Investigation of cardiopulmonary exercise testing using a dynamic leg press and comparison with a cycle ergometer.

Background: Leg-press machines are widely employed for musculoskeletal conditioning of the lower-limbs and they provide cardiovascular benefits for resistance training in cardiac patients. The aim of this study was to assess the feasibility of a dynamic leg press (DLP) for incremental cardiopulmonary exercise testing (CPET) and to compare the results with those obtained using a cycle ergometer (CE).

Methods: Twelve healthy participants aged 27±4 years (mean ± standard deviation) performed incremental cardiopulmonary exercise tests on a DLP and on a CE. To facilitate CPET, the DLP was augmented with force and angle sensors, a work rate estimation algorithm, and a visual feedback system. Gas exchange variables and heart rate were recorded breath-by-breath using a cardiopulmonary monitoring system.

Results: Peak oxygen uptake and peak heart rate were significantly lower for the DLP than for the CE: peak oxygen uptake was 3.2±0.5 vs. 4.1±0.5 L/min (DLP vs. CE, p =6.7×10-6 ); peak heart rate was 174±14 vs. 182±13 bpm (DLP vs. CE, p =0.0016). Likewise, the sub-maximal cardiopulmonary parameters, viz. the first and second ventilatory thresholds, and ramp duration were significantly lower for the DLP.

Conclusions: The dynamic leg press was found to be feasible for CPET: the approach was technically implementable and all peak and sub-maximal cardiopulmonary parameters were able to be identified. The lower outcome values observed with the DLP can be attributed to a peripheral factor, namely the earlier onset of muscular fatigue.