Reference values for cardiopulmonary exercise testing in healthy subjects - an updated systematic review

Introduction: Reference values for cardiopulmonary exercise testing (CPET) parameters provide the comparative basis for answering important questions concerning the normalcy of exercise responses in patients, and significantly impacts the clinical decision-making process. Areas covered: The aim of t...

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Published in:	Expert review of cardiovascular therapy Vol. 17; no. 6; pp. 413 - 426
Main Authors:	Takken, T., Mylius, C.F., Paap, D., Broeders, W., Hulzebos, H.J., Van Brussel, M., Bongers, B.C.
Format:	Journal Article
Language:	English
Published:	England Taylor & Francis 03.06.2019
Subjects:	2max aerobic capacity Cardiopulmonary exercise testing exercise physiology healthy adults healthy children maximal oxygen consumption reference values Exercise physiology Cardiopulmonary exercise testing Aerobic capacity Healthy adults VO Maximal oxygen consumption Reference values Healthy children
ISSN:	1477-9072, 1744-8344, 1744-8344
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Abstract	Introduction: Reference values for cardiopulmonary exercise testing (CPET) parameters provide the comparative basis for answering important questions concerning the normalcy of exercise responses in patients, and significantly impacts the clinical decision-making process. Areas covered: The aim of this study was to provide an updated systematic review of the literature on reference values for CPET parameters in healthy subjects across the life span. A systematic search in MEDLINE, Embase, and PEDro databases were performed for articles describing reference values for CPET published between March 2014 and February 2019. Expert opinion: Compared to the review published in 2014, more data have been published in the last five years compared to the 35 years before. However, there is still a lot of progress to be made. Quality can be further improved by performing a power analysis, a good quality assurance of equipment and methodologies, and by validating the developed reference equation in an independent (sub)sample. Methodological quality of future studies can be further improved by measuring and reporting the level of physical activity, by reporting values for different racial groups within a cohort as well as by the exclusion of smokers in the sample studied. Normal reference ranges should be well defined in consensus statements.
AbstractList	: Reference values for cardiopulmonary exercise testing (CPET) parameters provide the comparative basis for answering important questions concerning the normalcy of exercise responses in patients, and significantly impacts the clinical decision-making process. : The aim of this study was to provide an updated systematic review of the literature on reference values for CPET parameters in healthy subjects across the life span. A systematic search in MEDLINE, Embase, and PEDro databases was performed for articles describing reference values for CPET published between March 2014 and February 2019. : Compared to the review published in 2014, more data have been published in the last five years compared to the 35 years before. However, there is still a lot of progress to be made. Quality can be further improved by performing a power analysis, a good quality assurance of equipment and methodologies, and by validating the developed reference equation in an independent (sub)sample. Methodological quality of future studies can be further improved by measuring and reporting the level of physical activity, by reporting values for different racial groups within a cohort as well as by the exclusion of smokers in the sample studied. Normal reference ranges should be well-defined in consensus statements. Introduction: Reference values for cardiopulmonary exercise testing (CPET) parameters provide the comparative basis for answering important questions concerning the normalcy of exercise responses in patients, and significantly impacts the clinical decision-making process. Areas covered: The aim of this study was to provide an updated systematic review of the literature on reference values for CPET parameters in healthy subjects across the life span. A systematic search in MEDLINE, Embase, and PEDro databases were performed for articles describing reference values for CPET published between March 2014 and February 2019. Expert opinion: Compared to the review published in 2014, more data have been published in the last five years compared to the 35 years before. However, there is still a lot of progress to be made. Quality can be further improved by performing a power analysis, a good quality assurance of equipment and methodologies, and by validating the developed reference equation in an independent (sub)sample. Methodological quality of future studies can be further improved by measuring and reporting the level of physical activity, by reporting values for different racial groups within a cohort as well as by the exclusion of smokers in the sample studied. Normal reference ranges should be well defined in consensus statements. Introduction: Reference values for cardiopulmonary exercise testing (CPET) parameters provide the comparative basis for answering important questions concerning the normalcy of exercise responses in patients, and significantly impacts the clinical decision-making process. Areas covered: The aim of this study was to provide an updated systematic review of the literature on reference values for CPET parameters in healthy subjects across the life span. A systematic search in MEDLINE, Embase, and PEDro databases were performed for articles describing reference values for CPET published between March 2014 and February 2019. Expert opinion: Compared to the review published in 2014, more data have been published in the last five years compared to the 35 years before. However, there is still a lot of progress to be made. Quality can be further improved by performing a power analysis, a good quality assurance of equipment and methodologies, and by validating the developed reference equation in an independent (sub)sample. Methodological quality of future studies can be further improved by measuring and reporting the level of physical activity, by reporting values for different racial groups within a cohort as well as by the exclusion of smokers in the sample studied. Normal reference ranges should be well defined in consensus statements.Introduction: Reference values for cardiopulmonary exercise testing (CPET) parameters provide the comparative basis for answering important questions concerning the normalcy of exercise responses in patients, and significantly impacts the clinical decision-making process. Areas covered: The aim of this study was to provide an updated systematic review of the literature on reference values for CPET parameters in healthy subjects across the life span. A systematic search in MEDLINE, Embase, and PEDro databases were performed for articles describing reference values for CPET published between March 2014 and February 2019. Expert opinion: Compared to the review published in 2014, more data have been published in the last five years compared to the 35 years before. However, there is still a lot of progress to be made. Quality can be further improved by performing a power analysis, a good quality assurance of equipment and methodologies, and by validating the developed reference equation in an independent (sub)sample. Methodological quality of future studies can be further improved by measuring and reporting the level of physical activity, by reporting values for different racial groups within a cohort as well as by the exclusion of smokers in the sample studied. Normal reference ranges should be well defined in consensus statements.
Author	Paap, D. Van Brussel, M. Bongers, B.C. Broeders, W. Hulzebos, H.J. Takken, T. Mylius, C.F.
Author_xml	– sequence: 1 givenname: T. orcidid: 0000-0002-7737-118X surname: Takken fullname: Takken, T. email: t.takken@umcutrecht.nl organization: Child Development & Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht – sequence: 2 givenname: C.F. surname: Mylius fullname: Mylius, C.F. organization: Research Group Healthy Ageing, Hanze University of Applied Sciences, Allied Health Care and Nursing – sequence: 3 givenname: D. orcidid: 0000-0001-9076-3965 surname: Paap fullname: Paap, D. organization: Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen – sequence: 4 givenname: W. surname: Broeders fullname: Broeders, W. organization: Child Development & Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht – sequence: 5 givenname: H.J. orcidid: 0000-0003-3149-3998 surname: Hulzebos fullname: Hulzebos, H.J. organization: Child Development & Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht – sequence: 6 givenname: M. surname: Van Brussel fullname: Van Brussel, M. organization: Child Development & Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht – sequence: 7 givenname: B.C. surname: Bongers fullname: Bongers, B.C. organization: Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University
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