Martijn M Stuiver1, Caroline S Kampshoff2, Saskia Persoon3, Wim Groen4, Willem van Mechelen2, Mai J M Chinapaw2, Johannes Brug5, Frans Nollet3, Marie-José Kersten6, Goof Schep7, Laurien M Buffart8. 1. Department of Physical Therapy, Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; ACHIEVE, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands. Electronic address: m.stuiver@nki.nl. 2. Department of Public & Occupational Health/EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands. 3. Department of Rehabilitation, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. 4. Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands. 5. Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands. 6. Department of Hematology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. 7. SportMáx, Maxima Medical Center, Eindhoven, The Netherlands. 8. Department of Epidemiology and Biostatistics/EMGO+ Institute, VU University Medical Center, Amsterdam, The Netherlands; Department of Medical Oncology, VU University Medical Center, Amsterdam, The Netherlands; Exercise Medicine Research Institute, Edith Cowan University, Joondalup, Australia.
Abstract
OBJECTIVE: To further test the validity and clinical usefulness of the steep ramp test (SRT) in estimating exercise tolerance in cancer survivors by external validation and extension of previously published prediction models for peak oxygen consumption (Vo2peak) and peak power output (Wpeak). DESIGN: Cross-sectional study. SETTING: Multicenter. PARTICIPANTS: Cancer survivors (N=283) in 2 randomized controlled exercise trials. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Prediction model accuracy was assessed by intraclass correlation coefficients (ICCs) and limits of agreement (LOA). Multiple linear regression was used for model extension. Clinical performance was judged by the percentage of accurate endurance exercise prescriptions. RESULTS: ICCs of SRT-predicted Vo2peak and Wpeak with these values as obtained by the cardiopulmonary exercise test were .61 and .73, respectively, using the previously published prediction models. 95% LOA were ±705mL/min with a bias of 190mL/min for Vo2peak and ±59W with a bias of 5W for Wpeak. Modest improvements were obtained by adding body weight and sex to the regression equation for the prediction of Vo2peak (ICC, .73; 95% LOA, ±608mL/min) and by adding age, height, and sex for the prediction of Wpeak (ICC, .81; 95% LOA, ±48W). Accuracy of endurance exercise prescription improved from 57% accurate prescriptions to 68% accurate prescriptions with the new prediction model for Wpeak. CONCLUSIONS: Predictions of Vo2peak and Wpeak based on the SRT are adequate at the group level, but insufficiently accurate in individual patients. The multivariable prediction model for Wpeak can be used cautiously (eg, supplemented with a Borg score) to aid endurance exercise prescription.
RCT Entities:
OBJECTIVE: To further test the validity and clinical usefulness of the steep ramp test (SRT) in estimating exercise tolerance in cancer survivors by external validation and extension of previously published prediction models for peak oxygen consumption (Vo2peak) and peak power output (Wpeak). DESIGN: Cross-sectional study. SETTING: Multicenter. PARTICIPANTS: Cancer survivors (N=283) in 2 randomized controlled exercise trials. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Prediction model accuracy was assessed by intraclass correlation coefficients (ICCs) and limits of agreement (LOA). Multiple linear regression was used for model extension. Clinical performance was judged by the percentage of accurate endurance exercise prescriptions. RESULTS: ICCs of SRT-predicted Vo2peak and Wpeak with these values as obtained by the cardiopulmonary exercise test were .61 and .73, respectively, using the previously published prediction models. 95% LOA were ±705mL/min with a bias of 190mL/min for Vo2peak and ±59W with a bias of 5W for Wpeak. Modest improvements were obtained by adding body weight and sex to the regression equation for the prediction of Vo2peak (ICC, .73; 95% LOA, ±608mL/min) and by adding age, height, and sex for the prediction of Wpeak (ICC, .81; 95% LOA, ±48W). Accuracy of endurance exercise prescription improved from 57% accurate prescriptions to 68% accurate prescriptions with the new prediction model for Wpeak. CONCLUSIONS: Predictions of Vo2peak and Wpeak based on the SRT are adequate at the group level, but insufficiently accurate in individual patients. The multivariable prediction model for Wpeak can be used cautiously (eg, supplemented with a Borg score) to aid endurance exercise prescription.
Authors: Anja Großek; Thomas Elter; Max Oberste; Florian Wolf; Niklas Joisten; Philipp Hartig; David Walzik; Friederike Rosenberger; David Kiesl; Patrick Wahl; Wilhelm Bloch; Philipp Zimmer Journal: Support Care Cancer Date: 2021-02-05 Impact factor: 3.359
Authors: Laurien M Buffart; Maike G Sweegers; Cornelis J de Ruijter; Inge R Konings; Henk M W Verheul; Annette A van Zweeden; Cecile Grootscholten; Mai J Chinapaw; Teatske M Altenburg Journal: Scand J Med Sci Sports Date: 2020-08-02 Impact factor: 4.221
Authors: Anouk E Hiensch; Evelyn M Monninkhof; Martina E Schmidt; Eva M Zopf; Kate A Bolam; Yvonne Wengström; Karen Steindorf; Anne M May; Neil K Aaronson; Jon Belloso; Wilhelm Bloch; Dorothea Clauss; Johanna Depenbusch; Milena Lachowicz; Mireia Pelaez; Helene Rundqvist; Elzbieta Senkus; Martijn M Stuiver; Mark Trevaskis; Ander Urruticoechea; Friederike Rosenberger; Elsken van der Wall; G Ardine de Wit; Philipp Zimmer Journal: Trials Date: 2022-07-29 Impact factor: 2.728