HRPF Paper
Professor Jackson, KINE 486
Ryan Joerger, Steven Ruiz
12/01/2018
Supporting Peer Reviewed Research Articles
1. Actual Versus Predicted Cardiovascular Demands in Submaximal Cycle Ergometer Testing.
Having a low level of cardiovascular fitness should be a major cause for concern. This is due to the potential negative affects on health, from metabolic damage, higher risk for disease, and decreased life expectancy, all which coincide with having a lower level V02max. Thus it is important to be able to a test for an individuals level of cardiorespiratory health. The Astrand Cycle Test measures a persons cardiovascular endurance this sub-maximal fitness test has been shown to provide a reliable and valid estimate of V02max.
The Astrand-Rhyming cycle ergometer test is a very common sub-maximal test for estimating aerobic capacity. This test is usually administered in more clinical setting so the prediction capability of the Astrand-Rhyming in a female, non clinical population, is not very clear. That being said the main purpose of this study was to determine the accuracy of the Astrand-Rhyming compared to a maximal aerobic capacity cycle ergometer test in a population of college age, healthy, physically active male and females.
As the current research is less clear for the non-clinical, female population the subjects included more females totaling 13, and with 10 males. These 23 physically active college students were the age of 21.9 ± 0.7 years old, with a height of 171.4 ± 8.9 centimeters, and a weight ranging from 72.1 ± 13.7 kilograms. Inclusion criteria included physically active participants in good health. Subjects with any cardiorespiratory or exercise inhibiting injury were excluded from this study. Prior to testing all subjects signed informed consent documents along with a Physical Activity Readiness Questionnaire (PAR-Q). The subjects height and weight were recorded without shoes, they were also told not to eat or drink two hours prior to the maximal test. Respiratory Exchange Ratio (RER), maximal oxygen uptake (VO2max), and heart rate, were measured indirectly with a calorimetry on a metabolic cart.
Subjects performed a three minute warm up with 1kg for resistance, while pedaling at 70 RPM. Once the test began at minute 3 every minute after, 0.3kg was added. This progressed until the subject could no longer participate, or if they dropped below 65 RPM for 15 seconds. The Borg Rating of Perceived Exertion scale (RPE) was used on a scale of 6–2, and subjects cooled down with a 1kg until recovered. The subject’s total duration of the test (min), maximal oxygen uptake (ml/kg/min), and heart rate were recorded.
After a minimum of 48 hours later the sub-maximal Astrand-Rhyming cycle testing protocol was followed. The subjects participated in a warm up at 50 RPM for a total of 3 minutes, with 1kg for resistance. Pedal cadence was recorded digitally, while the cycle ergometer kept track of the RPMs. Once the 3 minute warm-up was completed, power output was adjusted and the six minute test began. Male subjects power output was set to 750kgm, while the female subjects had a set power output of 600 kgm. During the last 30 seconds of minutes 2 through 6 heart rate was recorded. Once minute 3 was finished the power output was increased or decreased, this was decided on wether the subjects target heart rate was reached by the end of their 6 minute test.
The test ended at the 6 minute mark when the heart rate was within the target heart rate zone, while being less than 10 bpm on minute 5 and 6 of the test. The test would be extended until the heart rate was within 10 bpm for 2 consecutive minutes if this was not met. Subjects were to cool down on the cycle ergometer until recovered once the test was completed. The results of this study show as a group, that there were no significant differences between the predicted and actual maximal aerobic capacity. The Astrand-Rhyming showed no difference with female subjects, while male subjects had an under predicted VO2max. These results suggest that in this specific population, maximal testing to exhaustion could be replaced by les taxing sub maximal testing protocols. The low SEE of the Astrand-Rhyming proves this test as a very reliable and accurate predictor of collegiate male, and female VO2max levels. Limitations to this study would be that the inclusion criteria includes only physically active college students, thus generalizing the population, while excluding less fit individuals. Expansion of inclusion criteria such as age, and activity population would help increase the overall accuracy of this study.
References
1. Hoehn AM, MJ, Fountaine CJ. (2015) Actual versus predicted cardiovascular demands in submaximal cycle ergometer testing. Int J Exerc Sci.1–10.
2. Siconolfi SF, Cullinane EM, Carleton RA, Thompson PD. (1981) Assessing VO2max in epidemiologic studies: modification of the Astrand-Rhyming test. Medicine and science in sports and exercise. 336–338.
