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A Self‐Paced Step Test to Predict Aerobic Fitness in Older Adults in the Primary Care Clinic
Author(s) -
Petrella Robert J.,
Koval John J.,
Cunningham David A.,
Paterson Donald H.
Publication year - 2001
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1046/j.1532-5415.2001.49124.x
Subject(s) - medicine , physical therapy , body mass index , test (biology) , treadmill , vo2 max , aerobic exercise , heart rate , gerontology , blood pressure , paleontology , biology
OBJECTIVES: To study the potential usefulness of a submaximal self‐paced step test as a prediction of maximal aerobic capacity (VO 2 max) in older adults in the primary care setting. DESIGN: Data were collected during a prospective randomized study of an exercise program. SETTING: Four university family medical clinics in London, Ontario, Canada. PARTICIPANTS: A random sample of 240 healthy older (≥65) men (n = 118) and women (n = 122) from four family medical clinics underwent self‐paced step testing in the clinic with a family physician (n = 16), and step testing and a maximal exercise treadmill test with measurement of respired gases in an exercise laboratory. Testing was done in random order (clinic/laboratory) separated by 2 weeks and then repeated at 52 weeks, following introduction of an exercise program. Relationships between outcome variables were examined by Pearson correlation coefficients while prediction of VO 2 max was examined using multivariate regression analysis. Cross‐validation with 30 age‐matched hypertensive and 40 age‐matched post‐hip arthroplasty patients was used to test the accuracy of the predictive models. MEASUREMENTS: Measured VO 2 max, predicted VO 2 max, step test time, step test heart rate, body mass index (BMI), and O 2 pulse. RESULTS: Two hundred women (n = 108) and men (n = 92) completed both the initial and 52‐week assessments. Stepping time, heart rate, age, BMI, and O 2 pulse were strongly associated with VO 2 max for both a normal and a fast step pace and were chosen to develop the predictive model. Normal step‐pace correlation with VO 2 max (ml/kg/min) was no different (female 0.93: male 0.91) from fast pace (0.95:0.90) with no difference between clinic and laboratory measurement at baseline or 52 weeks. Cross‐validation showed no significant difference from the main group using the predictive model. CONCLUSIONS: The self‐paced step test is a safe and simple clinical instrument that strongly and reliably predicts VO 2 max, is sensitive to change, and is generalizable in the family practice setting among community‐dwelling older adults differing in fitness and health status.