title: Exercise testing and training in a cancer rehabilitation program: the advantage of the steep ramp test.
abstract: OBJECTIVE
  To compare the short maximal exercise capacity test (steep ramp test) with the submaximal test to determine the most appropriate exercise test in cancer rehabilitation.
  
  
  METHODS
  A prospective study in which a submaximal test, a maximal short exercise capacity test (steep ramp test), and a maximal oxygen consumption test (Vo(2)max test) were performed before and after an 18-week training program. Vo(2)max testing, the criterion standard for the measurement of physical capacity, was compared with the submaximal test and the steep ramp test.
  
  
  METHODS
  Community hospital and physiotherapy.
  
  
  METHODS
  Thirty-seven cancer survivors (10 men, 27 women) treated with chemotherapy. The subjects' mean age +/- standard deviation (SD) was 48+/-11 years.
  
  
  METHODS
  An 18-week training program including strength training, interval aerobic training, and home-based activities (endurance).
  
  
  METHODS
  Estimated Vo(2)max (submaximal test) and maximal workload (steep ramp test) were assessed during the exercise tests and compared with the results of the Vo(2)max test.
  
  
  RESULTS
  A paired t test showed a significant improvement in Vo(2)max (+13%, P<.001) and maximal workload (+19%, P<.001) after the training program. This improvement was confirmed in the steep ramp test (maximal workload, +13%, P<.001) but not in the submaximal test (estimated Vo(2)max, +4%, P=.192). Pearson correlation quantified only a moderate correlation between the Vo(2)max test and the submaximal test and a high correlation between the Vo(2)max test and the steep ramp test. Intraclass correlation determined the test-retest reliability of the submaximal test (.873) and the steep ramp test (.996). A linear regression model (Vo(2)max, 6.7; steep ramp Wmax, +356.7) was estimated to predict Vo(2)max from the steep ramp test outcome, implying a prediction margin of +/-2 SDs (616 mL/min).
  
  
  CONCLUSIONS
  The submaximal test proved to be invalid, whereas the steep ramp test seems to be a practicable, reliable, and valid test for the assessment of the training dose. The steep ramp test can be regularly repeated during the training program, providing information needed to readjust the training dose according to the progress made.
authors.affiliation: Department of Sports Medicine, Máxima Medisch Centrum, Veldhoven, The Netherlands. I.deBacker@mmc.nl
authors.forename: Ingrid C
authors.initials: IC
authors.lastname: De Backer
authors.forename: Goof
authors.initials: G
authors.lastname: Schep
authors.forename: Adwin
authors.initials: A
authors.lastname: Hoogeveen
authors.forename: Gerard
authors.initials: G
authors.lastname: Vreugdenhil
authors.forename: Arnold D
authors.initials: AD
authors.lastname: Kester
authors.forename: Eric
authors.initials: E
authors.lastname: van Breda
mesh_terms: D000328:Adult; D000368:Aged; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000534:rehabilitation*; D010101:Oxygen Consumption; D010807:Physical Endurance; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013647:Task Performance and Analysis