VO2peak Test Research Articles

Arm Cycling Combined with Passive Leg Cycling Enhances VO2peak in Persons with Spinal Cord Injury Above the Sixth Thoracic Vertebra.

Objective: To test whether passive leg cycling (PLC) during arm cycling ergometry (ACE) affects peak oxygen uptake (VO2peak) differently in individuals with spinal cord injury (SCI) at/above the 6th thoracic vertebra (T6) and below T6. Methods: We conducted a cross-sectional study, analyzed by univariate and multivariate regression models. Between- and within-group differences were examined during (a) ACE only, (b) ACE combined with PLC (ACE-PLC), and (c) ACE combined with functional electrical stimulation cycling (FES hybrid). Fifteen SCI subjects were recruited and grouped according to injury level: at/above T6 (SCI-high, n = 8) or below T6 (SCI-low, n = 7). VO2peak tests during ACE only, ACE-PLC, and FES hybrid were performed in random order on separate days. Results: In the SCI-high group, mean (SD) VO2peak was 19% higher during ACE-PLC than during ACE only [21.0 (3.8) vs 17.7 (5.0) mL·kg-1·min-1; p = .002], while VO2peak during FES hybrid cycling was 16% higher than during ACE-PLC [24.4 (4.1) mL·kg-1·min-1; p = .001]. No significant differences among exercise modalities were found for the SCI-low group. Conclusion: Additional training modalities (eg, PLC) during ACE facilitate exercise in SCI-high individuals, but not to the level of the FES hybrid method. Conversely, additional training modalities may not increase training load in SCI-low individuals.

Comparison of Peak Oxygen Uptake and Test-Retest Reliability of Physiological Parameters between Closed-End and Incremental Upper-Body Poling Tests.

Objective: To compare peak oxygen uptake (VO2peak) and the test-retest reliability of physiological parameters between a 1-min and a 3-min closed-end and an incremental open-end upper-body poling test.Methods: On two separate test days, 24 healthy, upper-body trained men (age: 28.3 ± 9.3 years, body mass: 77.4 ± 8.9 kg, height: 182 ± 7 cm) performed a 1-min, a 3-min and an incremental test to volitional exhaustion in the same random order. Respiratory parameters, heart rate (HR), blood lactate concentration (BLa), rating of perceived exertion (RPE), and power output were measured. VO2peak was determined as the single highest 30-s average. Relative reliability was assessed with the intra-class correlation coefficient (ICC2, 1) and absolute reliability with the standard error of measurement (SEM) and smallest detectable change (SDC).Results: The incremental (3.50 ± 0.46 L·min−1 and 45.4 ± 5.5 mL·kg−1·min−1) and the 3-min test (3.42 ± 0.47 L·min−1 and 44.5 ± 5.5 mL·kg−1·min−1) resulted in significantly higher absolute and body-mass normalized VO2peak compared to the 1-min test (3.13 ± 0.40 L·min−1 and 40.4 ± 5.0 mL·kg−1·min−1) (all comparisons, p < 0.001). Furthermore, the incremental test resulted in a significantly higher VO2peak as compared to the 3-min test (p < 0.001). VO2peak was significantly higher on day 1 than day 2 for the 1-min test (p < 0.05) and displayed a trend toward higher values on day 2 for the incremental test (p = 0.07). High and very high ICCs across all physiological parameters were found for the 1-min (0.827–0.956), the 3-min (0.916–0.949), and the incremental test (0.728–0.956). The SDC was consistently small for HR (1-min: 4%, 3-min: 4%, incremental: 3%), moderate for absolute and body-mass normalized VO2peak (1-min: 5%, 3-min: 6%, incremental: 7%) and large for BLa (1-min: 20%, 3-min: 12%, incremental: 22%).Conclusions: Whereas both the 3-min and the incremental test display high relative reliability, the incremental test induces slightly higher VO2peak. However, the 3-min test seems to be more stable with respect to day-to-day differences in VO2peak. The 1-min test would provide a reliable alternative when short test-duration is desirable, but is not recommended for testing VO2peak due to the clearly lower values.

