A simple method of exercise testing patients with ventilatory impairment on the bicycle ergometer

The relationship between symptoms and objective findings is often poor in patients with ventilatory impairment and reduction in exercise tolerance. It is often difficult to know at what level to set the task, when attempting to do submaximal exercise evaluation in such patients. A method for assessing whether performance is appropriate for ventilation, which would also predict a reasonable level to set a submaximal exercise test, would be of value. A test has been devised to satisfy these requirements and is described in this paper. Patients were exercised on a bicycle ergometer using a rapidly progressive geometrical scale increasing the load at 10-second intervals. In 760 patients with airflow obstruction the work done was correlated with the forced vital capacity (r = 0.80). In 169 subjects the test was used to predict a satisfactory level for submaximal testing. Using two thirds of the maximum load achieved 70% of subjects achieved the task exercising for more than 5 min and reaching a pulse of greater than 130. The test has proved to be a satisfactory method for assessing whether performance is appropriate for measured ventilation and as an indicator of the right level at which to set a submaximal exercise test.