Energy expenditure during cardiopulmonary exercise testing

2021 ◽  
Vol 25 (2) ◽  
pp. 102-114
Author(s):  
Thanh Tuan Do ◽  
Duc Son Nguyen ◽  
Dinh Tung Le
Keyword(s):  
Physical Activity ◽  
Energy Expenditure ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Recovery Phase ◽  
Maximum Energy ◽  
Work Rate ◽  
Exercise Recovery ◽  
Phase 3 ◽  
Cardiopulmonary Exercise

Objectives: To determine energy expenditure during cardiopulmonary exercise testing in healthy adults aged 20-60 years old and to determine the correlation between energy expenditure with the duration and the capacity of physical activity. Methods: Thirty-two healthy volunteers aged 20-60 years old (17 males and 15 females) agreed to participate in our study and performed cardiopulmonary exercise testing: resting phase (4 minutes, work rate 0 w), warming-up phase (4 minutes, work rate 0 w, 50-60 rounds per minute), exercise phase (work rate increment 10 watts per minutes, 50-60 rounds per minute) and recovery phase (3 minutes, work rate 0 w, 10-20 rounds per minute). Results and conclusions: Energy expenditure during CPET was 1,03 ± 0,30 MET, 1,97 ± 0,74 MET, 3,48 ± 1,78 MET, 4,57 ± 2,26 in resting, warming-up, exercise, recovery phase, respectively. Maximum energy expenditure during CPET was 4,75 ± 2,17 MET. Energy expenditure is negatively correlated with the duration of physical activity and positively correlated with the capacity of physical activity at 95% confidence interval.

scholarly journals Can wearable technology be used to approximate cardiopulmonary exercise testing metrics?

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Laura Jones ◽  
Laura Tan ◽  
Suzanne Carey-Jones ◽  
Nathan Riddell ◽  
Richard Davies ◽  
...  
Keyword(s):  
Physical Activity ◽  
High Risk ◽  
Oxygen Uptake ◽  
Anaerobic Threshold ◽  
Exercise Testing ◽  
Low Cost ◽  
Cardiopulmonary Exercise Testing ◽  
Peak Oxygen Uptake ◽  
Wearable Device ◽  
Cardiopulmonary Exercise

Abstract Background Consumer wrist-worn wearable activity monitors are widely available, low cost and are able to provide a direct measurement of several markers of physical activity. Despite this, there is limited data on their use in perioperative risk prediction. We explored whether these wearables could accurately approximate metrics (anaerobic threshold, peak oxygen uptake and peak work) derived using formalised cardiopulmonary exercise testing (CPET) in patients undergoing high-risk surgery. Methods Patients scheduled for major elective intra-abdominal surgery and undergoing CPET were included. Physical activity levels were estimated through direct measures (step count, floors climbed and total distance travelled) obtained through continuous wear of a wrist worn activity monitor (Garmin Vivosmart HR+) for 7 days prior to surgery and self-report through completion of the short International Physical Activity Questionnaire (IPAQ). Correlations and receiver operating characteristic (ROC) curve analysis explored the relationships between parameters provided by CPET and physical activity. Device selection Our choice of consumer wearable device was made to maximise feasibility outcomes for this study. The Garmin Vivosmart HR+ had the longest battery life and best waterproof characteristics of the available low-cost devices. Results Of 55 patients invited to participate, 49 (mean age 65.3 ± 13.6 years; 32 males) were enrolled; 37 provided complete wearable data for analyses and 36 patients provided full IPAQ data. Floors climbed, total steps and total travelled as measured by the wearable device all showed moderate correlation with CPET parameters of peak oxygen uptake (peak VO2) (R = 0.57 (CI 0.29–0.76), R = 0.59 (CI 0.31–0.77) and R = 0.62 (CI 0.35–0.79) respectively), anaerobic threshold (R = 0.37 (CI 0.01–0.64), R = 0.39 (CI 0.04–0.66) and R = 0.42 (CI 0.07–0.68) respectively) and peak work (R = 0.56 (CI 0.27–0.75), R = 0.48 (CI 0.17–0.70) and R = 0.50 (CI 0.2–0.72) respectively). Receiver operator curve (ROC) analysis for direct and self-reported measures of 7-day physical activity could accurately approximate the ventilatory equivalent for carbon dioxide (VE/VCO2) and the anaerobic threshold. The area under these curves was 0.89 for VE/VCO2 and 0.91 for the anaerobic threshold. For peak VO2 and peak work, models fitted using just the wearable data were 0.93 for peak VO2 and 1.00 for peak work. Conclusions Data recorded by the wearable device was able to consistently approximate CPET results, both with and without the addition of patient reported activity measures via IPAQ scores. This highlights the potential utility of wearable devices in formal assessment of physical functioning and suggests they could play a larger role in pre-operative risk assessment. Ethics This study entitled “uSing wearable TEchnology to Predict perioperative high-riSk patient outcomes (STEPS)” gained favourable ethical opinion on 24 January 2017 from the Welsh Research Ethics Committee 3 reference number 17/WA/0006. It was registered on ClinicalTrials.gov with identifier NCT03328039.