Reproducibility of peak oxygen consumption and the impact of test variability on classification of individual training responses in young recreationally active adults

This study investigated whether VO2 peak is reproducible across repeated tests before (PRE) and after (POST) training, and whether variability across tests impacts how individual responses are classified following 3weeks of aerobic exercise training (cycle ergometry). Data from 45 young healthy adults (age: 20·1±0·9years; VO2 peak, 42·0±6·7ml·min-1 ) from two previously published studies were utilized in the current analysis. Non-responders were classified as individuals who failed to demonstrate an increase or decrease in VO2 peak that was greater than 2·0 times the typical error of measurement (107ml·min-1 ) away from zero, while responders and adverse responders were above and below this cut-off, respectively. VO2 peak tests at PRE (three total) and POST (three total) were highly reproducible (PRE and POST average and single measures ICCs: range 0·938-0·992), with low coefficients of variation (PRE:4·9±3·1%, POST: 4·8±2·7%). However, a potential learning effect was observed in the VO2 peak tests prior to training, as the initial pretraining test was significantly lower than the third (p=0·010, PRE 1: 2946±924 ml·min-1 , PRE 3: 3042±919 ml·min-1 ). This resulted in fewer individuals classified as adverse responders for Test 3 compared to any combination of tests that included Test 1, suggesting that a single ramp test at baseline may not be sufficient to accurately classify the VO2 peak response in young recreationally active individuals. Thus, it is our recommendation that the initial VO2 peak test be used as a familiarization visit and not included for analysis.

An examination of the Counting Talk Test’s ability to discern individual variability in exercise-induced metabolic stress

ABSTRACTThe purpose of this study was to determine if the counting talk test can be used to discern whether an individual is exercising above or at/below maximal lactate steady state. Twenty-two participants completed VO2peak and counting talk test incremental step tests followed by an endurance test at 65% of work rate at VO2peak (WRVO2peak). The change in relative count time during endurance exercise decreased in those exercising above maximal lactate steady state only (p < .01); however, this change was less than 1 second. Despite a significant correlation during the incremental step test, large changes in counting talk test performance and blood lactate concentration occurred at different points and there was considerable inter-individual variability in counting talk test performance at a given blood lactate concentration. These results suggest that the counting talk test cannot discern whether an individual is exercising above maximal lactate steady state and that it cannot be used to accurately prescribe intensities targeting specific blood lactate concentrations.

Wheelchair Shuttle Test for Assessing Aerobic Fitness in Youth With Spina Bifida: Validity and Reliability.

BackgroundTesting aerobic fitness in youth is important because of expected relationships with health.ObjectiveThe purpose of the study was to estimate the validity and reliability of the Shuttle Ride Test in youth who have spina bifida and use a wheelchair for mobility and sport.DesignThs study is a validity and reliability study.MethodsThe Shuttle Ride Test, Graded Wheelchair Propulsion Test, and skill-related fitness tests were administered to 33 participants for the validity study (age = 14.5 ± 3.1 y) and to 28 participants for the reliability study (age = 14.7 ± 3.3 y).ResultsNo significant differences were found between the Graded Wheelchair Propulsion Test and the Shuttle Ride Test for most cardiorespiratory responses. Correlations between the Graded Wheelchair Propulsion Test and the Shuttle Ride Test were moderate to high (r = .55–.97). The variance in peak oxygen uptake (VO2peak) could be predicted for 77% of the participants by height, number of shuttles completed, and weight, with large prediction intervals. High correlations were found between number of shuttles completed and skill-related fitness tests (CI = .73 to −.92). Intraclass correlation coefficients were high (.77–.98), with a smallest detectable change of 1.5 for number of shuttles completed and with coefficients of variation of 6.2% and 6.4% for absolute VO2peak and relative VO2peak, respectively.ConclusionsWhen measuring VO2peak directly by using a mobile gas analysis system, the Shuttle Ride Test is highly valid for testing VO2peak in youth who have spina bifida and use a wheelchair for mobility and sport. The outcome measure of number of shuttles represents aerobic fitness and is also highly correlated with both anaerobic performance and agility. It is not possible to predict VO2peak accurately by using the number of shuttles completed. Moreover, the Shuttle Ride Test is highly reliable in youth with spina bifida, with a good smallest detectable change for the number of shuttles completed.

