Estimating maximal oxygen consumption from heart rate response to submaximal ramped treadmill test
Open accessAbstract
The Cambridge Ramped Treadmill Test (CRTT) is an incremental, multistage exercise test (I: steady-state walk, II: walk ramped speed, III: walk ramped incline, and IV: run ramped speed on flat). It is typically deployed as a submaximal test with flexible test termination criteria, making it an attractive option for population-based studies of cardiorespiratory fitness. We conducted a study in healthy adults to test the validity of maximal oxygen consumption estimates (VO 2 max; ml O 2 ·kg -1 ·min -1 ) predicted from CRTT heart rate response using several methods: a heart rate-to-work rate linear regression method across several test termination criteria, either when a percentage of age-predicted maximal heart rate was achieved (50% through 100%) or at the end of distinct CRTT stages (II, III, and IV); and two single-point walk-test calibration methods using data from either CRTT stage I (low-point method) or stage II (high-point method). For estimates from the linear regression method, prediction bias ranged from −3.0 to −1.6 ml O 2 ·kg -1 ·min -1 and Pearson’s r ranged from 0.57 to 0.79 for endpoints at percentages of age-predicted maximal heart rate; results were similar for stages III and IV endpoints, but predictions using data only up to stage II had poorer agreement. Agreement was moderate when using the low-point (mean bias: −4.3 ml O 2 ·kg -1 ·min -1 ; Pearson’s r : 0.71) and high-point (mean bias: −3.5 ml O 2 ·kg -1 ·min -1 ; Pearson’s r : 0.69) methods. Heart rate response to the CRTT can be used to predict VO 2 max with acceptable validity in common epidemiological scenarios.
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The submaximal treadmill VO2max estimation procedure was validated against directly measured VO2max in a subsample of Fenland Study participants, showing low bias and high correlation (r = 0.70).
“This VO2max estimation procedure has been validated against directly measured VO2max in a subsample of Fenland Study participants (43 women; 42 men), demonstrating low bias and high correlation with directly measured VO2max (r = 0.70) [18,19].”
From Resting heart rate is a population-level biomarker of cardiorespiratory fitness: The Fenland Study (2023) · cites this paper as [18]
The Results and agreement table report comparisons with directly measured VO₂max, with correlations near 0.70 and modest mean underestimation. However, the Results give a final sample of 42 women and 41 men, not 43 and 42; the Participants section also says recruitment came from both Fenland Study invitations and hospital adverts, so the paper does not establish that the entire validation sample was a Fenland subsample. (LLM, conf=0.90)
Experimental — accuracy not yet measuredAssociations between RHR and fitness reported here may be influenced by residual error from the VO2max estimation process, which is dependent on reaching a percentage of age-predicted maximal heart rate.
“Even though we have validated this approach [18], associations between RHR and fitness reported here may be influenced by residual error from the VO2max estimation process, which is dependent on reaching a percentage of age-predicted maximal heart rate.”
From Resting heart rate is a population-level biomarker of cardiorespiratory fitness: The Fenland Study (2023) · cites this paper as [18]
The validity of non-exercise estimation of VO2max is still much lower than what can be achieved with dynamic exercise testing.
“However, the validity of such estimation is still much lower than what can be achieved with dynamic exercise testing [139].”
From Human-centred artificial intelligence for mobile health sensing: challenges and opportunities (2023) · cites this paper as [139]
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- Authors
- Gonzales, T. I., Westgate, K., Hollidge, S., Lindsay, T., Jeon, J., & Brage, S.
- Affiliations
- University of Cambridge (GB)
- Corresponding author
- Brage, Søren
- Venue
- medRxiv
- Publisher
- openRxiv
- Published
- 2020-02-20
- OpenAlex
- W3009410442
- Cited by
- 7
- References
- 25
- Citations by year
- 2026: 1 · 2023: 3 · 2022: 2 · 2020: 1
- Type
- posted content
- Language
- en
- Open access
- green
- doi.org
- Licence
- cc-by-nd
- Locations
- medRxiv (acceptedVersion, cc-by-nd)
- Funders
- National Institute for Health and Care Research ([IS-BRC-1215-20014, BRC1215-20014, MC_UU_12015/3, IS-BRC-1215)
- Medical Research Council (IS-BRC-1215-20014, MC_UU_12015, MC_UU_12015/3, BRC-1215-20014)
- NIHR Cambridge Biomedical Research Centre ((BRC-1215-20014), IS-BRC-1215-20014)
- Topics
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Keywords
- VO2max, VO2max prediction, heart rate response, cardiorespiratory fitness, submaximal exercise testing, test termination criteria, one-point calibration, prediction bias, treadmill exercise testing
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