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A practical and transferable new protocol for treadmill testing of children and adults**

Published online by Cambridge University Press:  01 December 2008

Karl-Otto Dubowy*
Affiliation:
Department of Paediatric Cardiology, Heartcenter of North Rhine-Westphalia, University of Bochum, Bad Oeynhausen, Germany
Winfried Baden
Affiliation:
Department of Paediatrics II, Children′s Hospital, University of Tübingen, Tübingen, Germany
Stefan Bernitzki
Affiliation:
Department of Paediatric Cardiology, Heartcenter of North Rhine-Westphalia, University of Bochum, Bad Oeynhausen, Germany
Brigitte Peters
Affiliation:
Institute for Biometry and Medical Informatics, University of Magdeburg, Magdeburg, Germany
*
Correspondence to: Dr med. Karl-Otto Dubowy, Heartcenter of North Rhine-Westphalia, Dept. of Paediatric Cardiology, Ruhr University of Bochum, Georgstr.11, 32545 Bad Oeynhausen, Germany. Tel: +49 5731 973605; Fax: +49 5731 972131; E-mail: kdubowy@hdz-nrw.de

Abstract

Background

It is just as vital to have an exact overview of the physical fitness of young and growing people as it is for adults. The currently used exercise protocols have limitations in healthy small children, and in senior citizens. In particular with chronically ill patients, regardless of their age, there is a need for an exercise protocol that permits observations over the long term. With this need in mind, we have designed a new transferable standardised exercise protocol, constructing reference values based on improved assessments on a treadmill that permitted stepwise increases of speed and gradient every 90 seconds – the so called treadmill protocol from the German Society of Paediatric Cardiology.

Objectives

We investigated the exercise performance in a healthy Caucasian population ranging in age from 4 to 75 years.

Methods

We measured, using a prospective study design, the distance run, the endurance, and the consumption of oxygen in 548 females and 647 males undergoing an enhanced spiroergometric treadmill protocol in two centres.

Results and conclusions

Until puberty, boys and girls have the same indicators of exercise performance. Subsequent to puberty, uptake of oxygen and distance run differ, with males showing higher uptake of oxygen. There is still an age-dependent dynamic of peak uptake of oxygen related to body surface area. Using these new reference values, covering the whole range of age, it proves possible to compare performance during growth and aging of the individual. In this fashion, we have calculated centiles for all recorded variables. External calibration, validation and quality control ensures transferability of our data to other spiroergometry units.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2008

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Footnotes

*

This study has been partly supported by the “Kompetenznetz Angeborene Herzfehler” (Competence Network for Congenital Heart Defects) funded by the Federal Ministry of Education and Research (BMBF), FKZ 01G10210.

