Exercise stress test in apparently healthy individuals − where to place the finish line? The Ferrari corporate wellness programme experience

Abstract

Aims The aim of our study was to assess the clinical significance of the exercise stress testing endpoints, namely 85% of maximal theoretical heart rate (MTHR), metabolic equivalent of task, and rating of perceived exertion (RPE), and their relation to electrocardiographic (ECG) changes in a healthy adult population. Methods A cross-sectional study was conducted on 408 males and 52 females (mean age 39.4 ± 8.6 years) who performed the maximal cycle ergometer exercise stress test until volitional exhaustion, reporting the RPE score at 85% of MTHR and at peak exercise. Metabolic equivalents of task were indirectly calculated from the maximum workload and compared with the predicted values. Sitting torso-lead ECG and blood pressure were recorded at rest, during exercise and during recovery. Results Of 460 participants, 73% exceeded 85% of MTHR. The RPE score represented the overall most significant endpoint of exercise stress testing, with the median value of 17 at peak exercise. ECG events were detected in 23/124 (18.5%) who reached ≤ 85% of MTHR and in 61/336 (18.2%) who achieved >85% of MTHR ( p = 0.92). In the latter group, 54% of ECG changes occurred at < 85% of MTHR and 46% at > 85% of MTHR ( p = 0.51). If the exercise stress testing had been interrupted at ≤ 85% of MTHR, almost half of the ECG events would have remained undetected and 35% of the cardiovascular abnormalities observed at the diagnostic follow-up would have remained undiagnosed. Conclusion Terminating exercise stress testing before volitional exhaustion and an RPE score of 17 limits the test accuracy and reduces the possibility to detect cardiovascular abnormalities in apparently healthy adult populations.

Guidelines for Physical Activity—A Cross-Sectional Study to Assess Their Application in the General Population. Have We Achieved Our Goal?

“…Unfortunately, this data is even more alarming, as subjects included in the sample of the present study were young adults, with a mean age of 29.18 years. This percentage is almost constant, and it is in line with data from previous studies [17,33], which highlight that a large portion of the population performs levels of PA below those recommended. Moreover, evidence suggests that regular PA among young people is declining [34] and being physical inactive during young adulthood can determine severe health effects later in life [35].…”

“…Indications and contraindications of PA have become a controversial discussion point among physicians and other health professionals [3,16]. Some research areas have contributed to defining risk factors related to PA and to implement algorithms and pre-participation screening strategies to avoid the harmful effects of PA in high-risk patients [17][18][19]. On the other hand, most national and international health organizations have proposed guidelines for PA, establishing the specific thresholds of type, duration, frequency and volume necessary to have positive effects on health [5].…”

External Responsiveness of the SuperOpTM Device to Assess Recovery After Exercise: A Pilot Study

“…Although we did not monitor BP continuously during the VO 2Max test, recorded posttest values should be considered normal, although higher than pre-test values (Table 2). Moreover, a previous study (Sirico et al, 2019) showed excessively higher BP-values during an exercise stress test among a small percentage of the general population.…”

Worksite Energy Cost Assessment in Non-surgical versus Surgical Medical Residency Programs

“…The mean METs recorded on the whole sample was 1.66 (SD 0.22); it was 1.72 (0.18) in non-surgical group 1.58 (0.20) in surgical group (p=0.043) (Table 1). Due to the recognized impact of body weight on energy cost, 3 the correlation between BMI and recorded METs of the whole sample was investigated; there was a non-significant correlation (r=0.189, p=0.326) between these two variables in the present sample.…”