Anouk T R Weemaes1, Milou Beelen2, Bart C Bongers3, Matty P Weijenberg4, Antoine F Lenssen5. 1. Department of Physical Therapy, Maastricht University Medical Center+, Maastricht, the Netherlands; Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands. Electronic address: anouk.weemaes@mumc.nl. 2. Department of Physical Therapy, Maastricht University Medical Center+, Maastricht, the Netherlands; Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands. 3. Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands. 4. Department of Epidemiology, School for Oncology and Developmental Biology (GROW), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands. 5. Department of Physical Therapy, Maastricht University Medical Center+, Maastricht, the Netherlands; Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
Abstract
OBJECTIVE: To evaluate the criterion validity and responsiveness of the steep ramp test (SRT) compared to the cardiopulmonary exercise test (CPET) in evaluating aerobic capacity in cancer survivors participating in a rehabilitation program. DESIGN: A prospective cohort study in which cancer survivors performed a SRT and CPET before (T=0) and after (T=1) a 10-week exercise rehabilitation program. Peak work rate achieved during the SRT (SRT-WRpeak) was compared with peak oxygen uptake measured during CPET (CPET-VO2peak), which is the criterion standard for aerobic capacity. Correlation coefficients were calculated between SRT-WRpeak and CPET-VO2peak at T=0 to examine criterion validity and between changes in SRT-WRpeak and CPET-VO2peak from T=0 to T=1 to determine responsiveness. Receiver operating characteristic (ROC) analysis was performed to examine the ability of the SRT to detect a true improvement (6%) in CPET-VO2peak Setting: University medical center Participants: Cancer survivors Interventions: Exercise rehabilitation Main outcome measure(s): Correlation coefficients between CPET-VO2peak and SRT-WRpeak and between changes in CPET-VO2peak and SRT-WRpeak. RESULTS: An r of 0.86 (N=106) was found for the relation between SRT-WRpeak and CPET-VO2peak at T=0. An r of 0.51 was observed for the relation between changes in SRT-WRpeak and CPET-VO2peak (N=59). ROC analysis showed an area under the curve of 0.74 for the SRT to detect a true improvement in CPET-VO2peak, with an optimal cut-off value of +0.26 W/kg (sensitivity 70.7%, specificity 66.7%). CONCLUSIONS: As SRT-WRpeak and CPET-VO2peak were strongly correlated, the SRT seems a valid tool to estimate aerobic capacity in cancer survivors. The responsiveness to measure changes in aerobic capacity seems moderate. Nevertheless, the SRT seems able to detect improvement in aerobic capacity, with a cut-off value of 0.26 W/kg.
OBJECTIVE: To evaluate the criterion validity and responsiveness of the steep ramp test (SRT) compared to the cardiopulmonary exercise test (CPET) in evaluating aerobic capacity in cancer survivors participating in a rehabilitation program. DESIGN: A prospective cohort study in which cancer survivors performed a SRT and CPET before (T=0) and after (T=1) a 10-week exercise rehabilitation program. Peak work rate achieved during the SRT (SRT-WRpeak) was compared with peak oxygen uptake measured during CPET (CPET-VO2peak), which is the criterion standard for aerobic capacity. Correlation coefficients were calculated between SRT-WRpeak and CPET-VO2peak at T=0 to examine criterion validity and between changes in SRT-WRpeak and CPET-VO2peak from T=0 to T=1 to determine responsiveness. Receiver operating characteristic (ROC) analysis was performed to examine the ability of the SRT to detect a true improvement (6%) in CPET-VO2peak Setting: University medical center Participants: Cancer survivors Interventions: Exercise rehabilitation Main outcome measure(s): Correlation coefficients between CPET-VO2peak and SRT-WRpeak and between changes in CPET-VO2peak and SRT-WRpeak. RESULTS: An r of 0.86 (N=106) was found for the relation between SRT-WRpeak and CPET-VO2peak at T=0. An r of 0.51 was observed for the relation between changes in SRT-WRpeak and CPET-VO2peak (N=59). ROC analysis showed an area under the curve of 0.74 for the SRT to detect a true improvement in CPET-VO2peak, with an optimal cut-off value of +0.26 W/kg (sensitivity 70.7%, specificity 66.7%). CONCLUSIONS: As SRT-WRpeak and CPET-VO2peak were strongly correlated, the SRT seems a valid tool to estimate aerobic capacity in cancer survivors. The responsiveness to measure changes in aerobic capacity seems moderate. Nevertheless, the SRT seems able to detect improvement in aerobic capacity, with a cut-off value of 0.26 W/kg.
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