Key result
A standardized verbal encouragement protocol significantly increased peak oxygen uptake (Δ 2.10 mL/kg/min, p<0.001) during incremental treadmill testing in healthy individuals.
Why the study?
Prior studies showed verbal encouragement influences peak oxygen uptake, but lacked protocol details, and whether motivation modulates this effect was unknown.
Does a standardized verbal encouragement protocol improve peak oxygen uptake in healthy volunteers?
RCT (n=24)
cross-over
Does a standardized verbal encouragement protocol improve peak oxygen uptake in healthy volunteers?
Mean Difference: 2.1
p-value: p=<0.001
Standardized verbal encouragement during incremental treadmill testing significantly increases peak oxygen uptake and respiratory exchange ratio in healthy individuals, independent of baseline motivation.
Clinicians should standardize verbal encouragement during treadmill CPET to avoid underestimating VO2peak; extends evidence on protocol factors in exercise testing.
Peak oxygen uptake (V̇O 2peak ) is considered a vital indicator of health and physical fitness that is often measured during incremental exercise testing. While previous research has shown that the attained V̇O 2peak during exercise testing can be influenced by verbal encouragement, no or limited details were provided on the verbal encouragement protocol, hereby hampering implementation in clinical practice or research. Moreover, it remains unknown whether motivation modulates the effect of verbal encouragement. This study aimed to develop and examine the influence of a standardized verbal encouragement protocol on the achieved V̇O 2peak , time to exhaustion (TTE), peak heart rate (HR peak ), and peak respiratory exchange ratio (RER peak ) during incremental treadmill testing. As a secondary aim, we investigated whether motivation modulated the effect of verbal encouragement on V̇O 2peak . 24 healthy volunteers performed two incremental treadmill runs with 1 week in between and received verbal encouragement during only one of the tests. Motivation toward exercise was measured using the behavioral regulation in exercise questionnaire‐2 (BREQ‐2) questionnaire. V̇O 2peak (Δ 2.10 mL/kg/min, p < 0.001) and RER peak (Δ 2%, p = 0.042) were significantly higher with verbal encouragement. In contrast, HR peak (Δ 1.5 beats/min, p = 0.225) and TTE (Δ 1.5%, p = 0.348) were not significantly different between conditions. Exercise motivation showed a weak and nonsignificant association with the change in V̇O 2peak between tests ( r −0.19, R 2 0.037, SEE 2.88, and p = 0.367). These findings show that verbal encouragement leads to higher physiological outcomes during incremental treadmill testing, but the magnitude of this effect is not higher for individuals with lower levels of pretest motivation.
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Hooren et al. (2024) conducted an RCT in healthy individuals (n=24). Standardized verbal encouragement protocol vs. No verbal encouragement was evaluated on Peak oxygen uptake (V̇O 2peak) (Δ 2.10 mL/kg/min, p=<0.001). A standardized verbal encouragement protocol significantly increased peak oxygen uptake (Δ 2.10 mL/kg/min, p<0.001) during incremental treadmill testing in healthy individuals.
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