International Journal of

Environmental Research
and Public Health

Article
Transferability of Cardiopulmonary Parameters between
Treadmill and Cycle Ergometer Testing in Male
Triathletes—Prediction Formulae
Szczepan Wiecha 1 , Szymon Price 2 , Igor Cieśliński 1 , Przemysław Seweryn Kasiak 3 , Łukasz Tota 4 ,
Tadeusz Ambroży 5 and Daniel Śliż 2,6, *

1 Department of Physical Education and Health, Faculty in Biala Podlaska, Jozef Pilsudski University of
Physical Education in Warsaw, 21-500 Biala Podlaska, Poland; [email protected] (S.W.);
[email protected] (I.C.)
2 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland;
[email protected]
3 Students’ Scientific Group of Lifestyle Medicine, 3rd Department of Internal Medicine and Cardiology,
Medical University of Warsaw, 02-091 Warsaw, Poland; [email protected]
4 Department of Physiology and Biochemistry, Faculty of Physical Education and Sport,
University of Physical Education in Krakow, 31-571 Krakow, Poland; [email protected]
5 Institute of Sports Sciences, University of Physical Education in Krakow, 31-541 Kraków, Poland;
[email protected]
6 Public Health School Centrum Medyczne Kształcenia Podyplomowego (CMKP), 01-826 Warsaw, Poland
* Correspondence: [email protected]





 Abstract: Cardiopulmonary exercise testing (CPET) on a treadmill (TE) or cycle ergometry (CE) is a
Citation: Wiecha, S.; Price, S.; common method in sports diagnostics to assess athletes’ aerobic fitness and prescribe training. In a
Cieśliński, I.; Kasiak, P.S.; Tota, Ł.; triathlon, the gold standard is performing both CE and TE CPET. The purpose of this research was
Ambroży, T.; Śliż, D. Transferability to create models using CPET results from one modality to predict results for the other modality. A
of Cardiopulmonary Parameters total of 152 male triathletes (age = 38.20 ± 9.53 year; BMI = 23.97 ± 2.10 kg·m−2 ) underwent CPET
between Treadmill and Cycle on TE and CE, preceded by body composition (BC) analysis. Speed, power, heart rate (HR), oxygen
Ergometer Testing in Male
uptake (VO2 ), respiratory exchange ratio (RER), ventilation (VE), respiratory frequency (fR), blood
Triathletes—Prediction Formulae. Int.
lactate concentration (LA) (at the anaerobic threshold (AT)), respiratory compensation point (RCP),
J. Environ. Res. Public Health 2022, 19,
and maximum exertion were measured. Random forests (RF) were used to find the variables with
1830. https://doi.org/10.3390/
ijerph19031830
the highest importance, which were selected for multiple linear regression (MLR) models. Based
on R2 and RF variable selection, MLR equations in full, simplified, and the most simplified forms
Academic Editor: Paul B.
were created for VO2AT , HRAT , VO2RCP , HRRCP , VO2max , and HRmax for CE (R2 = 0.46–0.78) and
Tchounwou
TE (R2 = 0.59–0.80). By inputting only HR and power/speed into the RF, MLR models for practical
Received: 28 December 2021 HR calculation on TE and CE (both R2 = 0.41–0.75) were created. BC had a significant impact on the
Accepted: 30 January 2022 majority of CPET parameters. CPET parameters can be accurately predicted between CE and TE
Published: 6 February 2022 testing. Maximal parameters are more predictable than submaximal. Only HR and speed/power
Publisher’s Note: MDPI stays neutral
from one testing modality could be used to predict HR for another. Created equations, combined
with regard to jurisdictional claims in with BC analysis, could be used as a method of choice in comprehensive sports diagnostics.
published maps and institutional affil-
iations. Keywords: exercise testing; sports diagnostic; maximal oxygen uptake; HRmax ; VO2max ; triathletes;
cardiorespiratory fitness; prediction models

Copyright: © 2022 by the authors.

Licensee MDPI, Basel, Switzerland. 1. Introduction
This article is an open access article
Precise training plans are a key requirement for optimal performance in endurance
distributed under the terms and
athletes, allowing us to improve both maximum oxygen uptake (VO2max ) and competition
conditions of the Creative Commons
Attribution (CC BY) license (https://
results [1,2]. Variables obtained from laboratory cardiopulmonary exercise tests (CPET) may
creativecommons.org/licenses/by/
also be used to predict race results with considerable accuracy [3]. It is still controversial
4.0/).
whether prescription of exercise should rely on heart rate (HR) zones (expressed as %HRmax )

