An interventional study of Cardiopulmonary Exercise Test and Incremental Step Test in Cardiorespiratory Fitness, Metabolic Health and Cardiac Function, sponsored by Heriot-Watt University. Enrolling by invitation at 1 site in United Kingdom. Open to participants aged 18 Years to 55 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-09-18.
Sponsored by Heriot-Watt University · Not applicable, Interventional, and Diagnostic
The purpose of this single-group diagnostic validation and test-retest reliability study is to determine whether a novel Incremental Step Test (IST) can accurately assess cardiorespiratory fitness and ventilatory thresholds in healthy adults compared with an established laboratory-based cycle ergometer Cardiopulmonary Exercise Test (CPET). The main questions are whether the step test can elicit reliable physiological responses sufficient to identify the anaerobic threshold and respiratory compensation point, and whether it produces reproducible results when repeated under standardised conditions. The study will compare the incremental step test (IST) with CPET to assess whether the IST provides similar peak and submaximal physiological measures and agreement with CPET comparator. Participants will complete three laboratory exercise tests across separate visits: one maximal CPET on a cycle ergometer, followed by two repeated ISTs performed on a 25 cm step board following the audio metronome.
Participants will attend three laboratory visits separated by at least 3 days and conducted at similar times of the day. The first visit will include screening, anthropometric assessment, and a maximal CPET on an electronically braked cycle ergometer using a ramp protocol of 25 W/min for males and 20 W/min for females. Participants will complete 3 minutes of unloaded cycling followed by incremental protocol while maintaining the cadence at least 60 rpm, and the test will be terminated if they can no longer can sustain this cadence. Following CPET, participants will complete a 6-minute familiarisation session to practise the stepping activity, including the up-up-down-down stepping technique and alternation of the leading leg every 2 minutes. The second and third visits will involve repeated IST trials performed on 25 cm step board, with cadence progressed from 20 beats per minute and increased by 4 beats per minute every 20 seconds until volitional exhaustion. The IST will be terminated if the participant is unable to maintain the prescribed stepping rhythm for more than 15 seconds. Continuous breath-by-breath gas exchange, ECG, and heart rate monitoring will be used during testing to characterise peak performance and ventilatory threshold responses. Agreement between the step test and CPET, as well as test-retest reproducibility of the IST, will be evaluated to determine whether the new protocol could support more individualised exercise prescription in stepping-based activities.
Heriot-Watt University is the lead sponsor of 5 studies on the registry; 3 are open to participants now.
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Exclusion Criteria:
Inability to complete study procedures or attend all required study visits.
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Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.
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A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
BMI (body mass index)
Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.
What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Contraindication
A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Participants will complete one laboratory-based Cardiopulmonary Exercise Test followed by two Incremental Step Test sessions conducted on separate visits. The first visit will include screening, anthropometric measurements, and a maximal incremental CPET on an electronically braked cycle ergometer using an individualised ramp protocol set at 25 W/min for males and 20 W/min for females, after 3 minutes of unloaded cycling. The second and third visits will involve two repeated incremental step tests on a standardised 25 cm step, with cadence starting at 20 beats per minute and increasing by 4 beats per minute every 20 seconds until volitional exhaustion. The CPET will be terminated if participants could not maintain a cadence of at least 60 rpm, and the step test will be terminated if participants could not maintain the prescribed stepping rhythm for 15 consecutive seconds. Exercise ECG, continuous heart rate, and breath-by-breath gas exchange will be recorded during all exercise tests.
Diagnostic Test: Cardiopulmonary Exercise Test · Diagnostic Test: Incremental Step Test
A maximal incremental exercise test performed on a cycle ergometer with continuous breath-by-breath gas exchange and heart rate monitoring to assess cardiorespiratory fitness and physiological response
A progressive step test using a standardised 25 cm step platform. Participants will complete a 3-minute warm-up at 20 beats per minute before cadence increases by 4 beats per minute every 20 seconds until volitional exhaustion or predefined termination criteria are reached.
Between-method agreement in oxygen uptake at Anaerobic Threshold (AT)
Agreement between the Incremental Step Test and the established laboratory-based cycle ergometer Cardiopulmonary Exercise Test comparator for oxygen uptake at Anaerobic Threshold (mL/min), will be assessed using intraclass correlation coefficients and Bland-Altman analysis.
Time frame: Baseline (Day 1-CPET) and IST assessments at Visits 2 and 3, scheduled at 3-7-day intervals.
Between-method agreement in oxygen uptake at Respiratory Compensation Point (RCP)
Agreement between the Incremental Step Test and the established laboratory-based cycle ergometer Cardiopulmonary Exercise Test comparator for oxygen uptake at Respiratory Compensation point / Ventilatory Threshold 2 (mL/min), will be assessed using intraclass correlation coefficients and Bland-Altman analysis.
Time frame: Baseline (Day 1-CPET) and IST assessments at Visits 2 and 3, scheduled at 3-7-day intervals.
Between-method agreement in Peak Oxygen Uptake (VO2peak)
Peak oxygen uptake will be defined as the highest 30-second rolling average value recorded prior to test termination.
Time frame: Baseline (Day 1-CPET) and IST assessments at Visits 2 and 3, scheduled at 3-7-day intervals.
Test-retest reliability of oxygen uptake at Anaerobic Threshold (AT)
Test-retest reliability of oxygen uptake at AT (mL/min) derived from the Incremental Step Test (IST) between the first and second IST visits.
Time frame: (Day 3-IST Visit 2) and IST Visit 3, scheduled 3-7 days apart.
Test-retest reliability of oxygen uptake at Respiratory compensation point (RCP)
Test-retest reliability of oxygen uptake at RCP (mL/min) derived from the Incremental Step Test (IST) between the first and second IST visits.
Time frame: (Day 3-IST Visit 2) and IST Visit 3, scheduled 3-7 days apart.
Plan to share: No — No individual participant data will be shared publicly. The study will report findings using aggregated and de-identified data. Individual participant data will be retained securely by the research team in accordance with Heriot-Watt University research governance and data protection requirements.
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