Robot-Assisted End-Effector-Based Stair Climbing for Cardiopulmonary Exercise Testing: Feasibility, Reliability, and Repeatability
Neurological impairments can limit the implementation of conventional cardiopulmonary exercise testing (CPET) and cardiovascular training strategies. A promising approach to provoke cardiovascular stress while facilitating task-specific exercise in people with disabilities is feedback-controlled rob...
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| description | Neurological impairments can limit the implementation of conventional cardiopulmonary exercise testing (CPET) and cardiovascular training strategies. A promising approach to provoke cardiovascular stress while facilitating task-specific exercise in people with disabilities is feedback-controlled robot-assisted end-effector-based stair climbing (RASC). The aim of this study was to evaluate the feasibility, reliability, and repeatability of augmented RASC-based CPET in able-bodied subjects, with a view towards future research and applications in neurologically impaired populations.
Twenty able-bodied subjects performed a familiarisation session and 2 consecutive incremental CPETs using augmented RASC. Outcome measures focussed on standard cardiopulmonary performance parameters and on accuracy of work rate tracking (RMSEP-root mean square error). Criteria for feasibility were cardiopulmonary responsiveness and technical implementation. Relative and absolute test-retest reliability were assessed by intraclass correlation coefficients (ICC), standard error of the measurement (SEM), and minimal detectable change (MDC). Mean differences, limits of agreement, and coefficients of variation (CoV) were estimated to assess repeatability.
All criteria for feasibility were achieved. Mean V'O2peak was 106±9% of predicted V'O2max and mean HRpeak was 99±3% of predicted HRmax. 95% of the subjects achieved at least 1 criterion for V'O2max, and the detection of the sub-maximal ventilatory thresholds was successful (ventilatory anaerobic threshold 100%, respiratory compensation point 90% of the subjects). Excellent reliability was found for peak cardiopulmonary outcome measures (ICC ≥ 0.890, SEM ≤ 0.60%, MDC ≤ 1.67%). Repeatability for the primary outcomes was good (CoV ≤ 0.12).
RASC-based CPET with feedback-guided exercise intensity demonstrated comparable or higher peak cardiopulmonary performance variables relative to predicted values, achieved the criteria for V'O2max, and allowed determination of sub-maximal ventilatory thresholds. The reliability and repeatability were found to be high. There is potential for augmented RASC to be used for exercise testing and prescription in populations with neurological impairments who would benefit from repetitive task-specific training. |
| doi_str_mv | 10.1371/journal.pone.0148932 |
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Twenty able-bodied subjects performed a familiarisation session and 2 consecutive incremental CPETs using augmented RASC. Outcome measures focussed on standard cardiopulmonary performance parameters and on accuracy of work rate tracking (RMSEP-root mean square error). Criteria for feasibility were cardiopulmonary responsiveness and technical implementation. Relative and absolute test-retest reliability were assessed by intraclass correlation coefficients (ICC), standard error of the measurement (SEM), and minimal detectable change (MDC). Mean differences, limits of agreement, and coefficients of variation (CoV) were estimated to assess repeatability.
All criteria for feasibility were achieved. Mean V'O2peak was 106±9% of predicted V'O2max and mean HRpeak was 99±3% of predicted HRmax. 95% of the subjects achieved at least 1 criterion for V'O2max, and the detection of the sub-maximal ventilatory thresholds was successful (ventilatory anaerobic threshold 100%, respiratory compensation point 90% of the subjects). Excellent reliability was found for peak cardiopulmonary outcome measures (ICC ≥ 0.890, SEM ≤ 0.60%, MDC ≤ 1.67%). Repeatability for the primary outcomes was good (CoV ≤ 0.12).