Int. J. Environ. Res. Public Health 2022, 19, 1830. https://doi.org/10.3390/ijerph19031830 https://www.mdpi.com/journal/ijerph
Int. J. Environ. Res. Public Health 2022, 19, 1830 2 of 11

or HR measured at key points, such as the anaerobic threshold (AT) or the respiratory
compensation point (RCP), corresponding most closely to critical power [1].
Usually, the modality of testing for CPET is chosen according to the dominant type
of exercise performed by the athletes, i.e., treadmill (TE) for runners or cycle ergometer
(CE) for cyclists. Results of CPET may vary considerably, depending on the chosen testing
modality, likely due to different training experience, muscle activation patterns, and the
static component in cycling [4–7]. A unique challenge is posed by duathletes and triathletes,
who train in multiple disciplines, including both cycling and running. Triathlon gained
popularity relatively recently, when compared with running or cycling alone; therefore,
less research has been conducted on triathletes, often on small groups, and much of the
training plan is created based on personal experience of trainers. The traditional ‘more is
better’ approach to training, with little training monitoring, is gradually being replaced by
sophisticated training monitoring to ensure optimal preparation for events and minimize
injury, fatigue, and illness [8]. Training plans are developed with high precision, based
on laboratory testing, for elite triathletes, and this trend naturally also affects amateur
triathletes. Due to the differences in HR, especially at AT, in cycling and running, it is most
likely optimal to use both testing modalities (and, if possible, swimming for triathletes) to
prescribe specific training plans. This approach is also used in current research [9]. Testing
is also usually carried out several times throughout the season to monitor training and
adjust recommendations [10]. A drawback of this approach for the amateur triathletes may
be the high cost of CPET testing, as well as the time required to make appointments in a
testing center, prepare for each test, and complete it. It would, therefore, be highly practical
for triathletes, if it were possible to model running parameters using the results obtained
from CE and vice versa.
Assessing the interchangeability of the two testing modalities for the monitoring
of triathlons has previously been attempted, and a linear relationship between HR and
oxygen consumption (VO2 ) has been observed [10,11]. Other studies also observed a
linear relationship between heart rate and VO2 , but the authors pointed out that large
individual variation was observed, which may further reduce the usefulness of this method
in sports [12]. However, these relationships do not take into account the different physiology
of cycling and running and the large differences in HR, at which the AT occurs, or the
differences in lactate levels [13]. Therefore, a simple linear relationship between HR and
VO2 is likely not sufficient to make the methods interchangeable for modern training
prescription, which is often based on HR at various thresholds or critical power, in the
case of interval training. This is supported by a more recent study on triathletes, which
concluded that separate exercise-specific tests should be used, due to the large differences
in HRAT [13].
In this study, we attempt to create regression models to predict exercise parameters in
TE (VO2max , VO2AT , VO2RCP , HRmax , HRAT , HRRCP , Lacmax , LacAT , and LacRCP ), based on
the results of CE, anthropometric data, and analogous models to predict CE parameters.

2. Material and Methods

2.1. General Study Information and Inclusion Criteria
This was a retrospective study using data recorded from commercial CPET testing in
the Sportslab clinic (Warsaw, Poland). This database has also previously been used to study
differences between CE and TE in triathletes and to test whether these differences might be
explained by anthropometric data [14]. Participants’ results from CPET performed in years
2013–2020 were included in the analysis. Exercise tests were carried out on personal request
for optimization of participant’s endurance as a part of prescribed training programs.
The study group consisted of amateur and professional triathletes with a history of
taking part in competitive events. Documented intership from the earliest competition
start to the day of the first test was an average of 105.1 ± 46.9 months; 95%CI from 96.6
to 113.6. Inclusion criteria were: male gender (due to too few females in the database),
age > 18 years, at least 3-month experience in triathlon training, and fulfilling maximum
Int. J. Environ. Res. Public Health 2022, 19, 1830 3 of 11

endurance criteria described below. Exclusion criteria were: suffering from any medical
condition (both chronic and acute, as well as musculoskeletal disorders or addictions) and
taking any medications.
Participants were advised to avoid any exercises at least 24 h prior to the test, eat a
light carbohydrate meal, and keep hydrated with isotonic sports drinks 2–3 h before the test.
They were instructed to exclude any drugs, caffeine, and cigarettes on the day of testing.
152 participants were finally selected from the database, each with at least one TE and
one CE test within 1–52 days of one another. The study group in this paper is an updated
and enlarged (an additional 27 males were recruited from January 2021 to November 2021)
group from a previous descriptive paper on the differences between CPET parameters in
TE and CE [14].

