Development of a Cardiopulmonary Exercise Test Protocol Using Aquatic Treadmill in Healthy Adults: A Pilot Study

Traditional cardiopulmonary exercise test (CPET) protocols are difficult to apply to patients who have difficulty walking on a treadmill. Therefore, this study aimed to develop an aquatic treadmill (AT) CPET protocol involving constant increments in exercise load (metabolic equivalents (METs)) at regular intervals. Fourteen healthy male participants were enrolled in this study. The depth of the water pool was set to the umbilicus level of each participant, and the water temperature was maintained at 28-29 degrees C. The testing protocol comprised a total of 12 stages at different speeds. The starting speed was 0.7 km/h, which was increased by 0.6 or 0.7 km/h every 2 min. Heart rate, blood pressure, oxygen uptake, minute ventilation, respiratory exchange ratio, and rate of perceived exertion were recorded at each stage. All values showed a significant increasing trend with stage progression (p < 0.001). Peak oxygen uptake and heart rate values were 29.76 +/- 3.75 and 168.36 +/- 13.12, respectively. We developed a new AT CPET protocol that brings about constant increments in METs at regular intervals. This new AT CPET protocol could be a promising alternative to traditional CPET protocols for patients who experience difficulty walking on a treadmill.