How to Measure Exercise Performance

Standardized exercise testing has almost become a routine procedure in pediatrics. However, exercise testing should only be performed when indications and contraindications for the procedure have been considered and experienced staff and adequate equipment for testing and emergency measures are available. Most tests are conducted in children aged 5 years or older using a treadmill or a cycle ergometer. Various test protocols are available. Most often, protocols requiring a maximal effort are employed. Criteria for a valid maximal test are a plateau in oxygen uptake despite an increase in exercise intensity, a heart rate near the predicted maximum, and a high respiratory exchange ratio. In children with pulmonary or cardiac diseases, these established criteria may not be valid. Exercise testing can be used to diagnose exercise-induced adverse events such as exercise-induced arrhythmias or bronchial constriction, to clarify the cause of a limited exercise capacity, to identify risks associated with exertion such as arterial hypoxemia, and to monitor the progression of an underlying health condition as well as the effects of treatment.