Leg Cycle Ergometer Stress Test Protocols

Leg cycle ergometer exercise test protocols depend on body mass and predict functional capacity [2]. Typically, a graded test consists of a 1–2 min warm-up (with a 10–20 Watt load or without a load); an initial load of 25 Watts (for inactive persons or individuals with a weight < 70 kg) or 50 Watts (for active persons or individuals with a weight > 70 kg), which is typically increased by 25 Watts every 3 min; then a cool-down without a load. A formula providing an approximate METs calculation following the bicycle stress test is provided in Table 10.

**Body Mass (kg) METS METS METS METS METS METS METS 50 W 75 W 100 W 125 W 150 W 175 W 200 W** 60 4.3 5.7 7.1 8.6 10 11.4 12.9 70 3.7 4.9 6.1 7.3 8.6 9.8 11 80 3.3 4.3 5.4 6.4 7.5 8.6 9.6 90 2.9 3.8 4.8 5.7 6.7 7.6 8.6 100 2.6 3.4 4.3 5.1 6 6.9 7.7

**Table 10.** Functional capacity calculation after cycle ergometer stress test [2].

Abbreviations: kg—kilogram; METS—multiples of resting metabolic equivalent; W—watts. Source: Adapted from [2].

The steep ramp protocol created by Meyer allows for the calculation of the so-called maximal short-term exercise capacity (MSEC) and has been used for high-intensity interval training prescription. After a 3 min warm-up on a cycle without a load, the intensity is increased to 25 watt every 10 s (i.e., 150 watts is attained after 1 min). The patient continues the test until he/she can cycle at a pace of 60 revolutions/min [17].

## 2.1.7. The Patient's Preparation

The preparation for the stress test includes:


On the test day, patients should not eat, drink caffeine, or smoke for 3 h before the test. Neither should they perform vigorous exercise within the 12 h prior to the testing. Patients should dress appropriately for exercise.

For a functional capacity assessment, patients should take their usual medications. For diagnostic stress tests, however, the withdrawal of some medications might be applied and should be discussed with a cardiologist, as, for example, beta-blockers attenuate exercise response [3]. In the case of patients with an implanted cardiac electrical device, testing personnel should know the reason for implantation and the current device parameters.

### 2.1.8. Measurements

Measurements taken during exercise testing, according to ACSM [2], are presented in Table 11.


**Table 11.** Monitoring intervals associated with exercise testing.

Abbreviations: BP—blood pressure; ECG—electrocardiogram; HR—heart rate; RPE—rating of perceived exertion. Source: Adapted from [2].

### 2.1.9. Indications for Test Termination

Absolute indications for stress test termination include [18]:

• Chest pain;


Relative indications for the termination of the test include:

