Evaluating Aerobic Fitness
HPS 410
Dr. Joe G. Schmalfeldt
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Aerobic Fitness – ability of the heart, lungs,
and blood vessels to supply oxygen to
working muscles and ability of the muscles to
use the available oxygen to continue work or
exercise
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Essential Definitions
Aerobic Fitness and Health
Evaluation of Aerobic Fitness
Risk Stratification for Exercise
Laboratory-based Aerobic Fitness Tests
Laboratory-based Maximal Tests of Aerobic
Fitness
•  Laboratory-based Submaximal Tests of Aerobic
Fitness
•  Field Tests of Aerobic Fitness
•  Nonexercise Estimates of Aerobic Fitness
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Importance of Aerobic Fitness
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Related to health outcomes
Mortality risk
Cardiovascular health
Ability to meet demands of physical work
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Definition of Aerobic Fitness
•  Capacity to meet the energy demands of
sustained, submaximal work
•  Capacity to deliver oxygen to working
muscles
•  Capacity to extract oxygen at working
muscles
•  VO2 max – maximal volume of oxygen one
can consume during exhaustion exercise
VO2 max
•  Delivery factors:
–  Blood supply (cardiac output, redistribution of
blood flow)
–  Carrying capacity (Hb, RBC)
•  Extraction factors:
–  Muscle mass
–  Capillary density
–  best index of aerobic capacity
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1
Aerobic Exercise
VO2 max
•  Important for health promotion
•  Efficient exercise mode for expending
calories (large muscle groups)
•  Examples:
•  Measured during maximal exercise
•  Incremental test
•  Components:
–  O2, CO2, VE
–  Walking
–  Jogging
–  Cycling
–  Swimming
–  Group classes (Step, Spin)
•  Can be expressed in absolute or relative
terms
–  Absolute – l·min-1 or ml·min-1
–  Relative - ml·kg-1·min-1
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VO2 max – Fit vs. Less fit
VO2 max – Average vs. Athlete
50
VO2 max
45
Males
Females
80
40
60
-1
min )
35
30
-1
VO2 max (mlkg min )
-1.
25
.
.
VO2 max (mlkg
-1.
VO2 max
20
Fit Man
Less Fit Man
15
40
20
10
5
0
Average
0
1
2
3
4
Stage I
1.7 mph, 10%
5
6
Stage II
2.5 mph, 12%
7
8
Minutes
9
10
Stage III
3.4 mph, 14%
11
12
13
Stage IV
4.2 mph, 16%
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14
Athlete
Group
15
(Fig 11.1)
VO2 max Quintile Norms - Women
(ACSM, Jackson et al.)
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VO2 max Quintile Norms - Men
(ACSM, Jackson et al.)
Age
Poor
Fair
Average
Good
Excellent
Age
Poor
Fair
Average
Good
Excellent
20-29
≤30.6
30.7-33.8
33.9-36.7
36.8-41.0
≥41.1
20-29
≤37.1
37.2-41.0
41.1-44.2
44.3-48.2
≥48.3
30-39
≤28.7
28.8-32.3
32.4-34.6
34.7-38.6
≥38.7
30-39
≤35.5
35.5-38.8
39.0-42.4
42.5-46.8
≥46.9
40-49
≤26.5
26.6-29.5
29.6-32.3
32.4-36.3
≥36.4
40-49
≤33.0
33.1-36.7
36.8-39.9
40.0-44.1
≥44.2
50-59
≤24.3
24.4-26.9
27.0-29.4
29.5-32.3
≥32.4
50-59
≤30.2
30.3-33.8
33.9-36.7
36.8-41.0
≥41.1
60-69
≤22.8
22.9-24.5
24.6-27.3
27.3-31.2
≥31.3
60-69
≤26.5
26.6-30.2
30.3-33.6
33.7-38.1
≥38.2
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(Table 11.1)
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(Table 11.1)
2
Age-adjusted VO2 max Standards*
Age Group
Men
Women
≤ 45
35
32
50
34
31
55
32
29
60
31
28
≥ 65
30
27
Risk Stratification for
Exercise Testing
•  Exercise testing carries low risk
•  Higher risk for maximal than submaximal
testing, and for persons at risk
•  ACSM Guidelines for stratifying risk
*Developed from data of Jackson et al. (1995; 1996)
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(Table 11.2)
ACSM Risk Factors
Positive
•  Family history – MI or sudden death before age 55 in father,
brother, or son; before age 65 in mother, sister, or daughter
•  Smoking
•  Hypertension (SBP ≥ 140 mm Hg or DBP ≥ 90 mm Hg)
•  Dyslipidemia – Total (> 200 mg/dL), HDL (< 40 mg/dL), or
LDL (> 130 mg/dL)
•  Fasting glucose – (> 100 mg/dL)
•  Obesity (BMI > 30 kg/m2 or waist girth > 102 cm for men
and > 99 cm for women, or waist/hip ratio ≥ 0.95 for men
and ≥ 0.86 for women)
•  Sedentary Lifestyle - (Surgeon General s recommendations)
Negative
•  High HDL cholesterol (HDL > 60 mg/dL)
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Laboratory-based Aerobic Fitness Tests
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Treadmill protocols
Cycle ergometer protocols
Arm ergometer protocols
