The CPX room was air‐conditioned and kept at a constant temperature of 19°C for all tests, and the hygrometry was not controlled in current practice. The measuring instruments were recalibrated every half day with a reading of the atmospheric pressure. Patients were advised to avoid strenuous exercise and the consumption of alcohol, tobacco or caffeine for 24 hours prior to examination. CPX was performed on an electromagnetic ergometer (Ergoselect 200, Ergoline, Bitz, Germany) using a standardized, incremental protocol.16 Following a three‐minute warm‐up, incremental ramp exercise (5 to 15 W/minute) was maintained until exhaustion. Markers used to consider the CPX as maximal were determined accorded to current guidelines.16 A face mask (Hans Rudolph, Inc., Kansas City, MO), pneumotach and gas analyzer (Ergocard, Medisoft, Louvain, Belgium) were used to measure breath‐by‐breath oxygen uptake (V˙O2) and carbon dioxide production (V˙CO2). Heart rate (HR) was continuously monitored with a 12‐lead electrocardiogram (Ergocard, Medisoft, Louvain, Belgium).
Ergocard
Manufactured by Medisoft
Sourced in Belgium
The Ergocard is a piece of lab equipment designed for cardiopulmonary exercise testing. It is used to measure and analyze various physiological parameters during exercise, such as heart rate, oxygen consumption, and carbon dioxide production.
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Lab products found in correlation
18 protocols using ergocard
1
Standardized Incremental Cardiopulmonary Exercise Testing
2
Standardized CPET Protocol with Customized Increments
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CPET was performed on an electromagnetic ergometer (Ergoselect 200, Ergoline, Bitz, Germany) using a standardised, incremental protocol (7 (link)). Following a three-minute warm-up, load was increased by a constant amount each minute until exhaustion. The selected increment was individualized between 5 to 15 watts/min according to the predicted maximal capacity and estimated physical level during the consultation preceding the CPET). Heart rate (HR) was continuously monitored with a 12-lead electrocardiogram (Ergocard, Medisoft, Louvain Belgium). A face mask (Hans Rudolph, Inc., Kansas City, MO, USA), pneumotach and gas analyser (Ergocard, Medisoft, Louvain, Belgium) were used to measure breath-by-breath oxygen consumption (V˙ O2) and carbon dioxide production (V˙ CO2). Peak oxygen consumption (V˙ O2peak) was the highest V˙ O2 value during an average of three to five breath during the exercise ramp. The predicted maximal work rate (Wmax) and V˙ O2max was derived from the equations reported by Wasserman et al. (13 ). Ventilatory threshold (VT) was manually determined as the average of the results obtained using the first break in VE, V-slope and ventilatory equivalents methods (7 (link)).
3
Incremental CPET on Ergometer
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CPET was performed on an electromagnetic braked ergometer (Ergoselect 200; Ergoline, Bitz, Germany). Following a 3 minutes warm-up period, incremental ramp exercise (5–20 W/min) was applied up to exhaustion. A pneumotachograph and a gas analyzer (Ergocard; Medisoft, Louvain, Belgium) were used to measure gases (oxygen consumption [VO2] and carbon dioxide production [VCO2] breath by breath) through a face mask (Hans Rudolph, Inc., Kansas City, MO, USA). The last ramp maintained before exhaustion or the workload achieved at VO2peak was considered as Wpeak.
4
Exergame Physiological Monitoring Protocol
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Participants in both groups wore a heart rate monitor to record their heart rate (beat/min) via a telemetry monitor (HxM BT Heart Rate Monitor, Zephyr Performance Systems; Erg Sorinnes, Belgium). They were asked to breathe through a mask that recorded their VO2 (L/min) via indirect calorimetry using a calibrated metabolic cart (Ergocard; Medisoft, Annapolis, MD, USA). Prior to each exergame session, the metabolic cart was calibrated with room air and standard gases of known volume and concentration for the oxygen and carbon dioxide analyzers. In addition, cadence (revolutions per minute) was continuously recorded every second by Vescape software.
