Key Takeaways
- VO2max is the gold standard for measuring aerobic capacity; direct measurement requires metabolic cart analysis.
- Field tests like the 12-minute run, 1.5-mile run, and PACER/beep test estimate aerobic capacity without laboratory equipment.
- Skinfold measurements use 3-site or 7-site protocols to estimate body fat percentage within 3-4% error.
- BIA (bioelectrical impedance analysis) accuracy is affected by hydration status, food intake, and exercise.
- DEXA provides the most accurate body composition assessment but requires specialized equipment and certified technicians.
Last updated: January 2026
Cardiovascular and Body Composition Testing
Quick Answer: VO2max testing measures maximal aerobic capacity either directly (metabolic cart) or indirectly (prediction equations from submaximal tests). Field tests like the 12-minute run, 1.5-mile run, and PACER test estimate aerobic fitness without lab equipment. Body composition can be assessed via skinfolds (3-4% error), BIA (hydration-dependent), or DEXA (gold standard).
Cardiovascular Endurance Testing
Direct vs. Indirect VO2max Measurement
| Method | Description | Accuracy | Equipment |
|---|---|---|---|
| Direct | Metabolic cart measures O2/CO2 during maximal exercise | Gold standard | Metabolic analyzer, treadmill/bike |
| Indirect Maximal | Prediction from maximal test performance | ±3-5 mL/kg/min | Treadmill/bike, timing |
| Indirect Submaximal | Extrapolation from submaximal HR response | ±10-15% | HR monitor, treadmill/bike |
Criteria for True VO2max
A true VO2max is achieved when at least 2-3 of these criteria are met:
| Criterion | Threshold |
|---|---|
| VO2 Plateau | <150 mL/min increase despite increased workload |
| Respiratory Exchange Ratio (RER) | ≥1.10-1.15 |
| Heart Rate | Within 10 bpm of age-predicted HRmax (220 - age) |
| Blood Lactate | ≥8 mmol/L |
| Rating of Perceived Exertion | ≥17 on 6-20 Borg scale |
Laboratory VO2max Protocols
Bruce Treadmill Protocol
| Stage | Speed (mph) | Grade (%) | Duration |
|---|---|---|---|
| 1 | 1.7 | 10 | 3 min |
| 2 | 2.5 | 12 | 3 min |
| 3 | 3.4 | 14 | 3 min |
| 4 | 4.2 | 16 | 3 min |
| 5 | 5.0 | 18 | 3 min |
| 6 | 5.5 | 20 | 3 min |
| 7 | 6.0 | 22 | 3 min |
Astrand Cycle Ergometer Protocol (Submaximal)
| Variable | Protocol |
|---|---|
| Workload | 50-150W based on fitness level |
| Duration | 6 minutes at steady state |
| Heart Rate | Record at minutes 5 and 6 |
| Prediction | Use Astrand-Ryhming nomogram |
Field Tests for Aerobic Capacity
12-Minute Run (Cooper Test)
| Variable | Protocol |
|---|---|
| Distance | Cover maximum distance in 12 minutes |
| Surface | 400m track preferred |
| Scoring | Distance in meters or miles |
| VO2max Equation | VO2max = (Distance in meters - 504.9) / 44.73 |
12-Minute Run Normative Data (Males, mL/kg/min)
| Age | Excellent | Good | Average | Below Average | Poor |
|---|---|---|---|---|---|
| 13-19 | >56 | 51-55 | 45-50 | 38-44 | <38 |
| 20-29 | >52 | 47-51 | 42-46 | 37-41 | <37 |
| 30-39 | >49 | 44-48 | 39-43 | 34-38 | <34 |
| 40-49 | >45 | 40-44 | 35-39 | 30-34 | <30 |
1.5-Mile Run
| Variable | Protocol |
|---|---|
| Distance | 1.5 miles (2.4 km) |
| Scoring | Time to completion |
| VO2max Equation | VO2max = 3.5 + 483 / time in minutes |
