Exercise Testing and Training in a Cancer Rehabilitation Program: The Advantage of the Steep Ramp Test

• Published in: Archives of physical medicine and rehabilitation Vol. 88; no. 5; pp. 610 - 616
• Main Authors: De Backer, Ingrid C., Schep, Goof, Hoogeveen, Adwin, Vreugdenhil, Gerard, Kester, Arnold D., van Breda, Eric
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.05.2007; Elsevier
• Subjects: Adult; Aged; Biological and medical sciences; Cancer; Diseases of the osteoarticular system; Ergometry; Exercise Test; Exercise Therapy; Female; Hospitals, Community; Humans; Male; Medical sciences; Middle Aged; Miscellaneous; Neoplasms - rehabilitation; Oxygen Consumption; Physical Endurance; Physical Medicine and Rehabilitation; Prospective Studies; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Rehabilitation; Sensitivity and Specificity; Task Performance and Analysis; Oxygen consumption; Rehabilitation; Exercise test; Ergometry; Cancer; Antineoplastic agent; Physical exercise; Human; Survivor; Physiotherapy; Malignant tumor; Medical screening; Chemotherapy; Reeducation; Treatment; Advantage; Criterion; At home; Female; Hospital; Woman; Age; Strength
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2007.02.013

De Backer IC, Schep G, Hoogeveen A, Vreugdenhil G, Kester AD, van Breda E. Exercise testing and training in a cancer rehabilitation program: the advantage of the steep ramp test. To compare the short maximal exercise capacity test (steep ramp test) with the submaximal test to determine the most appropriate exercise test in cancer rehabilitation. A prospective study in which a submaximal test, a maximal short exercise capacity test (steep ramp test), and a maximal oxygen consumption test (V̇ o 2max test) were performed before and after an 18-week training program. V̇ o 2max testing, the criterion standard for the measurement of physical capacity, was compared with the submaximal test and the steep ramp test. Community hospital and physiotherapy. Thirty-seven cancer survivors (10 men, 27 women) treated with chemotherapy. The subjects’ mean age ± standard deviation (SD) was 48±11 years. An 18-week training program including strength training, interval aerobic training, and home-based activities (endurance). Estimated V̇ o 2max (submaximal test) and maximal workload (steep ramp test) were assessed during the exercise tests and compared with the results of the V̇ o 2max test. A paired t test showed a significant improvement in V̇ o 2max (+13%, P<.001) and maximal workload (+19%, P<.001) after the training program. This improvement was confirmed in the steep ramp test (maximal workload, +13%, P<.001) but not in the submaximal test (estimated V̇ o 2max, +4%, P=.192). Pearson correlation quantified only a moderate correlation between the V̇ o 2max test and the submaximal test and a high correlation between the V̇ o 2max test and the steep ramp test. Intraclass correlation determined the test-retest reliability of the submaximal test (.873) and the steep ramp test (.996). A linear regression model (V̇ o 2max, 6.7; steep ramp Wmax, +356.7) was estimated to predict V̇ o 2max from the steep ramp test outcome, implying a prediction margin of ±2 SDs (616mL/min). The submaximal test proved to be invalid, whereas the steep ramp test seems to be a practicable, reliable, and valid test for the assessment of the training dose. The steep ramp test can be regularly repeated during the training program, providing information needed to readjust the training dose according to the progress made.