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Cardiopulmonary exercise testing

A cardiopulmonary exercise test (CPET), more widely known as a VO2max test, is a non-invasive gold standard assessment of aerobic fitness. CPET assesses exercise capacity by looking at how an individual’s heart and lungs are able to cope with increasing demand of incremental exercise as Gurinder Rayat, ISEH research technican reports: 

“Exercise capacity can be quantified by measuring the maximum oxygen consumption an individual can use in one minute per kilogram of body weight (ml/kg/min), this number is the VO2peak. The main difference between a VO2 peak and a VO2max is a VO2max is the maximum amount of oxygen an individual can consume, but a peak is the highest amount of oxygen consumed at peak exercise. Regardless, the higher the number, the fitter the individual. For a healthy person, their VO2 would be approximately >25 ml/kg/min, but the value largely depends on the demographics of the individual.

Many of the current Olympians in Rio would have undergone a CPET or another VO2max test to assess how fit they really are, or to see if there’s a need to adapt their training programmes. With elite endurance athletes, such as Chris Froome, attaining a VO2 of 85 ml/kg/min. Professional footballers and rugby players alike also endure the test before joining a new team to see if there’s any underlying medical problems.

More recently the use CPET has been transferred into the clinical setting, with the test being used in hospitals as part of a clinical pre-assessment to help guide clinicians in their care of patients. The test is also used in a diagnostic assessment of unexplained breathlessness.

The test is conducted on either a treadmill or exercise bike with the individual continuously monitored using an ECG (measuring heart rate) and the unmistakable facemask (collecting all the inspired and expired gases). The individual cycles against increasing resistance for as long as they can until near exhaustion.

A copious amount of data is collected, looking at cardiac, ventilatory, and pulmonary parameters that help to create a picture of the individual’s cardiovascular system. The exercise physiologist analyses the test determining the VO2max, ventilatory/anaerobic threshold, and other subtle variables. CPET can also assess what could be the limiting factor in an individual’s ability to exercise.

CPET has been across a broad spectrum of individuals, from patients to elite athletes; highlighting the importance of the test. But the results of the test can help anyone improve their fitness, by using the data to create an individually tailored training programme or to give some motivation to help improve cardiorespiratory fitness.”