Cardiovascular and Workload Responses to High Intensity Interval Training in Adolescents

Despite the promising evidence supporting positive health benefits of high-intensity interval training (HIIT) in adults, there is limited research focusing on adolescents. PURPOSE: The purpose of this study was to describe the impact of HIIT training on cardiovascular responses to exercise in male and female adolescents. METHODS: Ten (4 male, 6 female; Age=11.7+1.4 years; VO2peak=27.33+ 6.89; BMI=28.6+6.6) adolescents, referred from local pediatricians, completed 16 HIIT sessions over an 8 week period. Each HIIT session consisted of a 5 min warm up, a 20 minute stimulus, and a 5 min cool down. During the stimulus period, subjects completed twenty 30 sec “on”, 30 sec “off” intervals. During the initial session the “on” workload was set to be equivalent to 90% of maximal workload recorded during the VO2peak test, while the “off” workload was set to be equivalent to 50%. Subsequent to this initial session, workload was adjusted so that RPE during the last 5 intervals was equivalent to at least 9 out of 10 on the Borg RPE scale. Workload, heart rate, and RPE were recorded at the end of each interval. RESULTS: Maximal workload during HIIT increased in all subjects from the first (152+8 watts) to the last (240+18 watts) session (p<0.001). In comparison, no differences were seen between the genders at any time point (Male: First Session=155+14 watts, Last Session=255+15 watts; Female: First Session=150+11 watts, Last Session=230+13 watts). Similarly, heart rate (Male: First Session=186+9 bpm, Last Session=185+6 bpm; Female: First Session=184+8 bpm, Last Session=177+7 bpm) and RPE (Male: First Session=9+1, Last Session=10+1; Female: First Session=9+1, Last Session=10+1) were maintained across the HIIT sessions. CONCLUSION: The results of this investigation indicate that HIIT is well tolerated and facilitates significant cardiovascular adaptation in both male and female adolescents.

Passive And Active Intermittent Hypoxic Exposure Pre-acclimatization Does Not Alter Heart Rate Variability At Altitude.

PURPOSE: This study evaluated the impact of passive and active intermittent hypoxic (IH) exposure pre-acclimatization strategies on temporal and spectral power measures of heart rate variability (HRV) in normobaric hypoxia (NH), and natural altitude. METHODS: Thirty participants (17 male and 13 female, aged 20-62 years), matched by sex, age and maximal aerobic capacity (VO2peak), were randomly allocated to either a control, passive IH or active IH group. Experimental groups completed 10 x 2-h, passive (PIH) or active (AIH), normobaric IH exposures (FIO2 = 0.124, ~4,011 m) over the 14-day intervention period (weekends excluded). The control group received no IH exposure. During the intervention period, participants completed 20 minutes daily running training, at an individualised intensity equivalent to 80% heart rate reserve (HRR). Training workload was determined by regressing HR and running speed data from individual VO2peak tests in normal ambient conditions (control and PIH groups) or NH (AIH group, FIO2 = 0.124). AIH participants completed the exercise training sessions under supervision, during scheduled IH exposure sessions, while control and PIH groups completed training unsupervised in normal ambient conditions. Within 48 hours of completing pre-acclimatization, participants travelled by air from the UK to Nepal, a journey time of approximately 36 hours. Participants then trekked from 2800 m to 5300 m over 14 days. Temporal (RR, SDNN, RMSSD) and spectral power measures (LFnu, HFnu and LFHF ratio) of HRV were recorded, at rest with spontaneous breathing, in normal ambient conditions (FIO2 = 0.209), NH (FIO2 = 0.124, ~4011 m) and in hypobaric hypoxia (HH) at 4356 m and 5350 m, during ascent. RESULTS: Two-way ANOVA (group x condition) with repeated measures revealed neither significant interactions (P>0.05), nor between-group (P>0.05) nor within-group (P>0.05) differences for temporal or power spectral HRV measures between baseline, pre-IH and post-IH. No significant interactions, between-group or within-group changes were noted between post-IH, 4300 m and 5300 m (P>0.05) natural altitude. CONCLUSION: Pre-acclimatization using active and passive intermittent hypoxic exposure did not significantly alter heart rate variability responses during ascent to very high altitude.

Adolescent Female Ball Players Oxygen Consumption and the Association to Playing Ability and Fitness Estimation