scholarly journals Exertional dyspnoea in COPD: the clinical utility of cardiopulmonary exercise testing

2016 ◽  
Vol 25 (141) ◽  
pp. 333-347 ◽  
Author(s):  
Denis E. O'Donnell ◽  
Amany F. Elbehairy ◽  
Azmy Faisal ◽  
Katherine A. Webb ◽  
J. Alberto Neder ◽  
...  
Keyword(s):  
Physical Activity ◽  
Exercise Testing ◽  
Physiological Responses ◽  
Cardiopulmonary Exercise Testing ◽  
Chronic Obstructive ◽  
Exertional Dyspnoea ◽  
Obstructive Pulmonary Disease ◽  
Respiratory Impairment ◽  
Laboratory Exercise ◽  
Cardiopulmonary Exercise

Activity-related dyspnoea is often the most distressing symptom experienced by patients with chronic obstructive pulmonary disease (COPD) and can persist despite comprehensive medical management. It is now clear that dyspnoea during physical activity occurs across the spectrum of disease severity, even in those with mild airway obstruction. Our understanding of the nature and source of dyspnoea is incomplete, but current aetiological concepts emphasise the importance of increased central neural drive to breathe in the setting of a reduced ability of the respiratory system to appropriately respond. Since dyspnoea is provoked or aggravated by physical activity, its concurrent measurement during standardised laboratory exercise testing is clearly important. Combining measurement of perceptual and physiological responses during exercise can provide valuable insights into symptom severity and its pathophysiological underpinnings. This review summarises the abnormal physiological responses to exercise in COPD, as these form the basis for modern constructs of the neurobiology of exertional dyspnoea. The main objectives are: 1) to examine the role of cardiopulmonary exercise testing (CPET) in uncovering the physiological mechanisms of exertional dyspnoea in patients with mild-to-moderate COPD; 2) to examine the escalating negative sensory consequences of progressive respiratory impairment with disease advancement; and 3) to build a physiological rationale for individualised treatment optimisation based on CPET.

scholarly journals Reference Values and Predictive Equations for Cardiopulmonary Exercise Testing in Thai Adults

2020 ◽  
Vol 11 (2) ◽  
Author(s):  
Prapaporn Pornsuriyasak ◽  
Kitipong Ngaojaruwong ◽  
Suchada Saovieng ◽  
Jayanton Patumanond ◽  
Khanat Kruthkul ◽  
...  
Keyword(s):  
Physical Activity ◽  
Exercise Testing ◽  
Minute Ventilation ◽  
Cardiopulmonary Exercise Testing ◽  
Activity Level ◽  
Screening Tests ◽  
Peak Exercise ◽  
Predictive Equations ◽  
Cardiopulmonary Exercise ◽  
History Of

Background: A series of racial specific predictive equations for exercise parameters are needed to determine a lack of cardiopulmonary fitness or having an exercise limitation on cardiopulmonary exercise testing (CPET). Objectives: The study aimed to develop a new set of predictive equations of CPET parameters during maximal cycling exercise for Thai adults. Methods: A sample of 580 Thai adults whom could pass screening tests were asked to fill a health questionnaire and the Global Physical Activity questionnaire. Participants with history of symptomatic heart and pulmonary diseases, current smokers, history of smoking ≥ 10 pack-years, and abnormal spirometry were excluded. The CPET was performed using a cycle ergometer with an incremental symptom-limited protocol. Values of CPET parameters at the peak exercise (oxygen uptake [V̇O2], work rate, heart rate, oxygen pulse, and minute ventilation), lactic acidosis threshold, and ventilatory equivalents for oxygen and carbon dioxide were documented. Analyses were stratified using age and gender criterion. Predictive equations for CPET parameters were established using multivariable linear regression with age (A), weight (W), height (H), and physical activity level (Act) as independent variables. Results: A total of 493 participants (208 men and 285 women) were analysed. The predictive equation of V̇O2peak (L.min-1) for males was: -2.268 + (0.037 × A) - (0.0005 × A2) + (0.016 × W) + (0.014 × H) + (0.104 × Act), (R2 = 0.41, SEE = 0.392), and for females, it was: -0.34 + (0.009 × A) - (0.0002 × A2) + (0.012 × W) + (0.005 × H) + (0.058 × Act), (R2 = 0.44, SEE = 0.220). Conclusions: This is the first study that constructed the predictive equations for cycling CPET parameters in Thai adults. These equations are useful to evaluate the cardiopulmonary health of the Thai population and may be generalized to other populations with geographical or ethnic proximity to the Thai people.

scholarly journals ERS statement on standardisation of cardiopulmonary exercise testing in chronic lung diseases