Maximal vs. Submaximal
Data:
–  gas exchange; heart rate; RPE; BP
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Pre-Screening - PAR-Q
•  Physical Activity Readiness Questionnaire
•  Minimum for beginning moderate exercise
program
•  Series of Yes/No questions (see Fig 2-1 in text)
•  If all No answers, can begin exercise program
or fitness testing (with caveats regarding
temporary illness, pregnancy, or change in
status)
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Test Selection
•  Match intended/existing exercise mode
Treadmill:
•  Often yield higher maximal values
•  More familiar mode for most people
•  Running protocols may be unsuitable for some
medical conditions (e.g., osteoarthritis, obese)
Cycle ergometer:
•  Often yield lower maximal values (local muscular
fatigue)
•  Some people may feel safer than on treadmill
(balance/falling)
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Test Selection
Cycle Protocols
Arm ergometer:
•  Usually yields lowest maximal values (local
muscular fatigue, smaller muscle mass)
•  Suitable for people with medical conditions
affecting the legs (paraplegia, amputation,
severe osteoarthritis)
•  Power output – cadence, resistance,
flywheel distance/revolution
•  ACSM equations used to estimate O2 cost
•  Submaximal data used to estimate maximal
work output or VO2 max
–  Based on linear heart rate/workload relationship
(beyond approximately 40% VO2 max)
•  Different prediction models (single-stage,
multi-stage)
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Laboratory-based Maximal Tests of
Aerobic Fitness
•  Goal is to systematically increase exercise
intensity until participant reaches exhaustion.
•  VO2 max can be measured by open-circuit
spirometry.
–  expired gases are measured with metabolic
measurement system.
•  VO2 max can be estimated from maximal
treadmill time.
–  Bruce protocol
–  Balke protocol
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Stage
1
2
3
4
5
6
7
Time
1-3
4-6
7-9
10-12
13-15
16-18
19-21
Speed (mph) Grade (%)
1.7
10
2.5
12
3.4
13
4.2
16
5.0
18
5.5
20
6.0
22
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The Balke Protocol
Time (min)
1
2
3
•
•
•
22
The Bruce Protocol
Speed (mph)
% Grade
3.3
0
3.3
2
3.3
3
Speed is constant at 3.3 mph
Elevation increases
1% each minute
3.3
22
Laboratory-based Submaximal Tests
of Aerobic Fitness
•  Less accurate, but more practical method to
estimate aerobic capacity than maximal
tests.
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4
Submaximal Tests Principles
•  Heart rate increases in proportion to VO2
during aerobic exercise.
•  VO2 max is reached at maximal heart rate.
•  A less fit person will have a higher heart
rate at any given submaximal exercise
intensity than a more fit individual.
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Astrand-Ryhming Single-Stage Test
•  Can be administered on a cycle ergometer,
treadmill, or step.
•  Cycle protocol last 6 minutes.
•  Pedal rate is 50 rpm.
•  Heart rates between 125 and 170 bpm are
used for prediction.
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YMCA Protocol
Multi-Stage Model
–  Heart rates between 100 and 150 bpm are used.
–  3-minute exercise stages are used.
–  VO2 max is estimated by plotting heart rate –
power output relationship.
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Submaximal Treadmill Models
•  Both single-stage and double-stage models
can be used to estimate VO2 max from
treadmill tests.
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1st
Power
Output
150
kp.m.min-1
•  Heart rate and power output must be
measured at two or more submaximal
levels.
•  YMCA is best known multi-stage test.
3 Minute
Stages
HR
80-89
HR
<80
HR
90-100
HR
>100
750
kp.m.min-1
600
kp.m.min-1
450
kp.m.min-1
300
kp.m.min-1
900
kp.m.min-1
750
kp.m.min-1
600
kp.m.min-1
450
kp.m.min-1
1050
kp.m.min-1
900
kp.m.min-1
750
kp.m.min-1
600
kp.m.min-1
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2nd
Power
Output
3rd
Power
Output
4th
Power
Output
Single-Stage 4-minute
Treadmill Walking Test
•  Participant walks for 4 minutes at at
treadmill speed of either 2, 3, 4, or 4.5 mph
at 5% grade.
•  Speed should be a brisk, but comfortable
pace.
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5
Steady State Exercise
•  Subjects need to be at steady state for
submaximal estimates to be accurate.
•  Steady state heart rate is defined as two
successive heart rates within 5 beats.min-1.
