Editorial
Prediction of Maximal Oxygen Uptake From Submaximal Exercise Testing in Chronic Respiratory Patients. New Perspectives
Predicción del consumo máximo de oxígeno mediante pruebas de ejercicio submáximo en pacientes con patología respiratoria crónica
a Centro de Investigación en Tecnoloxías da Información (CiTIUS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
b Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon-Tyne, United Kingdom
c Servicio de Neumología del Hospital Universitario Gregorio Marañón, Madrid, Spain
d Instituto de investigación Sanitaria Gregorio Marañón, Madrid, Spain
e Facultad de Medicina de la Universidad Complutense de Madrid, Madrid, Spain
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New Perspectives" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "507" "paginaFinal" => "508" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Marcos Matabuena, Philip R. Hayes, Luis Puente-Maestu" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Marcos" "apellidos" => "Matabuena" "email" => array:1 [ 0 => "marcos.matabuena@usc.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Philip R." "apellidos" => "Hayes" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Luis" "apellidos" => "Puente-Maestu" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Centro de Investigación en Tecnoloxías da Información (CiTIUS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon-Tyne, United Kingdom" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Neumología del Hospital Universitario Gregorio Marañón, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Instituto de investigación Sanitaria Gregorio Marañón, Madrid, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Facultad de Medicina de la Universidad Complutense de Madrid, Madrid, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Predicción del consumo máximo de oxígeno mediante pruebas de ejercicio submáximo en pacientes con patología respiratoria crónica" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">One of the most effective non-pharmacological treatments for COPD is a programme of pulmonary rehabilitation.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> Both the American Thoracic Society and European Respiratory Society<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,3</span></a> agree that exercise is the cornerstone of such programmes, resulting in reduced dyspnoea, increased exercise tolerance and improved quality of life. One of the challenges that practitioners have faced in prescribing exercise is to decide the intensity for a personalised intensity.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The individualisation of exercise prescription should be based upon prior physiological assessment.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> For COPD patients the most appropriate approach is to measure cardiopulmonary capacity through an exercise test. Exercise tests require the integration of ventilatory, cardiovascular and skeletal muscle systems to supply oxygen to the respiring mitochondria. A limitation within these systems will result in impaired exercise tolerance. However, both the cardiovascular system and skeletal muscle adapt to regular exercise provided it is prescribed at appropriate exercise intensity.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Maximum oxygen uptake (VO<span class="elsevierStyleInf">2</span> max.), a measure that reflects the ability of skeletal muscle mitochondria use the oxygen supplied by the ventilatory and cardiovascular systems, is assessed by an incremental exercise test.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> The results of this test can be used to prescribe exercise at an individualised exercise intensity. Furthermore, VO<span class="elsevierStyleInf">2</span> max scores have been used to classify an individual's aerobic fitness<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> and it is also inversely related to post-operative complications.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">A valid VO<span class="elsevierStyleInf">2</span> max measurement however requires those undertaking it to perform exercise to exhaustion; this may not be appropriate for those with clinical conditions such as COPD. To avoid these risks, alternative sub-maximal tests are employed, the American Thoracic Society advocate cycle ergometer tests, while others prefer the 6<span class="elsevierStyleHsp" style=""></span>min walk test.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> Sub-maximal tests require VO<span class="elsevierStyleInf">2</span> max to be predicted either from heart rate recorded during the test or the level of exercise e.g. power output, achieved within the test. In both instances, there is usually high predictive errors,<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> while cycle tests suffer from the added limitation of being a non-specific movement pattern. The consequences of inaccurate prediction include inappropriate individualised training intensities, the misclassification of either fitness or post-operative risk. While not life threatening, these consequences can affect patient outcomes.</p><p id="par0025" class="elsevierStylePara elsevierViewall">In a recent work from our group, a 6-min sub-maximal run test was used to accurately predict VO<span class="elsevierStyleInf">2</span> max.