Cardiorespiratory Fitness Prediction in Vestibular Hypofunction: Does One Size Fit All?

Area of Science:

• Exercise Physiology
• Clinical Assessment
• Vestibular Disorders

Background:

• Cardiorespiratory fitness (CRF) is crucial for health and mortality prediction.
• Gold-standard CRF assessment (peak oxygen uptake via cardiopulmonary exercise testing) is often clinically impractical.
• Existing CRF prediction models may not be suitable for populations with vestibular hypofunction (VH).

Purpose of the Study:

• To develop and validate exercise-based CRF prediction models specifically for individuals with VH.
• To assess the accuracy of existing CRF prediction equations in the VH population.
• To enhance clinical management of VH by providing feasible CRF estimation tools.

Main Methods:

• Fifty-four adults with unilateral or bilateral VH underwent maximal cardiopulmonary exercise testing (CPX) for peak oxygen uptake (V̇O2peak) measurement.
• CRF prediction models were developed using maximal (VHmax) and submaximal (VHsub G, VHsub N-G) test data.
• Model accuracy was evaluated using 100-fold repeated cross-validation.

Main Results:

• Newly developed VH-specific models demonstrated high predictive accuracy: VHmax (r=0.90), VHsub G (r=0.86), and VHsub N-G (r=0.79), with minimal bias.
• Existing general CRF equations significantly misestimated CRF in the VH population.
• VH-specific models provided more accurate predictions within ±1 MET compared to existing equations.

Conclusions:

• The developed VH-specific exercise-based models provide accurate and clinically applicable CRF estimation for individuals with VH.
• These models are valuable in diverse clinical settings, especially when maximal CPX is not feasible.
• An automated calculator supports the clinical implementation of these new models for VH management.