References

1.Bruce, RA, Blackmon, JR, Jones, JW, et al. Exercising testing in adult normal participants and cardiac patients. Pediatrics 1963; II: 742756.CrossRefGoogle Scholar
2.Cumming, GR, Everatt, D, Hastmann, L. Bruce treadmill test in children: normal values in a clinic population. J Am Coll Cardiol 1978; 41: 6975.CrossRefGoogle Scholar
3.Dubowy, KO, Baden, W, Camphausen, C, et al. Vorschlag für ein einheitliches spiroergometrisches Laufbandprotokoll der Deutschen Gesellschaft für pädiatrische Kardiologie. Z Kardiol 2002 (Suppl): 31.Google Scholar
4.Lavoisier, AL, Laplace, PS. Mémoire sur la chaleur. Paris: Memoires de l′Academie Royale 1780: 355.Google Scholar
5.Hill, AV, Lupton, H. Muscular exercise, lactate acid and the supply and utilization of oxygen. Q J Med 1923; 16: 135139.CrossRefGoogle Scholar
6.Washington, R, Bricker, T. Guidelines for exercise testing in the pediatric age group. Circulation 1994; 90: 21662179.CrossRefGoogle ScholarPubMed
7.DuBois, D, DuBois, EF. A formula to estimate the approximate surface area if height and weight be known. Arch Intern Med 1916; 17: 863.CrossRefGoogle Scholar
8.Duncan, GE, Howley, ET, Johnson, BN. Applicability of VO2max criteria: discontinuous versus continuous protocols Medicine and science. Med Sci Sports 1997; 29: 273278.Google Scholar
9.Beaver, W, Lamarra, N, Wasserman, K. Breath-by-breath measurement of true alveolar gas exchange. J Appl Physiol 1981; 51: 16621675.CrossRefGoogle ScholarPubMed
10.Cole, TJ, Green, PJ. Smoothing reference centile curves: The LMS method and penalized likelihood. Statistics in Medicine 1992; 11: 13051319.CrossRefGoogle ScholarPubMed
11.Neu, CM, Manz, F, Schoenau, E. Die Entwicklung von Muskelkraft und -Masse bei Kindern und Jugendlichen. Monatsschr Kinderheilkd 2000; 148: 952968.Google Scholar
12.Fredriksen, PM, Ingjer, F, Nystad, W, et al. Aerobic endurance testing of children and adolescents – a comparison of two treadmill protocols. Scand J Med Sci Sports 1998; 8: 203207.CrossRefGoogle ScholarPubMed
13.Pettersen, SA, Fredriksen, PM. How to scale aerobic capacity in children and adolescents? Tidsskr Nors Laegeforen 2003; 123: 32033205.Google ScholarPubMed
14.Hebestreit, H. Ergometrie im Kindes- und Jugendalter. Monatschr Kinderheilkd 1997; 145: 13261336.CrossRefGoogle Scholar
15.Cumming G, R, Langford, S. Comparison of nine exercise tests used in Pediatric Cardiology. Children and Exercise XI. II. Human Kinetics Publisher, Champaign, 1985, pp 58–68.Google Scholar
16.Balke, B, Ware, RW. An experimental study of physical fitness of Air Force personnel. US Armed Forces Med J 1959; 10: 675688.Google ScholarPubMed
17.ACC/AHA guidelines for exercise testing: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Committee on Exercise Testing. J Am Coll Cardiol 1997; 30: 260315.Google Scholar
18.Armstrong, N, Welsman, J, Winsley, R. Is peak VO2 a maximal index of children’s aerobic fitness? Int J Sports Med 1996; 17: 356359.CrossRefGoogle ScholarPubMed
19. Thews G, Richter DW, Grote J. Atmung, Physiologie des Menschen, 26nd ed. HD, Ger 1997: 565–648.CrossRefGoogle Scholar
20.Tipton, KD. Gender differences in protein metabolism. Curr Opin Clini Nutr Metab Care 2001; 4: 493498.CrossRefGoogle ScholarPubMed
21.Beneke, R, Leithäuser, RM, Hütler, M. Leistungsfähigkeit und Trainierbarkeit im Kindes- und Jugendalter. Kinder- und Jugendsportmedizin. Thieme, Stuttgart Ger, 2002, pp 15–21.Google Scholar
22.Al-Hazzaa, HM. Development of maximal cardiorespiratory function in Saudi boys. A cross-sectional analysis. Saudi Med J 2001; 22: 875881.Google ScholarPubMed
23.Fredriksen, PM, Ingjer, F, Nystad, W, et al. A comparison of VO2peak between patients with congenital heart disease and healthy participants all aged 8–17 years. Eur J Appl Physiol 1999; 80: 409416.CrossRefGoogle Scholar
24.Armstrong, N, Welsman, JR. Peak uptake of oxygen in relation to growth and maturation in 11- to 17-year-old humans. Eur J Appl Physiol 2001; 85: 546551.CrossRefGoogle ScholarPubMed
25.Eiberg, S, Hasselstrom, H, Gronfeldt, V, et al. Maximum uptake of oxygen and objectively measured physical activity in Danish children 6–7 years of age: the Copenhagen school child intervention study. Bri J Sports Med 2005; 39: 725730.CrossRefGoogle ScholarPubMed
26.Mandadzhieva, S, Marinov, B, Kostianev, S, et al. Anthropometric and cardiopulmonary parameters in Bulgarian and Romany children: cross-sectional study. Croat Med J 2005; 46: 294301.Google ScholarPubMed