{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T01:52:20Z","timestamp":1760233940522,"version":"build-2065373602"},"reference-count":47,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2021,3,10]],"date-time":"2021-03-10T00:00:00Z","timestamp":1615334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>Chester step test (CST) estimates the exercise capacity through a submaximal response, which can limit its application in the prescription of exercise. This study aimed to assess whether an adaptation of the CST (with a progressive profile) can have maximal response characteristics in young women and compare it to the incremental shuttle walk test (ISWT). Another aim was to determine its within-day test\u2013retest reliability. A cross-sectional study was conducted with 25 women (20.3 \u00b1 1.5 years) who performed the field tests twice on two different days (48 h apart). The maximal effort attainment was assessed by the heart rate (HR), perception of exertion (Borg scale), and blood lactate concentration. For the performance variables, Pearson\u2019s correlation and intraclass correlation coefficient (ICC2,1) were used. In the best test, mean values of maximal response were observed in the adapted CST (94.0 \u00b1 6.5% of age-predicted HRmax, 11.3 \u00b1 4.5 mmol\/dl of blood lactate, and 18.4 \u00b1 1.5 of Borg rating). The correlations between the adapted CST and the ISWT were weak to moderate (0.38 \u2264 r \u2264 0.55; p &lt; 0.05). Fair to good reliability was found for the adapted CST (ICC2,1 = 0.48\u20130.61). The adapted CST showed mean values of maximal response, weak to moderate association with the ISWT, and low within-day test\u2013retest reliability in young women.<\/jats:p>","DOI":"10.3390\/healthcare9030308","type":"journal-article","created":{"date-parts":[[2021,3,10]],"date-time":"2021-03-10T13:27:20Z","timestamp":1615382840000},"page":"308","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Adapted Chester Step Test Can Have Maximal Response Characteristics for the Assessment of Exercise Capacity in Young Women"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4422-8440","authenticated-orcid":false,"given":"Rui","family":"Vilarinho","sequence":"first","affiliation":[{"name":"Center for Rehabilitation Research (CIR), Department of Physiotherapy, Polytechnic Institute of Porto, School of Health, 4200-072 Porto, Portugal"},{"name":"Healthcare Department, Nippon Gases Portugal, 2600-242 Lisbon, Portugal"}]},{"given":"Ana Rita","family":"Mendes","sequence":"additional","affiliation":[{"name":"Private Practice, Polytechnic Institute of Porto, School of Health, 4200-072 Porto, Portugal"}]},{"given":"Mariana","family":"Gomes","sequence":"additional","affiliation":[{"name":"Private Practice, Polytechnic Institute of Porto, School of Health, 4200-072 Porto, Portugal"}]},{"given":"Rui","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Private Practice, Polytechnic Institute of Porto, School of Health, 4200-072 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2664-4093","authenticated-orcid":false,"given":"Fab\u00edola","family":"Costa","sequence":"additional","affiliation":[{"name":"Private Practice, Polytechnic Institute of Porto, School of Health, 4200-072 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6630-7369","authenticated-orcid":false,"given":"Marcela","family":"Machado","sequence":"additional","affiliation":[{"name":"Private Practice, Polytechnic Institute of Porto, School of Health, 4200-072 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9221-1969","authenticated-orcid":false,"given":"M\u00e1rcia","family":"Neves","sequence":"additional","affiliation":[{"name":"Private Practice, Polytechnic Institute of Porto, School of Health, 4200-072 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3735-8554","authenticated-orcid":false,"given":"C\u00e1tia","family":"Caneiras","sequence":"additional","affiliation":[{"name":"Healthcare Department, Nippon Gases Portugal, 2600-242 Lisbon, Portugal"},{"name":"Microbiology Research Laboratory on Environmental Health (EnviHealthMicroLab), Faculty of Medicine, Institute of Environmental Health (ISAMB), University of Lisbon, 1649-028 Lisbon, Portugal"}]},{"given":"Ant\u00f3nio Mesquita","family":"Montes","sequence":"additional","affiliation":[{"name":"Center for Rehabilitation Research (CIR), Department of Physiotherapy, Polytechnic Institute of Porto, School of Health, 4200-072 Porto, Portugal"},{"name":"Department of Physiotherapy, Santa Maria Health School, 4049-024 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1513\/AnnalsATS.201609-733AS","article-title":"Functional Tests in Chronic Obstructive Pulmonary Disease, Part 1: Clinical Relevance and Links to the International Classification of Functioning, Disability, and Health","volume":"14","author":"Bui","year":"2017","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e653","DOI":"10.1161\/CIR.0000000000000461","article-title":"Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association","volume":"134","author":"Ross","year":"2016","journal-title":"Circulation"},{"key":"ref_3","unstructured":"ACSM (2013). American College of Sports Medicine\u2019s Guidelines for Exercise Testing and Prescription, Lippincott Williams & Wilkins."