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Prediction of Maximal Heart Rate in Children and Adolescents

Gelbart, Miri MD; Ziv-Baran, Tomer PhD; Williams, Craig A. PhD; Yarom, Yoni MD; Dubnov-Raz, Gal MD

Clinical Journal of Sport Medicine: March 2017 - Volume 27 - Issue 2 - p 139–144
doi: 10.1097/JSM.0000000000000315
Original Research

Objective: To identify a method to predict the maximal heart rate (MHR) in children and adolescents, as available prediction equations developed for adults have a low accuracy in children. We hypothesized that MHR may be influenced by resting heart rate, anthropometric factors, or fitness level.

Design: Cross-sectional study.

Setting: Sports medicine center in primary care.

Participants: Data from 627 treadmill maximal exercise tests performed by 433 pediatric athletes (age 13.7 ± 2.1 years, 70% males) were analyzed.

Independent Variables: Age, sex, sport type, stature, body mass, BMI, body fat, fitness level, resting, and MHR were recorded.

Main Outcome Measures: To develop a prediction equation for MHR in youth, using stepwise multivariate linear regression and linear mixed model. To determine correlations between existing prediction equations and pediatric MHR.

Results: Observed MHR was 197 ± 8.6 b·min−1. Regression analysis revealed that resting heart rate, fitness, body mass, and fat percent were predictors of MHR (R2 = 0.25, P < 0.001), whereas age was not. Resting heart rate explained 15.6% of MHR variance, body mass added 5.7%, fat percent added 2.4%, and fitness added 1.2%. Existing adult equations had low correlations with observed MHR in children and adolescents (r = −0.03-0.34).

Conclusions: A new equation to predict MHR in children and adolescents was developed, but was found to have low predictive ability, a finding similar to adult equations applied to children.

Clinical Relevance: Considering the narrow range of MHR in youth, we propose using 197 b·min−1 as the mean MHR in children and adolescents, with 180 b·min−1 the minimal threshold value (−2 standard deviations).

*Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;

Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;

Children's Health and Exercise Research Centre, University of Exeter, Exeter, United Kingdom;

§Medix Sport Medicine Center, Tel Aviv, Israel; and

Exercise, Nutrition and Lifestyle Clinic, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel.

Corresponding Author: Gal Dubnov-Raz, MD, MSc, Exercise, Nutrition and Lifestyle Clinic, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, Israel 52621 (gal.dubnov-raz@sheba.health.gov.il).

The authors report no conflicts of interest.

This study was performed in partial fulfillment of the requirements for an MD degree by Miri Gelbart at the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Received July 13, 2015

Accepted December 18, 2015

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.