Validity of the Ekblom-Bak Cycle Ergometer Test in Patients with Cardiovascular Disease.
Magnus Fransplass Storli, Marius Steiro Fimland, Harald Kåre Engan and 1 others
PMID 39136289WHAT IT FOUND
The Ekblom-Bak cycle test overestimated peak oxygen uptake by 4.3 mL/kg/min in patients with cardiovascular disease, making it inaccurate for assessing fitness.
It was less accurate in those taking beta-blockers. Cardiopulmonary exercise testing remains the standard.
Key findings
01The Ekblom-Bak test overestimated V̇O2 peak by a mean bias of 4.3 mL/kg/min compared to the gold-standard CPET.
02Accuracy was worse in patients taking beta-blockers, with an overestimation bias of 6.2 mL/kg/min versus 3.1 mL/kg/min in those not taking them.
03The test is not recommended for assessing cardiorespiratory fitness in this population due to the wide limits of agreement and systematic overestimation.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The sample size was small (26 patients), which reduces the precision of the estimates. The study used an electronically braked cycle ergometer, whereas the test was originally validated on a mechanically braked one, which may have introduced minor errors. Most participants were male, so the results may not apply equally to women. Three patients were too exhausted to complete the Ekblom-Bak test, meaning the results do not reflect the test's performance in the most severely impaired patients.
Declared interests
The authors declared no conflicts of interest. The study was internally funded by NTNU and Unicare Røros.
The easy way to misread this
Do not interpret the strong correlation between the tests as evidence that the Ekblom-Bak test is accurate. A strong correlation only means the two tests move together; it does not mean they give the same score. The Ekblom-Bak test consistently gave higher values than the actual fitness level, so using it to set exercise targets would likely result in prescribing too much intensity.