5
Incremental CPET Protocol Methodology
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CPET was performed according to an incremental protocol on a cycle ergometer (Ergometrics 800; ergoline, Bitz, Germany), with blood pressure and electrocardiographic monitoring (Medcard; Medisoft®, Dinant, Belgium), according to the usual guidelines.22 (link),23 (link) The protocol included a 3-minute rest period, a 3-minute unloaded pedaling period, an incremental ramp exercise (10–15 W/min) pursued to a symptom-limited end point, and a 3-minute recovery time. Inspired and expired gases were collected by a mouthpiece connected to a gas analyzer (Ergocard, Medisoft®). Maximal oxygen consumption (VO2 max) and oxygen consumption at the ventilatory threshold (VT) were expressed in mL/min/kg. VT was defined by a nonlinear increase in ventilation (VE) during exercise and was determined by the level of effort at which carbon dioxide production (VCO2) increased more rapidly than VO2,24 (link) or by an increase in the respiratory equivalent for oxygen (VE/VO2) with no increase in the respiratory equivalent for carbon dioxide (VE/VCO2).25 (link) All CPET were limited by dyspnea, fatigue, or both and provided at least one objective criterion of maximum among the following: breathing reserve <15%, peak heart rate >90% of predicted, peak lactate >7 mEq/L, peak exercise partial pressure of oxygen (PaO2) in arterial blood <55 mmHg, or peak VE/VO2 >35.22 (link)
6
Maximal Incremental Exercise Test
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On day one, patients performed a maximal incremental test on an electromagnetically braked ergometer (Livestrong, LS 5.0 R model, Austin, TX, USA). The test started at 10 W for two minutes, with 10 W increase every minute until voluntary exhaustion or until the patients were unable to maintain 60 revolutions per minute of cadence [18 (link)]. Oxygen consumption (VO2) and carbon dioxide production (VCO2) were assessed using a breath-by-breath gas analyzer (Ergocard, Medisoft, Belgium). POmax and VO2peak were obtained as described in previous study [32 (link)].
7
Graded Exercise and Strength Testing
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Graded Exercise Test (GXT): The GXT was conducted to determine peak oxygen uptake (VO2peak) and peak power output (PPO). Each participant was tested on their bicycle attached to a Wahoo Kickr ergometer in the laboratory (Wahoo Fitness, model: WF113, Vietnam). VO2peak was measured with a gas analyzer (Ergocard, Medisoft, Sorinnes, Belgium), and heart rate was measured with a heart rate monitor (Polar FT1, Helsinki, Finland). Participants completed an incremental protocol in which intensity was increased by 25 W every 2 min, starting at 100 W until exhaustion and using a freely chosen cadence [24 (link)]. The PPO (W) was calculated as PPO = W completed + 25 (t/120), where W is the last completed workload, and t is the number of seconds in the last workload [25 (link)].
Strength test: The mean propulsive velocity (MPV) was measured with a validated encoder (linear encoder, Chronojump Boscosystem, Barcelona, Spain) to determine individual force workloads during the intervention. Participants performed a half squat, with the test terminated when a load of 0.6 m·s−1 was reached, 80% of one-repetition maximum (RM) [26 (link)].
Strength test: The mean propulsive velocity (MPV) was measured with a validated encoder (linear encoder, Chronojump Boscosystem, Barcelona, Spain) to determine individual force workloads during the intervention. Participants performed a half squat, with the test terminated when a load of 0.6 m·s−1 was reached, 80% of one-repetition maximum (RM) [26 (link)].
8
Incremental CPET Protocol on Cycle Ergometer
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CPET was performed according to an incremental protocol on a cycle ergometer (Ergometrics 800), with blood pressure and electrocardiographic monitoring (Medcard®; Medisoft, Dinant, Belgium), according to the usual guidelines.25 (link) The protocol included a 3-minute rest period, a 3-minute unloaded pedaling period, an incremental ramp exercise (10–15 W/min) pursued to a symptom-limited end point, and a 3-minute recovery time. Inspired and expired gases were collected by a mouthpiece connected to a gas analyzer. Gas exchange was measured breath-by-breath by a computerized system (Ergocard, Medisoft). The exercise was stopped when the subjects, in spite of verbal encouragement, were unable to maintain the imposed pedaling rhythm of 55–60 revolutions per minute. All CPET were limited by dyspnea, fatigue, or both. The oxygen saturation (SpO2) was measured using a portable oximeter (Nonin Oxymontre 3100; Nonin, Plymouth, MN, USA).
9
Incremental Treadmill VO2max Test
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The VO2max was determined by a breath-by-breath pulmonary gas exchange system (Ergocard, Medisoft, Belgium) during an incremental treadmill test. The starting speed was 3 km−1/h−1, with speed increments of 1 km−1/h−1 every 60 s. Prior to the tests, the gas analyser was calibrated using gases of known concentrations (VO2 = 16.0% and VCO2 = 4.0%), and the airflow was calibrated using a 3-liter syringe (Hans Rudolph, Kansas, MO, United States).
10
Maximal Exercise Test for VO2max
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All participants performed a maximal graded exercise test (GXT) on an electrically braked cycloergometer (Ergoselect 200P, Ergolyne, Bitz, Germany) to determine VO2max according to the international standards (American Thoracic Society/American College of Chest Physicians, 2003 (link)). During the exercise test, VO2 was measured and calculated by a breath-by-breath analysis (Ergocard®, MediSoft, Sorinnes, Belgium) as previously described (Gouzi et al., 2013 (link)).
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