WO2006041741A1 - Methodes de determination du pourcentage de capacite d'exercice basee sur l'age des femmes - Google Patents

Methodes de determination du pourcentage de capacite d'exercice basee sur l'age des femmes Download PDF

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Publication number
WO2006041741A1
WO2006041741A1 PCT/US2005/035351 US2005035351W WO2006041741A1 WO 2006041741 A1 WO2006041741 A1 WO 2006041741A1 US 2005035351 W US2005035351 W US 2005035351W WO 2006041741 A1 WO2006041741 A1 WO 2006041741A1
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WIPO (PCT)
Prior art keywords
age
exercise capacity
woman
predicted
nomogram
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Application number
PCT/US2005/035351
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English (en)
Inventor
Martha Gulati
Ronald A. Thisted
Henry R. Black
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Rush University Medical Center
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Publication date
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Publication of WO2006041741A1 publication Critical patent/WO2006041741A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B69/00—Training appliances or apparatus for special sports
    • A—HUMAN NECESSITIES
    • A63—SPORTS; GAMES; AMUSEMENTS
    • A63B—APPARATUS FOR PHYSICAL TRAINING, GYMNASTICS, SWIMMING, CLIMBING, OR FENCING; BALL GAMES; TRAINING EQUIPMENT
    • A63B24/00—Electric or electronic controls for exercising apparatus of preceding groups; Controlling or monitoring of exercises, sportive games, training or athletic performances
    • A63B24/0075—Means for generating exercise programs or schemes, e.g. computerized virtual trainer, e.g. using expert databases

