{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T14:55:16Z","timestamp":1773932116596,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":77,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001779","name":"Monash University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001779","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Canadian Respiratory Journal"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Alfred Step Test Exercise Protocol (A\u2010STEP) and feasibility study were previously published. The aim here was to determine the validity of the A\u2010STEP compared to cycle ergometry (CPET) in adults with CF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The A\u2010STEP and CPET were carried out in random order 2\u2009weeks apart. A wearable, portable metabolic system was used to measure breath\u2010by\u2010breath and minute\u2010by\u2010minute sampling of O\n                      <jats:sub>2<\/jats:sub>\n                      , CO\n                      <jats:sub>2<\/jats:sub>\n                      , heart rate, and VO\n                      <jats:sub>2<\/jats:sub>\n                      . The main outcome measures were VO\n                      <jats:sub>2max<\/jats:sub>\n                      and HRmax.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seven stable\u2010state adults (3 male) on CFTR modulator therapy with a mean (SD) and range of age 38.2 (13.4) 26\u201364\u2009years; height 169.9 (10.9) 149.7\u2013185.3\u2009cm; BMI 22.8 (2.10) 19.5\u201328\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ; FEV1 79.4 (18.9) 38.0\u2013106.0; and FVC 95.1 (16.7) 63.0\u2013114.0 percent predicted (pp) completed both A\u2010STEP and CPET. The VO\n                      <jats:sub>2Max<\/jats:sub>\n                      had high correlation and good agreement between the A\u2010STEP 31.3 (5.9) and CPET 29.8 (6.2) mL\/min\/kg,\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.88. The HR\n                      <jats:sub>MAX<\/jats:sub>\n                      was strongly correlated with the A\u2010STEP 174 (17) bpm and 95.7 (7.4) pp versus 168 (15) bpm and 92.4 (5.3) pp with\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.92 and 0.86, respectively. The SpO\n                      <jats:sub>2Nadir<\/jats:sub>\n                      for A\u2010STEP was 91.0 (4.0) and CPET 92.0 (3.3),\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.82. The VO\n                      <jats:sub>2<\/jats:sub>\n                      at the anaerobic threshold (VO\n                      <jats:sub>2@AT<\/jats:sub>\n                      ) occurred significantly earlier for the CPET at 1021 (260) versus A\u2010STEP 1361 (234) mL\/minute,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05. The VE\n                      <jats:sub>Max<\/jats:sub>\n                      for CPET was 84.1 (18.8) and A\u2010STEP 73.5 (15.8) L\/minute,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05. The AWESCORE also ensured baseline stability. The number of levels completed during the A\u2010STEP was 10.7 (12.9) ranging from 9 to 15.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The A\u2010STEP may be a portable, valid surrogate to cardiopulmonary exercise testing using cycle ergometry.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/carj\/9062245","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T12:27:19Z","timestamp":1773923239000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validity of Alfred Step Test Exercise Protocol (A\u2010STEP) as a Surrogate VO\n                    <sub>2Max<\/sub>\n                    Cardiopulmonary Exercise Test (CPET) to Cycle Ergometry in Adults With Cystic Fibrosis"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3044-8872","authenticated-orcid":false,"given":"Brenda","family":"Button","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahesh","family":"Dharmakumara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nic","family":"Parry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faizel","family":"Hartley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brigitte","family":"Borg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominic","family":"T. Keating","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2019.01382"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1159\/000439057"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.01016"},{"key":"e_1_2_11_4_2","doi-asserted-by":"crossref","first-page":"2240","DOI":"10.1002\/ppul.26452","article-title":"Vallidation of the 25 Level Modified Shuttle Test in Children With Cystic Fibrosis","volume":"58","author":"Corda J.","year":"2023","journal-title":"Pediatric Pulmonology"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0029-2023"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0142-2024"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/(sici)1099-0496(199804)25:4<278::aid-ppul8>3.0.co;2-g"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/1099-0496(200007)30:1<56::aid-ppul9>3.0.co;2-r"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.25667"},{"key":"e_1_2_11_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.26069"},{"key":"e_1_2_11_11_2","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00120-2021"},{"key":"e_1_2_11_12_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.167.2.211"},{"key":"e_1_2_11_13_2","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1983.55.5.1558"},{"key":"e_1_2_11_14_2","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0101-2018"},{"key":"e_1_2_11_15_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.97.10112662"},{"key":"e_1_2_11_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.prrv.2015.09.009"},{"key":"e_1_2_11_17_2","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.00292023"},{"key":"e_1_2_11_18_2","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1097\/CPT.0000000000000016","article-title":"Exercise and Habitual Physical Activity for People With Cystic Fibrosis: Expert Consensus, Evidence-Based Guide for Advising Patients","volume":"26","author":"Swisher H.","year":"2015","journal-title":"Cardiopulmonary Physical Therapy Journal"},{"key":"e_1_2_11_19_2","article-title":"A Guideline for Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research","volume":"9","author":"Koo T. 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Validity of A-STEP as a Surrogate VO2Max Using CPET Cycle Ergometry in Adults With Cystic Fibrosis https:\/\/authorea.com\/users\/936080\/articles\/1306456-validity-of-a-step-as-a-surrogate-vo2max-using-cpet-cycleergometry-in-adults-with-cystic-fibrosis."}],"container-title":["Canadian Respiratory Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/carj\/9062245","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/carj\/9062245","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/carj\/9062245","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T12:27:21Z","timestamp":1773923241000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/carj\/9062245"}},"subtitle":[],"editor":[{"given":"Youfeng","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/carj\/9062245"],"URL":"https:\/\/doi.org\/10.1155\/carj\/9062245","archive":["Portico"],"relation":{},"ISSN":["1198-2241","1916-7245"],"issn-type":[{"value":"1198-2241","type":"print"},{"value":"1916-7245","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-08-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"9062245"}}