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Sports Medicine

, Volume 46, Issue 5, pp 737–750 | Cite as

Validity of Submaximal Step Tests to Estimate Maximal Oxygen Uptake in Healthy Adults

  • Hunter Bennett
  • Gaynor Parfitt
  • Kade Davison
  • Roger Eston
Systematic Review

Abstract

Background

Aerobic capacity (VO2max) is a strong predictor of health and fitness and is considered a key physiological measure in the healthy adult population. Submaximal step tests provide a safe, simple and ecologically valid means of assessing VO2max in both the general population and a rehabilitation setting. However, no studies have attempted to synthesize the existing knowledge regarding the validity of the multiple step-test protocols available to estimate VO2max in the healthy adult population.

Objectives

The objective of this study was to systematically review literature on the validity and reliability of submaximal step-test protocols to estimate VO2max in healthy adults (age 18–65 years).

Data Sources and Study Selection

A systematic literature search of the MEDLINE, EMBASE, Scopus, Web of Science, and Cochrane Library databases was performed. The search returned 690 studies that underwent the initial screening process. To be included, the study had to (1) have participants deemed to be healthy and aged between 18 and 65 years; (2) assess VO2max by means of a submaximal step test against a graded exercise test (GXT) to volitional exhaustion; and (3) be available in English. Reference lists from included articles were screened for additional articles.

Data Analysis and Study Appraisal Methods

The primary outcome measures used were the validity statistics between the actual measured VO2max and predicted VO2max values, and the reported direction of the statistically significant difference between the measured VO2max and the predicted VO2max. The Quality Assessment Tool for Quantitative Studies was used to assess the risk of bias in each included study, and was adapted to the type of quantitative study design used.

Results

The combined database search produced 690 studies, from which 644 were excluded during the screening process. Following full-text assessment, a further 39 studies were excluded based on the eligibility criteria detailed previously. Four additional studies were located via the reference lists of the included studies, leaving 11 studies that fulfilled the inclusion criteria and which compared eight different step-test protocols against a direct measure of VO2max incurred during a maximal GXT. Validity measures varied, with a broad range of correlation coefficients reported across the 11 studies (r = 0.469–0.95). Of the 11 studies, two reported reliability measures, demonstrating good test–retest reliability [mean −0.8 ± 3.7 mL kg−1 min−1 (±7.7 % of the mean measured VO2max)].

Conclusions

Considering the relationship between VO2max and various markers of health, the use of step tests as a measure of health in both the general adult population and rehabilitation settings is advocated. Step tests provide a simple, effective and ecologically valid method of submaximally assessing VO2max that can be implemented in a variety of situations within the general adult population. Future research is needed to assess the reliability of the majority of the step-test procedures reviewed. Based on the validity measures, submaximal step-test protocols are an acceptable means of estimating VO2max in the generally healthy adult population. For tracking changes in cardiorespiratory fitness, the Chester Step test appears to be an appropriate tool due to its high test–retest reliability.

Keywords

Cardiorespiratory Fitness Step Height Step Test Recovery Heart Rate Step Rate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Compliance with Ethical Standards

Funding

No sources of funding were used to assist the preparation of this article.

Conflicts of interest

Hunter Bennett, Roger Eston, Gaynor Parfitt and Kade Davison declare they have no conflicts of interest relevant to content of this review.

