A Systematic Approach to Interpreting the Cardiopulmonary Exercise Test in Pediatrics

Pediatr Exerc Sci. 2019 May 1;31(2):194-203. doi: 10.1123/pes.2018-0235. Epub 2019 Jan 28.


The use of cardiopulmonary exercise testing in pediatrics provides critical insights into potential physiological causes of unexplained exercise-related complaints or symptoms, as well as specific pathophysiological patterns based on physiological responses or abnormalities. Clinical interpretation of the results of a cardiopulmonary exercise test in pediatrics requires specific knowledge with regard to pathophysiological responses and interpretative strategies that can be adapted to address concerns specific to the child's medical condition or disability. In this review, the authors outline the 7-step interpretative approach that they apply in their outpatient clinic for diagnostic, prognostic, and evaluative purposes. This approach allows the pediatric clinician to interpret cardiopulmonary exercise testing results in a systematic order to support their physiological reasoning and clinical decision making.

Keywords: child; differential diagnosis; exercise physiology; interpretation; normal responses.

Publication types

  • Review

MeSH terms

  • Cardiorespiratory Fitness / physiology*
  • Cardiovascular Diseases / diagnosis*
  • Cardiovascular Diseases / physiopathology
  • Child
  • Clinical Decision-Making / methods
  • Data Interpretation, Statistical
  • Diagnosis, Differential
  • Exercise / physiology*
  • Exercise Test / methods*
  • Humans
  • Pediatrics
  • Prognosis
  • Respiratory Tract Diseases / diagnosis*
  • Respiratory Tract Diseases / physiopathology