RASC-based CPET with feedback-guided exercise intensity demonstrated comparable or higher peak cardiopulmonary performance variables relative to predicted values, achieved the criteria for V'O2max, and allowed determination of sub-maximal ventilatory thresholds. The reliability and repeatability were found to be high. There is potential for augmented RASC to be used for exercise testing and prescription in populations with neurological impairments who would benefit from repetitive task-specific training.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0148932</identifier><identifier>PMID: 26849137</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Biology and Life Sciences ; Care and treatment ; Change detection ; Climbing ; Coefficient of variation ; Correlation coefficient ; Correlation coefficients ; Criteria ; Disabilities ; Disabled persons ; Error analysis ; Error detection ; Exercise intensity ; Exercise Test - instrumentation ; Exercise Test - methods ; Exercise therapy ; Feasibility studies ; Feedback ; Female ; Fitness equipment ; Health care ; Heart rate ; Humans ; Information technology ; Male ; Mechanical engineering ; Medicine and Health Sciences ; Methods ; Middle Aged ; People with disabilities ; Physical fitness ; Physical Sciences ; Populations ; Preventive medicine ; Rehabilitation ; Reliability analysis ; Reproducibility ; Research and Analysis Methods ; Robotics ; Robotics - instrumentation ; Robotics - methods ; Robots ; Standard error ; Student athletes ; Thresholds ; Training ; Walking</subject><ispartof>PloS one, 2016-02, Vol.11 (2), p.e0148932-e0148932</ispartof><rights>COPYRIGHT 2016 Public Library of Science</rights><rights>2016 Stoller et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2016 Stoller et al 2016 Stoller et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-6c50d191c57bbee05136ca26422339d4a4956c91ee37b8f7c1a9b7323bc468ac3</citedby><cites>FETCH-LOGICAL-c692t-6c50d191c57bbee05136ca26422339d4a4956c91ee37b8f7c1a9b7323bc468ac3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4743938/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4743938/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53769,53771,79346,79347</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26849137$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Buiu, Catalin</contributor><creatorcontrib>Stoller, Oliver</creatorcontrib><creatorcontrib>Schindelholz, Matthias</creatorcontrib><creatorcontrib>Hunt, Kenneth J</creatorcontrib><title>Robot-Assisted End-Effector-Based Stair Climbing for Cardiopulmonary Exercise Testing: Feasibility, Reliability, and Repeatability</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Neurological impairments can limit the implementation of conventional cardiopulmonary exercise testing (CPET) and cardiovascular training strategies. A promising approach to provoke cardiovascular stress while facilitating task-specific exercise in people with disabilities is feedback-controlled robot-assisted end-effector-based stair climbing (RASC). The aim of this study was to evaluate the feasibility, reliability, and repeatability of augmented RASC-based CPET in able-bodied subjects, with a view towards future research and applications in neurologically impaired populations.
Twenty able-bodied subjects performed a familiarisation session and 2 consecutive incremental CPETs using augmented RASC. Outcome measures focussed on standard cardiopulmonary performance parameters and on accuracy of work rate tracking (RMSEP-root mean square error). Criteria for feasibility were cardiopulmonary responsiveness and technical implementation. Relative and absolute test-retest reliability were assessed by intraclass correlation coefficients (ICC), standard error of the measurement (SEM), and minimal detectable change (MDC). Mean differences, limits of agreement, and coefficients of variation (CoV) were estimated to assess repeatability.
All criteria for feasibility were achieved. Mean V'O2peak was 106±9% of predicted V'O2max and mean HRpeak was 99±3% of predicted HRmax. 95% of the subjects achieved at least 1 criterion for V'O2max, and the detection of the sub-maximal ventilatory thresholds was successful (ventilatory anaerobic threshold 100%, respiratory compensation point 90% of the subjects). Excellent reliability was found for peak cardiopulmonary outcome measures (ICC ≥ 0.890, SEM ≤ 0.60%, MDC ≤ 1.67%). Repeatability for the primary outcomes was good (CoV ≤ 0.12).
RASC-based CPET with feedback-guided exercise intensity demonstrated comparable or higher peak cardiopulmonary performance variables relative to predicted values, achieved the criteria for V'O2max, and allowed determination of sub-maximal ventilatory thresholds. The reliability and repeatability were found to be high. There is potential for augmented RASC to be used for exercise testing and prescription in populations with neurological impairments who would benefit from repetitive task-specific training.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Change detection</subject><subject>Climbing</subject><subject>Coefficient of variation</subject><subject>Correlation coefficient</subject><subject>Correlation coefficients</subject><subject>Criteria</subject><subject>Disabilities</subject><subject>Disabled persons</subject><subject>Error analysis</subject><subject>Error detection</subject><subject>Exercise intensity</subject><subject>Exercise Test - instrumentation</subject><subject>Exercise Test - methods</subject><subject>Exercise therapy</subject><subject>Feasibility studies</subject><subject>Feedback</subject><subject>Female</subject><subject>Fitness equipment</subject><subject>Health care</subject><subject>Heart rate</subject><subject>Humans</subject><subject>Information technology</subject><subject>Male</subject><subject>Mechanical engineering</subject><subject>Medicine and Health Sciences</subject><subject>Methods</subject><subject>Middle Aged</subject><subject>People with disabilities</subject><subject>Physical fitness</subject><subject>Physical Sciences</subject><subject>Populations</subject><subject>Preventive medicine</subject><subject>Rehabilitation</subject><subject>Reliability analysis</subject><subject>Reproducibility</subject><subject>Research and Analysis Methods</subject><subject>Robotics</subject><subject>Robotics - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stoller, Oliver</au><au>Schindelholz, Matthias</au><au>Hunt, Kenneth J</au><au>Buiu, Catalin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Robot-Assisted End-Effector-Based Stair Climbing for Cardiopulmonary Exercise Testing: Feasibility, Reliability, and Repeatability</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2016-02-05</date><risdate>2016</risdate><volume>11</volume><issue>2</issue><spage>e0148932</spage><epage>e0148932</epage><pages>e0148932-e0148932</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Neurological impairments can limit the implementation of conventional cardiopulmonary exercise testing (CPET) and cardiovascular training strategies. A promising approach to provoke cardiovascular stress while facilitating task-specific exercise in people with disabilities is feedback-controlled robot-assisted end-effector-based stair climbing (RASC). The aim of this study was to evaluate the feasibility, reliability, and repeatability of augmented RASC-based CPET in able-bodied subjects, with a view towards future research and applications in neurologically impaired populations.
