Background and Purpose: Accurate measurement of cardiorespiratory fitness (VO2max) is very important in sport sciences. The direct measurement of VO2max using a respiratory gas analysis device cannot be very operational and comprehensive due to the high cost, time-consuming, need for an expert, and the possibility of some cardio-respiratory risks during the performance of an increasing exercise test. Estimating VO2max using equations based on heart rate index (HRindex) is one of the most widely used methods in sports fields, which can estimate an individual's VO2max without needing breath gas analysis. However, this requires accurate measurements of resting and maximal heart rates with the least error. In the present study we aimed to evaluate the validity of VO2max equations based on heart rate index in adolescent boys. Material and Methods: One hundred and fifty-seven healthy adolescent boys (Mean±SD; age, 14.92±1.35 years; BMI, 21.39 ± 4.50 kg/m2 and VO2max: 41.80 ± 6.67 ml/kg/min) from middle and high schools in Hamadan city voluntarily participated in this cross-sectional study. Initially, the resting heart rate and body composition of the subjects were measured. The subjects' VO2max and maximal heart rate were measured by the respiratory gas analysis method by using modified Bruce incremental exercise test (criterion method). Moreover, the subjects' VO2max were estimated using HRindex-based equations. Pearson correlation, pair sample t-test, and Bland and Altman agreement were used to evaluate the validity of heart rate index based on VO2max equations. Results: A significant correlation was observed between the criterion method of VO2max and HRindex-based VO2max equations (R=0.328, p<0.05). A significant difference (p<0.05) was observed between measured and HRindex-based VO2max equations (Mean difference = 3.34 - 5.45 ml/kg/min). In healthy adolescent boys, both estimation equations led to underestimation of VO2max by 11.36 ± 17.93% and 5.84 ± 16.39%, respectively. In addition, the Bland and Altman plot showed low agreement between measured and HRindex-based VO2max equations. Conclusions: HRindex-based VO2max equations do not have sufficient validity to be used in healthy adolescent boys and they led to the underestimation of VO2max. Therefore, it is recommended to employ HRindex-based VO2max equations for healthy adolescent boys.
1. Raghuveer G, Hartz J, Lubans DR, Takken T, Wiltz JL, Mietus-Snyder M, et al. Cardiorespiratory Fitness in Youth: An Important Marker of Health: A Scientific Statement From the American Heart Association. Circulation. 2020;142(7):e101-e18.
2. Al-Mallah MH, Sakr S, Al-Qunaibet A. Cardiorespiratory Fitness and Cardiovascular Disease Prevention: an Update. Current atherosclerosis reports. 2018;20(1):1.
3. Bahreini Nejad A, Moflahi D, Abbaspour M. Evaluation of intermittent protocol at incremental laboratory test in measuring physiological indices of soccer players. Journal of Sport and Exercise Physiology. 2022;15(2):41-51.[In Persian]
Hozourri T, Fashi M, Hasanloei Ha. The effect of four weeks of polarized training on aerobic fitness and performance of professional rowers. Journal of Sport and Exercise Physiology. 2022;15(4):31-41. [In Persian]
Hawkins MN, Raven PB, Snell PG, Stray-Gundersen J, Levine BD. Maximal oxygen uptake as a parametric measure of cardiorespiratory capacity. Med Sci Sports Exerc. 2007;39(1):103-7.
NAZEM F, SAKI H, JALILI M. Validation of Francis Step Protocol by Respiratory Gases Analyses and Design Native Equation to Estimate Aerobic Capacity in Iranian Boys. Journal of Knowledge & Health 2017;12(1):66-72. [In Persian]
Jalili M, Nazem F, Sazvar A, Ranjbar K. Prediction of Maximal Oxygen Uptake by Six-Minute Walk Test and Body Mass Index in Healthy Boys. J Pediatr. 2018;200:155-9.
Wicks JR, Oldridge NB, Nielsen LK, Vickers CE. HR index--a simple method for the prediction of oxygen uptake. Medicine and science in sports and exercise. 2011;43(10):2005-12.
Uth N, Sørensen H, Overgaard K, Pedersen PK. Estimation of VO2max from the ratio between HRmax and HRrest–the heart rate ratio method. European journal of applied physiology. 2004;91(1):111-5.
Esco MR, Olson MS, Williford HN, Mugu EM, Bloomquist BE, McHugh AN. Crossvalidation of Two Heart Rate–based Equations for Predicting V [Combining Dot Above] O2max in White and Black Men. The Journal of Strength & Conditioning Research. 2012;26(7):1920-7.
