Post-processing Peak Oxygen Uptake Data Obtained During Cardiopulmonary Exercise Testing in Individuals With Spinal Cord Injury: A Scoping Review and Analysis of Different Post-processing Strategies.

Abstract

To review the evidence regarding the most common practices adopted with cardiopulmonary exercise testing (CPET) in individuals with spinal cord injury (SCI), with the following specific aims to (1) determine the most common averaging strategies of peak oxygen uptake (V̇o_2peak), (2) review the endpoint criteria adopted to determine a valid V̇o_2peak, and (3) investigate the effect of averaging strategies on V̇o_2peak values in a convenience sample of individuals with SCI (between the fourth cervical and sixth thoracic spinal segments). Searches for this scoping review were conducted in MEDLINE (PubMed), EMBASE, and Web Science. Studies were included if (1) were original research on humans published in English, (2) recruited adults with traumatic and non-traumatic SCI, and (3) V̇o_2peak reported and measured directly during CPET to volitional exhaustion. Full-text review identified studies published before April 2021 for inclusion. Extracted data included authors name, journal name, publication year, participant characteristics, and comprehensive information relevant to CPET. We extracted data from a total of 197 studies involving 4860 participants. We found that more than 50% of studies adopted a 30-s averaging strategy. A wide range of endpoint criteria were used to confirm the attainment of maximal effort. In the convenience sample of individuals with SCI (n=30), the mean V̇o_2peak decreased as epoch (ie, time) lengths increased. Reported V̇o_2peak values differed significantly (P<.001) between averaging strategies, with epoch length explaining 56% of the variability. The adoption of accepted and standardized methods for processing and analyzing CPET data are needed to ensure high-quality, reproducible research, and inform population-specific normative values for individuals with SCI.