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Cardiopulmonary Exercise Test Using Arm Ergometry in Children With Spina Bifida

A Prediction Model for VO2peak

Tuijtelaars, Jana A. M., MSc; Leonardi-Figuiredo, Marisa Maia, PT, MSc; Crescencio, Julio, PhD; Gallo, Lourenço Jr, MD, PhD; Martinez, Edson Zangiacomi, PhD; Bloemen, Manon, PT, PhD; Takken, Tim, PhD; Mattiello-Sverzut, Ana Claudia, PT, PhD

doi: 10.1097/PEP.0000000000000590

Purpose: This study aimed to develop a prediction model for peak oxygen uptake (

O2peak) in children with spina bifida (SB), considering peak workload (Wpeak), peak heart rate, age, sex, anthropometric measures, walking level, physical activity level, and level of the lesion.

Methods: Data of 26 participants with SB performing a graded arm crank test were used to develop the prediction model. An unrelated data set of participants with SB was used for validation.

Results: The following equation was developed to predict

O2peak of participants with SB:

O2peak (mL/min) = 194+18 × Wpeak – 110 × sex (adjusted R2 = 0.933, SEE = 96 mL/min). Bland-Altman analysis showed a nonsignificant mean difference between the measured and predicted values of

O2peak (−0.09 L/min) and limits of agreement of −0.4036 and 0.2236 L/min.

Conclusions: The prediction model shows promising results; however, further validation using the same protocol is warranted before implementation in clinical practice.

This study aimed to develop a prediction model for peak oxygen uptake in children with spina bifida, considering peak work load, peak heart rate, age, sex, anthropometric measures, and walking level.

Department of Physiology (Ms Tuijtelaars), Radboud Universiteit, Nijmegen, the Netherlands; Departments of Health Sciences (Ms Leonardi-Figuiredo and Dr Mattiello-Sverzut), Cardiology (Drs Crescencio and Gallo), and Social Medicine (Dr Martinez), Ribeirão Preto Medical School, University of Sao Paulo, Sao Paulo, SP, Brazil; Child Development & Exercise Center (Drs Bloemen and Takken), Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands; Research Group Lifestyle and Health (Dr Bloemen) and Master Program Pediatric Physical Therapy (Dr Bloemen), HU University of Applied Sciences Utrecht, Utrecht, the Netherlands.

Correspondence: Ana Claudia Mattiello-Sverzut, PT, PhD, Ribeirão Preto Medical School, University of Sao Paulo, Av Miguel Covian, 120, Ribeirão Preto, Fisioterapia e Terapia Ocupacional, 2nd Floor, CEP 14.049-900, Sao Paulo, Brazil (

Grant Support: The study was funded by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) (2013/05936-4) and by a personal scholarship from Capes (Coordenadoria de Aperfeiçoamento de Pessoal de Nível Superior) and other grants (CNPq). Jana A. M. Tuijtelaars received a grant from Stichting Nijmeegs Universiteitsfonds (SNUF).

The authors declare no conflicts of interest.

Copyright © 2019 Academy of Pediatric Physical Therapy of the American Physical Therapy Association