Does Exercise Testing with Arm Crank Ergometer Substitute for Cycle Ergometer to Evaluate Exercise Capacity?

Abstract

Using the upper limbs to test cardiopulmonary exercise can be a useful option in the case of individuals who are unable to pedal a bicycle due to lower limb injury or disability. We evaluated whether exercise testing with the upper limbs can be used equivalently to that of the lower limbs in assessing exercise capacity. Nine collegiate rowers and eight collegiate cyclists underwent incremental exercise testing with an arm crank ergometer (ACE) and cycle ergometer (CE). Heart rate (HR) and oxygen uptake (VO2) were monitored throughout the tests. Segmental muscle mass and flow-mediated dilation of brachial artery were measured to assess the training status of the upper limbs. The muscle mass of the brachium, upper limb, and trunk were greater in the rowers than in the cyclists (p < 0.05). The correlations between HR and VO2 was significantly different depending on exercise modalities, ACE and CE, in both groups (p < 0.001). The estimated maximal VO2 using the correlation formula and age-predicted maximal HR was significantly lower in the exercise testing group with ACE than in the group with CE in rowers and cyclists (41.7 ± 7.3 vs. 52.6 ± 8.6 mL/kg/min, p = 0.010 and 35.5 ± 14.2 vs. 50.4 ± 13.4 mL/kg/min, p = 0.011, respectively). The results suggested that exercise capacity assessed by exercise testing with ACE is underestimated, regardless of the training status of the upper limbs. Further research is needed to verify factors which affect the correlations between HR and VO2 during upper- and lower-limb exercise.