5.2 Modified Canadian Aerobic Fitness Test (mCAFT) Protocols

5.2 Modified Canadian Aerobic Fitness Test (mCAFT) Protocols

Stepping is a practical field test. It needs little space and inexpensive equipment, and it uses the familiar movement of stair climbing. The mCAFT is a progressive submaximal test: the client steps to music in 3-minute stages, each stage faster than the last, until heart rate reaches the age-predicted ceiling.

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Equipment

• Stepping apparatus: two steps, each 20.3 cm (8 in) high, giving a top platform of 40.6 cm (16 in). The final stages use a single 40.6 cm step, often built into the back of the same unit.
• mCAFT audio track: pre-recorded stage tracks set the cadence, count the client in, and cue the end-of-stage pulse count ("stop exercising, find your pulse, ready... count... stop"). Separate tracks exist for women and men because the stage cadences differ by sex.
• Heart rate measurement: palpation, auscultation or an electronic monitor (the worksheet records which method was used), plus a stopwatch.
• Forms: the mCAFT Data Collection Worksheet (CSEP-PATH Toolkit Tool #19), with the starting-stage table, O₂-cost table and Health Benefit Rating table, and the client's pre-calculated 85% ceiling.

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Stepping Pattern

On the double step the pattern is a six-count cycle: "step, step, up; step, step, down". The client places one foot on the middle step, then the other foot on the top step, and brings the feet together on top. They then step down to the middle step, down to the floor, and bring the feet together on the floor. The client:

• places the whole foot on each step;
• fully extends the knees and hips at the top;
• may change the leading foot at the end of each stage;
• does not hold the rails, which are for safety only.

For the final stages, the client switches to the single 40.6 cm step, stepping "up, up, down, down".

• Men: Stages 1 to 6 use the double step; Stages 7 and 8 use the single step.
• Women: Stages 1 to 7 use the double step; Stage 8 uses the single step.

Let clients practise the pattern briefly (no more than a couple of times) before the test, and demonstrate the single-step pattern if they are likely to reach the final stages.

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Starting Stage (CSEP-PATH mCAFT Worksheet, Table 1)

The starting stage keeps older or less fit clients from beginning too hard, and spares younger clients unnecessary early stages.

O₂ Cost of Each Stage (Worksheet, Table 2)

From Stage 5 on, the men's stages carry a higher O₂ cost than the women's at the same stage number.

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Running the Test

1. Before the test: confirm the Step 1 screening is complete and resting vitals are within limits. Calculate the 85% ceiling with Tanaka: $0.85 \times [208 - (0.7 \times \text{age})]$, and divide by 6 for the 10-second value. Record age, sex and body mass on the worksheet.
2. Each stage lasts 3 minutes. At the end of the stage the client stops and stands still, and the trainer takes a 10-second heart rate count on the audio cue. RPE can be recorded too.
3. Decision after each stage:
   • If the 10-second count is below the ceiling, the client continues with the next stage.
   • If the count reaches or exceeds the ceiling, the test ends. The stage just completed is the last completed stage.
   • If the client completes Stage 8 without reaching the ceiling, the test ends, and Stage 8 is the last completed stage.
4. Stop early for any standard termination criterion: the client asks to stop, angina-like symptoms, dizziness, pallor, unusual shortness of breath, loss of coordination, or inability to keep the cadence. A stage the client could not complete is not used as the last completed stage.
5. Recovery: apply the CSEP-PATH standardized recovery protocol (Section 5.1). That means active recovery with HR and BP at minutes 1 to 3 (extendable by 2), then seated recovery with HR and BP at minutes 1 to 3.

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Predicting VO₂max

The mCAFT equation on the CSEP-PATH worksheet (Weller et al., 1995) is:

${\dot{V}\text{O}_2\text{max} = 17.2 + (1.29 \times \text{O}_2\text{ cost}) - (0.09 \times \text{mass, kg}) - (0.18 \times \text{age, years})}$

where O₂ cost is the value for the last completed stage, taken from the sex-specific table.

Worked Example

A 44-year-old woman weighing 68 kg takes the mCAFT.

1. Ceiling: Tanaka HRmax $= 208 - (0.7 \times 44) = 208 - 30.8 = 177.2$ bpm; $85\% = 150.6$ bpm; 10-second ceiling $= 150.6 / 6 = 25.1$, about 25 beats.
2. Starting stage: women aged 40–49 start at Stage 2.
3. Stages:
   • After Stage 2 her count is 20 beats (below 25): continue.
   • After Stage 3 it is 23 beats: continue.
   • After Stage 4 it is 25 beats, which reaches the ceiling: stop. The last completed stage is Stage 4, with an O₂ cost of 24.5.
4. Equation:
   • $1.29 \times 24.5 = 31.61$
   • $0.09 \times 68 = 6.12$
   • $0.18 \times 44 = 7.92$
   • $\dot{V}\text{O}_2\text{max} = 17.2 + 31.61 - 6.12 - 7.92 = 34.77 \approx 34.8\text{ mL}\cdot\text{kg}^{-1}\cdot\text{min}^{-1}$

On the CSEP-PATH Health Benefit Rating table for women aged 40–49, 34.8 falls in the Good band (31.9 to 35.0).

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Health Benefit Rating (HBR)

The predicted $\dot{V}\text{O}_2\text{max}$ is compared with age- and sex-specific bands on the worksheet: Excellent, Very Good, Good, Fair and Poor. Examples from the CSEP-PATH table:

The rating is a starting point for the Advise step. It is not a diagnosis, and it carries the error of any submaximal prediction.

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Strengths and Limitations