Field Tests of Aerobic Fitness
•  Can be conducted in the field on large
numbers of people.
•  Extensive technical equipment or expertise
not required.
•  Generally less accurate than laboratory tests.
•  Most involve maximal or strenuous effort.
–  Risks involved
•  Suitable for young people in good physical
condition, without significant CVD risk
factors.
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Field Tests of Aerobic Fitness
•  Distance run/walk
–  12-minute run/walk for distance
•  Timed run/walk
–  1.5-mile run
–  1-mile run/walk
•  20-meter shuttle run (e.g., PACER)
•  Rockport 1-mile walk test
•  BYU Jog test
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Generalized 1-mile
Run/Walk Test
•  Participants cover the 1 mile distance as
fast as possible.
•  Developed on 8- to 25-year-old (n = 750),
males and females.
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12-Minute Run/Walk Test
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Developed on 115 men, 17-52 years.
High correlation with VO2 max (r = .90).
Practice required, need to learn pacing.
Run/walk for 12 minutes.
Measure distance traveled in miles.
VO2 max (ml·kg-1·min-1) =
(Distance – 0.3138) ÷ 0.0278
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PACER (20-meter Shuttle Run)
•  Progressive Aerobic Cardiovascular
Endurance Run.
•  Participants run together (same pace).
•  Paced by audio tape.
•  Pace increases with time.
•  Less fit finish first, fittest finish last.
•  Record individual s fastest speed (km·hr-1).
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Distance Runs – Important Considerations
•  Select appropriate test.
•  Be sure participant is motivated – accurate
score depends on maximal exertion.
•  Provide practice.
•  Discuss pacing.
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Rockport 1-Mile Walk Test
•  Developed on 343 males and females 30-69
years of age.
•  Requires accurate measurement of heart rate.
•  Participants walk as fast as possible for 1 mile.
•  Heart rate monitor was used in original study.
•  Pace should be brisk (> 120 beats·min-1), and
constant.
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BYU Jog Test
•  Similar to the 1-Mile Walk Test, but
participant jogs instead of walks.
•  To ensure a submaximal pace, run times of
≥ 8 minutes per mile for males and ≥ 9
minutes per mile for females.
–  Heart rates should be ≤ 180 bpm.
•  Developed on 54 males and females 18 to
29 years of age.
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Walking and Jogging Tests
•  Do not require maximal exertion.
•  Pace is self-determined.
•  Post-test heart rate response is measured.
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Rockport 1-Mile Walk Test
•  Not suitable for highly fit or people on HRaltering medications (anti-hypertensives, betablockers).
•  Measure time (minutes), post-walk HR, weight
(lb).
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Non-Exercise Estimates of
Aerobic Fitness
•  Can accurately estimate VO2 max without
exercise testing.
•  Include age, sex, body composition (BMI or %
fat), and self-reported physical activity (SRPA).
–  30-day physical activity recall (7-point scale)
•  Suitable for people on HR-altering medication.
•  Accuracy is similar to many exercise tests.
•  Less accurate for highly fit (top 5%).
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7
30-day Physical Activity Recall
Use the appropriate number (0 to 7) that best describes your general
ACTIVITY LEVEL for the PREVIOUS MONTH
______________________________________________________________________________
Do not participate regularly in programmed recreation, sport or heavy physical activity.
0 - Avoid walking or exertion, e.g., always use elevator, ride whenever possible instead of
walking.
1 - Walk for pleasure, routinely use stairs, occasionally exercise sufficiently to cause heavy
breathing or perspiration.
Participate regularly in recreation or work requiring modest physical activity, such as
gymnastics, horseback riding, calisthenics, gymnastics, table tennis, softball, baseball, weight
lifting, yard work.
2 - Spend 10 to 60 minutes per week in these types of physical activity.
3 - Spend over 1 hour per week in these types of physical activity.
Participate regularly in heavy physical exercise, e.g., running or jogging, swimming, cycling,
rowing, jumping rope, or engaging in vigorous aerobic activity type exercise such as tennis,
basketball, soccer, or other similar sports activities.s
4 - Run less than 1 mile per week or spend less than 30 minutes per week in comparable
physical activity.
5 - Run 1 to 5 miles per week or spend 30 to 60 minutes per week in comparable physical
activity.
6 - Run 5 to 10 miles per week or spend 1 to 3 hours per week in comparable physical
activity.
7 - Run over 10 miles per week or spend over 3 hours per week in comparable physical
activity.
Note: This scale was developed for use in the Cardio-pulmonary Laboratory, NASA/Johnson
Space Center, Houston, TX.
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Summary
•  Aerobic fitness is important for health.
•  Aerobic fitness can be tested in the lab or in
the field.
•  Lab tests are generally more accurate than
field tests.
•  Maximal effort tests are generally more
accurate than submaximal effort tests.
•  Non-exercise models are as accurate as
many submaximal exercise tests.
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