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1007\/s40279-015-0445-1","article-title":"Validity of Submaximal Step Tests to Estimate Maximal Oxygen Uptake in Healthy Adults","volume":"46","author":"Bennett","year":"2016","journal-title":"Sports Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.physio.2004.03.008","article-title":"The Chester step test\u2014A simple yet effective tool for the prediction of aerobic capacity","volume":"90","author":"Sykes","year":"2004","journal-title":"Physiotherapy"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1136\/bjsm.2003.005389","article-title":"Reliability and validity of measures taken during the Chester step test to predict aerobic power and to prescribe aerobic exercise","volume":"38","author":"Buckley","year":"2004","journal-title":"Br. J. Sports Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e13","DOI":"10.1164\/rccm.201309-1634ST","article-title":"An official American Thoracic Society\/European Respiratory Society statement: Key concepts and advances in pulmonary rehabilitation","volume":"188","author":"Spruit","year":"2013","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_8","first-page":"3968393","article-title":"Graded Exercise Testing Protocols for the Determination of VO(2)max: Historical Perspectives, Progress, and Future Considerations","volume":"2016","author":"Beltz","year":"2016","journal-title":"J. Sports Med. (Hindawi Publ. Corp)"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1183\/09031936.00150314","article-title":"An official European Respiratory Society\/American Thoracic Society technical standard: Field walking tests in chronic respiratory disease","volume":"44","author":"Holland","year":"2014","journal-title":"Eur. Respir. J."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Neves, C.D., Lacerda, A.C., Lage, V.K., Lima, L.P., Fonseca, S.F., de Avelar, N.C., Teixeira, M.M., and Mendon\u00e7a, V.A. (2015). Cardiorespiratory responses and prediction of peak oxygen uptake during the shuttle walking test in healthy sedentary adult men. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0117563"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Lima, L.P., Leite, H.R., Matos, M.A., Neves, C.D.C., Lage, V., Silva, G.P.D., Lopes, G.S., Chaves, M.G.A., Santos, J.N.V., and Camargos, A.C.R. (2019). Cardiorespiratory fitness assessment and prediction of peak oxygen consumption by Incremental Shuttle Walking Test in healthy women. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0211327"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Gomes, A.L., Mendon\u00e7a, V.A., Dos Santos Silva, T., Pires, C.K.V., Lima, L.P., Gomes, A.M., Camargos, A.C.R., Neves, C.D.C., Lacerda, A.C.R., and Leite, H.R. (2018). Cardiorespiratory and metabolic responses and reference equation validation to predict peak oxygen uptake for the incremental shuttle waking test in adolescent boys. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0208826"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1161\/CIR.0b013e3181e52e69","article-title":"Clinician\u2019s Guide to Cardiopulmonary Exercise Testing in Adults","volume":"122","author":"Balady","year":"2010","journal-title":"Circulation"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1513\/AnnalsATS.201612-997FR","article-title":"Cardiopulmonary Exercise Testing: Basics of Methodology and Measurements","volume":"14","author":"Mezzani","year":"2017","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"95","DOI":"10.2165\/11319670-000000000-00000","article-title":"Recommendations for improved data processing from expired gas analysis indirect calorimetry","volume":"40","author":"Robergs","year":"2010","journal-title":"Sports Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1183\/09031936.00059814","article-title":"Ageing and the epidemiology of multimorbidity","volume":"44","author":"Divo","year":"2014","journal-title":"Eur. Respir. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1249\/00005768-198205000-00012","article-title":"Psychophysical bases of perceived exertion","volume":"14","author":"Borg","year":"1982","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1093\/occmed\/kqx063","article-title":"The Borg Rating of Perceived Exertion (RPE) scale","volume":"67","author":"Williams","year":"2017","journal-title":"Occup. Med."},{"key":"ref_19","first-page":"307","article-title":"The effects of training on heart rate; a longitudinal study","volume":"35","author":"Karvonen","year":"1957","journal-title":"Ann. Med. Exp. Biol. Fenn."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s00421-009-1107-5","article-title":"Accuracy, reliability, linearity of Accutrend and Lactate Pro versus EBIO plus analyzer","volume":"107","author":"Baldari","year":"2009","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_21","unstructured":"(2021, March 08). Correlation and Regression. Available online: https:\/\/www.bmj.com\/about-bmj\/resources-readers\/publications\/statistics-square-one\/11-correlation-and-regression."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/BF02294183","article-title":"Sample size requirements for estimating pearson, kendall and spearman correlations","volume":"65","author":"Bonett","year":"2000","journal-title":"Psychometrika"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","article-title":"A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research","volume":"15","author":"Koo","year":"2016","journal-title":"J. Chiropr. Med."},{"key":"ref_24","unstructured":"Fleiss, J.L. (1986). The Design and Analysis of Clinical Experiments, Wiley-Interscience."},{"key":"ref_25","first-page":"231","article-title":"Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM","volume":"19","author":"Weir","year":"2005","journal-title":"J. Strength Cond. Res."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Huang, S.-L., Hsieh, C.-L., Lin, J.-H., and Chen, H.-M. (2011). Optimal scoring methods of hand-strength tests in patients with stroke. Int. J. Rehabil. Res., 34.","DOI":"10.1097\/MRR.0b013e328342dd96"},{"key":"ref_27","unstructured":"World Health Organization (2002). Diet, Physical Activity and Health: Report by the Secretariat, World Health Organization."