The Steep Ramp Test in Healthy Children and Adolescents: Reliability and Validity

BONGERS, B. C., S. I. DE VRIES, P. J. M. HELDERS, and T. TAKKEN. The Steep Ramp Test in Healthy Children and Adolescents: Reliability and Validity. Med. Sci. Sports Exerc., Vol. 45, No. 2, pp. 366-371, 2013. Purpose: This study aimed to examine the reliability and validity of the steep ramp test (SRT), a feasible, maximal exercise test on a cycle ergometer that does not require the use of respiratory gas analysis, in healthy children and adolescents. Methods: Seventy-five children were randomly divided in a reliability group (n = 37, 17 boys and 20 girls; mean +/- SD age = 13.86 +/- 3.22 yr), which performed two SRTs within 2 wk, and a validity group (n = 38, 17 boys and 21 girls; mean +/- SD age = 13.85 +/- 3.20 yr), which performed both an SRT and a regular cardiopulmonary exercise test (CPET) with respiratory gas analysis within 2 wk. Peak work rate (WRpeak) was the main outcome of the SRT. Peak oxygen uptake ((V) over dotO(2peak)) was the main outcome of the CPET. Reliability was examined with the intraclass correlation coefficient and a Bland and Altman plot, whereas validity was assessed using Pearson correlation coefficients and stepwise linear regression analysis. Results: Reliability statistics for the WRpeak values attained at the two SRTs showed an intraclass correlation coefficient of 0.986 (P < 0.001). The average difference between the two SRTs was -6.4 W, with limits of agreement between +24.5 and -37.5 W. A high correlation between WRpeak attained at the SRT and the (V) over dotO(2peak) achieved during the CPET was found (r = 0.958; P < 0.001). Stepwise linear regression analysis provided the following prediction equation: (V) over dotO(2peak) (mL.min(-1)) = (8.262WR(peak) SRT) + 177.096 (R-2 = 0.917, SEE = 237.4). Conclusion: The results suggest that the SRT is a reliable and valid exercise test in healthy children and adolescents, which can be used to predict (V) over dotO(2peak).