Definitions

  • This invention relates to methods, systems and apparatus for determining percent age-predicted exercise capacity for women using a nomogram for percent age-predicted exercise capacity developed from a large study of asymptomatic women.
  • Exercise capacity has been shown to be an independent predictor of mortality and future cardiac events in asymptomatic women and men.
  • 1'5 Exercise capacity is an estimate of the maximal oxygen uptake for a given workload, 6 ' 7 and can be measured by performing a symptom-limited stress test.
  • Exercise capacity may be expressed in units of metabolic equivalents (MET), where a MET is a measure of ventilatory oxygen consumption expressed as multiples of basal resting requirements.
  • MET is one unit of basal oxygen consumption, which equals 3.5 ml-body oxygen consumption per kilogram body weight per minute for an average adult. 8
  • Exercise capacity is dependent upon age, as well as gender and disease state.
  • a number of studies have established that there is a negative linear relationship between exercise capacity and age in men and a nomogram has been established for men, estimating percent-predicted exercise capacity achieved relative to age.
  • 6 ' 7 ' 10"12 A number of regression equations for predicting exercise capacity in a variety of male populations have been described. 6 ' 7 ' 10 ⁇ 12 Only two studies directly measured maximal oxygen uptake, 6 ' 10 whereas the remainder estimated the exercise capacity, based on the speed and degree of incline achieved. Three of these studies examined the relationship of exercise capacity to age in healthy male volunteers. 6 ' 7> 10 In contrast, there have been few studies evaluating exercise capacity in women, and to date, determinations of normative values of exercise capacity for age in women have not been well established and no nomogram has been established for women.
  • a nomogram for predicting percent age-predicted exercise capacity in women has been developed.
  • the nomogram was based on a study of a group of women and, for women, provides more accurate results than other presently available nomograms that were based solely on studies of men.
  • the percent age-predicted exercise capacity may be related to cardiac death rates and all-cause mortality in women. Methods, systems and apparatus which implement the nomogram are also provided.
  • the nomogram has two outer scales, one for a woman's actual (i.e., measured) exercise capacity and a one for the woman's age.
  • a center scale represents percent age-predicted exercise capacity. The intersection between a line connecting a woman's actual exercise capacity and the woman's age and the center scale provides the woman's percent age-predicted exercise capacity.
  • the nomogram may be applied to both symptomatic woman (e.g., women that have been referred for testing by a physician or other health care professional) or asymptomatic (e.g., healthy or seemingly healthy) women.
  • the invention also provides a computer program for determining percent age-predicted exercise capacity in women.
  • the program includes computer code adapted to determine where a line connecting a woman's actual exercise capacity and the woman's age would intersect the line representing percent age- predicted exercise capacity in a nomogram based on a study of a group of women.
  • the computer program may be incorporated into a computer system that includes a central processing unit, an input interface for transmitting a woman's actual exercise capacity and age to the central processing unit and a memory storage medium for storing the computer code.
  • a testing apparatus for determining a woman's percent age-predicted exercise capacity.
  • This apparatus may include the computer system described above and an exercise platform, such as a treadmill or a stepping stool. While the woman is exercising on the exercise platform her exercise capacity is measured and input into the input interface of the computer system. The woman's age is also input into the system. Based on these inputs, the computer code is used to calculate the woman's percent age-predicted exercise capacity.
  • a variety of protocols may be used to determine the woman's exercise capacity. These include, but are not limited to, the Bruce protocol, the Ellestad protocol, the Naughton protocol and the Balke-Ware protocol.
  • FIG. 1 Regression equation of exercise capacity (in METs) versus age
  • Liner lines represent 95% confidence limits for the mean; outer lines represent 95% prediction limits.
  • FIG. 2 Nomogram of percent age-predicted exercise capacity (in
  • FIG. 3. Nomogram of percent age-predicted exercise capacity (in
  • FIG. 4 Illustrative nomogram for percent age-predicted exercise capacity for two women, ages 60 and 30, with a measured MET level of 7.
  • FIG. 5 Nomogram of percent normal exercise capacity (in METs) for age in asymptomatic men and women. DETAILED DESCRIPTION
  • the present methods and systems for calculating a predicted exercise capacity for women and for determining the percent of predicted exercise capacity for a woman were developed through the study of a large sample of women of different ages.
  • the percent predicted exercise capacity for women provides a predictor of cardiac death rates and all-cause mortality in women based on the results of a relatively simple stress test.
  • equation (1) can be used to calculate a nomogram for percent age- predicted exercise capacity from the exercise capacity values that are equal to 14.7- 0.13 x (age or woman), within a SD of the estimate of 2.3 or better and a P value ⁇ 0.001.
  • % age-predicted exercise capacity (Actual MET Level/exercise capacity) x 100, (2)
  • the percent age-predicted exercise capacity represents the percent age-predicted exercise capacity for a given age based on measured MET Level, where 100% represents the average for a given age.
  • the present invention provides systems and apparatus for implementing the methods.
  • One such system includes a central processing unit, an input interface for transmitting inputs to the central processing unit and a memory for storing the predicted exercise capacity nomogram.
  • a computer program product including a set of instructions for calculating a percent age-predicted exercise capacity from a patient's age and actual MET level, using the methods described above, may be embedded in computer code stored in the memory.
  • the interface is used to input a woman's age and actual MET level and the stored nomogram is used to convert these inputs into a calculated percent age- predicted exercise capacity.
  • the system may also optionally include a display unit and/or a printer for displaying and/or printing the calculated percent age-predicted exercise capacity.
  • a display unit and/or a printer for displaying and/or printing the calculated percent age-predicted exercise capacity.
  • suitable storage media include, but are not limited to, random access memory, read-only memory, a CD and a disc.
  • suitable input interfaces include, but are not limited to, keyboards, touch screens, voice- activated systems and digital interfaces.
  • suitable display units include, but are not limited to, a computer monitor, a digital screen and a liquid crystal display.
  • the system may be integrated into a stress testing or exercise apparatus adapted to collect exercise capacity data in the form of METs from a patient.
  • the components of the apparatus may vary depending upon the nature of the stress testing protocol to be performed.
  • the apparatus will generally include an exercise platform, such as a treadmill or a steeping stool.
  • the system may further include a patient interface for measuring physiological data from the patient.
  • the system may include a mask for measuring expired oxygen and exhaled carbon dioxide, hi practice data collected from a woman on the exercise platform is converted into exercise capacity data in the form of METs which are provided to the system central processing unit through the input interface.
  • the purpose of the study was to create a simple nomogram for women to allow the translation of the MET level achieved on a stress test into a percent of normal exercise capacity for women for any age, based on a population of asymptomatic women.
  • the results of the study were validated by a symptomatic, referral-base population of women to determine the usefulness of this nomogram in clinical practice.
  • Study-specific exclusion criteria included the following: 1)
  • the referral population has been previously described. 14 ' 15 Briefly, these women were prospectively enrolled and followed from 1990 to 1995. This cohort was composed of 4471 consecutive women from 6 medical centers who were referred for a symptom-limited exercise stress test using the Bruce protocol for evaluation of suspected coronary disease. Women were excluded if they had been recently hospitalized for unstable angina, myocardial infarction and coronary revascularization. [0031 ] Following-up information was obtained on this referral population by clinic visit or telephone interview. Deaths were identified and cause of death was classified after review of death certificates by an independent reviewer, unaware of the patient's clinical history or stress testing data.
  • MET is an estimate of the maximal oxygen uptake for a given workload. 6 ' 7 A MET is a measure of ventilatory oxygen consumption expressed as multiples of basal resting requirements; where one MET is one unit of basal oxygen consumption, which equals 3.5 ml-body oxygen consumption per kilogram body weight per minute for an average adult.
  • the exercise capacity (in MET) was estimated by the speed and the grade of the treadmill. 19
  • the percent age-predicted exercise capacity represents the percent age- predicted exercise capacity for a given age based on the MET performed, where 100% represents the average for the given age. Values for percent age-predicted exercise capacity (from 20% to 150%) were calculated using the equation above. A nomogram for the healthy population was plotted using specific ages and observed MET levels for different values of exercise capacity, where a best-fit line was drawn though the intercepts for the percent age-predicted exercise capacity for age. Similarly, a nomogram was created for both the active and sedentary groups.
  • FIG. 1 A scatter plot and linear regression line (with the 95% confidence intervals), demonstrating the relationship between exercise capacity and age is shown in FIG. 1, where the mean exercise capacity for age is estimated for the asymptomatic volunteer cohort. Regression analyses of exercise capacity (METs) for age was performed for the entire volunteer cohort where
  • FIG. 2 The nomogram based on self-reported activity level (equations (3) and (4)) is shown on FIG. 3, where the active women had a greater percent predicted exercise capacity for any given age, compared to their more sedentary counterparts.
  • the percent predicted exercise capacity achieved was measured for the symptomatic and referral population. Within the asymptomatic population, those who achieved ⁇ 85% age-predicted METs had a hazards ratio of death twice as great as those who achieved ⁇ 85% age-predicted METs, PO.001.
  • the established nomogram allows translation of exercise capacity (measured in METs) to be estimated in terms of percent predicted for any given age.
  • achievement of an exercise capacity less than predicted for age translates into a greater risk of all-cause mortality and cardiac mortality.
  • equation (1) is similar to an equation derived from the healthy male volunteers from the study by Morris et al., 6 where their regression equation was
  • Roberts JM, Sullivan M, Froeaji VF, Genter F, Myers J Predicting oxygen uptake from treadmill testing in normal subjects and coronary artery disease patients. Am Heart J 1984; 108:1454-60.

