What is the most commonly used protocol for maximal stress testing?

What is the most commonly used protocol for maximal stress testing?

The most common protocol used during treadmill exercise stress testing is the Bruce protocol. This protocol is divided into successive 3-minute stages, each of which requires the patient to walk faster and at a steeper grade.

What is a maximal stress test?

By definition: Maximal stress testing involves increasing the intensity level until you can no longer keep up, either because you are winded or the ECG indicates there is a cardiac problem. A maximal stress test also requires the heart rate to reach at least 85% of the maximum predicted heart rate.

What is the Bruce protocol for stress test?

The Bruce protocol is a standard test in cardiology and is comprised of multiple exercise stages of three minutes each. At each stage, the gradient and speed of the treadmill are elevated to increase work output, called METS. Stage 1 of the Bruce protocol is performed at 1.7 miles per hour and a 10% gradient.

What are the 7 stages of the Bruce protocol?


  • Level 1 – 10% Incline at 2.7 km/h.
  • Level 2 – 12% Incline at 4.02 km/h.
  • Level 3 – 14% Incline at 5.47 km/h.
  • Level 4 – 16% Incline at 6.76 km/h.
  • Level 5 – 18% Incline at 8.05 km/h.
  • Level 6 – 20% Incline at 8.85 km/h.
  • Level 7 – 22% Incline at 9.65 km/h.
  • Level 8 – 24% Incline at 10.46 km/h.

What is the standard Bruce protocol?

In the standard Bruce protocol, the starting point (ie, stage 1) is 1.7 mph at a 10% grade (5 METs). Stage 2 is 2.5 mph at a 12% grade (7 METs). Stage 3 is 3.4 mph at a 14% grade (9 METs). This protocol includes 3-minute periods to allow achievement of a steady state before workload is increased.

When is modified Bruce protocol used?

The Modified Bruce protocol starts at a lower workload than the Standard Bruce, and is typically used for patients who are deconditioned and/or post MI, whose history suggests symptoms at a low workload, and for elderly or sedentary patients who may not be able to keep pace with the faster Standard Bruce protocol.

How many Mets is good on a stress test?

Exercise capacity is based on metabolic equivalents (MET) achieved, (one MET is defined as 3.5 mL O2 uptake/kg per min, which is the resting oxygen uptake in a sitting position). Less than 5 METS is poor, 5–8 METS is fair, 9–11 METS is good, and 12 METS or more is excellent.

How many levels of stress test are there?

In the most widely used test, called the Bruce protocol, there are seven stages, each one lasting for three minutes. If you get to the last stage, you’ll be walking at 5.5 mph up a 20% grade.

What is Stage 3 Bruce protocol?

Stage 3 is 3.4 mph at a 14% grade (9 METs). This protocol includes 3-minute periods to allow achievement of a steady state before workload is increased. The modified Bruce protocol has 2 warmup stages, each lasting 3 minutes. The first is at 1.7 mph and a 0% grade, and the second is at 1.7 mph and a 5% grade.

Is Bruce protocol maximal?

Measuring VO2 Max With the Bruce Protocol The Bruce treadmill test is an indirect maximal oxygen uptake test. It is considered indirect because it estimates VO2 max using a formula and the person’s performance on a treadmill as the workload is increased.

What is the difference between Bruce protocol and modified Bruce protocol?

Conclusions: Modified Bruce protocol has a lighter initial increment, but decreases moderately the capacity of peak exercise due to peripheral fatigue secondary to the first stage of low intensity. Bruce protocol has a higher initial increment but permits to attain higher peak exercise intensities.

What are guidelines for stress test?

– I. Introduction. – II. Exercise Testing in Diagnosis of Obstructive Coronary Artery Disease. – III. Risk Assessment and Prognosis in Patients With Symptoms or a Prior History of Coronary Artery Disease. – IV. After Myocardial Infarction. – V. Exercise Testing Using Ventilatory Gas Analysis. – VI. – VII.

How to pass the Bruce Protocol stress test?

How To Pass The Bruce Protocol Stress Test? Bruce’s standard protocol starts with a slow walking pace, but with the treadmill at an incline of 10%. Every 3 minutes, the treadmill speed increases as well.

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  • What is modified Bruce Protocol stress test?

    – Medication Stop beta and calcium channel blockers 24 to 48 hours prior to exercise – Why? – Test protocols Bruce protocol increases the speed and angle of the treadmill every 3 minutes Remember the formula (220 – pt age) x 0.85 = Maximum heart rate (85%) achieve – At what point should the radiopharmaceutical be injected?