Using two steps for health: Testing fitness and prescribing exercise with STEP

Emily Knight, Melanie I Stuckey, Robert J Petrella


Background: The Step Test and Exercise Prescription (STEP) tool was designed as an office-based instrument for measuring cardiorespiratory fitness (VO2max) and prescribing tailored exercise in the primary care setting. The fitness assessment portion of the STEP tool involves a standardized step unit. Purpose: To test validity of the prediction equation for VO2max from the fitness assessment portion of the tool among a range of step heights, which would allow for more widespread use of the STEP tool. Method: Participants completed two versions of the fitness assessment stepping protocol during a single testing session: one using the standardized step unit, and the other using variable step heights (e.g. step stool, commercial and residential stairs). Tests were completed in random order, and participants rested between tests until blood pressure returned to baseline. Results: 64 adults aged 18-64 years (Mean age 41.2 15y) participated. Predicted VO2max was strongly correlated between stepping conditions (r=0.93, p<0.01), and acceptable agreement was further demonstrated through Bland-Altman analysis. Conclusion: The prediction equation for VO2max from STEP is valid across a range of readily available step heights, which may facilitate more widespread use of the tool for clinical or community based, individualized exercise prescription.


Exercise prescription; validation study; self-paced VO2max test; Fitness assessment; Community-based health promotion

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ISSN: 19206216