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Are fixed-rate step tests medically safe for assessing physical fitness?

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Abstract

Maximal oxygen uptake (VO2max) can be predicted by fixed-rate step tests. However, it remains to be analyzed as to what exercise intensities are reached during such tests to address medical safety. In this study, we compared the physiological response to a standardized fixed-rate step test with maximal cardiopulmonary exercise testing (CPET). One hundred and thirteen healthy adults executed a maximal CPET on bike, followed by a standardized fixed-rate step test 1 week later. During these tests, heart rate (HR) and VO2 were monitored continuously. From the maximal CPET, the ventilatory threshold (VT) was calculated. Next, the physiological response between maximal CPET and step testing was compared. The step test intensity was 85 ± 24% CPET VO2max and 88 ± 11% CPET HRmax (VO2max and HRmax were significantly different between CPET and step testing; p < 0.01). In 41% of the subjects, step test exercise intensities >95% CPET VO2max were noted. A greater step testing exercise intensity (%CPET VO2max) was independently related to higher body mass index, and lower body height, exercise capacity (p < 0.05). Standardized fixed-rate step tests elicit vigorous exercise intensities, especially in small, obese, and/or physically deconditioned subjects. Medical supervision might therefore be required during these tests.

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References

  • Albert CM, Mittleman MA, Chae CU, Lee IM, Hennekens CH, Manson JE (2000) Triggering of sudden death from cardiac causes by vigorous exertion. N Engl J Med 343:1355–1361

    Article  PubMed  CAS  Google Scholar 

  • Bartsch P (1999) Platelet activation with exercise and risk of cardiac events. Lancet 354:1747–1748

    Article  PubMed  CAS  Google Scholar 

  • Beaver WL, Wasserman K, Whipp BJ (1986) A new method for detecting anaerobic threshold by gas exchange. J Appl Physiol 60:2020–2027

    PubMed  CAS  Google Scholar 

  • Buchfuhrer MJ, Hansen JE, Robinson TE, Sue DY, Wasserman K, Whipp BJ (1983) Optimizing the exercise protocol for cardiopulmonary assessment. J Appl Physiol 55:1558–1564

    PubMed  CAS  Google Scholar 

  • Buckley JP, Sim J, Eston RG, Hession R, Fox R (2004) Reliability and validity of measures taken during the Chester step test to predict aerobic power and to prescribe aerobic exercise. Br J Sports Med 38:197–205

    Article  PubMed  CAS  Google Scholar 

  • Cadroy Y, Pillard F, Sakariassen KS, Thalamas C, Boneu B, Riviere D (2002) Strenuous but not moderate exercise increases the thrombotic tendency in healthy sedentary male volunteers. J Appl Physiol 93:829–833

    PubMed  Google Scholar 

  • Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, Pratt M, Ekelund U, Yngve A, Sallis JF, Oja P (2003) International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35:1381–1395

    Article  PubMed  Google Scholar 

  • Fairbarn MS, Blackie SP, McElvaney NG, Wiggs BR, Paré PD, Pardy RL (1994) Prediction of heart rate and oxygen uptake during incremental and maximal exercise in healthy adults. Chest 105:1365–1369

    Article  PubMed  CAS  Google Scholar 

  • Fletcher GF, Balady GJ, Amsterdam EA, Chaitman B, Eckel R, Fleg J, Froelicher VF, Leon AS, Piña IL, Rodney R, Simons-Morton DA, Williams MA, Bazzarre T (2001) Exercise standards for testing and training: a statement for healthcare professionals from the American Heart Association. Circulation 104:1694–1740

    Article  PubMed  CAS  Google Scholar 

  • Hansen D, Dendale P, Berger J, Meeusen R (2007) Low agreement of ventilatory threshold between training modes in cardiac patients. Eur J Appl Physiol 101:547–554

    Article  PubMed  Google Scholar 

  • Hilberg T, Menzel K, Glaser D, Zimmermann S, Gabriel HH (2008) Exercise intensity: platelet function and platelet-leukocyte conjugate formation in untrained subjects. Thromb Res 122:77–84

    Article  PubMed  CAS  Google Scholar 

  • Ikarugi H, Shibata M, Shibata S, Ishii H, Taka T, Yamamoto J (2003) High intensity exercise enhances platelet reactivity to shear stress and coagulation during and after exercise. Pathophysiol Haemost Thromb 33:127–133

    Article  PubMed  Google Scholar 

  • Jones PW, Wakefield JM, Kontaki E (1987) A simple and portable paced step test for reproducible measurements of ventilation and oxygen consumption during exercise. Thorax 42:136–143

