Background: In the latest statement for CPET (ERS,2019) 84% of the included studies were based on ergometer cycling protocols while only 16% were based on treadmill protocols. More studies with treadmill protocols are requested. The Glittreprotocol was designed based on a modified Bruce protocol in 1992 for patients with lung disease and has been used in clinical practice since then but has not been validated.
Aim: To validate the Glittreprotocol in patients with COPD. Do these patients achieve the criteria for a maximal test when performing a CPET using the Glittreprotocol on a treadmill?
Methods: Data from patients who had performed CPET on a treadmill using the Glittreprotocol were retrospectively analyzed. Criteria for a validated test were based on the ERS statement: 1) patients had to achieve one or more of the six criteria for maximum effort (achieved expected VO2peak; HRpeak ?95% pred.; VEpeak ?85% of MVV; RER >1,05 or according to age/gender, blood lactate >8mmol^.L-1 or according to age/gender, Borg CR10 ?9); 2) time of the stress phase within 8-12 minutes; 3) whether the Glittreprotocol consisted of recommended phases (rest-stress-recovery).
Results: 80 patients with COPD (55% men, age 65(9) years, FEV1%pred 45(17)) were included. 91% of the patients met criteria for maximal effort. The average stress-phase time was 09:24 min. The Glittreprotocol contained phases of rest, stress and recovery.
Conclusion: The Glittreprotocol appears to be a valid protocol for maximal CPET in patients with COPD. Patients achieved the criteria for maximum effort, and the criteria were achieved within the recommended time. More prospective studies are needed to fully validate the Glittreprotocol.