A Nomogram to Select the Optimal Treadmill Ramp Protocol in Subjects With High Exercise Capacity

Maeder, Micha T.; Wölber, Thomas; Atefy, Ramin; Gadza, Mirko; Ammann, Peter; Myers, Jonathan; Rickli, Hans

doi:10.1097/00008483-200601000-00004

Cited by 26 publications

(30 citation statements)

References 13 publications

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“…In this study, 100% of the patients on a ramped Bruce protocol achieve the 80%-85% of the APMHR needed to demonstrate competence for diagnostically valid treadmill time in 8-10 min, whereas only 14% reached that level on the standard Bruce (P , 0.0001) (8).…”

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confidence: 65%

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Comparison of Bruce Treadmill Exercise Test Protocols: Is Ramped Bruce Equal or Superior to Standard Bruce in Producing Clinically Valid Studies for Patients Presenting for Evaluation of Cardiac Ischemia or Arrhythmia with Body Mass Index Equal to or Greater Than 30?

Bires

Lawson

Wasser

et al. 2013

Journal of Nuclear Medicine Technology

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Clinically valid cardiac evaluation via treadmill stress testing requires patients to achieve specific target heart rates and to successfully complete the cardiac examination. Methods: A comparison of the standard Bruce protocol and the ramped Bruce protocol was performed using data collected over a 1-y period from a targeted patient population with a body mass index (BMI) equal to or greater than 30 to determine which treadmill protocol provided more successful examination results. Results: The functional capacity, metabolic equivalent units achieved, pressure rate product, and total time on the treadmill as measured for the obese patients were clinically valid and comparable to normal-weight and overweight patients (P , 0.001). Data gathered from each protocol demonstrated that the usage of the ramped Bruce protocol achieved more consistent results in comparison across all BMI groups in achieving 80%-85% of their age-predicted maximum heart rate. Conclusion: This study did not adequately establish that the ramped Bruce protocol was superior to the standard Bruce protocol for the examination of patients with a BMI equal to or greater than 30.Key Words: cardiac exercise stress testing protocols; cardiac assessment; Bruce protocol versus ramped Bruce protocol; body mass index (BMI)

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confidence: 65%

“…Many studies have compared the standard and ramped Bruce protocols with various patient populations ranging from known healthy individuals to older populations with varying comorbidities (2)(3)(4)(5)(6)(7)(8)(9)(10). This literature review was instrumental in establishing the basis of the problem.…”

mentioning

confidence: 99%

Comparison of Bruce Treadmill Exercise Test Protocols: Is Ramped Bruce Equal or Superior to Standard Bruce in Producing Clinically Valid Studies for Patients Presenting for Evaluation of Cardiac Ischemia or Arrhythmia with Body Mass Index Equal to or Greater Than 30?

Bires

Lawson

Wasser

et al. 2013

Journal of Nuclear Medicine Technology

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“…While both tests were in progress, the players were given continual verbal encouragement. [35][36] The subjective perception of effort was estimated in each stage by means of Borg's graduated linear scale of 15 points (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). [37][38][39] In the present study, the test was considered to have reached the maximum when the soccer players attained 2 of the following validation criteria: 1) maximum respiration exchange ratio (RER) ≥ 1.10; 2) Borg´s scale of subjective perception of tiredness ≥ 18 and 3) maximum heart rate ≥ 95% of the maximum chronotropic response predicted for the age.…”

Section: Logistics Of the Testsmentioning

confidence: 99%

“…14 In ergometry, various effort test protocols using treadmills and/or cycle ergometers, with different models for load increases, stage duration, and styles (ramped, stepped, or intermittent) have been used for testing VO 2max and other metabolic variables. [15][16][17][18][19][20] However, the validity and reproducibility of these protocols are not always tested. 21 Moreover, the specialized literature has suggested that VO 2max should be repeatedly measured within a maximum duration of 8 to 12 min.…”

Section: Introductionmentioning

confidence: 99%

Reproducibility of Maximum Aerobic Power (Vo2max) Among Soccer Players Using a Modified Heck Protocol