References

  1. 1.
    Lee DC, Artero EG, Sui X, et al. Review: mortality trends in the general population: the importance of cardiorespiratory fitness. J Psychopharmacol. 2010;24(4):27–35.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Pedersen BK. Body mass index-independent effect of fitness and physical activity for all-cause mortality. Scand J Med Sci Spor. 2007;17(3):196–204.CrossRefGoogle Scholar
  3. 3.
    Katch V, Katch F, Mcardle W. Essentials of exercise physiology. Philadelphia: Lippincott Williams & Wilkins; 2011.Google Scholar
  4. 4.
    American College of Sports Medicine (ACSM). ACSM’s guidelines for exercise testing and prescription. Philadelphia: Lippincott Williams & Wilkins; 2008.Google Scholar
  5. 5.
    Sartor F, Vernillo G, Morree H, et al. Estimation of maximal oxygen uptake via submaximal exercise testing in sports, clinical and home settings. Sports Med. 2013;43(3):865–73.CrossRefPubMedGoogle Scholar
  6. 6.
    Bassett DR, Howley ET. Limiting factors for maximal oxygen uptake and determinants of endurance performance. Med Sci Sport Exer. 2000;32(1):70–84.CrossRefGoogle Scholar
  7. 7.
    Hartung GH, Blancq RJ, Lally DA, et al. Estimation of aerobic capacity from submaximal cycle ergometry in women. Med Sci Sport Exer. 1995;27(3):452–7.CrossRefGoogle Scholar
  8. 8.
    Grant S, Corbett K, Amjad AM, et al. A comparison of methods of predicting maximum oxygen uptake. Br J Sports Med. 1995;29(3):147–52.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Noonan V, Dean E. Submaximal exercise testing: clinical application and interpretation. Phys Ther. 2000;80(8):782–807.PubMedGoogle Scholar
  10. 10.
    Astrand PO. Quantification of exercise capability and evaluation of physical capacity in man. Prog Cardiovasc Dis. 1976;19(1):51–67.CrossRefPubMedGoogle Scholar
  11. 11.
    Balderrama C, Ibarra G, De La Riva J, et al. Evaluation of three methodologies to estimate the VO2max in people of different ages. Appl Ergon. 2010;42(1):162–8.CrossRefPubMedGoogle Scholar
  12. 12.
    Sykes K, Roberts A. The Chester step test—a simple yet effective tool for aerobic capacity. Physiotherapy. 2004;90(1):183–8.CrossRefGoogle Scholar
  13. 13.
    Buckley J, Sim J, Eston R, et al. Reliability and validity of measures taken during the Chester step test to predict aerobic power and to prescribe aerobic exercise. Br J Sports Med. 2004;38(2):197–205.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Shephard R, Bailey D, Mirwald R. Development of the Canadian home fitness test. Can Med Assoc J. 1976;114(8):675.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Shephard R. The current status of the Canadian home fitness test. Br J Sports Med. 1980;14(2):114–25.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Shephard RJ, Thomas S, Weiler I. The Canadian home fitness test. Sports Med. 1991;11(6):358–66.CrossRefPubMedGoogle Scholar
  17. 17.
    Jetté M, Campbell J, Mongeon J, et al. The Canadian home fitness test as a predictor of aerobic capacity. Can Med Assoc J. 1976;114(8):680–2.PubMedPubMedCentralGoogle Scholar
  18. 18.
    Hansen D, Jacobs N, Bex S, et al. Are fixed-rate step tests medically safe for assessing physical fitness? Eur J Appl Physiol. 2011;111(2):2593–9.CrossRefPubMedGoogle Scholar
  19. 19.
    Santo A, Golding LA. Predicting maximum oxygen uptake from a modified 3-minute step test. Res Q Exer Sport. 2003;74(1):110–5.CrossRefGoogle Scholar
  20. 20.
    Webb C, Vehrs PR, George JD, et al. Estimating VO2max using a personalised step test. Meas Phys Educ Exer Sci. 2014;18(1):184–97.CrossRefGoogle Scholar
  21. 21.
    Jones J, Bell J, Buckley J, et al. Physical activity and exercise in the management of cardiovascular disease. Estimation of MET max from submaximal exercise. London: The British Cardiovascular Society; 2014. p. 211.Google Scholar
  22. 22.
    Eston R, Lamb K, Parfitt G, et al. The validity of predicting maximal oxygen uptake from a perceptually-regulated graded exercise test. Eur J Appl Physiol. 2005;94(3):221–7.CrossRefPubMedGoogle Scholar
  23. 23.
    Eston R, Faulkner J, Mason E, et al. The validity of predicting maximal oxygen uptake from perceptually-regulated graded exercise tests of different durations. Eur J Appl Physiol. 2006;97(5):535–54.CrossRefPubMedGoogle Scholar
  24. 24.