2019 ◽  
Vol 28 (154) ◽  
pp. 180101 ◽  
Author(s):  
Thomas Radtke ◽  
Sarah Crook ◽  
Georgios Kaltsakas ◽  
Zafeiris Louvaris ◽  
Danilo Berton ◽  
...  
Keyword(s):  
Exercise Testing ◽  
Lung Diseases ◽  
Cardiopulmonary Exercise Testing ◽  
Work Rate ◽  
Cochrane Library ◽  
Future Research ◽  
Test Protocol ◽  
Cardiopulmonary Exercise ◽  
Chronic Lung Diseases ◽  
Multicentre Research

The objective of this document was to standardise published cardiopulmonary exercise testing (CPET) protocols for improved interpretation in clinical settings and multicentre research projects. This document: 1) summarises the protocols and procedures used in published studies focusing on incremental CPET in chronic lung conditions; 2) presents standard incremental protocols for CPET on a stationary cycle ergometer and a treadmill; and 3) provides patients' perspectives on CPET obtained through an online survey supported by the European Lung Foundation. We systematically reviewed published studies obtained from EMBASE, Medline, Scopus, Web of Science and the Cochrane Library from inception to January 2017. Of 7914 identified studies, 595 studies with 26 523 subjects were included. The literature supports a test protocol with a resting phase lasting at least 3 min, a 3-min unloaded phase, and an 8- to 12-min incremental phase with work rate increased linearly at least every minute, followed by a recovery phase of at least 2–3 min. Patients responding to the survey (n=295) perceived CPET as highly beneficial for their diagnostic assessment and informed the Task Force consensus. Future research should focus on the individualised estimation of optimal work rate increments across different lung diseases, and the collection of robust normative data.

scholarly journals Can wearable technology be used to approximate cardiopulmonary exercise testing metrics?

2021 ◽  
Author(s):  
Matt Morgan ◽  
Laura Jones ◽  
Laura Tan ◽  
Suzanne Carey-Jones ◽  
Nathan Riddell ◽  
...  
Keyword(s):  
Physical Activity ◽  
High Risk ◽  
Oxygen Uptake ◽  
Anaerobic Threshold ◽  
Exercise Testing ◽  
Low Cost ◽  
Cardiopulmonary Exercise Testing ◽  
Peak Oxygen Uptake ◽  
Wearable Device ◽  
Cardiopulmonary Exercise

Abstract Background Consumer wrist-worn wearable activity monitors are widely available, low cost and are able to provide a direct measurement of several markers of physical activity. Despite this, there is limited data on their use in perioperative risk prediction. We explored whether these wearables could accurately approximate metrics (anaerobic threshold, peak oxygen uptake and peak work) derived using formalised cardiopulmonary exercise testing (CPET) in patients undergoing high-risk surgery.Methods Patients scheduled for major elective intra-abdominal surgery and undergoing CPET were included. Physical activity levels were estimated through direct measures (step count, floors climbed and total distance travelled) obtained through continuous wear of a wrist worn activity monitor (Garmin Vivosmart HR+) for 7 days prior to surgery and self-report through completion of the short International Physical Activity Questionnaire (IPAQ). Correlations and receiver operating characteristic (ROC) curve analysis explored the relationships between parameters provided by CPET and physical activity. Device selection Our choice of consumer wearable device was made to maximise feasibility outcomes for this study. The Garmin Vivosmart HR+ had the longest battery life and best waterproof characteristics of the available low-cost devices.Results Of 55 patients invited to participate, 49 (mean age 65.3 ± 13.6 years; 32 male) were enrolled; 37 provided complete wearable data for analyses and 36 patients provided full IPAQ data. Floors climbed, total steps and total travelled as measured by the wearable device all showed moderate correlation with CPET parameters of peak oxygen uptake (peak VO2) (R=0.57 (CI 0.29-0.76), R=0.59 (CI 0.31-0.77) and R=0.62 (CI 0.35-0.79) respectively), anaerobic threshold (R = 0.37 (CI 0.01-0.64), R = 0.39 (CI 0.04-0.66) and R = 0.42 (CI 0.07-0.68) respectively) and peak work (R = 0.56 (CI 0.27-0.75), R = 0.48 (CI 0.17-0.70) and R = 0.50 (CI 0.2-0.72) respectively).Receiver Operator Curve (ROC) analysis for direct and self-reported measures of 7 day physical activity could accurately approximate the ventilatory equivalent for carbon dioxide (VE/VCO2) and the anaerobic threshold. The area under these curves was 0.89 for VE/VCO2 and 0.91 for the anaerobic threshold. For peak VO2 and peak work, models fitted using just the wearable data were 0.93 for peak VO2 and 1.00 for peak work.Conclusions Data recorded by the wearable device was able to consistently approximate CPET results, both with and without the addition of patient reported activity measures via IPAQ scores. This highlights the potential utility of wearable devices in formal assessment of physical functioning and suggests they could play a larger role in pre-operative risk assessment.Ethics This study entitled “uSing wearable TEchnology to Predict perioperative high-riSk patient outcomes (STEPS)” gained favourable ethical opinion on 24/1/2017 from the Welsh Research Ethics Committee 3 reference number 17/WA/0006. It was registered on ClinicalTrials.gov with identifier NCT03328039.

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