Silva

Fonseca

Castro

et al. 2007

Clinics

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JM; Hernandez AJ. Reproducibility of maximum aerobic power (VO 2max ) among soccer players using a modified heck protocol. Clinics. 2007;62(4):391-6. OBJECTIVE:To determine the degree of reproducibility of maximum oxygen consumption (VO 2max ) among soccer players, using a modified Heck protocol. METHODS: 2 evaluations with an interval of 15 days between them were performed on 11 male soccer players. All the players were at a high performance level; they were training for an average of 10 hours per week, totaling 5 times a week. When they were evaluated, they were in the middle of the competitive season, playing 1 match per week. The soccer players were evaluated on an ergometric treadmill with velocity increments of 1.2 km . h -1 every 2 minutes and a fixed inclination of 3% during the test. VO 2max was measured directly using a breath-by-breath metabolic gas analyzer. RESULTS:The maximum running speed and VO 2max attained in the 2 tests were, respectively: (15.6 ± 1.1 vs. 15.7 ± 1.2 km ; [P = .88]). There was high and significant correlation of VO 2max between the 2 tests with a 15-day interval between them [r = 0.97; P < .001]. CONCLUSION: The modified Heck protocol was reproducible, and the 15-day interval between the ergospirometric testing was insufficient to significantly modify the soccer players' VO 2max values.

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“…Great part of the research worked with steady velocities, promoting increment in the treadmill inclination. The curiosity is that this inclination ranged in some studies from 0 to 29% degree (11,26,43,(47)(48)(49)53) . Midgley et al (26) , in a study assessing the use of the exercise test time between eight and 12 minutes, recommend that the treadmill tests do not surpass 15% degree in inclination.…”

Section: Problems Associated With the Ramp Protocols Designingmentioning

confidence: 99%

Avaliação da capacidade máxima de exercício: uma revisão sobre os protocolos tradicionais e a evolução para modelos individualizados

Silva

Monteiro

Farinatti

2011

Rev Bras Med Esporte

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The physiological adjustments to exercise have been extensively investigated. Despite the agreement on the importance of cardiopulmonary exercise testing to assess the maximal oxygen uptake capacity ( O 2max ), expressive differences within the available protocols may compromise the comparison between studies as well as their clinical or functional utilization. The present study analyzed the most frequently used exercise testing protocols to assess the O 2max highlighting their pros and cons. Furthermore, the characteristics of staggered protocols were compared to those of individualized models, generally referred as ramp protocols. 102 studies published between 1955 and 2009 were revised. The available studies suggest that ramp protocols would produce better results compared to more traditional staggered tests. However, there is clearly a lack of recommendations regarding the application of such individualized protocols. Very few studies investigated the influence of the testing variables on the main expected results, as O 2max and metabolic transition thresholds. It is not clear yet which is the best strategy to determine the maximal exercise capacity, the initial speed of the test, increment ratio, interaction between speed and treadmill inclination, and total duration of the protocol. In conclusion, exercise ramp protocols have been elaborated based on the evaluator experience, since precise recommendations that would define a real 'protocol' do not exist. Studies that contribute to the development of formal and precise criteria for exercise testing ramp protocols design are therefore necessary.

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A Nomogram to Select the Optimal Treadmill Ramp Protocol in Subjects With High Exercise Capacity

Cited by 26 publications

References 13 publications

Comparison of Bruce Treadmill Exercise Test Protocols: Is Ramped Bruce Equal or Superior to Standard Bruce in Producing Clinically Valid Studies for Patients Presenting for Evaluation of Cardiac Ischemia or Arrhythmia with Body Mass Index Equal to or Greater Than 30?

Comparison of Bruce Treadmill Exercise Test Protocols: Is Ramped Bruce Equal or Superior to Standard Bruce in Producing Clinically Valid Studies for Patients Presenting for Evaluation of Cardiac Ischemia or Arrhythmia with Body Mass Index Equal to or Greater Than 30?

Reproducibility of Maximum Aerobic Power (Vo2max) Among Soccer Players Using a Modified Heck Protocol

Avaliação da capacidade máxima de exercício: uma revisão sobre os protocolos tradicionais e a evolução para modelos individualizados

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