Development of a standardized single-session cardiopulmonary exercise test for combined assessment of peak oxygen uptake and on/off-kinetics

Peak oxygen uptake (V-O2peak) and on/off-kinetics are key indicators of exercise capacity and health outcomes, but their assessment often requires separate laboratory visits, which limits feasibility. This cross-sectional study aimed to develop a single cardiopulmonary exercise test (CPET) for both assessments. We designed a single-session combined CPET protocol using an upright cycle ergometer in healthy volunteers (n = 20). V-O2peak was first estimated using an a priori formula. The constant work rate (CWR) part of the test (on-kinetics) was set to an intensity of 30% V-O2reserve. After an incremental test to measure V-O2peak, a 10-min recovery period was used to evaluate off-kinetics. Twenty volunteers (9 females and 11 males), 28.0 +/- 8.1 years completed the protocol. No significant differences were found between predicted and measured V-O2peak (P = 0.47). A strong correlation (r = 0.88) and good agreement (Bland-Altman bias = -0.82 mL kg(-1) min(-1)) were found between the calculated/actual individuals' 30% V-O2reserve (mL kg(-1) min(-1)) and the measured steady-state V-O2 at CWR. The measured exercise intensity at CWR closely matched the target of 30%, with no statistical differences, with an average difference of 0.2 percentage points. Small-medium Cohen's d (0.16) indicated high similarity between predicted and measured V-O2peak. V-O2 on- and off-kinetics analyses were also performed for all participants with mono-exponential fittings. A single-session protocol for the combined assessment of V-O2peak and V-O2 on/off-kinetics was developed. This protocol will enable greater recruitment and participation in research and enhanced detail for clinical CPET use. Future research should evaluate intra- and inter-participant reproducibility over repeated sessions.