Peak oxygen consumption (VO2peak) is used to estimate aerobic capacity. Data regarding adolescence female ball players is limited. Furthermore, the association to coaches’ estimation of playing ability and aerobic fitness is scarce and can be of interest for players selection. PURPOSE: This study evaluates VO2peak of soccer and basketball elite adolescent female players from the Israeli Academy for Sport Excellence. The purpose of the current investigation was to evaluate VO2peak based on playing position and to compare VO2peak to coaches’ estimation of individual general playing ability and aerobic fitness. METHODS: Results of treadmill VO2peak testing were collected from medical records and were analyzed. Head coaches (national level) were asked to estimate general playing ability and aerobic fitness of each player on a scale of 5 (best) to 1 (worst). RESULTS: Twenty eight female soccer players (14.3-17.9 years) and 23 female basketball players (12.6-16.0 years) were included. Average VO2peak was 48 and 47.9 ml/kg/min, respectively. Forward soccer players had a better VO2peak comparing to other positions (goalkeepers=42.2, defenders=48.4, midfield=47.3, forwards=54.7ml/kg/min). Soccer coach playing ability (average=4.21) and fitness estimation (average=3.96) did not correlate with VO2peak results (Correlation Coefficient= 0.292, p=0.13 and 0.257, p=0.18 respectively). Center basketball players had the lowest and point guards the highest average VO2peak (centers=34.2, forwards=44.6, guards=50.5 and point guard=53.1 ml/kg/min). Basketball coach playing ability (average=3.14) and fitness estimation (average=2.86) correlate with VO2peak results (Correlation Coefficient= 0.464,p=0.03 and 0.547,p=0.008 respectively). CONCLUSIONS: Adolescent female soccer and basketball players at different playing positions exhibited different VO2peak values as reported in the literature. Basketball coaches’ estimation of aerobic fitness and general playing ability were associated with VO2peak results whereas soccer coaches’ estimation did not. VO2peak may be considered as a parameter for team selection of ball game players game players, however in light of the inconsistence results, further research is required.

The Effect Of Acute Body Mass Reduction On Metabolism And Endurance Running Performance

Reduced body mass and/or relative fat mass is expected to improve endurance running performance, by lowering energy cost of running and allowing the runner to maintain higher mean race velocity using identical %VO2max. The majority of studies during the last 40 years have been centered mainly on the effect of adding external load on energy cost of walking and running. PURPOSE: The purpose of this study was to examine the effect 5 and 10% reduction of inactive body mass on metabolic responses and 3 km running performance. METHODS: Eleven trained (8 male, 3 female) club level runners (mean ± sd body mass, height, %fat, peakVO2 and vVO2max, 65.71 ± 12.07 kg, 174.59 ± 8.32 cm, 12.54 ± 3.55%, 56.30 ± 4.57 ml.kg-1.min-1 and 17.1 ± 1.4 km.h-1 respectively) participated in a series of 4 maximal trials 4–6 days apart. During the first trial, the subjects completed an exhaustive incremental peakVO2 test on the treadmill. On the second visit they completed a 3 km race time trial on the treadmill running with normal body mass (BM). During the last two laboratory visits, the subjects completed two 3 km race trials in random order on the treadmill while body mass (a rope through a system of pulleys lifted the runner with the calculated body weight throughout striding phases while not interfering with running technique) was reduced 5 (5%BM) or 10% (10%BM). Repeated Anova was used for the statistical analysis. RESULTS: Mean (±sd) 3 km performance time was lowered (improved) during 5%BM (663.5 ± 76.05 s) and 10%BM (648.9 ± 74.9 s) trials (p<0.05) compared with BM (684.9 ± 74.8 s). The 5 and 10% reduction in body mass induced a mean 3.1 and 5.2% improvement in 3 km race performance accordingly. Every kg reduction of inactive body mass improved 1.4% running endurance performance. Mean values of the Rate of perceived exertion, heart rate, VO2 ml.min-1, RQ, Blood lactate and Volume of expired air were not different between time trials and peak VO2max test (p>0.05). CONCLUSIONS: The results of the present study showed that the reduction of 5 and 10% of inactive body mass may improve significantly 3 km performance time without noticeable effects on metabolic parameters and are supportive of the notion that one way to maximize further running performance is to reduce inactive body mass.

Effect of a moderate caffeine dose on endurance cycle performance and thermoregulation during prolonged exercise in the heat.

