Validation of the step test and exercise prescription tool for adults

Emily Knight; Melanie I Stuckey; Robert J Petrella

doi:10.1016/j.jcjd.2014.03.007

Validation of the step test and exercise prescription tool for adults

Can J Diabetes. 2014 Jun;38(3):164-71. doi: 10.1016/j.jcjd.2014.03.007.

Authors

Emily Knight¹, Melanie I Stuckey¹, Robert J Petrella²

Affiliations

¹ Lawson Health Research Institute, Aging Rehabilitation and Geriatric Care Research Centre, London, Ontario, Canada; University of Western Ontario, Faculty of Health Sciences, London, Ontario, Canada.
² Lawson Health Research Institute, Aging Rehabilitation and Geriatric Care Research Centre, London, Ontario, Canada; University of Western Ontario, Faculty of Health Sciences, London, Ontario, Canada; University of Western Ontario, Schulich School of Medicine and Dentistry, London, Ontario, Canada. Electronic address: petrella@uwo.ca.

PMID: 24909087
DOI: 10.1016/j.jcjd.2014.03.007

Abstract

Objective: Canadian clinical practice guidelines for the management of diabetes highlight the value of physical activity for improving clinical markers and risk factors for diabetes. The use of tools like the Step Test and Exercise Prescription (STEP) in clinical practice facilitates chronic disease management and prevention through the promotion of healthy physical activity. The validity and reliability of STEP has been established previously for use with adults 65 to 85 years of age. The purpose of this study was to test the validity of the prediction equation for VO₂max from the STEP tool for use with adults older than 65 years.

Methods: Forty participants completed both the predictive self-paced VO₂max stepping protocol from the STEP tool, and a maximal graded exercise treadmill test with breath-by-breath analysis of expired gases. Tests were completed in random order, and participants rested between tests until blood pressure returned to baseline.

Results: The average age of the sample was 43±14 years. There was a strong relationship between predicted VO₂max from STEP and direct measures of VO₂max from the maximal treadmill test in the present study (r=.78, p<0.001). Bland-Altman analysis demonstrated statistical agreement between tests, although there was systematic overestimation of 6.4 mL/kg/min.

Conclusions: STEP is an evidence-based cardiorespiratory fitness assessment and exercise prescription tool appropriate for use by various health professionals in clinical practice. The prediction equation for VO₂max from the STEP tool is valid for use with adults 18 to 85 years of age. However, more research is warranted to explore age corrections to the prediction algorithm among younger adults.

Keywords: cardiorespiratory fitness assessment; clinical tool; diabetes management; diabetes prevention exercise prescription; outil clinique; prescription d’exercice pour la prévention du diabète; prise en charge du diabète; self-paced fitness test; test adapté pour l’évaluation de la condition physique; validation study; étude de validation; évaluation de la capacité cardiorespiratoire.

Publication types

Research Support, Non-U.S. Gov't
Validation Study

MeSH terms

Adult
Aged
Canada / epidemiology
Diabetes Mellitus, Type 2 / prevention & control*
Exercise Test / methods*
Exercise*
Female
Health Promotion*
Humans
Male
Middle Aged
Oxygen Consumption
Patient Selection
Practice Guidelines as Topic
Predictive Value of Tests
Reproducibility of Results

Grants and funding

Canadian Institutes of Health Research/Canada