A simplified strategy for the estimation of the exercise ventilatory thresholds.
OBJECTIVE
To analyze the limits of agreement between exercise ventilatory threshold values (VT1 and VT2) estimated from a combination of pulmonary gas exchange and ventilatory variables (cardiopulmonary exercise testing) and those derived from an alternative approach based on the ventilatory response only (V(E), ventilometry).


METHODS
Forty-two nontrained subjects (24 males, aged 18-48, peak VO(2) = 33.1 +/- 8.6 mL.min(-1).kg(-1)) performed a maximum incremental cardiopulmonary exercise testing on an electromagnetically braked cycle ergometer. The participants breathed through a Pitot tube (Cardio2 System, MGC) and a fixed-resistance ventilometer (Micromed, Brazil), which were connected in series. HR values at the estimated VT (VTHR1 and VTHR2) were obtained by the conventional method (ventilatory equivalents, end-expiratory pressures for O(2) and CO(2), and the V-slope procedure) and an experimental approach (V(E) vs time, V(E)/time vs time, and breathing frequency vs time).


RESULTS
There were no significant between-method differences on VT(HR1), VT(HR2), VT(VE1), VT(VE2), and peak V(E) (P > 0.05). After certification of data normality, a Bland-Altman analysis revealed that the mean bias +/- 95% confidence interval of the between-method differences were lower for VT(HR2) than VT(HR1) (2 +/- 9 and 0 +/- 17 bpm, respectively). VT(HR2) according to ventilometry differed more than 10 bpm from the standard procedure in 3 out of 42 subjects (9%). Between-method differences were independent of the level of fitness, as estimated from peak VO(2) (P > 0.05).


CONCLUSIONS
: A simplified approach, based on the ventilatory response as a function of time, can provide acceptable estimates of the exercise ventilatory thresholds--especially VT2--during ramp-incremental cycle ergometry. This new strategy might prove to be useful for exercise training prescription in nontrained adults.
Neder
J Alberto
JA
Pulmonary Function and Clinical Exercise Physiology Unit, Division of Respiratory Diseases, Federal University of Sao Paulo, Brazil. albneder@pneumo.epm.br
Stein
Ricardo
R