This study investigated the influence of a moderate caffeine dose on endurance cycle performance and thermoregulation during prolonged exercise in high ambient temperature. Double-blind cross-over study. Eight healthy, recreationally active males (mean±SD; age: 22±1 years; body mass: 71.1±8.5kg; VO2peak: 55.9±5.8mLkg-1min-1; Wmax: 318±37W) completed one VO2peak test, one familiarisation trial and two experimental trials. After an overnight fast, participants ingested a placebo or a 6mgkg-1 caffeine dose 60min before exercise. The exercise protocol consisted of 60min of cycle exercise at 55% Wmax, followed by a 30min performance task (total kJ produced) in 30°C and 50% RH. Performance was enhanced (Cohen's d effect size=0.22) in the caffeine trial (363.8±47.6kJ) compared with placebo (353.0±49.0kJ; p=0.004). Caffeine did not influence core (p=0.188) or skin temperature (p=0.577) during exercise. Circulating prolactin (p=0.572), cortisol (p=0.842) and the estimated rates of fat (p=0.722) and carbohydrate oxidation (p=0.454) were also similar between trial conditions. Caffeine attenuated perceived exertion during the initial 60min of exercise (p=0.033), with no difference in thermal stress across trials (p=0.911). Supplementation with 6mgkg-1 caffeine improved endurance cycle performance in a warm environment, without differentially influencing thermoregulation during prolonged exercise at a fixed work-rate versus placebo. Therefore, moderate caffeine doses which typically enhance performance in temperate environmental conditions also appear to benefit endurance performance in the heat.

The effect of exercise training on biventricular myocardial strain in heart failure with preserved ejection fraction.

AimsHigh‐intensity interval training (HIIT) improves peak oxygen uptake and left ventricular diastology in patients with heart failure with preserved ejection fraction (HFpEF). However, its effects on myocardial strain in HFpEF remain unknown. We explored the effects of HIIT and moderate‐intensity aerobic continuous training (MI‐ACT) on left and right ventricular strain parameters in patients with HFpEF. Furthermore, we explored their relationship with peak oxygen uptake (VO2peak).Methods and resultsFifteen patients with HFpEF (age = 70 ± 8.3 years) were randomized to either: (i) HIIT (4 × 4 min, 85–90% peak heart rate, interspersed with 3 min of active recovery; n = 9) or (ii) MI‐ACT (30 min at 70% peak heart rate; n = 6). Patients were trained 3 days/week for 4 weeks and underwent VO2peak testing and 2D echocardiography at baseline and after completion of the 12 sessions of supervised exercise training. Left ventricular (LV) and right ventricular (RV) average global peak systolic longitudinal strain (GLS) and peak systolic longitudinal strain rate (GSR) were quantified. Paired t‐tests were used to examine within‐group differences and unpaired t‐tests used for between‐group differences (α = 0.05). Right ventricular average global peak systolic longitudinal strain improved significantly in the HIIT group after training (pre = −18.4 ± 3.2%, post = −21.4 ± 1.7%; P = 0.02) while RV‐GSR, LV‐GLS, and LV‐GSR did not (P > 0.2). No significant improvements were observed following MI‐ACT. No significant between‐group differences were observed for any strain measure. ΔLV‐GLS and ΔRV‐GLS were modestly correlated with ΔVO2peak (r = −0.48 and r = −0.45; P = 0.1, respectively).ConclusionsIn patients with HFpEF, 4 weeks of HIIT significantly improved RV‐GLS.

Validation of the Garmin Forerunner 920XT Fitness Watch VO2peak Test

Aerobic capacity (VO2peak ) testing equipment can be expensive. Garmin fitness watches are significantly cheaper, and Garmin has developed a fitness test that estimates VO 2peak . The purpose of this study was to validate the Garmin fitness test, using a Garmin Forerunner 920XT fitness watch, against VO 2peak measurement, using a Parvomedics TrueOne 2400 open circuit spirometry device. Sixteen college students (10 male and 6 female) volunteered to complete the Garmin fitness test followed several days later by a Bruce treadmill test while oxygen consumption was measured via open circuit spirometry. The average VO 2peak from the Garmin test was 45.4 (± 5.6) ml/kg/min, compared to 45.0 (± 8.9) ml/kg /min from open circuit spirometry. There were no significant differences between the measurements (t = 0.221 with p = 0.828). The two measurements were highly correlated with a correlation coefficient of 0.84 (p =0.000). The Garmin fitness test seems to be a highly accurate estimation of VO 2peak2peak.

Effect of prehabilitation in gastro-oesophageal adenocarcinoma: study protocol of a multicentric, randomised, control trial—the PREHAB study

IntroductionPerioperative chemotherapy is the gold standard treatment of the resectable gastro-oesophageal adenocarcinoma. However, 70% of patients cannot receive the complete sequence because of a postoperative complication or a decrease in...

Dopamine/noradrenaline reuptake inhibition in women improves endurance exercise performance in the heat.

