A 3-minute test of cardiorespiratory fitness for use in primary care clinics

Abstract

BackgroundCardiorespiratory fitness (CRF) is the only major risk factor that is not routinely assessed in the clinical setting, for preventive medicine. A valid and practical CRF test is needed for use in the clinics. The objective of this study is to demonstrate the validity of a 3-minute squat test to assess CRF in primary care.MethodsA cross-sectional study in which the participants performed both the Ruffier squat test and the Balke maximal treadmill test. The study was conducted in a clinical setting from September 2016 to March 2017. We recruited a convenient sample of 40 adults between 18 and 64 years from the general U.S. population. Participants completed 30 squats in 45 seconds, paced by a metronome. Heart rate was measured at rest (P1), immediately after the test (P2), one minute after the test (P3). was measured using the Balke maximal treadmill fitness test.ResultsOf the 40 participants, there were 18 men and 22 women. Mean age was 31.2 years (SD = 9.9). We found that the best predictors were HR features P1/height and (P2–P3)/age3. Our best-performing model using these two features predicted individuals’ CRF levels with an adjusted R2 of 0.637, sensitivity of 0.79, and specificity of 0.56.ConclusionsThe study provided strong evidence for the validity of the squat test in the clinical setting. Further, the equation of our model along with normative tables provides an efficient and easy way to assess CRF in a primary care setting.

Simple tests of cardiorespiratory fitness in a pediatric population

“…To our knowledge, this is the first study to attempt to validate the Squat Test [13] relative to the VO 2max treadmill test in a pediatric age group. The Squat and Step Tests have been validated previously in adults [16,27] and various submaximal step test protocols have been validated previously in children and adolescents [15,28,29]. However, this is the first study to show that all three fitness determinations may be able to discriminate low and high risk populations using FITNESSGram standards, an observation that can be used to estimate an individual patient's risk and provide appropriate counseling within the clinic setting.…”

“…Children aged 10-17 were recruited (N = 40) from the Gainesville, Florida area and surrounding community. Forty participants were included as this sample size was sufficient to achieve stability in statistical models based on analysis of the Root Mean Square Error (RMSE) in a similar study of adults performed at our institution [16]. Flyers were posted in campus buildings, schools, public locations, and UF Pediatric Clinics for recruitment.…”

Cardiorespiratory Fitness as a Correlate of Cardiovascular, Anthropometric, and Physical Risk Factors: Using the Ruffier Test as a Template

“…At the end of the test, the post-test heart rate 1 (HR 2) was measured after 15 seconds of the test. The post-test heart rate 2 (HR 3) was measured after one minute of the test, and the HR was measured using a Polar heart rate monitor (POLAR T31, China) [ 5 , 6 ]. The VO 2max was estimated based on the following equation [ 5 ]: …”

“…Three measurements of HR are taken: resting HR (pretest), HR immediately after completing the squats (post-test 1), and recovery HR 60 seconds, which is measured after the completion of the test (post-test 2). Studies have proven that the test has strong validity to predict CRF in terms of the estimated maximal oxygen uptake (VO 2max ) [ 5 , 6 ].…”

Heart Snapshot: a broadly validated smartphone measure of VO2max for collection of real world data

“…However, one of the most predictive biometrics for cardiovascular health 10 and overall mortality 1 , VO 2 max, is typically not incorporated in these risk calculators due to the burdens associated with obtaining this measurement. 3,4 Cardiorespiratory fitness as measured by VO 2 max represents the integrated function of physiological systems involved in transporting oxygen from the atmosphere to the skeletal muscles to perform physical work. Existing gold standard techniques for measuring VO 2 max are based on protocols that use exercise on a treadmill or stationary bicycle paired with direct measurement of oxygen consumption at various workloads including maximal exertion.…”