Twenty able-bodied subjects performed a familiarisation session and 2 consecutive incremental CPETs using augmented RASC. Outcome measures focussed on standard cardiopulmonary performance parameters and on accuracy of work rate tracking (RMSEP-root mean square error). Criteria for feasibility were cardiopulmonary responsiveness and technical implementation. Relative and absolute test-retest reliability were assessed by intraclass correlation coefficients (ICC), standard error of the measurement (SEM), and minimal detectable change (MDC). Mean differences, limits of agreement, and coefficients of variation (CoV) were estimated to assess repeatability.
All criteria for feasibility were achieved. Mean V'O2peak was 106±9% of predicted V'O2max and mean HRpeak was 99±3% of predicted HRmax. 95% of the subjects achieved at least 1 criterion for V'O2max, and the detection of the sub-maximal ventilatory thresholds was successful (ventilatory anaerobic threshold 100%, respiratory compensation point 90% of the subjects). Excellent reliability was found for peak cardiopulmonary outcome measures (ICC ≥ 0.890, SEM ≤ 0.60%, MDC ≤ 1.67%). Repeatability for the primary outcomes was good (CoV ≤ 0.12).
RASC-based CPET with feedback-guided exercise intensity demonstrated comparable or higher peak cardiopulmonary performance variables relative to predicted values, achieved the criteria for V'O2max, and allowed determination of sub-maximal ventilatory thresholds. The reliability and repeatability were found to be high. There is potential for augmented RASC to be used for exercise testing and prescription in populations with neurological impairments who would benefit from repetitive task-specific training.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26849137</pmid><doi>10.1371/journal.pone.0148932</doi><oa>free_for_read</oa></addata></record> |
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| issn | 1932-6203 1932-6203 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adolescent Adult Biology and Life Sciences Care and treatment Change detection Climbing Coefficient of variation Correlation coefficient Correlation coefficients Criteria Disabilities Disabled persons Error analysis Error detection Exercise intensity Exercise Test - instrumentation Exercise Test - methods Exercise therapy Feasibility studies Feedback Female Fitness equipment Health care Heart rate Humans Information technology Male Mechanical engineering Medicine and Health Sciences Methods Middle Aged People with disabilities Physical fitness Physical Sciences Populations Preventive medicine Rehabilitation Reliability analysis Reproducibility Research and Analysis Methods Robotics Robotics - instrumentation Robotics - methods Robots Standard error Student athletes Thresholds Training Walking |
| title | Robot-Assisted End-Effector-Based Stair Climbing for Cardiopulmonary Exercise Testing: Feasibility, Reliability, and Repeatability |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-25T00%3A50%3A11IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Robot-Assisted%20End-Effector-Based%20Stair%20Climbing%20for%20Cardiopulmonary%20Exercise%20Testing:%20Feasibility,%20Reliability,%20and%20Repeatability&rft.jtitle=PloS%20one&rft.au=Stoller,%20Oliver&rft.date=2016-02-05&rft.volume=11&rft.issue=2&rft.spage=e0148932&rft.epage=e0148932&rft.pages=e0148932-e0148932&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0148932&rft_dat=%3Cgale_plos_%3EA442496955%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1762831752&rft_id=info:pmid/26849137&rft_galeid=A442496955&rft_doaj_id=oai_doaj_org_article_7cbcc6cc88364e74b2ac838171b8b224&rfr_iscdi=true |