3. Beekley M, Brechue W, DeHoyos D, Garzarella L, Weber-Zion G, Pollock M. (2004) Cross-validation of the YMCA submaximal cycle ergometer test to predict VO2max. Res Q Exerc Sport. 337–342
4. Fitchett MA. (1985) Predictability of VO2max from submaximal cycle ergometer and bench stepping tests. Brit J Sports Med. 85–88.
2. Criterion validation of two submaximal aerobic fitness tests, the self-monitoring Fox-walk test and the Åstrand cycle test in people with rheumatoid arthritis
Having a low level of cardiovascular fitness should be a major cause for concern. Rheumatoid arthritis may often increase a persons risk for cardiovascular problems due to low levels of physical activity. The potential negatives on health, include metabolic damage, higher risk for disease, and decreased life expectancy, all which coincide with having a lower level V02max. People with Rheumatoid arthritis often report symptoms of fatigue, and joint pain, as this chronic inflammatory disease has a major impact on everyday activities. Thus it is important to be able to a test for levels of cardiorespiratory health. The Astrand Cycle Test measures a persons cardiovascular endurance this sub-maximal fitness test has been shown to provide a reliable and valid estimate of V02max.
The purpose of the study was to examine the criterion validity of the sub-maximal self-monitoring Fox-walk test and the sub-maximal Åstrand cycle test against a maximal cycle test in people with rheumatoid arthritis. A secondary aim was to study the different formulas for age predicted maximal heart rate when estimating VO2max by the Åstrand test.
Participants in this study included 27 subjects, 81% of which were female, with a mean age of 62 years old, and had been diagnosed with RA for a mean average of 11.7 years. They performed the Fox-walk test of 775 meters, and the Åstrand test and a measured VO2max cycle test. The Fox-walk test was performed 3-5 days before or after the cycle tests. The sub-maximal Åstrand cycle test was performed on the same test day as the cycle VO2max test, and separated by five minutes rest in between. The participants were told to avoid from smoking and vigorous activity the day before the cycle test and to avoid eating heavy meals within two hours before the test. Pearson’s correlation coefficients were calculated to find out the direction and strength of the association between the tests, while paired t-tests were used to test possible differences between each test.
Results include a strong correlation between the estimated and measured VO2max values, and ranged between r = 0.52/r = 0.82. These include different formulas for age predicted maximal heart rate, needed for estimating VO2max by the Åstrand test. The VO2max was overestimated 30% by the Fox-walk test, while being underestimated by 10% in the Åstrand test. A minor strength from this study includes its population, while at the same time it could have been more diverse and studied another type of chronic disease to broaden the overall validity of the test. The population in this study had exercised regularly throughout the past year, and were well conditioned. A limitation to this study includes the participants having relatively low disease activity and better overall health as opposed to the general population of people with rheumatoid arthritis. The majority of the participants included in this study happen to be female, which could also affect the results. The cycle tests were also performed on the same day with only 5 minutes of rest in between, which raises a major red flag as a sub maximal Astrand VO2max test could majorly affect a following maximal cycle test. A strength in our study was the testing accuracy as the same scientist conducted all cycle ergometry tests.
The Fox-walk test is not a reliable test for estimating VO2max as it does not correlate well. The Åstrand test is valid and reliable due to the age prediction VO2max method for predicting maximal heart rate. The Åstrand test, should be considered as highly valid and reliable in physically active people with rheumatoid arthritis as it may help in prescribing a fitness routine to help combat the side effects of this condition. It is recommended for use by health professionals in the clinical and research environments.
References
1. Nordgren B, Fridén C, Jansson E, Österlund T, Grooten WJ, Opava CH. (2014) Criterion validation of two submaximal aerobic fitness tests, the self-monitoring Fox-walk test and the Åstrand cycle test in people with rheumatoid arthritis. BMC Musculoskeletal Disorders. 306.
2. Turesson C, Jacobsson LT, Matteson EL. (2008) Cardiovascular co-morbidity in rheumatic diseases. Vasc Health Risk Manag. 605–614.
3. Eurenius E, Brodin N, Opava CH. (2007) Clinical applicability of of two tests of aerobic fitness in patients with rheumatoid arthritis. Adv Physiol Educ. 9:97–104.