Comparison of Cardiovascular Responses Between Upright and Recumbent Cycle Ergometers in Healthy Young Volunteers Performing Low-Intensity Exercise: Assessment of Reliability of the Oxygen Uptake Calculated by Using the ACSM Metabolic Equation


      Saitoh M, Matsunaga A, Kamiya K, Ogura MN, Sakamoto J, Yonezawa R, Kasahara Y, Watanabe H, Masuda T. Comparison of cardiovascular responses between upright and recumbent cycle ergometers in healthy young volunteers performing low-intensity exercise: assessment of reliability of the oxygen uptake calculated by using the ACSM metabolic equation.


      To clarify (1) differences in cardiovascular response during low-intensity exercise in the upright versus the recumbent position, and (2) whether the oxygen uptake (V̇o2) calculated by the American College of Sports Medicine (ACSM) metabolic equation reflects the actual V̇o2 at low-intensity testing.


      Repeated-measures comparison study.


      University research laboratory.


      Thirty-one healthy, young volunteers (age, 23±2y).


      Not applicable

      Main outcome measures

      Blood pressure, rate pressure product (RPP), V̇o2, oxygen pulse, carbon dioxide output (V̇co2), and ventilatory equivalent (V̇e) were measured during graded exercise testing using upright and recumbent cycle ergometers. The estimated V̇o2 was calculated by using the ACSM metabolic equation.


      Systolic blood pressure, RPP, V̇o2, oxygen pulse, V̇co2, and V̇e at 15 or 30W were significantly higher in the recumbent position than in the upright one (P<.05), however, no significant differences were observed at 50 and 70W. The estimated V̇o2 during exercise was significantly higher than the actual one, at every level of intensity, from 15 to 70W (P<.05).


      Cardiovascular responses should be carefully monitored even during low-intensity exercise using a recumbent cycle ergometer. The V̇o2 estimated using the ACSM metabolic equation did not reflect the actual V̇o2 during low-intensity exercise at 70W or less.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • American College of Sports Medicine
        ACSM’s guidelines for exercise testing and prescription.
        6th ed. Williams & Wilkins, Philadelphia2000
        • Bonzheim S.C.
        • Franklin B.
        • DeWitt C.
        • et al.
        Physiologic response to recumbent versus upright cycle ergometry, implications for exercise prescription in patients with coronary arteries disease.
        Am J Cardiol. 1992; 69: 40-44
        • Walsh-Riddle M.
        • Blumenthal J.
        Cardiovascular responses during upright and semirecumbent cycle ergometry testing.
        Med Sci Sport Exerc. 1989; 21: 581-585
        • Quinn T.
        • Smith S.
        • Vroman N.
        • Kertzer R.
        • Olney W.
        Physical responses of cardiac patients to supine, recumbent, and upright cycle ergometry.
        Arch Phys Med Rehabil. 1995; 76: 257-261
        • Mcardle W.
        • Katch F.
        • Katch Y. editors
        Exercise physiology. System of energy delivery and utilization.
        in: 4th ed. Williams & Wilkins, Philadelphia1996: 296-312
        • Takahashi T.
        • Tanabe K.
        • Nakayama M.
        • et al.
        [Cardiopulmonary response during supine and sitting bicycle exercise].
        Jpn J Phys Fitness Med. 1995; 44 ([Japanese]): 105-112
        • Matsunaga A.
        • Masuda T.
        • Ogura N.M.
        • et al.
        [Adaptation to a cycle ergometer exercise of patients with acute myocardial infarction undergoing phase I cardiac rehabilitation. Cardiovascular responses and autonomic nervous activities during low-intensity exercise].
        J Jpn Assoc Cardiac Rehabil. 2002; 7 ([Japanese]): 104-108
        • Matsunaga A.
        • Masuda T.
        • Ogura N.
        • et al.
        Adaptation process to a low-intensity exercise with cycle ergometer by patients with acute myocardial infarction undergoing phase I cardiac rehabilitation.
        Circ J. 2004; 68: 938-945
        • Taniguchi K.
        • Itoh H.
        • Yajima T.
        • Doi M.
        • Niwa A.
        • Marumo F.
        Predischarge early exercise therapy in patients with acute myocardial infarction on the basis of anaerobic threshold (AT).
        Jpn Circ J. 1990; 54: 1419-1425
        • Weissman C.
        • Askanazi J.
        • Rosenbaum S.
        • Hyman A.
        • Emili J.
        • Kinney J.
        The effects of posture on the metabolic and ventilatory response to low level steady state exercise.
        Clin Sci. 1986; 71: 553-558
        • Ellestad M.
        Cardiovascular and pulmonary responses to exercise.
        in: Ellestad M. Selvester R. Mishkin F. James F. Stress testing. 5th ed. Oxford Univ Pr, New York2003: 11-41
        • Whipp B.
        • Higgenbotham M.
        • Cobb F.
        Estimating exercise stroke volume from asymptomatic oxygen pulse in humans.
        J Appl Physiol. 1996; 81: 2674-2679
        • Wasserman K.
        • Hansen J.
        • Sue D.
        • Whipp B.
        • Casaburi R.
        Exercise testing and interpretation.
        Lea & Febiger, Philadelphia1987
        • Cotsamire D.
        • Sullivan M.
        • Bashore T.
        • Leier C.
        Position as a variable for cardiovascular responses during exercise.
        Clin Cardiol. 1987; 10: 137-142
        • Proctor D.
        • Sining W.
        • Quinn T.
        • et al.
        Submaximal responses to upright, recumbent and supine bicycle ergometer exercise [abstract].
        Med Sci Sport Exerc. 1990; 22: S12
        • Takahashi T.
        • Yamada S.
        • Tanabe K.
        • Izawa K.
        • Itoh H.
        • Murayama M.
        Cardiopulmonary responses at various angles of cycle backrest inclination.
        J Jpn Phys Ther Assoc. 1999; 2: 31-36
      1. American College of Sports Medicine. ACSM resource manual for the guidelines for exercise testing and prescription.
        4th ed. Williams & Wilkins, Philadelphia2001
        • Greenleaf J.
        Energy and thermal regulation during bed rest and spaceflight.
        J Appl Physiol. 1989; 67: 507-516
        • Bonde P.
        • Suzuki Y.
        • Kawakubo K.
        • Gunji A.
        Effect of 20 days bed rest upon peripheral capillary filtration rate, venous compliance and blood flow in arms and legs.
        Acta Physiol Scand. 1994; 616: 65-69
        • Drexler H.
        • Depenbusch J.
        • Truog A.
        • Zelis R.
        • Flaim S.
        Effects of diltiazem on cardiac function and regional blood flow at rest and during exercise in a conscious rat preparation of chronic heart failure.
        Circulation. 1985; 71: 1262-1270
        • Drexler H.
        Reduced exercise tolerance in chronic heart failure and its relationship to neurohumoral factors.
        Eur Heart J. 1991; 12: 21-28