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Criterion validation of two submaximal aerobic fitness tests, the self-monitoring Fox-walk test and the Astrand cycle test in people with rheumatoid arthritis
Karolinska Inst, Div Physiotherapy, Dept Neurobiol Care Sci & Soc, SE-14183 Stockholm, Sweden.
Karolinska Inst, Div Physiotherapy, Dept Neurobiol Care Sci & Soc, SE-14183 Stockholm, Sweden.ORCID iD: 0000-0002-6989-719X
Karolinska Univ Hosp, Karolinska Inst, Dept Lab Med, Div Clin Physiol C188, SE-14186 Stockholm, Sweden.
Karolinska Univ Hosp, Karolinska Inst, Dept Lab Med, Div Clin Physiol C188, SE-14186 Stockholm, Sweden.
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2014 (English)In: BMC Musculoskeletal Disorders, E-ISSN 1471-2474, Vol. 15, article id 305Article in journal (Refereed) Published
Abstract [en]

Background: Aerobic capacity tests are important to evaluate exercise programs and to encourage individuals to have a physically active lifestyle. Submaximal tests, if proven valid and reliable could be used for estimation of maximal oxygen uptake (VO2max). The purpose of the study was to examine the criterion-validity of the submaximal self-monitoring Fox-walk test and the submaximal Astrand cycle test against a maximal cycle test in people with rheumatoid arthritis (RA). A secondary aim was to study the influence of different formulas for age predicted maximal heart rate when estimating VO2max by the Astrand test. Methods: Twenty seven subjects (81% female), mean (SD) age 62 (8.1) years, diagnosed with RA since 17.9 (11.7) years, participated in the study. They performed the Fox-walk test (775 meters), the Astrand test and the maximal cycle test (measured VO2max test). Pearson's correlation coefficients were calculated to determine the direction and strength of the association between the tests, and paired t-tests were used to test potential differences between the tests. Bland and Altman methods were used to assess whether there was any systematic disagreement between the submaximal tests and the maximal test. Results: The correlation between the estimated and measured VO2max values were strong and ranged between r = 0.52 and r = 0.82 including the use of different formulas for age predicted maximal heart rate, when estimating VO2max by the Astrand test. VO2max was overestimated by 30% by the Fox-walk test and underestimated by 10% by the Astrand test corrected for age. When the different formulas for age predicted maximal heart rate were used, the results showed that two formulas better predicted maximal heart rate and consequently a more precise estimation of VO2max. Conclusions: Despite the fact that the Fox-walk test overestimated VO2max substantially, the test is a promising method for self-monitoring VO2max and further development of the test is encouraged. The Astrand test should be considered as highly valid and feasible and the two newly developed formulas for predicting maximal heart rate according to age are preferable to use when estimating VO2max by the Astrand test.

Place, publisher, year, edition, pages
Springer Nature , 2014. Vol. 15, article id 305
Keywords [en]
Aerobic capacity, Aerobic power, Exercise, Maximal oxygen uptake, Peak oxygen uptake
National Category
Physiotherapy
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URN: urn:nbn:se:mdh:diva-74638DOI: 10.1186/1471-2474-15-305ISI: 000342517100001PubMedID: 25226876Scopus ID: 2-s2.0-84907264375OAI: oai:DiVA.org:mdh-74638DiVA, id: diva2:2017847
Available from: 2025-12-01 Created: 2025-12-01 Last updated: 2026-04-01Bibliographically approved

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