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> We proposed a new and innovative methodology to estimate the VO<span class="elsevierStyleInf">2</span> max that could easily be adapted for any physiological parameter or sport performance indicator. The test was a low intensity, incremental treadmill test coupled with, with a novel statistical technique called functional data analysis (FDA). Its main advantage compared to other widely used alternative tests, was the low predictive error of the VO<span class="elsevierStyleInf">2</span> max score. In our work, the accuracy achieved through using FDA resulted in a reduction of measurement error by more than 25% compared other traditional approaches. We attained a measurement error (RMSE) of 2.8<span class="elsevierStyleHsp" style=""></span>mL<span class="elsevierStyleHsp" style=""></span>min<span class="elsevierStyleSup">−1</span><span class="elsevierStyleHsp" style=""></span>kg<span class="elsevierStyleSup">−1</span>, a value very close to that achieved in maximal, directly measured tests. Our method is not without its limitations, requiring the measurement of VO<span class="elsevierStyleInf">2</span> during the test and a value for maximum heart rate, although most clinical units can now record this data. These results were obtained using a large (<span class="elsevierStyleItalic">N</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>299), heterogeneous sample of sportsmen and women (VO<span class="elsevierStyleInf">2</span> max (range): 30.2–80.1<span class="elsevierStyleHsp" style=""></span>mL<span class="elsevierStyleHsp" style=""></span>min<span class="elsevierStyleSup">−1</span><span class="elsevierStyleHsp" style=""></span>kg<span class="elsevierStyleSup">−1</span>, mass (range): 35.2–132.0<span class="elsevierStyleHsp" style=""></span>kg). The validity of this test in patients with chronic clinical conditions e.g. COPD, must be established but further refinements could include the use of a personalised intensity to terminate the test, e.g. ventilatory threshold. An improved accuracy in predicting VO<span class="elsevierStyleInf">2</span> max increases the likelihood of individualised exercise programmes being even more effective in treating patients with chronic diseases.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financing</span><p id="par0030" class="elsevierStylePara elsevierViewall">This work has received financial support from the <span class="elsevierStyleGrantSponsor" id="gs1">Consellería de Cultura, Educación e Ordenación Universitaria</span> (accreditation 2016–2019, <span class="elsevierStyleGrantNumber" refid="gs1">ED431G/08</span>) and the <span class="elsevierStyleGrantSponsor" id="gs2">European Regional Development Fund (ERDF)</span>.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Financing" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Practical recommendations for exercise training in patients with COPD" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. 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Kubis" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s40279-013-0068-3" "Revista" => array:6 [ "tituloSerie" => "Sports Med" "fecha" => "2013" "volumen" => "43" "paginaInicial" => "865" "paginaFinal" => "873" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23821468" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A 6-minute sub-maximal run test to predict VO<span class="elsevierStyleInf">2</span> max" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Matabuena" 1 => "J.C. Vidal" 2 => "P.R. Hayes" 3 => "F. Huelin Trillo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/02640414.2019.1664536" "Revista" => array:5 [ "tituloSerie" => "J Sports Sci" "fecha" => "2018" "paginaInicial" => "1" "paginaFinal" => "6" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31506039" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03002896/0000005500000010/v1_201910021029/S030028961930002X/v1_201910021029/en/main.assets" "Apartado" => array:4 [ "identificador" => "14517" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Editorials / Editoriales" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000005500000010/v1_201910021029/S030028961930002X/v1_201910021029/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S030028961930002X?idApp=UINPBA00003Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 8 | 3 | 11 |
| 2024 October | 63 | 21 | 84 |
| 2024 September | 68 | 11 | 79 |
| 2024 August | 82 | 33 | 115 |
| 2024 July | 57 | 21 | 78 |
| 2024 June | 55 | 21 | 76 |
| 2024 May | 86 | 33 | 119 |
| 2024 April | 50 | 25 | 75 |
| 2024 March | 47 | 23 | 70 |
| 2024 February | 41 | 21 | 62 |
| 2024 January | 1 | 0 | 1 |
| 2023 March | 12 | 6 | 18 |
| 2023 February | 59 | 29 | 88 |
| 2023 January | 41 | 37 | 78 |
| 2022 December | 81 | 18 | 99 |
| 2022 November | 80 | 27 | 107 |
| 2022 October | 84 | 34 | 118 |
| 2022 September | 46 | 20 | 66 |
| 2022 August | 43 | 46 | 89 |
| 2022 July | 36 | 34 | 70 |
| 2022 June | 31 | 27 | 58 |
| 2022 May | 44 | 38 | 82 |
| 2022 April | 42 | 43 | 85 |
| 2022 March | 46 | 43 | 89 |
| 2022 February | 44 | 35 | 79 |
| 2022 January | 49 | 30 | 79 |
| 2021 December | 35 | 36 | 71 |
| 2021 November | 40 | 46 | 86 |
| 2021 October | 47 | 52 | 99 |
| 2021 August | 1 | 0 | 1 |
| 2021 May | 2 | 1 | 3 |
| 2020 October | 0 | 2 | 2 |
| 2020 September | 1 | 0 | 1 |
| 2020 May | 1 | 0 | 1 |
| 2020 March | 1 | 2 | 3 |
| 2019 December | 12 | 0 | 12 |
| 2019 November | 12 | 10 | 22 |
| 2019 October | 199 | 75 | 274 |
| 2019 September | 1 | 0 | 1 |
| 2019 July | 4 | 2 | 6 |
| 2019 May | 1 | 2 | 3 |
| 2019 April | 1 | 0 | 1 |
| 2019 March | 2 | 2 | 4 |
| 2019 February | 12 | 8 | 20 |
Show all
