Metabolic cost of extremely slow walking in cardiac patients: implications for exercise testing and training

To assess metabolic cost of extremely slow walking, nine patients with coronary heart disease (means age, 56.1 yr) underwent multistage treadmill testing using standard open circuit calorimetry techniques. Heart rate, blood pressure, minute ventilation, and oxygen uptake in METS (1MET = 3.5 ml/kg/min) were determined at rest and at six submaximal work loads: 0.8, 1.0, 1.5, 2.0, 3.0 and 3.5mph, 0% grade. The oxygen uptake versus walking speed (0.8 to 3.5mph) relationship was y = 0.2064 (x)2 + 0.0180 (x) + 1.7260 (y = METS and x = speed in mph), r = 0.99. Results indicate that low-level exercise test protocols employing work loads between 0.8 and 2.0 mph impose similar metabolic and cardiac demands. Extremely slow walking approximates 2METS and may impose metabolic loads sufficient for exercise training in select patients with coronary heart disease.