Comparison of the Danish step test and the watt-max test for estimation of maximal oxygen uptake: the Health2008 study

Mette Aadahl, Morten Zacho, Allan Linneberg, Betina H Thuesen, Torben Jørgensen

Research output: Contribution to journalJournal articleResearchpeer-review


INTRODUCTION: There is a need for simple and feasible methods for estimation of cardiorespiratory fitness (CRF) in large study populations, as existing methods for valid estimation of maximal oxygen consumption are generally time consuming and relatively expensive to administer. The Danish step test may be a feasible alternative for estimation of VO2max.

AIM: To compare a simple fitness test, the Danish step test, to an indirect maximal test, the watt-max test, for estimation of VO2max.

METHODS: In the population-based Health2008 study, 2218 men and women aged 30-60 years were invited. Altogether, 795 eligible participants (response rate 35.8%) performed the watt max and the Danish step test. Correlation and agreement between the two VO2max test results was explored by Pearson's rho, Bland-Altman plots, Kappa(w), and gamma coefficients.

RESULTS: The correlation between VO2max (ml/kg/min) estimated by the two tests was moderate to high (men: r = 0.69, p < 0.0001; women: r = 0.77, p < 0.0001). The Danish step test slightly overestimated VO2max compared to the watt-max test, more so in women than in men. Agreement between the two tests when VO2max was classified in five levels was gamma = 0.77, Kappa(w )= 0.42 in women, and gamma = 0.64, Kappa(w )= 0.37 in men.

CONCLUSION: The Danish step test is a safe and feasible alternative to the more time-consuming watt-max test as a method for estimation of VO2max in large adult population-based studies.

Original languageEnglish
JournalEuropean Journal of Preventive Cardiology
Issue number6
Pages (from-to)1088-1094
Publication statusPublished - Dec 2013


  • Adult
  • Bicycling
  • Cross-Sectional Studies
  • Denmark
  • Exercise Test/methods
  • Feasibility Studies
  • Female
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Muscle Contraction
  • Muscle, Skeletal/metabolism
  • Oxygen Consumption
  • Physical Fitness
  • Predictive Value of Tests
  • Reproducibility of Results
  • Cardiorespiratory fitness
  • epidemiological studies
  • validation


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