or near VO2max during intermittent treadmill running. Int J Sports Med 2007; 28: 40-47
• 20 Montenegro R, Okano AH, Cunha FA, Fontes EB, Farinatti P. Does prefrontal cortex transcranial direct current ctimulation influence the oxygen uptake at rest and post-exercise?. Int J Sports Med 2014; 35: 459-464
• 21 Montenegro RA, Okano AH, Cunha FA, Gurgel JL, Fontes EB, Farinatti PT. Prefrontal cortex transcranial direct current stimulation associated with aerobic exercise change aspects of appetite sensation in overweight adults. Appetite 2012; 58: 333-338
• 22 Myers J, Bader D, Madhavan R, Froelicher V. Validation of a specific activity questionnaire to estimate exercise tolerance in patients referred for exercise testing. Am Heart J 2001; 142: 1041-1046
• 23 Myers J, Bellin D. Ramp exercise protocols for clinical and cardiopulmonary exercise testing. Sports Med 2000; 30: 23-29
• 24 Myers J, Do D, Herbert W, Ribisl P, Froelicher VF. A nomogram to predict exercise capacity from a specific activity questionnaire and clinical data. Am J Cardiol 1994; 73: 591-596
• 25 Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE. Exercise capacity and mortality among men referred for exercise testing. N Engl J Med 2002; 346: 793-801
• 26 Silva SCd, Monteiro WD, Farinatti PdTV. Exercise maximum capacity assessment: a review on the traditional protocols and the evolution to individualized models. Rev Bras Med Esporte 2011; 17: 363-369
• 27 Wisen AG, Farazdaghi RG, Wohlfart B. A novel rating scale to predict maximal exercise capacity. Eur J Appl Physiol 2002; 87: 350-357