Soares ZV; Federal University of Espirito Santo (UFES), Vitoria, ES, Brazil.
Gasparini Neto VH; Ferreguetti Costa AK; Brum L; Nascimento Dos
Santos Neves L; Barbieri RA; Leite RD; Carletti L

Journal of Bodywork & Movement Therapies. 46:157-167, 2026 Jun.

OBJECTIVE: To investigate the physiological and perceptual responses to
the cardiopulmonary exercise test with elastic resistance (CPxEL), using
the traditional treadmill cardiopulmonary exercise test (CPx) as the
standard reference.

METHODS: Twenty-seven physically active adults (57 +/- 7 years; both
sexes) performed two maximal cardiopulmonary exercise tests in randomized
order, seven days apart: treadmill CPx and CPxEL involving back-and-forth
movements against elastic resistance. Cardiorespiratory variables, heart
rate, and ratings of perceived exertion (central and peripheral) were
assessed. A verification phase was performed to confirm maximal
physiological responses.

RESULTS: At the first ventilatory threshold (VT1), CPxEL showed higher
oxygen uptake (V O2) (15.8 +/- 3.0 vs 12.7 +/- 3.3 ml kg-1.min-1; P =
0.02) and heart rate (HR) (115 +/- 12 vs 105 +/- 11 bpm; P = 0.01). At the
second ventilatory threshold (VT2), peripheral effort was greater for
CPxEL (Z = -2.38; P = 0.02). At maximal effort, the respiratory exchange
ratio (RER) was higher in the CPx (P < 0.05), and peripheral exertion
remained higher in CPxEL (Z = -1.97; P = 0.05).

CONCLUSION: CPxEL is a feasible method for identifying ventilatory
thresholds and VO2max, and may be applied to prescribing aerobic exercise
with elastic resistance in middle-aged adults. However, it elicits
distinct physiological and perceptual responses compared with the CPx and
the two protocols should not be used interchangeably. Further studies are
needed to confirm the accuracy and safety of CPxEL in different clinical
populations