    Article  PubMed  CAS  Google Scholar 

  • McArdle WD, Katch FI, Katch VL (2010) Individual differences and measurement of energy capacities. Exercise physiology, 7th edn. Lippincott Williams & Wilkins, Philadelphia, pp 225–247

    Google Scholar 

  • Myers J, Arena R, Franklin B, Pina I, Kraus WE, McInnis K, Balady GJ (2009) Recommendations for clinical exercise laboratories. A scientific statement from the American Heart Association. Circulation 119:3144–3161

    Article  PubMed  Google Scholar 

  • Noonan V, Dean E (2000) Submaximal exercise testing: clinical application and interpretation. Phys Ther 80:782–807

    PubMed  CAS  Google Scholar 

  • Olson MS, Williford HN, Blessing DL, Greathouse R (1991) The cardiovascular and metabolic effects of bench stepping exercise in females. Med Sci Sports Exerc 23:1311–1317

    PubMed  CAS  Google Scholar 

  • Petrella RJ, Koval JJ, Cunningham DA, Paterson DH (2001) A self-paced step test to predict aerobic fitness in older adults in the primary care clinic. J Am Geriatr Soc 49:632–638

    Article  PubMed  CAS  Google Scholar 

  • Petrella RJ, Koval JJ, Cunningham DA, Paterson DH (2003) Can primary care doctors prescribe exercise to improve fitness? The step test exercise prescription (STEP) project. Am J Prev Med 24:316–322

    Article  PubMed  Google Scholar 

  • Poole DC, Wilkerson DP, Jones AM (2008) Validity of criteria for establishing maximal O2 uptake during ramp exercise tests. Eur J Appl Physiol 102:403–410

    Article  PubMed  CAS  Google Scholar 

  • Renehan AG, Howell A (2005) Preventing cancer, cardiovascular disease, and diabetes. Lancet 365:1449–1451

    Article  PubMed  Google Scholar 

  • Richardson S, Hardman AE (1989) Endurance fitness and blood lactate concentration during stepping exercise in untrained subjects. Br J Sports Med 23:190–193

    Article  PubMed  CAS  Google Scholar 

  • Siconolfi SF, Garber CE, Lasater TM, Carleton RA (1985) A simple, valid step test for estimating maximal oxygen uptake in epidemiologic studies. Am J Epidemiol 121:382–390

    PubMed  CAS  Google Scholar 

  • Stanforth D, Stanforth PR, Velasquez KS (1993) Aerobic requirement of bench stepping. Int J Sports Med 14:129–133

    Article  PubMed  CAS  Google Scholar 

  • Thomas SC, Weller IM, Cox MH (1993) Sources of variation in oxygen consumption during a stepping task. Med Sci Sports Exerc 25:139–144

    Article  PubMed  CAS  Google Scholar 

  • Thompson PD, Franklin BA, Balady GJ, Blair SN, Corrado D, Estes NA 3rd, Fulton JE, Gordon NF, Haskell WL, Link MS, Maron BJ, Mittleman MA, Pelliccia A, Wenger NK, Willich SN, Costa F (2007) Exercise and acute cardiovascular events placing the risks into perspective: a scientific statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism and the Council on Clinical Cardiology. Circulation 115:2358–2368

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was partially funded by the scientific chair ‘De Onderlinge Ziekenkaspreventie’, and by a research grant from Hartcentrum Hasselt, Belgium.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Jessa Hospital/Heart Centre Hasselt, Rehabilitation and Health Centre, Stadsomvaart 11, Hasselt, Belgium

    Dominique Hansen & Paul Dendale

  2. Rehabilitation and Healthcare Research Centre, Department Healthcare, PHL-University College, Hasselt, Belgium

    Dominique Hansen & Paul Dendale

  3. Faculty of Medicine, Hasselt University, Diepenbeek, Belgium

    Dominique Hansen, Nele Jacobs, Steven Bex, Goedele D’Haene, Paul Dendale & Neree Claes

Authors
  1. Dominique Hansen
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  2. Nele Jacobs
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  3. Steven Bex
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  4. Goedele D’Haene
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  5. Paul Dendale
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  6. Neree Claes
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Corresponding author

Correspondence to Dominique Hansen.

Additional information

Communicated by Susan A. Ward.

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Hansen, D., Jacobs, N., Bex, S. et al. Are fixed-rate step tests medically safe for assessing physical fitness?. Eur J Appl Physiol 111, 2593–2599 (2011). https://doi.org/10.1007/s00421-011-1886-3

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  • DOI: https://doi.org/10.1007/s00421-011-1886-3

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