Language
Country/Area
No result found
The Evolution of Cardiac Testing: Why the Bruce Protocol Became the Gold Standard in Sports Medicine?
The Bruce Protocol is a standardized diagnostic test designed to assess heart function and physical health. The protocol, developed by American cardiologist Robert A. Bruce, uses walking on an incline treadmill and monitoring through electrodes on the chest. This test increases the speed and incline of the treadmill every three minutes, allowing most patients to effectively monitor heart function at varying exercise intensities.
The ease and effectiveness of the Bruce test make it a powerful predictor of clinical outcome.
Program
Under the Bruce protocol, subjects exercise on a treadmill and have electrocardiogram (ECG) electrodes installed on their chest wall. The test began with the treadmill running at a speed of 2.74 km/h (approximately 1.7 mph) and a 10% incline. The incline and speed were increased every three minutes, and the heart rate and subjective feelings of the subjects were recorded. If there are signs of obstruction of blood flow to the heart, irregular heartbeat, fatigue, shortness of breath, etc. during the test, the test will be stopped immediately.
Stage
The standard Bruce protocol is divided into seven stages, with a total test time of 21 minutes. The changes in cardiac function in each stage are continuously monitored, providing important data for further cardiac evaluation.
History
Prior to the advent of the Bruce protocol, there was no safe, standardized method for monitoring cardiac function in exercising patients. Master's two-step test, although it has been used, is too strenuous and difficult to accept for many patients. So Bruce and his colleagues began developing a cardiac stress test using a relatively novel electrocardiogram device and an electric treadmill. Their research is not limited to heart monitoring, but also goes into the assessment of respiratory and circulatory function.
The first study on treadmill exercise testing published by Bruce in 1949 analyzed the physiological changes during exercise in normal adults and patients with cardiopulmonary disease. In 1950, Bruce joined the University of Washington and continued his research on prediction of cardiac surgery, eventually publishing a multi-stage test called the Bruce Protocol for the first time in 1963.
Modified Bruce Protocol
In order to adapt to elderly or sedentary patients, the modified Bruce protocol is adjusted based on the original protocol. The exercise load is lower at the beginning, and the first stage is set in a horizontal exercise state, which reduces the initial challenge compared to the standard Bruce protocol. .
Through the Bruce protocol, doctors can identify hidden dangers such as angina pectoris and heart attack in advance.
Result evaluation
The final score of the test is the duration the subject was on the test, usually measured in minutes. As exercise increases, the patient's maximum oxygen uptake can also be calculated based on exercise time. This process is particularly important for assessing an individual's exercise capacity and cardiac tolerance.
Heart rate calculation
The maximum heart rate calculation method often used in the Bruce protocol is 220-age, but there is a certain error in this formula. Relatively speaking, Calvo's annual formula appears to be more accurate and can be considered in conjunction with resting heart rate when calculating target heart rate. Such analysis helps provide a more comprehensive health assessment.
Conclusion
The evolution of the Bruce Protocol not only demonstrates the progress of cardiac medicine, but also provides a solid foundation for sports science. Today, with the advancement of technology, the demand for heart health assessment during exercise is getting higher and higher. What new challenges and opportunities will arise in this field in the future?
