title: Prediction of Maximal Heart Rate in Children and Adolescents.
abstract: OBJECTIVE
  To identify a method to predict the maximal heart rate (MHR) in children and adolescents, as available prediction equations developed for adults have a low accuracy in children. We hypothesized that MHR may be influenced by resting heart rate, anthropometric factors, or fitness level.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Sports medicine center in primary care.
  
  
  METHODS
  Data from 627 treadmill maximal exercise tests performed by 433 pediatric athletes (age 13.7 ± 2.1 years, 70% males) were analyzed.
  
  
  METHODS
  Age, sex, sport type, stature, body mass, BMI, body fat, fitness level, resting, and MHR were recorded.
  
  
  METHODS
  To develop a prediction equation for MHR in youth, using stepwise multivariate linear regression and linear mixed model. To determine correlations between existing prediction equations and pediatric MHR.
  
  
  RESULTS
  Observed MHR was 197 ± 8.6 b·min. Regression analysis revealed that resting heart rate, fitness, body mass, and fat percent were predictors of MHR (R = 0.25, P < 0.001), whereas age was not. Resting heart rate explained 15.6% of MHR variance, body mass added 5.7%, fat percent added 2.4%, and fitness added 1.2%. Existing adult equations had low correlations with observed MHR in children and adolescents (r = -0.03-0.34).
  
  
  CONCLUSIONS
  A new equation to predict MHR in children and adolescents was developed, but was found to have low predictive ability, a finding similar to adult equations applied to children.
  
  
  CONCLUSIONS
  Considering the narrow range of MHR in youth, we propose using 197 b·min as the mean MHR in children and adolescents, with 180 b·min the minimal threshold value (-2 standard deviations).
authors.affiliation: *Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; †Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; ‡Children's Health and Exercise Research Centre, University of Exeter, Exeter, United Kingdom; §Medix Sport Medicine Center, Tel Aviv, Israel; and ¶Exercise, Nutrition and Lifestyle Clinic, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Miri
authors.initials: M
authors.lastname: Gelbart
authors.forename: Tomer
authors.initials: T
authors.lastname: Ziv-Baran
authors.forename: Craig A
authors.initials: CA
authors.lastname: Williams
authors.forename: Yoni
authors.initials: Y
authors.lastname: Yarom
authors.forename: Gal
authors.initials: G
authors.lastname: Dubnov-Raz
mesh_terms: D000293:Adolescent; D000465:Algorithms; D002648:Child; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male