Elsevier

Physiotherapy

Volume 90, Issue 4, December 2004, Pages 183-188
Physiotherapy

The Chester step test—a simple yet effective tool for the prediction of aerobic capacity

https://doi.org/10.1016/j.physio.2004.03.008Get rights and content

Abstract

Objectives The assessment of cardiorespiratory fitness is becoming more commonplace in both community and occupational health settings. This study investigates the reliability and validity of the Chester step test, a submaximal test for the prediction of aerobic capacity, when compared to maximal oxygen uptake (V̇O2Max) measured during a treadmill test.

Design Participants completed a V̇O2Max Treadmill Test using a standardised fast incremental ramp protocol designed to elicit exhaustion in 8–12 minutes. Following this, on separate days, subjects then completed the Chester step test (CST) on two occasions (CST1 and CST2). During the submaximal step test, subjects were asked to step on to and off a 30-cm step at a rate set by the metronome beat on an audio cassette. The initial step rate was 15 steps per minute and every 2 minutes the tempo increased by 5 steps per minute. The subject continued stepping until he/she reached 80% of their maximum predicted heart rate, or reported a rating of perceived exertion of 15 (hard) on the Borg scale, or reached the end of the 10-minutes 5-stage test.

Setting Human Performance Laboratory, University College Chester

Participants Sixty-eight subjects (mean age 30.6±9.7 years; range 18–52 years) with a wide range of ages and abilities

Main outcome measures Gas exchange and heart rate were measured continuously using a Polar heart rate monitor. Heart rate and rating of perceived exertion were recorded after each 2-minute stage.

Results Results revealed a high correlation (r=0.92) between V̇O2Max and CST1 (P<0.001) and a standard error of the estimate of 3.9 ml O2/kg/min, thus confirming the face validity of CST as a predictor of V̇O2Max. Using the method of analysis recommended by Bland and Altman (1986) [Lancet 5 (1986) 307] the mean difference between repeated predicted measures using CST was −0.7 ml O2/kg/min. The limits of agreement analysis also demonstrated that a measurement repeated on a separate day was within 4.5 ml O2/kg/min of the original predicted measurement. The Chester step test is therefore appropriate for use in situations where a change in aerobic capacity is expected to be more than 3.8 ml O2/kg/min higher or more than 5.2 ml O2/kg/min lower than the baseline measurement.

Conclusions The Chester step test was shown to be a valid test for the estimation of aerobic capacity within this group. The error of measurement is sufficiently small and suggests that this method is well suited to monitoring changes in aerobic capacity in rehabilitation settings.

Section snippets

Background

Regular exercise, which improves cardiorespiratory fitness, is a powerful factor in enhancing health and wellbeing. Not only can those with active lifestyles gain substantial health benefits from physical activity but regular exercisers also tend to have healthier lifestyles compared to non-exercisers—being less likely to smoke, suffer fewer minor illnesses, make fewer visits to the doctor and generally eat more healthily.

The assessment of cardiorespiratory fitness commonly assessed by the

Rationale for the study

To investigate the validity of CST by comparing the results obtained with the results of a Treadmill V̇O2Max test and to estimate its reproducibility with apparently healthy subjects from a wide cross-section of ages and fitness levels.

Subjects

Sixty-eight subjects (mean age 30.6±9.7 years; range 18–52 years) completed a Treadmill V̇O2Max test on one occasion and the CST on a further two separate occasions. All subjects were volunteers, who were apparently healthy, free from medical contraindication to vigorous exercise and not taking any form of medication that would depress heart rate scores. All subjects signed an informed consent form.

Pre-test conditions

Subjects were asked to refrain from eating, smoking or drinking tea, coffee or alcohol for at

Results

The subjects were a group of apparently healthy males and females from a wide range of ages (18–52 years) and fitness levels (25–68 ml O2/kg/min) (Table 1).

Table 2 illustrates the high overall correlation (r=0.92; P<0.001) between V̇O2Max and the results of the CST, with the marginally higher values for females (r=0.95; P<0.001) than for males (r=0.87; P<0.001). The regression equation (V̇O2Max=0.964×1.007(CST); P<0.0005) further illustrates the ability of CST to predict V̇O2Max (Fig. 2), whilst

Discussion

These results demonstrated that the CST is a valid predictor of aerobic capacity in males and females from a wide range of ages and fitness levels. However, the overall standard error of estimate of ±3.9 ml O2/kg/min means that its accuracy of prediction, in subjects with aerobic capacity values ranging from 25 to 68 ml O2/kg/min, is approximately 5–15%. The estimate was found to be slightly more accurate in females than males (standard error of estimate for males and females was ±4.3 and ±3.1 ml O2

Conclusions

The Chester step test was shown to provide a valid test for the estimation of aerobic capacity within this group, who were representative of males and females from a wide range of ages and fitness levels. The error of measurement is sufficiently small and suggests that this method is well suited to monitoring changes in aerobic capacity in rehabilitation settings.

Key Messages

  • The Chester step test is a valid and reliable tool for the assessment of aerobic capacity.

  • It is an inexpensive, easily

Acknowledgements

Ethical approval: Centre for Exercise and Nutrition Science Ethics Committee.

Funding: None.

Conflicts of interest: None.

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