Catecholamine reuptake inhibition improves the performance of male volunteers exercising in warm conditions, but sex differences in thermoregulation, circulating hormones, and central neurotransmission may alter this response. With local ethics committee approval, nine physically active women (mean±SD age 21 ± 2 years; height 1.68 ±0.08m; body mass 64.1±6.0kg; VO2peak 51±7mL/kg/min) were recruited to examine the effect of pre-exercise administration of Bupropion (BUP; 4×150mg) on prolonged exercise performance in a warm environment. Participants completed a VO2peak test, two familiarization trials, and two randomized, double-blind experimental trials. All trials took place during the first 10days of the follicular phase of the menstrual cycle. Participants cycled for 1h at 60% VO2peak followed by a 30-min performance test. Total work done was greater during the BUP trial (291±48kJ) than the placebo trial (269±46kJ, P=0.042, d=0.497). At the end of the performance test, core temperature was higher on the BUP trial (39.5±0.4°C) than on the placebo trial (39.2±0.6°C, P=0.021; d=0.588), as was heart rate (185±9 vs 179±13, P=0.043; d=0.537). The results indicate that during the follicular phase of the menstrual cycle, an acute dosing protocol of BUP can improve self-regulated performance in warm conditions.

Effects of Rhodiola rosea supplementation on mental performance, physical capacity, and oxidative stress biomarkers in healthy men

PurposeThe objective of this study was to investigate the effects of chronic Rhodiola rosea (R. rosea) supplementation on mental and physical performance, as well as hormonal and oxidative stress biomarkers. MethodsTwenty-six healthy male students received either R. rosea extract (600 mg/day; RR) or placebo (PL) in a randomized double-blind trial. Prior to supplementation (Term I) and following 4 weeks of supplementation (Term II), the students underwent psychomotor tests for simple and choice reaction time, included in the Vienna Test System. Also, the subjects performed VO2peak test. Blood samples were obtained before and after the test to measure the hormonal profile (cortisol, testosterone, and growth hormone), as well as the biomarkers of oxidative stress (lipid hydroperoxides, total antioxidant capacity, and superoxide dismutase) and muscle damage (creatine kinase). ResultsR. rosea ingestion shortened reaction time and total response time. Moreover, a greater relative increase in the number of correct responses was observed in RR group as compared to the PL group. No changes in endurance exercise capacity and hormonal profile were observed after R. rosea ingestion. R. rosea ingestion raised plasma total antioxidant capacity. It did not, however, affect other measured parameters. ConclusionChronic R. rosea ingestion does not affect physical performance, but can improve the results of some psychomotor tests (simple and choice reaction time) in young, healthy, and physically active men. The improvements in mental performance, however, at least in our study, seem not to be related to changes in cortisol release or antioxidant activity of R. rosea extract. Thus, the specific mechanisms responsible for these effects still need to be elucidated.

Predicting Peak Oxygen Uptake From Submaximal Exercise After Spinal Cord Injury

PURPOSE: To determine the validity of the six-minute arm test (6MAT) in predicting peak oxygen consumption (VO2peak) in individuals with chronic spinal cord injury (SCI). METHODS: Fifty-two individuals with chronic SCI (age 38±10 years; American Spinal Injury Association Impairment Scale A-D, neurological level of injury C1-L2, years post-injury 13±10 years) completed an incremental arm VO2peak test and a submaximal 6MAT. Oxygen consumption data from both tests were used to create a predictive equation with regression analysis. Subsequently, a cross-validation group of an additional 10 individuals with SCI (age 39±13 years; AIS A-D, NLI C3-L3, YPI 9±9 years) were used to determine the predictive power of the equation. RESULTS: All subjects were able to complete both the VO2peak and 6MAT assessments. Regression analysis yielded the following equation to predict VO2peak from end-stage 6MAT VO2: VO2peak (mL·kg-1·min-1) = 1.501(6MAT VO2) - 0.940. Correlation between measured and predicted VO2peak was excellent (r=0.89). No significant difference was found between measured (17.41±7.44 mL·kg-1·min-1) and predicted (17.42±6.61 mL·kg-1·min-1) VO2peak (p=0.97). When cross-validated with a sample of 10 individuals with SCI, correlation between measured and predicted VO2peak remained high (r=0.89), with no differences between measured (18.81 ± 8.35 mL·kg-1·min-1) and predicted (18.73 ± 7.27 mL·kg-1·min-1) VO2peak (p=0.75). CONCLUSIONS: Results suggest that 6MAT VO2 can be used to predict VO2peak among individuals with chronic SCI. The 6MAT should be used as a clinical tool for assessing aerobic capacity when peak exercise testing is not feasible. Key Words: Arm Ergometry; Peak Oxygen Consumption; Prediction Equation, Submaximal Exercise Test, Spinal Cord Injury

