Exercise testing is used for a variety of reasons. For example, individuals without disease but with certain disease risk factors are tested to determine the probability of heart attack within a 5-year period. Individuals with cardiovascular disease are tested to determine disease severity, and patients are tested after a heart attack to determine whether a return to normal life is probable. Individuals interested in beginning a fitness program are also tested to determine aerobic fitness. The Ellestad test is one of many used in clinical and laboratory environments to determine maximal aerobic capacity and diagnose disease.
Step 1
Obtain a medical history questionnaire for your test subject. If in the past the individual has suffered a heart attack, is taking blood pressure or cholesterol lowering medications, is diabetic, is obese as determined by BMI, is inactive or smokes, clearance from a physician to take part in the test is necessary. Once the physician gives the go ahead, proceed with the evaluation. If the test subject has not indicated any of the above risk factors, a physician's clearance is unnecessary.
Step 2
Determine age predicted maximum heart rate (APMHR) for your test subject prior to testing. To determine APMHR, use the Karvonen formula (220 -- age). For example, the APMHR for a 35-year-old person would be 185 beats per minute (220 -- 35 = 185).
Step 3
Wet the chest strap portion of the heart rate monitor. Have the test subject place the heart rate monitor around the chest at the level of the sternum. Place the heart rate watch near the chest strap to determine if it's picking up the heart rate transmission. Place the heart rate monitor watch on your wrist for easy assessment during testing.
Step 4
Seat the test subject comfortably in a hardback chair for 5 minutes. After 5 minutes, record the resting heart rate reading as determined by the heart rate monitor watch. Record the data on the Ellestad protocol sheet (see Resources) as resting heart rate.
Step 5
Explain testing procedures to the test subject. Discuss stages, RPE scale and assessment of heart rate during each stage. Instruct the test subject that if any time he needs to stop, he should notify you and the test will end. Stand very close to the treadmill without resting on the handrails. Have the clipboard and stopwatch in hand or very close by.
Step 6
Have the test subject stand on the treadmill facing the console, holding the handrails. Start the treadmill at 2 miles per hour and instruct the subject to step on the moving conveyor belt. Allow the subject to walk for 60 seconds. Notify the test subject that the test will begin once the 60 seconds are complete.
Step 7
After 60 seconds, increase the treadmill incline to 15 and the treadmill speed to 6 miles per hour. Once the treadmill speed is at 6 miles per hour and the incline is at 15, start the stopwatch. This is stage 1 and lasts for 3 minutes. At the 2-minute mark of stage 1, place the heart rate watch near the chest strap of the test subject to determine heart rate reading. At 2:45 ask the test subject for an RPE reading; record the information on the protocol sheet. At 2:50 seconds, place the heart rate watch near the chest strap to determine heart rate reading. Record the heart rate on the protocol sheet. If the test subject has not reached maximum heart rate proceed to stage 2. Three minutes marks the end of stage 1 and time to alter speed and incline.
At stage 2, decrease the treadmill speed to 5 miles per hour; the treadmill incline remains at 15%. This stage lasts for 2 minutes. At 4:45 ask the subject for an RPE reading. At 4:50 place the heart rate watch near the chest strap to determine the heart rate reading. Record both values on the protocol sheet. If at 5 minutes the test subject has yet to reach his APMHR, proceed to stage 3. If maximum heart rate is reached, begin the cool-down.
At stage 3, the treadmill speed remains at 5 miles per hour and the treadmill incline decreases to 10%. This stage lasts for 3 minutes. At 7:45 ask the test subject for an RPE reading. At 7:50 place the heart rate watch near the chest strap to determine heart rate for stage 3. Record the heart rate information for stage 3 with the RPE reading. If at 8:00 the test subject has not reached APMHR, proceed to stage 4. If he has reached his APMHR, begin the cool-down.
At stage 4, the treadmill speed decreases to 4 miles per hour and the treadmill incline remains at 10%. This stage lasts for 3 minutes. At 10:45 ask the test subject at what RPE he is working. At 10:50, place the heart rate monitor watch near the chest strap to determine heart rate. Record both values. At 11:00 if the test subject has yet to reach the APMHR, proceed to stage 5. If maximum heart rate is reached, begin cool-down.
At stage 5, the treadmill speed decreases to 3 miles per hour. The treadmill incline remains at 10%. This stage lasts for 2 minutes. At 12:45 ask the test subject at what RPE he is working. At 12:50 determine heart rate. Record both RPE and heart rate on the protocol sheet. At 13:00 if the test subject has not reached APMHR, proceed to the final stage. If APMHR is reached, begin cool-down.
At stage 6, the treadmill speed slows to 1.7 miles per hour. The treadmill incline remains at 10%. This stage lasts for 3 minutes. At 15:45 ask the test subject for an RPE reading. At 15:50 determine heart rate. Record both values on the protocol sheet. At 16:00, begin the cool-down.
Step 8
For the cool-down, reduce the treadmill incline to zero and the speed to 2 miles per hour. The cool-down stage lasts for 2 minutes. After 2 minutes record the heart rate and RPE. Allow the test subject to continue to walk on the treadmill until his heart rate returns to 10 beats within resting heart rate.
Tips and Warnings
- Have your test subject complete a Physical Acitivity Readiness Questionnaire prior to testing. If a heart rate monitor is not available, use the radial pulse. The RPE scale is used in addition to heart rate to determine exertion level. Any level above 17 early in the test is reason to stop the test. Increase the treadmill speeds quickly to obtain true heart rate readings for each stage. Wait until the end of the stage to obtain a heart rate reading.
- Only skilled exercise or health professionals certified in CPR/AED should conduct this test on others. Individuals with known cardiovascular disease risk should not participate in this test. An AED should be nearby in case of cardiac event. If the test subject requests to stop the test at any time, begin the cool-down. Do not press the stop button or abruptly stop the treadmill during testing. Abruptly stopping the treadmill belt midtest can cause your test subject to faint. If the participant asks to stop during testing, ask if he can walk at a slower pace to cool down. If he says yes, begin the cool-down. If no, allow the individual to stop.
Things You'll Need
- Ellestad protocol sheet
- RPE scale
- Treadmill
- Stopwatch
- Calculator
- Par-Q
- Heart rate monitor
- Heart rate monitor watch
References
- ACSM's Resource Manual for Guidelines for Exercise Testing and Prescription; 4th edition; American College of Sports Medicine, 2000
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