Validity of values for metabolic equivalents of task during submaximal all-extremity exercise and reliability of exercise responses in frail older adults

Background and Purpose. Physical therapists and rehabilitation professionals in hospital and long-term care centers are using all-extremity semirecumbent exercise machines in their treatment programs. This study was undertaken to investigate the concurrent validity of values for software-generated metabolic equivalents of task (MET) from an all-extremity semirecumbent exercise machine and directly measured values for MET from a portable metabolic unit across a range of submaximal exercise intensities. A second purpose of this study was to determine the test-retest reliability of oxygen consumption and heart rate responses in older adults between standardized sessions of submaximal all-extremity aerobic exercise. Subjects and Methods. The study participants were 18 older adults (mean age = 82 years, SD = 5; 3 women, 15 men) who were living in long-term care centers and who completed 2 test sessions of a standardized exercise protocol 1 week apart. The exercise protocol included a warm-up period, three 4-minute stages of exercise at incremental workload levels, and a cool-down period. The breath-by-breath metabolic data from the portable metabolic unit, heart rate, MET values from the exercise machine, Borg Rating of Perceived Exertion, and watts were recorded continuously throughout the exercise protocol. Results. The concurrent validity of the MET values from the exercise machine and the portable metabolic unit ranged from very good to excellent on both day 1 and day 2 (r = .85-.97). The test-retest reliability of subjects' heart rate responses and MET values from the portable metabolic unit was moderate to high across submaximal exercise intensities (intraclass correlation coefficients [2, 1] = .85-.91). Discussion and Conclusion. The exercise machine software-generated MET values were representative of directly measured oxygen consumption values across a range of submaximal intensities during all-extremity semirecumbent exercise in older adults with multisystem impairments.