Maeder Micha, Wolber Thomas, Atefy Ramin, Gadza Mirko, Ammann Peter, Myers Jonathan, Rickli Hans
Division of Cardiology, Department of Internal Medicine, Kantonsspital, St. Gallen, Switzerland.
J Cardiopulm Rehabil. 2006 Jan-Feb;26(1):16-23. doi: 10.1097/00008483-200601000-00004.
Guidelines suggest that individualized ramp protocols with treadmill times targeted between 8 and 12 minutes are most suitable to estimate exercise capacity. However, previous methods to determine individualized ramp rates and comparisons between ramp and standardized protocols have been limited to clinically referred populations.
Forty-three healthy volunteers [median (interquartile range), age 36 (30-41) years; 10 women] performed an individualized ramp and a Bruce treadmill exercise protocol in random order. The Veterans Specific Activity Questionnaire [VSAQ, resulting in metabolic equivalents (METs)VSAQ] combined with a modified variant of the VSAQ nomogram (resulting in METs(NOMOGRAM)) was used to individualize the ramp protocol. Exercise capacity estimated from speed and grade of the treadmill (METs(ESTIMATED)) and that derived from directly measured peak oxygen uptake (VO2) [METs(MEASURED)] were compared with the pretest estimates of exercise capacity.
Median values for METs(VSAQ), METs(NOMOGRAM), METs(ESTIMATED), and METs(MEASURED) for the ramp protocol were 12.0 (10-12), 15.0 (14-16.5), 16.7 (15.9-17.8), and 15.2 (13.5-16.7), respectively. For the ramp protocol, all 43 participants achieved a treadmill time between 8 and 12 minutes, whereas with the Bruce protocol only 6 (14%) participants fell within this range (P < .0001). Peak VO2 [ramp: 53.1 (47.4-58.3) versus Bruce: 53.5 (48.7-58.3) mL/kg/min; P = .008] was slightly lower using the ramp protocol.
The modified variant of the VSAQ nomogram is a useful tool to estimate an individual's exercise capacity and to select a treadmill ramp protocol to yield the recommended exercise duration for moderately to highly fit, healthy individuals. The individualized ramp and the Bruce protocols are similar with regard to directly measured peak VO2 achieved.
指南建议，将跑步机运动时间设定在8至12分钟之间的个性化递增运动方案最适合用于评估运动能力。然而，以往确定个性化递增速率的方法以及递增运动方案与标准化方案之间的比较仅限于临床转诊人群。
43名健康志愿者[中位数（四分位间距），年龄36（30 - 41）岁；10名女性]以随机顺序进行个性化递增运动方案和布鲁斯跑步机运动方案。退伍军人特定活动问卷[VSAQ，得出代谢当量（METs）VSAQ]与VSAQ列线图的改良变体[得出METs（列线图）]用于制定个性化递增运动方案。将根据跑步机速度和坡度估算的运动能力（METs（估算值））以及直接测量的峰值摄氧量（VO₂）得出的运动能力（METs（测量值））与运动能力的预测试估算值进行比较。
递增运动方案的METs（VSAQ）、METs（列线图）、METs（估算值）和METs（测量值）的中位数分别为12.0（10 - 12）、15.0（14 - 16.5）、16.7（15.9 - 17.8）和15.2（13.5 - 16.7）。对于递增运动方案，所有43名参与者的跑步机运动时间均在8至12分钟之间，而采用布鲁斯运动方案时，只有6名（14%）参与者在此范围内（P <.0001）。使用递增运动方案时，峰值VO₂[递增运动方案：53.1（47.4 - 58.3）与布鲁斯运动方案：53.5（48.7 - 58.3）mL/kg/分钟；P =.008]略低。
VSAQ列线图的改良变体是评估个体运动能力以及选择跑步机递增运动方案以获得推荐运动持续时间的有用工具，适用于中度至高度健康的个体。在直接测量的峰值VO₂方面，个性化递增运动方案和布鲁斯运动方案相似。