Abstract P4-10-16: Long term effects of trastuzumab on cardiopulmonary and left ventricular function in women with HER2 overexpressing breast cancer

Abstract Background: Adjuvant trastuzumab (TRZ) is the standard of care for HER2-overexpressing (HER2+) early stage breast cancer (EBC) patients (PTS), with five-year survival rates exceeding 90%. However, significant cardiac toxicities are observed, with a fivefold increase in clinical heart failure (HF). Left ventricular (LV) remodeling (increased heart size and mass) is an early indicator of cardiac injury, progressing to further LV dysfunction, reduced exercise tolerance and overt HF. Therefore, effective prevention of such negative sequelae is of enormous clinical interest. As the pivotal TRZ trials assessed cardiac function with MUGA or echocardiography, insensitive modalities to evaluate LV remodeling, the long-term sequelae of TRZ remain unknown. Objective: to determine the long term effects of trastuzumab on cardiopulmonary and left ventricular function in women with HER2 overexpressing breast cancer. Additionally as aerobic training is an effective intervention in HF PTS who adhere to prescribed exercise, a sub-analysis compared those who adhered during a 4 month exercise intervention (AEX) vs those who did not adhere (NEX). Methods: 16 PTS (mean age 58 ± 7) who participated in an exercise intervention study during the first 4 months of TRZ therapy were recruited, with an average of 4 years elapsing since TRZ completion. Cardiopulmonary exercise (VO2peak) testing and resting cardiac MRI (CMR) were performed and compared with baseline and 4 month assessments. Adherence to exercise intevention was defined as attendance ≥80% prescribed sessions. Results: All 16 PTS reported independent living with no limitations to ADLs. At 4 years, mean VO2peak for all PTS was 22.4 ml/kg/min (20.0 at baseline and 22.0 at 4 months). In AEX PTS, higher VO2peak persisted 4 years after cessation of therapy, 4.1 mL/kg/min higher than NEX PTS (24.9 and 20.8 mL/kg/min, respectively ). Mean LVEF for all PTS was 60 ± 6%, not significantly different from baseline or 4 months (61 ± 5 and 55 ± 4%, respectively) . Statistically significant interactions of exercise adherence to other CMR metrics were not observed. Conclusions: Clinically significant impairment of cardiopulmonary function (equal to 14 years of aging) are present before therapy and persist in PTS four years following exposure to TRZ-based chemotherapy. This observation is consistent with our other work, and occurs on a background of normal LVEF, implying additional negative effects to other components of the oxygen cascade. As mortality risk has been shown to decrease by 17% for every 3.5 mL/kg/min difference in aerobic capacity in healthy females, these findings indicate adherence to exercise interventions during TRZ-based therapy has potentially important long-term implications. Citation Format: Pituskin E, Paterson I, Ghosh S, Mackey JR, Haykowsky MJ. Long term effects of trastuzumab on cardiopulmonary and left ventricular function in women with HER2 overexpressing breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-10-16.

Peak oxygen uptake and self-reported physical health are strong predictors of long-term survival after heart transplantation.

Peak oxygen uptake (VO2peak ) is known as the gold standard measure of cardiopulmonary fitness. We therefore hypothesized that measures of physical health would predict long-term survival in heart transplant recipients (HTx). This retrospective study investigated survival in two HTx populations; the cardiopulmonary exercise test (CPET) cohort comprised 178 HTx patients who completed a VO2peak test during their annual follow-up (1990-2003), and the SF-36 cohort comprised 133 patients who completed a quality of life questionnaire, SF-36v1 (1998-2000). Mean (SD) age in the CPET cohort was 52 (12) yr and 54 (11) yr in the SF-36 cohort. Mean observation time was, respectively, 11 and 10 yr. Mean (SD) VO2peak was 19.6 (5.3) mL/kg/min, and median (IR) physical function (PF) score was 90 (30). VO2peak and PF scores were both significant predictors in univariate Cox regression. Multiple Cox regression analyses adjusted for other potential predictors showed that VO2peak , age, and cardiac allograft vasculopathy (CAV) were the most important predictors in the CPET cohort, whereas age, PF score, smoking, and CAV were the most important predictors in the SF-36 cohort. In Kaplan-Meier analysis, VO2peak and PF scores above the median value were related to significant longer survival time. Peak oxygen uptake and self-reported physical health are strong predictors for long-term survival in HTx recipients. VO2peak is a crucial measurement and should be more frequently used after HTx.

