PURPOSE Aerobic exercise prescriptions in clinical populations commonly involve target intensities based on cardiopulmonary exercise tests (CPET). CPETs are often discontinued prior to a patient achieving true maximum oxygen consumption (VO2 max) which can adversely affect exercise dose and efficacy monitoring; however, reasons for early discontinuation are poorly reported. Accordingly, we explored the CPET termination reasons in persons with cancer participating in exercise intervention studies. METHODS This study comprised of an exploratory, descriptive analysis of retrospective CPET data (VO2 and anaerobic threshold) and termination reasons in a convenience sample of people with cancer participating in exercise intervention studies in a single laboratory. CPETs were standardized using the modified Bruce treadmill protocol with expired gas collection and analysis using a metabolic cart. VO2 max was considered "met" when participants demonstrated (a) oxygen consumption plateau or (b) two of the following criteria: rating of perceived exertion ≥ 9/10, respiratory exchange ratio ≥ 1.15, and/or heart rate of 95% of age-predicted maximum. The frequency and distribution of reasons for test termination relative to the number of CPET exposures for the participants were reported. RESULTS Forty-four participants engaged in exercise studies between February 2016 and March 2018 provided data for the analysis. Participants completed up to three CPETs during this period (total of 78 CPETs in the current analysis). Eighty-six percent of all CPETs were terminated prior to achieving VO2 max verification criteria and no tests resulted in an oxygen consumption plateau. For those that did not demonstrate achievement of VO2 max verification criteria, reasons for discontinuation were distributed as follows: equipment discomfort-49%, volitional peak-36%, and physical discomfort-14.9%. For those who met VO2 max criteria, volitional peak was the most common reason for test termination (45.5%), followed by physical discomfort (36.4%), and equipment discomfort (18.2%). CONCLUSIONS In our sample of cancer survivors, VO2 max criteria were infrequently met with equipment discomfort being a primary reason for participant-driven test termination. Protocol and equipment considerations are necessary for interpretation and application of CPET findings in clinical practice.

中文翻译：

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癌症患者有氧运动能力的获得和心肺运动测试终止的原因：来自单个实验室的描述性回顾性分析。

目的临床人群中的有氧运动处方通常涉及基于心肺运动试验（CPET）的目标强度。在患者达到真正的最大耗氧量（VO2最大值）之前，通常会停止使用CPET，这可能会对运动剂量和疗效监测产生不利影响；但是，早期停药的原因报道很少。因此，我们探讨了参加运动干预研究的癌症患者中CPET终止的原因。方法该研究包括对回顾性CPET数据（VO2和无氧阈值）和终止原因的探索性，描述性分析，该研究在单个实验室中参加运动干预研究的癌症患者便利样本中进行。使用改良的Bruce跑步机协议对CPET进行标准化，并使用代谢推车对过期的气体进行收集和分析。当参与者表现出（a）耗氧量平稳或（b）以下两个标准中的两个时，VO2 max被视为“满足”：感知劳累等级≥9/10，呼吸交换率≥1.15和/或心率95％年龄预测的最大值。报告了终止测试的原因的频率和分布（相对于参与者的CPET暴露次数）。结果2016年2月至2018年3月之间从事运动研究的44名参与者提供了分析数据。在此期间，参与者最多完成了三个CPET（当前分析中总共78个CPET）。在达到最大VO2验证标准之前，终止了所有CPET的百分之八十六，并且没有测试导致耗氧量达到平稳状态。对于那些未证明达到VO2 max验证标准的产品，停产原因如下：设备不适感为49％，自愿性峰值为36％，身体不适为14.9％。对于那些达到VO2 max最高标准的人，自愿终止测试的最常见原因是出现峰值（45.5％），其次是身体不适（36.4％）和设备不适（18.2％）。结论在我们的癌症幸存者样本中，很少达到VO2 max标准且设备不适是参与者驱动测试终止的主要原因。协议和设备考虑因素对于在临床实践中解释和应用CPET所发现的结果是必不可少的。