Related Experiment Video
Updated: Jun 23, 2026
Determining and Controlling External Power Output During Regular Handrim Wheelchair Propulsion
Published on: February 5, 2020
Exercise capacity in Dutch children: new reference values for the Bruce treadmill protocol
M H M van der Cammen-van Zijp1, R J G van den Berg-Emons, S P Willemsen
1Department of Physical Therapy, Subdivision Pediatric Physical Therapy, Erasmus MC-Sophia's Children's Hospital, Rotterdam, The Netherlands.
Insights
Children's exercise capacity has declined, particularly in those under 10, according to new Dutch reference values. Factors like BMI and sports participation significantly impact endurance time in children.
Area of Science:
- Pediatrics
- Exercise Physiology
- Public Health
Background:
- Established Dutch reference values for exercise capacity using the Bruce treadmill protocol date back to 1987.
- Potential declines in children's exercise capacity are suspected due to shifts in physical activity and dietary patterns.
- Updated reference values and determinants of exercise capacity in children are needed.
Purpose of the Study:
- To determine current reference values for maximal endurance time in healthy Dutch children aged 6-13 years.
- To evaluate anthropometric and lifestyle factors influencing children's exercise capacity.
- To compare current findings with previously established Dutch reference values.
Main Methods:
- Cross-sectional observational study involving 267 healthy Dutch children aged 6-13 years.
- Maximal endurance time on the Bruce treadmill protocol was measured as the primary indicator of exercise capacity.
- Data collected included anthropometry, smoking status, socioeconomic status, ethnicity, sports participation, and school transport habits.
Main Results:
- Maximal endurance time was lower in children up to 10 years old compared to previous Dutch reference values (boys: 1.4 min less, girls: 1.6 min less).
- Higher Body Mass Index (BMI) was negatively associated with endurance time (beta=-0.412, P<0.001).
- Intense sports participation showed a positive association with endurance time (beta=0.789, P<0.001).
Conclusions:
- Exercise capacity appears to have decreased in Dutch children up to 10 years of age.
- Reference values for older children (over 10) remained similar to those established in 1987.
- BMI and engagement in intense sports are significant determinants of exercise capacity in children.
Abstract:
The Bruce treadmill protocol is suitable for children 4 years of age and older. Dutch reference values were established in 1987. We considered that children's exercise capacity has deteriorated due to changes in physical activity patterns and eating habits. We determined new reference values and evaluated determinants of exercise capacity. Healthy Dutch children (n=267) aged 6-13 years participated in this cross-sectional observational study. The maximal endurance time on the treadmill was the criterion of exercise capacity. Furthermore, we obtained data on anthropometry, smoking habits, socioeconomic status, ethnicity, sports participation, and school transport habits. The maximal endurance time for children aged up till 10 was lower (up to 1.6 and 1.4 min in girls and boys, respectively) than previously published. Body mass index was negatively, and intense sports participation was positively associated with endurance time (beta=-0.412 and 0.789, respectively; P<0.001). In conclusion, exercise capacity seems to have deteriorated in Dutch children aged up till 10 years whereas the values from the older children are remarkably similar to those from the previous study.