Overestimation of Aerobic Capacity With the Bruce Treadmill Protocol in Patients Being Assessed for Suspected Myocardial Ischemia

Pinkstaff, Sherry; Peberdy, Mary Ann; Kontos, Michael C.; Fabiato, A; Finucane, Sheryl; Arena, Ross

doi:10.1097/hcr.0b013e318211e3ed

Cited by 18 publications

(11 citation statements)

References 16 publications

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“…It has been shown that performing an exercise Protocol with frontal or lateral support can change metabolic demand and adaptation to the treadmill. This also occurs for the evaluated executing the protocol with free arms 17 .…”

Section: Discussionmentioning

confidence: 86%

Análise comparativa de fórmulas preditivas de avaliação da capacidade funcional com o teste cardiopulmonar de jogadoras de futebol profissional

et al. 2018

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RESUMO Comparar a validade de duas fórmulas de predição do consumo de oxigênio (VO2) com os valores obtidos no teste cardiopulmonar (TCP) em esteira ergométrica de jogadoras de futebol profissional. Dezoito jogadoras de futebol profissional foram submetidas ao TCP em esteira em um protocolo de carga incremental. Na sequência, foi determinado o VO2 da potência do limiar anaeróbio ventilatório (LAV) e no pico do exercício físico. Posteriormente, as fórmulas de predição de VO2 - i) VO2 = (0,2 x velocidade) + (0,9 x velocidade x inclinação) + 3,5 - velocidade em mph e inclinação %); e ii) MET (equivalente metabólica) = 6xHRI-5, onde HRI = frequência cardíaca máxima/frequência cardíaca de repouso - foram aplicadas nas mesmas potências para comparação. Para a primeira fórmula foi observado que tanto no LAV como no pico do TCP, os dados obtidos ficaram abaixo do previsto, sugerindo que a fórmula superestima o VO2 e, consequentemente, a capacidade e a potência aeróbicas. Na segunda fórmula foi observado que os valores ficaram abaixo do obtido, sugerindo que a fórmula subestimou o VO2 e, consequentemente a potência aeróbica, e mais uma vez a capacidade funcional. Diante disso, as fórmulas de predição não mostraram similaridade na determinação da capacidade funcional (CF) de jogadoras de futebol profissional, sugerindo não serem recomendadas para essa população.

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Section: Discussionmentioning

confidence: 86%

Análise comparativa de fórmulas preditivas de avaliação da capacidade funcional com o teste cardiopulmonar de jogadoras de futebol profissional

et al. 2018

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“…For example, in treadmill studies investigating the effect of handrail support, a practice that lengthens treadmill time, VO 2peak is over-predicted by 20% to 30% [9–13,17] which would lead to a potentially false prognostic classification of CRF. To correct for the consistently observed over-prediction of VO 2peak of around 20% resulting from the use of handrail support, Foster has developed simple modifications of the ACSM equations for use when handrail support is observed during treadmill testing [17].…”

Section: Discussionmentioning

confidence: 99%

“…However, many factors may contribute to the error of TM-VO 2pred . They include 1) treadmill handrail support [9–13], 2) failure to use population specific equations [14–18], 3) inappropriate testing protocol [19–21], 4) delayed oxygen kinetics [22–24], 5) reproducibility of cardiopulmonary parameters [25,26], 6) altered mechanical efficiency with treadmill walking [27] and 7) lack of treadmill calibration [28]. …”

Section: Introductionmentioning

confidence: 99%

How Accurate Is the Prediction of Maximal Oxygen Uptake with Treadmill Testing?

Wicks

Oldridge

2016

PLoS ONE

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BackgroundCardiorespiratory fitness measured by treadmill testing has prognostic significance in determining mortality with cardiovascular and other chronic disease states. The accuracy of a recently developed method for estimating maximal oxygen uptake (VO2peak), the heart rate index (HRI), is dependent only on heart rate (HR) and was tested against oxygen uptake (VO2), either measured or predicted from conventional treadmill parameters (speed, incline, protocol time).MethodsThe HRI equation, METs = 6 x HRI– 5, where HRI = maximal HR/resting HR, provides a surrogate measure of VO2peak. Forty large scale treadmill studies were identified through a systematic search using MEDLINE, Google Scholar and Web of Science in which VO2peak was either measured (TM-VO2meas; n = 20) or predicted (TM-VO2pred; n = 20) based on treadmill parameters. All studies were required to have reported group mean data of both resting and maximal HRs for determination of HR index-derived oxygen uptake (HRI-VO2).ResultsThe 20 studies with measured VO2 (TM-VO2meas), involved 11,477 participants (median 337) with a total of 105,044 participants (median 3,736) in the 20 studies with predicted VO2 (TM-VO2pred). A difference of only 0.4% was seen between mean (±SD) VO2peak for TM- VO2meas and HRI-VO2 (6.51±2.25 METs and 6.54±2.28, respectively; p = 0.84). In contrast, there was a highly significant 21.1% difference between mean (±SD) TM-VO2pred and HRI-VO2 (8.12±1.85 METs and 6.71±1.92, respectively; p<0.001).ConclusionAlthough mean TM-VO2meas and HRI-VO2 were almost identical, mean TM-VO2pred was more than 20% greater than mean HRI-VO2.

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“…Peak estimated METs achieved during maximal exercise testing are used to risk-stratify patients, prescribe individual exercise intensities for exercise training, and to determine changes in CRF following exercise interventions (ACPICR 2015). However, estimates of functional capacity may not accurately quantify VO 2peak , particularly during treadmill protocols (Myers et al, 1991;Milani et al, 1995;Pinkstaff et al, 2011). Whilst the limitations of estimating VO 2peak from a single exercise test are known, the accuracy of estimated changes in VO 2peak following an exercise training intervention is unclear.…”

Section: Introductionmentioning

confidence: 99%

Estimated peak functional capacity: an accurate method for assessing change in peak oxygen consumption after cardiac rehabilitation?

Nichols

Gleadall-Siddall

Antony

et al. 2017

Clin Physio Funct Imaging

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Overestimation of Aerobic Capacity With the Bruce Treadmill Protocol in Patients Being Assessed for Suspected Myocardial Ischemia

Abstract: This study demonstrates that estimates of aerobic capacity are significantly higher than measured values and this difference may result in a significant underestimation of morbidity/mortality risk.

Cited by 18 publications

References 16 publications

Análise comparativa de fórmulas preditivas de avaliação da capacidade funcional com o teste cardiopulmonar de jogadoras de futebol profissional

Análise comparativa de fórmulas preditivas de avaliação da capacidade funcional com o teste cardiopulmonar de jogadoras de futebol profissional

How Accurate Is the Prediction of Maximal Oxygen Uptake with Treadmill Testing?

Estimated peak functional capacity: an accurate method for assessing change in peak oxygen consumption after cardiac rehabilitation?

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