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  • Health & Medical Sciences (AREA)
  • General Health & Medical Sciences (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Investigating Or Analysing Biological Materials (AREA)

Abstract

L'invention concerne des procédés, des systèmes et un appareil de détermination du pourcentage de capacité d'exercice basée sur l'âge des femmes à l'aide d'un nomogramme du pourcentage de capacité d'exercice basée sur l'âge des femmes, obtenu à partir d'une étude approfondie menée sur des femmes asymptomatiques.
PCT/US2005/035351 2004-10-04 2005-10-03 Methodes de determination du pourcentage de capacite d'exercice basee sur l'age des femmes WO2006041741A1 (fr)

Applications Claiming Priority (2)

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US61570704P 2004-10-04 2004-10-04
US60/615,707 2004-10-04

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WO2006041741A1 true WO2006041741A1 (fr) 2006-04-20

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Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5007430A (en) * 1986-11-05 1991-04-16 Dardik Irving I Rhythmic biofeedback technique
US5158093A (en) * 1989-04-24 1992-10-27 Esar Shvartz Universal fitness testing system
US6313167B1 (en) * 1997-06-16 2001-11-06 Nippon Suisan Kaisha Ltd. Composition having capability of removing risk factor during exercise

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5007430A (en) * 1986-11-05 1991-04-16 Dardik Irving I Rhythmic biofeedback technique
US5158093A (en) * 1989-04-24 1992-10-27 Esar Shvartz Universal fitness testing system
US6313167B1 (en) * 1997-06-16 2001-11-06 Nippon Suisan Kaisha Ltd. Composition having capability of removing risk factor during exercise

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