The Bruce Protocol Test at The Lown Cardiovascular Group

Exploring Intensity

The Bruce Protocol Test at The Lown Cardiovascular Group

Mark, your trusty lab rat correspondent, visited the Lown Cardiovascular Group to do a VO2 Max test using something called the Bruce Protocol. VO2 Max is the rate of oxygen consumption based on the difficulty of exercise. The formula to calculate it measures oxygen consumption rate factoring in body mass.

Jill Geriak, the technician running the test, placed a rubber mouthpiece in my mouth and then sealed my nose shut with a clothespin type device. The first test was a breathe test in which your lab rat needed to take in a huge breath and then breathe out until all the air was gone. After two attempts we tried some varied breathing techniques to see if I could draw in more air with some extra little Pilates-style inhales. The results were the same.

With EKG stickies in place and taped to the back we started the Bruce Protocol which is used for patients who have heart disease. The test goes for 21 minutes or until the lab rat signals “no mas” with a frantic thumbs down gesture. The test is done on a treadmill in which speed and incline are increased every 3 minutes – starting with 1.7 mph at a 10% incline. This is a very slow walk up a small hill.

The final stage is 6mph at a 22% incline – though there are versions that go to 9 stages ending with 7 mph at a 26% grade. Your lab rat just wanted to get to 21 minutes. There is one additional difficulty with the test; the lab rat must go through the test with nose pinched and a tube shoved into the mouth which makes swallowing hard to do – and drinking water impossible. A scratchy sensation in the back of the throat, if it develops, must be tolerated.

The first 3 stages (9 minutes involved walking) – by stage 4 a slow jog up a decent incline was required. In stage 5 I could see that my heart rate was entering the “orange zone” – above 80% of HR Max. I could feel my calf muscles straining as the hill running required lots of calf. Jill told me I could hang on the front of the treadmill, and I took her up on the offer and settled into a nice groove with HR sitting between 150-155 bpm (89-90% of HR Max – low red zone). With 30 seconds to go in the test I dropped my hands from the rail and sprinted up the 22% treadmill hill. At that point I hit 164 bpm and a VO2 Max score of 63.4. I would score this workout as a nice Cardio High. I finished the test 4+ hours ago, but I still feel a good buzz.

After the test I met with Dr. Brian Bilchik, one of the cardiologists who see patients at the Lown. Dr. Bilchik is an avid squash player who usually follows his Saturday squash game with an hour spin class. The man likes to exercise. He’s also a recent convert to kiteboarding, a sport that requires intense focus. Dr. Bilchik is a sports cardiologist, and he is passionate about discovering ways to motivate his patients to exercise because he sees in case after case how a solid exercise program can keep cardiac patients off the operating table. We hope to work with Dr. Bilchik to explore how different styles of training impact cardiac health and performance. His nuggets of wisdom for Cardio High clients;

  1. Keep it simple. Find something you like to do and do it often.
  2. Try not have long layoffs between sessions of exercise. The heart can be damaged by long layoffs and then sudden bursts of activity (The Weekend Warrior Syndrome).
  3. Try to make exercise sessions last 20 minutes or more to boost your Nitric Oxide.

– Mark G.