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"142","DOI":"10.3389\/fphys.2012.00142","article-title":"Effects of physical activity and inactivity on muscle fatigue","volume":"3","author":"Bogdanis","year":"2012","journal-title":"Front. Physiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1136\/hrt.2007.121558","article-title":"Cardiopulmonary exercise testing and its application","volume":"83","author":"Albouaini","year":"2007","journal-title":"Postgrad. Med. J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1177\/193229680700100414","article-title":"Blood lactate measurements and analysis during exercise: A guide for clinicians","volume":"1","author":"Goodwin","year":"2007","journal-title":"J. Diabetes Sci. Technol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/S0966-6362(01)00201-6","article-title":"Knee and hip kinetics during normal stair climbing","volume":"16","author":"Costigan","year":"2002","journal-title":"Gait Posture"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Todd, J.J. (2014). Lactate: Valuable for physical performance and maintenance of brain function during exercise. Biosci. Horiz. Int. J. Stud. Res., 7.","DOI":"10.1093\/biohorizons\/hzu001"},{"key":"ref_33","first-page":"1637","article-title":"Effect of Lactate Accumulation during Exercise-induced Muscle Fatigue on the Sensorimotor Cortex","volume":"25","author":"Ishii","year":"2013","journal-title":"J. Phys. Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"179","DOI":"10.2165\/00007256-200939030-00002","article-title":"Physiological Differences Between Cycling and Running","volume":"39","author":"Millet","year":"2009","journal-title":"Sports Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1080\/026404102320761787","article-title":"Criterion-related validity of the Borg ratings of perceived exertion scale in healthy individuals: A meta-analysis","volume":"20","author":"Chen","year":"2002","journal-title":"J. Sports Sci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1378\/chest.13-2071","article-title":"Measurement properties of the incremental shuttle walk test. a systematic review","volume":"145","author":"Parreira","year":"2014","journal-title":"Chest"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1590\/1517-86922014200301714","article-title":"Reprodutibilidade do teste de caminhada e do degrau de 6 minutos em adultos jovens saud\u00e1veis","volume":"20","author":"Davi","year":"2014","journal-title":"Rev. Bras. Med. Esporte"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1097\/JSM.0000000000000190","article-title":"Validity and Reliability of the 6-Minute Step Test in Healthy Individuals: A Cross-sectional Study","volume":"26","author":"Arcuri","year":"2016","journal-title":"Clin. J. Sport Med."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Vilarinho, R., Caneiras, C., and Montes, A.M. (2020). Measurement properties of step tests for exercise capacity in COPD: A systematic review. Clin. Rehabil.","DOI":"10.1177\/0269215520968054"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1378\/chest.108.2.452","article-title":"The relationship of the 6-min walk test to maximal oxygen consumption in transplant candidates with end-stage lung disease","volume":"108","author":"Cahalin","year":"1995","journal-title":"Chest"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1136\/thx.47.10.781","article-title":"Portable liquid oxygen and exercise ability in severe respiratory disability","volume":"47","author":"Leach","year":"1992","journal-title":"Thorax"},{"key":"ref_42","first-page":"1020","article-title":"Repeatability of the 6-Minute Walk Test in Adolescents and Adults With Cystic Fibrosis","volume":"55","author":"Ziegler","year":"2010","journal-title":"Respir. Care"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1097\/00008483-200311000-00007","article-title":"A New Unsupported Upper Limb Exercise Test for Patients With Chronic Obstructive Pulmonary Disease","volume":"23","author":"Takahashi","year":"2003","journal-title":"J. Cardiopulm. Rehabil. Prev."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/j.ijcard.2017.02.109","article-title":"Reliability, construct validity and determinants of 6-minute walk test performance in patients with chronic heart failure","volume":"240","author":"Mesquita","year":"2017","journal-title":"Int. J. Cardiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1177\/2047487312437038","article-title":"Reliability, agreement, and responsiveness of a 6-minute walk\/run test in patients with heart disease","volume":"20","author":"Berghmans","year":"2013","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"11","DOI":"10.3138\/ptc.2016-42","article-title":"The Unsupported Upper Limb Exercise Test in People Without Disabilities: Assessing the Within-Day Test\u2013Retest Reliability and the Effects of Age and Gender","volume":"70","author":"Oliveira","year":"2018","journal-title":"Physiother. Can."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1080\/09593985.2018.1425786","article-title":"Test\u2013retest reliability of the unsupported upper-limb exercise test (UULEX) and 6-min peg board ring test (6PBRT) in healthy adult individuals","volume":"34","author":"Lima","year":"2018","journal-title":"Physiother. Theory Pract."}],"container-title":["Healthcare"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9032\/9\/3\/308\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:33:34Z","timestamp":1760160814000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9032\/9\/3\/308"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,10]]},"references-count":47,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,3]]}},"alternative-id":["healthcare9030308"],"URL":"https:\/\/doi.org\/10.3390\/healthcare9030308","relation":{},"ISSN":["2227-9032"],"issn-type":[{"type":"electronic","value":"2227-9032"}],"subject":[],"published":{"date-parts":[[2021,3,10]]}}}