Objectives: To investigate the feasibility of
individualized workload increments, as used in adults, for exercise
testing in children; and to investigate whether this individualized
protocol makes it possible to satisfy the usual criteria for maximal
exercise (clinical exhaustion, predicted maximum heart rate [HRmax],
oxygen uptake [V̇o2] plateau, maximal
respiratory exchange ratio > 1.1).
Prospective clinical study.
exercise testing laboratory.
children aged 5 to 17 years with various cardiac and respiratory
diseases (33 with asthma, 11 with bronchopulmonary dysplasia, 6 with
cystic fibrosis, 10 with congenital heart disease, and 32
Interventions: Individualized maximal
incremental exercise testing. The increase in workload was adapted to
the individual and was calculated from predicted maximal oxygen uptake
(V̇o2max) for each child. The test lasted
10 to 12 min.
Results: The exercise test was well
tolerated by all children and was maximal in all but seven patients. A
total of 65.7% of children reached the predicted
V̇o2max and 68.4% satisfied the criteria
for a V̇o2 plateau at peak exercise. The
predicted HRmax was achieved in all but two children. The mean maximal
respiratory exchange ratio was 1.06.
individualized protocol for increasing workload, based on
V̇o2 rather than power, was well tolerated
by children. In our view, the best two criteria for assessing the
maximality of the tests were clinical exhaustion and HRmax, especially
if the V̇o2 plateau was not reached. These
results suggest that individualized protocols could be used instead of
standardized tests for exercise testing in children.