1.5-Mile Run Normative Data (Time in Minutes)
| Rating | Males 20-29 | Females 20-29 |
|---|---|---|
| Excellent | <9:45 | <11:50 |
| Good | 9:45-10:45 | 11:50-13:15 |
| Average | 10:46-12:00 | 13:16-15:00 |
| Below Average | 12:01-14:00 | 15:01-17:00 |
| Poor | >14:00 | >17:00 |
PACER/Beep Test (20-Meter Shuttle Run)
| Variable | Protocol |
|---|---|
| Distance | 20 meters between lines |
| Pace | Progressively increases (8.5 km/h start) |
| Scoring | Number of completed shuttles |
| Termination | Failure to reach line twice |
Body Composition Assessment Methods
Method Comparison
| Method | Accuracy (% BF error) | Cost | Practicality |
|---|---|---|---|
| DEXA | ±1-2% | High | Low - lab only |
| Hydrostatic Weighing | ±2-3% | Moderate | Low - pool needed |
| Bod Pod | ±2-3% | High | Moderate |
| Skinfolds | ±3-4% | Low | High |
| BIA | ±3-5% | Low-Moderate | High |
| BMI | N/A - not body composition | Free | High |
Skinfold Testing
3-Site Protocols
Men (Jackson-Pollock):
- Chest (diagonal fold, midway between anterior axillary line and nipple)
- Abdomen (vertical fold, 2 cm lateral to umbilicus)
- Thigh (vertical fold, midway between hip and knee)
Women (Jackson-Pollock):
- Triceps (vertical fold, midway between acromion and olecranon)
- Suprailiac (diagonal fold, above iliac crest)
- Thigh (vertical fold, midway between hip and knee)
7-Site Protocol (Both Genders)
- Chest
- Subscapular
- Midaxillary
- Triceps
- Abdomen
- Suprailiac
- Thigh
Skinfold Testing Procedures
| Step | Protocol |
|---|---|
| 1 | Identify anatomical landmarks on RIGHT side |
| 2 | Grasp skinfold 1 cm above site with thumb and index finger |
| 3 | Apply caliper perpendicular to fold, 1 cm from fingers |
| 4 | Wait 1-2 seconds before reading |
| 5 | Take 2-3 measurements at each site |
| 6 | Use median value if measurements differ by >2 mm |
Body Fat Classification
| Category | Males | Females |
|---|---|---|
| Essential Fat | 2-5% | 10-13% |
| Athletes | 6-13% | 14-20% |
| Fitness | 14-17% | 21-24% |
| Average | 18-24% | 25-31% |
| Obese | ≥25% | ≥32% |
Bioelectrical Impedance Analysis (BIA)
Pre-Test Guidelines for BIA Accuracy
| Factor | Guideline |
|---|---|
| Hydration | Normal hydration status (no diuretics) |
| Food/Drink | No eating or drinking 4 hours prior |
| Exercise | No exercise 12 hours prior |
| Alcohol | No alcohol 48 hours prior |
| Caffeine | No caffeine 12 hours prior |
| Bladder | Empty bladder before testing |
BIA Limitations
- Highly affected by hydration status
- Less accurate for athletes vs. general population
- Population-specific equations required
- Environmental temperature affects results
Test Your Knowledge
Which of the following criteria indicates that a subject has achieved a true VO2max during testing?
A
B
C
D
Test Your Knowledge
Before conducting a BIA body composition test, which of the following should be avoided for the longest time period?
A
B
C
D
Test Your Knowledge
A strength and conditioning coach needs to estimate body fat percentage for a team of 25 athletes at an off-site facility with limited equipment. Which method would be MOST appropriate?
A
B
C
D
Test Your Knowledge
According to the Jackson-Pollock 3-site skinfold protocol for men, which sites should be measured?
A
B
C
D