Estimating VO2peak in 18–90 Year-Old Adults: Development and Validation of the FitMáx©-Questionnaire

Abstract

Purpose Cardiorespiratory fitness (CRF) plays an essential role in health outcomes and quality of life. However, it is often not assessed nor estimated. Objective CRF assessment is costly, labour intensive and not widely available. Patient-reported outcome measures estimate CRF more cost-efficiently, but current questionnaires lack accuracy. The aim of this study is to develop a new self-reported questionnaire to estimate CRF. Materials and Methods The FitMáx©-questionnaire, consisting of only three questions assessing walking, stair climbing, and cycling capacity, was compared with the commonly used Duke Activity Status Index (DASI) and Veterans Specific Activity Questionnaire (VSAQ). These questionnaires were compared to peak oxygen uptake (VO 2peak ) as measured with cardiopulmonary exercise testing. This study included 759 cardiac, pulmonary and oncologic patients and healthy persons aged 18‒90. Results FitMáx© strongly correlated (r = 0.94 (0.92‒0.95) SEE = 4.14 mL∙kg −1 ∙min −1 ) with measured VO 2peak . Bias between predicted and measured VO 2peak was −0.24 (−9.23‒8.75; 95% limits of agreement) mL·kg −1 ·min −1 . The FitMáx© scored superiorly on correlation and SEE compared with the DASI and VSAQ, r = 0.75 (0.68‒0.80) SEE = 4.62 mL∙kg −1 ∙min −1 and r = 0.87 (0.83‒0.90) SEE = 6.75 mL∙kg −1 ∙min −1 , respectively. Conclusion FitMáx© is a valid and accessible questionnaire to estimate CRF expressed as VO 2peak in clinical practice and shows substantial improvement compared to currently used questionnaires.

Usefulness of the Duke Activity Status Index to Assess Exercise Capacity and Predict Risk Stratification in Patients with Pulmonary Arterial Hypertension

“…The DASI score of 33.8 was sensitive and specific to discriminate high-risk patients from those who were non-high-risk. The DASI was originally developed for the evaluation of patients with cardiovascular diseases, and, therefore, a significant correlation with peakVO 2 is well demonstrated in multiple cardiovascular cohorts, with the correlation coefficients ranging from 0.31 to 0.71 [19,[32][33][34][35][36]. Furthermore, the DASI score is associated with exercise capacity in patients with chronic obstructive pulmonary disease, patients with cancer, and patients undergoing general surgery [17,21,37].…”

Telerehabilitation in patients with recent hospitalisation due to acute decompensated heart failure: protocol for the Tele-ADHF randomised controlled trial

“…CPET will be used to determine the maximal exercise capacity and the peak workload, to support the prescription of a tailored exercise rehabilitation programme [ 42 , 43 ]. The effect of the intervention on maximal exercise capacity, defined as VO 2peak , will be evaluated with the validated FitMáx©-questionnaire at randomisation, and follow-up [ 44 ]. Furthermore, recovery of O 2 kinetics (τ-rec) after submaximal exercise will be assessed with a Constant-Load Exercise Test (CLET) at 50% of the peak workload at randomisation and follow-up.…”

Monitoring aerobic capacity in cancer survivors using self-reported questionnaires: criterion validity and responsiveness

“…In a recent study, the FitMáx showed a strong intraclass correlation (ICC = 0.93) with CPET-VO 2peak , and acceptable bias (-0.24 with 95%-LoA − 9.23–8.75), in a heterogeneous group of 228 patients (with lung, cardiac and oncologic diseases) and athletes. The results for FitMáx were compared with DASI (ICC = 0.62, bias of 3.32 with 95%-LoA − 14.81–21.44) and VSAQ (ICC = 0.87, bias of 3.44 with 95%-LoA − 10.11–16.98) in the same population and showed better agreement with CPET-VO 2peak [ 17 ].…”

“…We hypothesized the population specific agreement between CPET-VO 2peak and FitMáx-VO 2peak at T 0 to be moderate-to good, with an ICC of > 0.70 [ 17 – 19 ]; and the ICC between change over time in CPET-VO 2peak and FitMáx-VO 2peak to be between 0.40 and 0.60 [ 20 , 21 ]. Furthermore, the ability of the FitMáx to discriminate between participants who did or did not improve in aerobic capacity was expected to be moderate.…”

“…As such, the area under the curve (AUC) of the receiver operating characteristic curve (ROC-curve) was expected to be in the range of 0.60–0.80 [ 18 ]. Lastly, looking at the results of previous studies, the validity and responsiveness of FitMáx-VO 2peak in this population are expected to be better compared to the validity and responsiveness of the DASI-VO 2peak and VSAQ-VO 2peak , which are expected to show poor-to moderate agreement with CPET-VO 2peak (ICC < 0.70) [ 11 , 17 , 22 ].…”