OBJECTIVE: To assess which exercise testing protocol is most sensitive for assessing peak oxygen uptake (VO2peak) changes as a result of cardiac rehabilitation. DESIGN: Prospective randomized clinical trial. SETTING: Outpatient cardiac rehabilitation center. PARTICIPANTS: Forty-two cardiac patients (33 men; mean age 65.4 +/- 8.4y). INTERVENTION: All patients were included into a 7-week cardiac rehabilitation program and randomized in 2 subgroups. One group of patients was evaluated by a 1-minute stage (n = 21) and another group by a 3-minute stage (n = 21) exercise testing protocol. MAIN OUTCOME MEASURES: In both groups, maximal cardiopulmonary exercise tests on a bicycle with analysis of VO2peak, expiratory volume (Ve), respiratory exchange ratio, heart rate, cycling resistance (W), and test duration were performed at the start and end of the program. RESULTS: Subgroups were closely matched, and no changes in beta-blocker treatment occurred during this study. As result of the rehabilitation program, total test duration and Wpeak improved significantly in both groups (p < 0.05). Nonetheless, VO2peak and Vepeak increased significantly in the 1-minute stage duration group (p < 0.05) but not in the 3-minute stage duration group (p > 0.05). In addition, the change of VO2peak, Vepeak, and total test duration was significantly greater in the 1-minute stage duration group compared with the 3-minute stage duration group (p < 0.05). CONCLUSIONS: For detecting changes of VO2peak as result of cardiac rehabilitation, a 1-minute stage exercise testing protocol is more sensitive when compared with a 3-minute stage exercise testing protocol.

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