Exercise Maximum Capacity Assessment: A Review on the Traditional Protocols and the Evolution to Individualized Models

Mailing address: Paulo de Tarso Veras Farinatti Laboratório de Atividade Física e Promoção da Saúde (LABSAU), Instituto de Educação Física e Desportos, Universidade do Estado do Rio de Janeiro Rua São Francisco Xavier, 524, 8o andar, salas 8.121-F e 8.133-F 20550-013 – Rio de Janeiro, RJ, Brazil. E-mail: [email protected] ABSTRACT The physiological adjustments to exercise have been extensively investigated. Despite the agreement on the importance of cardiopulmonary exercise testing to assess the maximal oxygen uptake capacity ( O2max), expressive differences within the available protocols may compromise the comparison between studies as well as their clinical or functional utilization. The present study analyzed the most frequently used exercise testing protocols to assess the O2max highlighting their pros and cons. Furthermore, the characteristics of staggered protocols were compared to those of individualized models, generally referred as ramp protocols. 102 studies published between 1955 and 2009 were revised. The available studies suggest that ramp protocols would produce better results compared to more traditional staggered tests. However, there is clearly a lack of recommendations regarding the application of such individualized protocols. Very few studies investigated the influence of the testing variables on the main expected results, as O2max and metabolic transition thresholds. It is not clear yet which is the best strategy to determine the maximal exercise capacity, the initial speed of the test, increment ratio, interaction between speed and treadmill inclination, and total duration of the protocol. In conclusion, exercise ramp protocols have been elaborated based on the evaluator experience, since precise recommendations that would define a real ‘protocol’ do not exist. Studies that contribute to the development of formal and precise criteria for exercise testing ramp protocols design are therefore necessary.