2.2. Conditions and Equipment Used during CPET

Every test was preceded by an analysis of body mass (BM) and fat mass (FM), on
the body composition (BC) measuring device (Tanita, MC 718, Tokyo, Japan), with the
multifrequency 5 kHz/50 kHz/250 kHz electrical bioimpedance method. If the period
between both tests was >48 h, the BC measuring has been conducted directly before each
of them, and the mean result was used for further analysis.
BC and CPET took place under the same conditions in the Sportslab Medical Clinic
(www.sportslab.pl, Warsaw, Poland, access on 10 December 2021): 40 m2 of indoor, air-
conditioned space, 40–60% humidity, temperature 20–22 degrees centigrade, and altitude
100 m MSL.
The running test was on a mechanical treadmill (h/p/Cosmos quasar, Nussdorf—
Traunstein, Germany), and the cycling test was on a cycle ergonometer Cyclus-2 (RBM
elektronik-automation GmbH, Leipzig, Germany). Cardio-pulmonary exertion values
were measured by a Cosmed Quark CPET device (Rome, Italy), calibrated before the tests,
according to the producer’s instruction. HR indices were taken with the usage of ANT and
a chest strap, as a part of the Cosmed Quark CPET equipment (manufacturer’s declared
accuracy similar to ECG; ±1 bpm).

2.3. Overview of Testing Protocol

Both tests started with a 5 min warm-up, consisting of walking or light pedaling.
Initial loads were determined individually to account for participants’ different endurance
capacities. The starting power in cycling tests ranged from 60 to 150 W; every 2 min, the
load was increased by 20–30 W. The initial treadmill inclination was 1%. A running speed,
described individually as a “slow pace”, was selected (ranges between 7 and 12 km/h).
Then, the pace increased every 2 min by 1 km/h.
Athletes were verbally encouraged to maintain the intensity for the longest possible
period, in order to assess their maximal aerobic fitness level most accurately. The termina-
tion of the test occurred by the operator when the VO2 or HR did not increase with higher
speed/power or if the participant felt unable to maintain the effort. Cardiopulmonary
monitoring was applied during the whole test.

2.4. Blood Lactate Examination

A 20 µL blood sample was taken from the fingertip, immediately prior to each CPET,
after any change in load or speed, and 3 min after finishing the test. Blood was taken
without a break in cycling or running during the CPET. The initial drops of blood were
collected into a swab before the proper sample was drawn. A Super GL2 analyzer (Müller
Gerätebau GmbH, Freital, Germany) was used to assess lactate concentration (LA). The
device was calibrated before each round of analysis.
Int. J. Environ. Res. Public Health 2022, 19, 1830 4 of 11

2.5. Final Characteristics of Selected Participants

Results were imported to the Excel file (Microsoft Corporation, Washington, DC,
USA). Basic data were anonymized, and analysis was conducted in a custom tool, created
in a Python environment, to export AT, RCP, and maximum exertion values from Excel
files. According to current standards, CPET results were measured breath-by-breath,
with averaged 10 s periods. The highest HR during intervals was recorded, and HR was
not averaged [15].
Only cases where at least three of four of the following criteria of maximum exertion
were fulfilled were included: (1) RER not smaller than 1.10, (2) achieved VO2 plateau (a VO2
increase with growth in speed/power lower than 100 mL/min), (3) breathing frequency
higher than 45/min, and (4) perceived exertion above 18 in the Borg scale [16].
AT was reached after meeting the following criteria: (1) common start of VE/VO2 and
VE/VCO2 curves, (2) end-tidal partial pressure of oxygen raised constantly with end-tidal
partial pressure of carbon dioxide. RCP was reached after meeting the following criteria:
(1) PetCO2 must decrease after reaching maximal amount, (2) presence of fast nonlinear
growth in VE (second deflection), (3) the VE/VCO2 ratio achieved minimum and started to
rise, and (4) a nonlinear increase in VCO2 versus VO2 (lack of linearity) [17].
For greater accuracy of calculations, the exact threshold and maximum power/speed
were determined based on the linear relationship between the time and rise of power/speed
values during the tests. The exact blood lactate concentration, related to speed/power,
was estimated for each threshold, based on the lactate measurements and speed/power-
time graphs.

2.6. Ethical Approval

Due to humans’ involvement, the study was reviewed and obtained approval from
the Bioethical Committee-IRB of the Medical University of Warsaw (AKBE/32/2021). Each
patient had to provide written informed consent to participate in the study. Procedures have
been performed in accordance with the recommendations from the Declaration of Helsinki.

