Development and validation of a 1-km cardio-trekking test to estimate cardiorespiratory fitness in healthy adults

Maximum oxygen uptake (V̇O(2max)), the gold standard measure of cardiorespiratory fitness (CRF), supports cardiovascular risk assessment and is mainly assessed during maximal spiroergometry. However, for field use, submaximal exercise tests might be appropriate and feasible. There have been no studies attempting a submaximal test protocol involving uphill hiking. This study aimed to develop and validate a 1-km cardio-trekking test (CTT) controlled by heart rate monitoring and Borg’s 6–20 rating of perceived exertion (RPE) scale to predict V̇O(2max) outdoors. Healthy participants performed a maximal incremental treadmill walking laboratory test and a submaximal 1-km CTT on mountain trails in Austria and Germany, and V̇O(2max) was assessed with a portable spirometry device. Borg’s RPE scale was used to control the exercise intensity of the CTT. All subjects wore a chest strap to measure heart rate (HR). A total of 134 participants (median age: 56.0 years [IQR: 51.8–63.0], 43.3 % males) completed both testing protocols. The prediction model is based on age, gender, smoking status, weight, mean HR, altitude difference, duration, and the interaction between age and duration (R(2) = 0.65, adj. R(2) = 0.63). Leave-one-out cross-validation revealed small shrinkage in predictive accuracy (R(2) = 0.59) compared to the original model. Submaximal exercise testing using uphill hiking allows for practical estimation of V̇O(2max) in healthy adults. This method may allow people to engage in physical activity while monitoring their CRF to avert unnecessary cardiovascular events.