New Protocol for Submaximal and Peak Exercise Values for Children and Adolescents: The Muscatine Study

This paper demonstrates the reliability, validity, and practical applications of a unique protocol developed to obtain both submaximal steady-state and peak exercise responses in the same test in children and adolescents. The study examined exercise efficiency, cardiovascular fitness, and cardiovascular responses in 237 children, ages 7 to 17, during exercise stress on a cycle ergometer. The graded exercise test was continuous, consisting of three steady-state submaximal stages followed by 30-sec ramp stages to obtain peak values. Intraclass correlation coefficients ranged from r=0.69 to r=0.99, with no significant mean difference for any test parameter. Mean peak heart rate, peak VO₂, and 84% of the respiratory exchange ratio (RER) values equal to or greater than 1.1 were comparable to other reported values. The validity for the protocol is substantiated by the results showing normal linear exercise responses, nonsignificant mean difference between the last two 30-sec periods, normal mean peak heart rate and VO₂ values, and high mean peak RER values. The protocol is practical, as demonstrated by an optimal test duration and the ability to obtain valid submaximal and peak exercise data in the same test in subjects of varying ages and body size.