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January 2, 2025Scientific Reports5 citationsOpen Access

Validity and reliability of the step test to estimate maximal oxygen consumption in pediatric population

GWGerardo WeisstaubJGJosé GonzálezIOIgnacio Orizola

Key Result

The submaximal step test validly and reliably estimated VO2max in children and adolescents aged 8-16 years, demonstrating a robust correlation (r = 0.86) with measured VO2max.

Study Design

Type

Cross-Sectional (n=242)

Structured PICO

Does a 3-minute submaximal step test validly and reliably estimate VO2max compared to maximal cardiopulmonary exercise testing in children and adolescents aged 8-16?

P
Population
242 children and adolescents (102 females, 42.1% girls) aged 8-16 years, recruited from the primary health care system, in a state of health compatible with physical exhaustion testing. Mean age 12.5 ± 2.6 years, 51.6% overweight or obese.
I
Intervention
A 3-minute submaximal step test maintaining a steady pace of 22 steps per minute (60 bpm) using a 2-step footstool (15 cm and 35 cm high), with heart rate recorded at the end to estimate VO2max.
C
Comparator
Maximal incremental test on a treadmill until exhaustion with gas analysis (cardiopulmonary exercise testing) to directly measure VO2max.
O
Outcome
Validity and reliability of the step test to estimate VO2max, assessed by correlation and Bland-Altman concordance between predicted and measured VO2max.surrogate

A simple 3-minute step test is a valid and reliable low-cost tool for estimating maximal oxygen consumption (VO2max) in children and adolescents aged 8-16 years.

Main Result

Effect estimate: r = 0.86 (95% CI -0.513 to 0.513)

Absolute Event Rate: 1.84% vs 1.841%

p-value: p=<0.001

Limitations

  • Conducted in a specific population, which may have limited its generalizability
  • Does not include children or adolescents with illness or reduced mobility
  • May not provide the same level of accuracy and detail as a gas analyzer
  • Conducted in a specific population, which may limit generalizability

Abstract

Cardiorespiratory fitness is the most important variable related to health and a strong predictor of mortality. However, it is rarely used in clinics due to costs, specialized equipment, space needs, and the requirements of expert staff such as an exercise physiologist, physician, or other health professional. This work aims to validate and test the reliability of a submaximal step test to estimate VO2max of 8-to 16-year-old pediatric populations as a simple and low-cost tool for clinical practice. A cross-sectional study included 242 children and adolescents (42.1% girls) aged 8–16. Cardiorespiratory fitness was determined by a maximal incremental test on a treadmill until exhaustion. The step test entailed maintaining a steady pace of 22 steps per minute for 3 min (60 bpm), with the heart rate being recorded at the end of the test. Nutritional status was computed through BMI z-score. A multiple linear regression model validated the step test and developed a new equation to predict VO2max, including the third-minute heart rate, weight, and height. The reliability among predicted and measured VO2max was assessed by Bland-Altman analysis. The mean age was 12.5 ± 2.6; 51.6% were overweight or obese. The cardiorespiratory fitness measured as VO2max was 35.01 ± 0.58 ml·min-1·kg−1. A robust correlation was observed between the predicted VO2max from the step test and the measured VO2max (r = 0.86, p < 0.001). Bland-Altman analysis indicated statistical concordance between predicted and measured VO2max. Our findings indicate that the step test protocol is valid and reliable for estimating VO2max in children and adolescents. Furthermore, the predictive equation is suitable for application among children aged 8–16.

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Cite This Study

Weisstaub et al. (2025) conducted a cross-sectional in Cardiorespiratory fitness (n=242). Submaximal step test vs. Cardiopulmonary exercise testing (CPET) was evaluated on Correlation between predicted and measured VO2max (r = 0.86, 95% CI -0.513 to 0.513, p=<0.001). The submaximal step test validly and reliably estimated VO2max in children and adolescents aged 8-16 years, demonstrating a robust correlation (r = 0.86) with measured VO2max.

synapsesocial.com/papers/6a1d72cfcc9f7df1b70574cbhttps://doi.org/10.1038/s41598-024-84336-w
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