11. Colosio AL, Pedrinolla A, Da Lozzo G, Pogliaghi S. Heart rate-index estimates oxygen uptake, energy expenditure and aerobic fitness in rugby players. Journal of sports science & medicine. 2018;17(4):633.
Ducharme JB, Gibson AL. Efficacy of estimating VO2max with the Heart Rate Ratio Method in middle-aged and older adults. European Journal of Applied Physiology. 2021;121(12):3431-6.
Voutilainen A, Setti MO, Tuomainen T-P. Estimating Maximal Oxygen Uptake from the Ratio of Heart Rate at Maximal Exercise to Heart Rate at Rest in Middle-Aged Men. The World Journal of Men's Health. 2021;39(4):666.
14. Colosio AL, Lievens M, Pogliaghi S, Bourgois JG, Boone J. Heart rate-index estimates aerobic metabolism in professional soccer players. Journal of science and medicine in sport. 2020;23(12):1208-14.
Kang J, Ratamess NA, Faigenbaum AD, Bush JA, Roser C, Montemarano D, et al. Use of Heart Rate Index to Predict Oxygen Uptake - A Validation Study. International journal of exercise science. 2020;13(7):1705-17.
Tanaka H, Monahan KD, Seals DR. Age-predicted maximal heart rate revisited. Journal of the American College of Cardiology. 2001;37(1):153-6.
Bruce RA, Kusumi F, Hosmer D. Maximal oxygen intake and nomographic assessment of functional aerobic impairment in cardiovascular disease. American heart journal. 1973;85(4):546-62.
Atkinson G, Nevill AM. Statistical methods for assessing measurement error (reliability) in variables relevant to sports medicine. Sports Med. 1998;26(4):217-38.
Bland JM, Altman D. Statistical methods for assessing agreement between two methods of clinical measurement. The lancet. 1986;327(8476):307-10.
Haller JM, Fehling PC, Barr DA, Storer TW, Cooper CB, Smith DL. Use of the HR index to predict maximal oxygen uptake during different exercise protocols. Physiological reports. 2013;1(5).
Drescher U, Koschate J, Hoffmann U. Oxygen uptake and heart rate kinetics during dynamic upper and lower body exercise: an investigation by time-series analysis. European journal of applied physiology. 2015;115:1665-72.
Gibson AL, Wagner D, Heyward V. Advanced fitness assessment and exercise prescription, 8E: Human kinetics; 2019.
Fleming S, Thompson M, Stevens R, Heneghan C, Plüddemann A, Maconochie I, et al. Normal ranges of heart rate and respiratory rate in children from birth to 18 years of age: a systematic review of observational studies. The Lancet. 2011;377(9770):1011-8.
Lequeux B, Uzan C, Rehman MB. Does resting heart rate measured by the physician reflect the patient’s true resting heart rate? White-coat heart rate. Indian Heart Journal. 2018;70(1):93-8.
Shadabnik, E., Nazem, F., & Jalili, M. (2023). Evaluation of heart rate index equations for prediction of maximal oxygen uptake in healthy adolescent boys: Cross-validation by respiratory gas analysis method. Journal of Sport and Exercise Physiology, 16(3), 76-86. doi: 10.48308/joeppa.2023.103910
MLA
Eelahe Shadabnik; Farzad Nazem; Majid Jalili. "Evaluation of heart rate index equations for prediction of maximal oxygen uptake in healthy adolescent boys: Cross-validation by respiratory gas analysis method". Journal of Sport and Exercise Physiology, 16, 3, 2023, 76-86. doi: 10.48308/joeppa.2023.103910
HARVARD
Shadabnik, E., Nazem, F., Jalili, M. (2023). 'Evaluation of heart rate index equations for prediction of maximal oxygen uptake in healthy adolescent boys: Cross-validation by respiratory gas analysis method', Journal of Sport and Exercise Physiology, 16(3), pp. 76-86. doi: 10.48308/joeppa.2023.103910
VANCOUVER
Shadabnik, E., Nazem, F., Jalili, M. Evaluation of heart rate index equations for prediction of maximal oxygen uptake in healthy adolescent boys: Cross-validation by respiratory gas analysis method. Journal of Sport and Exercise Physiology, 2023; 16(3): 76-86. doi: 10.48308/joeppa.2023.103910