Abstract
Background: Cardiorespiratory (aerobic) fitness is strongly and directly related to major health outcomes, including all-cause mortality. Maximum oxygen uptake (VO2max), directly measured by maximal cardiopulmonary exercise test (CPET), represents the subject’s aerobic fitness. However, as CPET is not always available, aerobic fitness estimation tools are necessary. Objectives: a) to propose the CLINIMEX Aerobic Fitness Questionnaire (C-AFQ); b) to validate C-AFQ against measured VO2max; and c) to analyze the influence of some potentially relevant variables on the error of estimate. Methods: We prospectively studied 1,000 healthy and unhealthy subjects (68.6% men) aged from 14 to 96 years that underwent a CPET. The two-step C-AFQ describes physical activities with corresponding values in metabolic equivalents (METs) - ranging from 0.9 to 21 METs. Results: Application of C-AFQ took less than two minutes. Linear regression analysis indicated a very strong association between estimated (C-AFQ) and measured (CPET) maximal METs - r2 = 0.83 (Sy.x = 1.63; p < .001) - with median difference of only 0.2 METs between both values and interquartile range (percentiles 25 and 75) of 2 METs. The difference between estimated and measured METs was not influenced by age, sex, body mass index, clinical condition, ß-blocker use or sitting-rising test scores. Conclusion: C-AFQ is a simple and valid tool for estimating aerobic fitness when CPET is unavailable and it is also useful in planning individual ramp protocols. However, individual error of estimate is quite high, so C-AFQ should not be considered a perfect substitute for CPET’s measured VO2max.
Highlights
Application of CLINIMEX Aerobic Fitness Questionnaire (C-AFQ) took less than two minutes
The estimated aerobic fitness is characterized by the number of METs corresponding to the MET value that contains a sentence with 5 any exercise or physical activity he/she believes that it will be able to perform
This study proposed the C-AFQ, a new assessment tool for non-exercise estimation of aerobic fitness, and validated it against the gold standard and criterion measurement of VO2max obtained during a maximal cardiopulmonary exercise test (CPET)
Summary
Several long-term cohort studies have clearly shown a strong and direct association between cardiorespiratory (aerobic) fitness and a better and longer survival in adult men and women from different countries.[1,2,3] Quantified in mL O2.kg-1.min-1 or as metabolic equivalents or METs (1 MET = 3.5 mL O2.kg-1.min-1), aerobic fitness is associated with lower chances of developing major clinically relevant diseases, such as coronary artery disease, arterial hypertension and several types of cancer.[4,5,6] functional capacity, which is strongly related to aerobic fitness, has been recently recognized as a clinical vital sign.[7]. As CPET is not always available, aerobic fitness estimation tools are necessary
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