    Eston R, Lambrick D, Sheppard K, et al. Prediction of maximal oxygen uptake in sedentary males from a perceptually regulated, sub-maximal graded exercise test. J Sports Sci. 2008;26(2):131–9.CrossRefPubMedGoogle Scholar
  25. 25.
    Eston R, Evans H, Faulkner J, et al. A perceptually regulated, graded exercise test predicts peak oxygen uptake during treadmill exercise in active and sedentary participants. Eur J Appl Physiol. 2012;112(10):3459–68.CrossRefPubMedGoogle Scholar
  26. 26.
    Faulkner J, Parfitt G, Eston R. Prediction of maximal oxygen uptake from the ratings of perceived exertion and heart rate during a perceptually-regulated sub-maximal exercise test in active and sedentary participants. Eur J Appl Physiol. 2007;101(3):397–407.CrossRefPubMedGoogle Scholar
  27. 27.
    Morris M, Lamb KL, Hayton J, et al. The validity and reliability of predicting maximal oxygen uptake from a treadmill-based sub-maximal perceptually regulated exercise test. Eur J Appl Physiol. 2010;109(5):983–8.CrossRefPubMedGoogle Scholar
  28. 28.
    Al-Rahamneh H, Eston R. The validity of predicting peak oxygen uptake from a perceptually guided graded exercise test during arm exercise in paraplegic individuals. Spinal Cord. 2010;49(3):430–4.CrossRefPubMedGoogle Scholar
  29. 29.
    Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–9.CrossRefPubMedGoogle Scholar
  30. 30.
    Effective Public Health Practice Project. Quality Assessment Tool for Quantitative Studies. 2008. http://www.ephpp.ca/PDF/Quality%20Assessment%20Tool_2010_2.pdf. Accessed 15 Mar 2015.
  31. 31.
    Oja P, Titze S, Bauman A, et al. Health benefits of cycling: a systematic review. Scand J Med Sci Spor. 2011;21(4):496–509.CrossRefGoogle Scholar
  32. 32.
    Ferrar K, Evans H, Smith A, et al. A systematic review and meta-analysis of submaximal exercise-based equations to predict maximal oxygen uptake in young people. Pediatr Exer Sci. 2014;26(3):342–57.CrossRefGoogle Scholar
  33. 33.
    Chatterjee S, Chatterjee P, Bandyopadhyay A. Validity of Queen’s College step test for estimation of maximum oxygen uptake in female students. Indian J Med Res. 2005;121(1):32–5.PubMedGoogle Scholar
  34. 34.
    McArdle WD, Katch FI, Pechar GS, et al. Reliability and interrelationships between maximal oxygen intake, physical work capacity and step-test scores in college women. Med Sci Sports. 1971;4(4):182–6.Google Scholar
  35. 35.
    Francis K, Culpepper M. Height-adjusted, rate-specific, single-stage step test for predicting maximal oxygen consumption. South Med J. 1989;82(5):602–6.CrossRefPubMedGoogle Scholar
  36. 36.
    Chatterjee S, Chatterjee P, Mukherjee PS, et al. Validity of Queen’s College step test for use with young Indian men. Br J Sports Med. 2004;38(3):289–91.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Perroni F, Cortis C, Minganti C, et al. Maximal oxygen uptake of Italian firefighters: laboratory vs. field evaluations. Sport Sci. Health. 2013;9(2):31–5.Google Scholar
  38. 38.
    Astrand P, Ryhming I. A nomogram for calculation of aerobic capacity (physical fitness) from pulse rate during submaximal work. J Appl Physiol. 1954;7(2):218–21.PubMedGoogle Scholar
  39. 39.
    Knight E, Stuckey M, Petrella R. Validation of the step test and exercise prescription tool for adults. Can J Diabetes. 2014;38(1):164–71.CrossRefPubMedGoogle Scholar
  40. 40.
    Culpepper M, Francis K. An anatomical model to determine step height in step testing for estimating aerobic capacity. J Theor Biol. 1987;129(1):1–8.CrossRefPubMedGoogle Scholar
  41. 41.
    Ryhming I. A modified Harvard step test for the evaluation of physical fitness. Eur J Appl Physiol Occup Phys. 1953;15(3):235–50.CrossRefGoogle Scholar
  42. 42.
    Robergs R, Landwehr R. The surprising history of the ‘HRmax = 220-age” equation. J Exerc Physiol. 2002;5(2):1–10.Google Scholar
  43. 43.
    Tanaka H, Monahan KD, Seals DR. Age-predicted maximal heart rate revisited. J Am Coll Cardiol. 2001;37(1):153–6.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Hunter Bennett
    • 1
  • Gaynor Parfitt
    • 1
  • Kade Davison
    • 1
  • Roger Eston
    • 1
  1. 1.Alliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health ResearchUniversity of South AustraliaAdelaideAustralia

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