The reliability and validity of the Astrand nomogram and linear extrapolation for deriving VO2max from submaximal exercise data.

BACKGROUND: While the accepted measure of aerobic power remains the VO2max this test is extremely demanding even for athletes. There are serious practical and ethical concerns in attempting such testing in non-athletic or patient populations. An alternative method of measuring aerobic power in such populations is required. A limited body of work exists evaluating the accuracy of the Astrand-Ryhming nomogram and linear extrapolation of the heart rate/oxygen uptake plot. Issues exist in terms of both equipment employed and sample numbers. METHODS: Twenty-five normal subjects (mean age 28.6, range 22-50) completed 52 trials (Bruce treadmill protocol) meeting stringent criteria for VO2max performance. Respiratory gases were measured with a portable gas analyser on a five-sec sample period. The data was analysed to allow comparison of the reliability and validity of linear extrapolations to three estimates of heart rate maximum with the Astrand nomogram prediction. RESULTS: Extrapolation was preferable yielding intraclass correlation co-efficients (ICC) of 0.9433 comparable to that of the observed VO2max at 0.9443 and a bias of -1.1 ml x min(-1) x kg(-1) representing a 2.19 percent underestimate. CONCLUSIONS: This study provides empirical evidence that extrapolation of submaximal data can be employed with confidence for both clinical monitoring and research purposes. With the use of portable equipment and submaximal testing the scope for future research in numerous populations and non-laboratory environments is considerably increased.

A validation of the 10-meter incremental shuttle walk test as a measure of aerobic power in cardiac and rheumatoid arthritis patients.

OBJECTIVE: To validate a simple, clinically relevant, and inexpensive test of aerobic power-the 10-meter incremental shuttle walk test (SWT)--in 2 separate patient populations. DESIGN: Two-sample validity study. SETTING: Physiotherapy department of major hospital in the United Kingdom. PATIENTS: Convenience samples of rheumatoid arthritis (RA) patients (n = 10) and cardiac patients (n = 10). INTERVENTION: Subjects were attached to a portable respiratory gas analyzer to measure oxygen uptake. They walked around an oval 10-meter course, starting at 0.5m/s, with velocity gradually increased by .17m/s increments for as long as they could, for up to 12 minutes. MAIN OUTCOME MEASURES: A subject's maximal rate of oxygen uptake during exercise (V(O)(2)max) established with linear extrapolation was regressed against the number of shuttles completed (distance walked). An earlier study (n = 28) showed high levels of reliability and validity with linear extrapolation. RESULTS: No significant linear relationship was found between V(O)(2)max and the number of shuttles completed (R(2); RA subjects = 9.7%, cardiac subjects = .03%, p > .05). CONCLUSION: These results do not support use of the SWT as a representative measure of aerobic power. Despite this finding, the advantages of developing a clinically viable alternative to costly laboratory testing warrants further study of the SWT in patient groups.