Hospital-based and telemonitoring guided home-based training programs: Effects on exercise tolerance and quality of life in patients with heart failure (NYHA class III) and cardiac resynchronization therapy. A randomized, prospective observation.

Cardiac resynchronization therapy with defibrillator function (CRT-D) along with an optimal medical therapy improves symptoms, cardiac efficiency, quality of life (QoL) and prognosis in patients with heart failure (CHF). The aim of the study was to assess effects of hospital-based and home-based/telemonitoring exercise training. MethodsThe prospective, randomized study was conducted in 52 patients (pts), aged 45–75years (mean 62±9.3), with CHF of ischemic or another etiology, NYHA class III and implanted CRT-D. Group CRT-Ex (n=26) underwent initial exercise training in the hospital setting and continued training program at home with telemonitoring 5 times a week for 8weeks. The CRT-control group (n=26) consisted of patients who had hospital rehabilitation, but no training program after discharge. ResultsNo differences between the groups in CHF etiology, comorbidities, medical therapy and in any of spiroergometry (CPX) parameters at baseline were observed. After 3–4months the CRT-Ex group achieved better results in VO2 peak, VCO2 peak and treadmill test duration. But after 12months the measurements returned to the baseline values. No significant differences were observed directly between two groups in distances of 6-MWT at baseline, at 3–4months and at 12months. Echocardiographic evaluation showed significant reduction of left ventricular dimensions and improvement in the left ventricular ejection fraction (EF), in both groups (25.3±7.4% to 28.9±9.1%, CRT-Ex group, p=0.0213 and 24.9±7.2% to 31.7±10.6%, CRT-Control group, p=0.0001). Significant improvement in all domains of QoL was observed in the CRT-Ex group, while the CRT-Control pts declared only higher energy levels and less pain. Intensity of telemonitoring guided home-based exercise training was low. In the 12- and 18-months follow-up there were no differences in the ICD-interventions, mortality or hospitalization rates between the groups. ConclusionsA structured exercise training program in the hospital and home-based with telemonitoring was safe option of additional treatment and improved directly physical fitness and, quality of life in patients with NYHA III CHF and CRT-D. However these effects haven't been sustained in longer period of time and had no impact on prognosis.

Laboratory Determinants of Repeated-Sprint and Sport-Specific-Technique Ability in World-Class Ice Sledge Hockey Players.

To investigate on-ice repeated-sprint and sports-specific-technique abilities and the relationships to aerobic and anaerobic off-ice capacities in world-class ice sledge hockey players. Twelve Norwegian national team players performed 8 repeated maximal 30-m sprints and a sports-specific-technique test while upper-body poling on ice, followed by 4 maximal upper-body strength tests and 8-s peak power and 3-min peak aerobic-capacity (VO2peak) tests while ergometer poling. The fastest 30-m sprint time was 6.5 ± 0.4 s, the fastest initial 10-m split-time 2.9 ± 0.2 s, and the corresponding power output 212 ± 37 W. Average 30-m time during the 8 repeated sprints was 6.7 ± 0.4 s, and the sprint-time decrement was 4.3% ± 1.8%. Time to execute the sport-specific-technique test was 25.6 ± 2.7 s. Averaged 1-repetition-maximum strength of the 4 exercises correlated with the fastest 30-m sprint time (r = -.77), the fastest initial 10-m split time (r = -.72), the corresponding power output (r = .67), and the average 30-m sprint time (r = -.84) (all P < .05). Peak power of the 8-s ergometer sprint test correlated with the highest initial 10-m power (r = .83, P < .01) and the average 30-m sprint time (r = -.68, P < .05). Average 3-min ergometer power (r = -.86, P < .01) and VO2peak (r = -.67, P < .05) correlated with the sprint-time decrement. All off-ice variables except VO2peak correlated with technique-test time (r = -.58 to .73, all P < .05). Maximal strength and power are associated with the ability to sprint fast and rapid execution of a technically complex test, whereas mode-specific endurance capacity is particularly important for maintenance of sprint ability in ice sledge hockey.