Maximal Aerobic Power testing with the COSMED Fitmate Pro
Cardiorespiratory fitness (CRF) determines the ability of the body to perform large
muscle, dynamic, moderate to intense exercise for prolonged durations. Maximal
oxygen uptake (VO2MAX) is accepted as the criterion for measuring CRF. VO2MAX is
usually expressed in mL/kg/min to make meaningful comparisons between/ among
individuals; otherwise reported in absolute terms (mL.min-L).
Maximal aerobic power (MAP) tests require you to exercise to the point of volitional
fatigue. This will provide a more accurate estimate of VO2max compared to submaximal
testing. The use of open circuit spirometry during maximal aerobic testing also allows
for the accurate assessment of anaerobic/ventilatory threshold and direct measurement
of VO2MAX /VO2PEAK. VO2MAX is the product of cardiac output (Q= L blood x min-1)) and
the arterial-venous oxygen difference (a-v/O2diff= mL O2 x L blood). So maximal aerobic
capacity can be calculated as:
VO2MAX = Q x a-v/O2diff= (L blood x min-1) x (mL O2 x L blood)
MAP at PEP is focused on healthy subjects that are low risk stratification (ACSM,
Guidelines For Exercise Prescription and Testing, 9th edition, 2011)) with an emphasis
on providing data for improving fitness and performance. A non-latex mask is used to
measure VO2 and VE (ventilation of oxygen).
Operating the COSMED Fitmate Pro
1) Record subject heart rate (HR) and blood pressure (BP) after 5 min of rest while
seated. Complete required paperwork if not done already.
2) Record subject height and weight (kg)
3) Power on Fitmate Pro unit
4) Select (with arrows around OK button) “1 New” and follow steps to create a
subject profile (the profile should be created before subject begins testing)
5) Adjust COSMED cycle ergometer (Ergoselect 100 model) seat and handlebar
position to a comfortable and functional position for the subject.
6) Connect serial cable to Port 1 underneath the COSMED cycle ergometer, and
the other end to the serial/RS 232 adapter to the Fitmate Pro. Plug ethernet end
into RS 232 port on the rear of the Fitmate Pro.
7) Power on COSMED cycle ergometer with switch on rear of seat post; Select “PC
Mode”.
8) Begin testing after subjects have completed a sufficient warm up and hydration.
9) Attach and fit COSMED heart rate (HR) chest strap to subject torso; apply
ultrasound transmission gel to contact points bordering the transmitter. The
ANT1 receiver probe must be inserted into USB port on rear of Fitmate Pro unit
10) Attach the black RMR COSMED VO2MAX DIGITAL FLOW METER to the
appropriate blue face mask
11) Attach the optoelectronic reader (DSL plug) into the Flow port on the back of the
Fitmate Pro unit
12) Attach the RMR gas sampling line into the Sampling port on the rear of the
Fitmate Pro unit.
13) Find and select appropriate mask. Attach mask and fit to subject with gray fitting
strap facing out. Ensure a tight seal around the face. Reposition and apply gel if
necessary to seal and remove air leaks
14) Power on Fitmate Pro unit
15) Return to menu and select “2 View/ Search”
16) Select desired subject profile for testing
17) Select “5 Cardiorespiratory Fitness”
18) Select “1 Cardiorespiratory Fitness VO2MAX “
19) Press “OK” to continue when prompted with warning alert
20) Select “Maximal” for Test type
-Under Ergometer select “COSMED-Bike”
-Under Exercise protocol:
For cycle ergometer select “Bike-Ramp x W/min”, where x = number of
Watts desired for subject test: 10W/min (pulmonary risk factor/very low
functional capacity); 15W/min (elderly people/deconditioned); 20W/min
(sedentary); 25W/min (men average condition/women fit); 30W/min (men
fit/women athlete); and 40W/min (men athlete).
-Subjects must maintain a cadence of 50 rpm. Failure to maintain 50 rpm
for longer than 5 seconds results in termination of testing session. The
cadence is displayed on the handlebar computer screen facing the
subject.
21) Under Load UM select “Watt” for cycle ergometer.
22) Press “OK” to proceed to testing
23) Press “OK” after warning prompt if appropriate supervision is present
24) Wait for analyzer calibration to complete.
25) After parameters screen appears; press “1” to start testing.
26) Record subject vitals:
a) Monitor heart rate (HR) continuously.
b) Monitor blood pressure (BP) every 3rd minute of the cycle test.
c) Monitor RPE (rate of perceived exertion using the Borg 6-20 scale) every
3rd minute, and every 30 seconds after 80%-85% APMHR.
d) Monitor signs and symptoms continuously at every stage.
27) Press “OK” to end test at volitional request, VO2MAX plateau, or if signs and
symptoms present criteria for termination (see “Indications for terminating
exercise testing” following protocol).
28) Press “1 Confirm” to end test
29) Press “2” or “3” to print paper copy from analyzer
30) Open Fitmate Pro program on Windows laptop
31) Download all new tests
32) Select subject profile from menu
33) Follow prompts to view and print data. Compare data with Fitmate Pro printout
for analysis and errors. Use the Fitmate Pro printout as default data for editing
download to the computer version
Indications for terminating exercise testing
Absolute Indications
1. ST-segment elevation (>1.0 mm) in leads without Q waves (other than V1 or
aVR)
2. Drop in systolic blood pressure >10 mmHg (persistently below baseline), despite
an increase in workload, when accompanied by any other evidence of ischemia
3. moderate-to-severe angina (grade 3 to 4)
4. central nervous system symptoms (eg, ataxia, dizziness, or near syncope)
5. signs of poor perfusion (cyanosis or pallor)
6. sustained ventricular tachycardia
7. technical difficulties in monitoring the ECG or systolic blood pressure
8. patient’s request to stop.
Relative Indications
1. ST or QRS changes such as excessive ST displacement (horizontal or
downsloping of >2 mm) or marked axis shift
2. drop in systolic blood pressure >10 mm Hg (persistently below baseline), despite
an increase in workload, in the absence of other evidence of ischemia
3. increasing chest pain
4. fatigue, shortness of breath, wheezing, leg cramps, or claudication
5. arrhythmias other than sustained ventricular tachycardia, including multifocal
ectopic, ventricular triplets, supraventricular tachycardia, heart block, or
bradyarrhythmias
6. general appearance (see below)
7. hypertensive response (systolic blood pressure >250 mmHg and/or diastolic
blood pressure >115 mmHg)
8. development of bundle-branch block that cannot be distinguished from
ventricular tachycardia.