2.7. Statistical Analysis

R environment/programming language (version 3.6.4) was applied for statistical
analysis. If a lack of results in lactate values was found, imputation was performed
with random forests (in seven cases total) [18]. Anderson-Darling test was used to check
for normality. Results were calculated as means with standard deviation (SD) and 95%
confidence intervals (CI). Maximal power/speed was computed as mean SD (Z-score) for
random forest analysis.
To select the variables to include in the MLR models, random forest was used to predict
whether the test was performed on TE or CE, based on the CPET results (HR, VO2 , RER,
VE, fR, LA, at the AT, RCP, and maximum). The variables with highest prediction values
were selected for further modelling in MLR. It has been demonstrated that RF is one of the
most accurate method for variable selection [19–21]. Apart from the variables selected with
RF, body fat, BMI, and age were also included in the models, as they were previously linked
to differences between CPET results in TE and CE [14]. These variables were then used to
build predictive models, using multiple linear regression with the brute-force approach (all
combinations were tested). In a further attempt to simplify the models (reduce the number
of variables), they were also recalculated using only the variables with p < 0.05 in the first
MLR model. Simple models for practical application were also created by imputing only
HR and power/speed into random forest data selection and then creating MLR models
with the use of only these variables.
Evaluation of the dependencies in running and cycling scores (dependent variables),
body fat (BF), and BMI, with the usage of multiple linear regression (MLR) models. R-
squared (R2 ) was used to evaluate the quality of models.
Int. J. Environ. Res. Public Health 2022, 19, 1830 5 of 11

3. Results
All the variables displayed normal distribution. The mean differences between groups for
the predicted variables are presented in the Supplementary Material (Supplementary Table S1.
CPET characteristics). Participants’ characteristics are shown in Table 1.

Table 1. Participants’ characteristics.

Participants Characteristics
Variable Mean CI SD
−95% 95%
CPET interval (days) 7.28 5.40 9.16 11.74
Age (years) 38.20 36.68 39.73 9.53
Height (cm) 180.64 179.55 181.72 6.77
Weight (kg) 78.31 76.88 79.74 8.92
BMI (kg·m−2 ) 23.97 23.64 24.31 2.10
BF (%) 15.41 14.76 16.05 4.03
FM (kg) 12.28 11.61 12.96 4.19

Prediction formulae were created based on multiple linear regression results and are
presented in Tables 2 and 3, along with R2 and mean absolute error (MAE).
Figures 1 and 2 present graphs of observed vs. predicted results using each of the formulae.

Table 2. Cycling prediction equations in a full form.

Category Multiple Regression Equation MAE Adjusted R2

20.83[13.56]SE + 0.56[0.12]SE x R VO2AT − 0.11[0.05]SE x R VEAT − 0.11[0.05]SE x R HRAT +
12.06[9.00]SE x R RERAT r + 0.04[0.03]SE x R fRRCP − 23.13[12.59]SE x R RERRCP − 0.36[0.17]SE x
VO2AT 2.17 0.71
R Lacmax + 0.30[0.09]SE x R VO2max + 0.05[0.05]SE x R HRmax + 0.05[0.03]SE x R VERCP −
0.13[0.08]SE x BF
54.84[30.34]SE + 0.41[0.12]SE x R HRAT − 49.99[27.99]SE x R RERRCP + 0.41[0.12]SE x R HRmax −
HRAT 6.25 0.46
0.30[0.19]SE x BF
−2.39[5.83]SE + 0.62[0.17]SE x R VO2AT − 0.01[0.001]SE x R VO2ATA − 0.53[0.17]SE x R Lacmax +
VO2RCP 0.32[0.12]SE x R VO2max + 0.34[0.18]SE x R VO2RCP + 0.03[0.03]SE x R VERCP + 0.52[0.24]SE x BMI 2.44 0.78
− 0.32[0.11]SE x BF
53.27[21.96]SE + 0.17[0.11]SE x R HRAT + 0.33[0.20]SE x R HRRCP − 38.36[19.97]SE x R RERRCP +
HRRCP 4.47 0.68
0.40[0.16]SE x R HRmax − 0.42[0.13]SE x BF
11.75[4.59]SE − 0.05[0.03]SE x R VEAT + 0.07[0.03]SE x R fRRCP − 0.35[0.18]SE x R Lacmax +
VO2max 2.55 0.78
0.44[0.12]SE x R VO2max + 0.50[0.14]SE x R VO2RCP − 0.33[0.09]SE x BF
16.51[11.24]SE + 0.26[0.13]SE x R HRRCP + 0.57[0.27]SE x R Lacmax + 0.60[0.12]SE x R HRmax +
HRmax 3.31 0.78
0.33[0.31]SE x BMI − 0.45[0.15]SE x BF
Abbreviations: CI, confidence interval; SD, standard deviation; CPET, cardiopulmonary exercise test; BMI, body
mass index (kg·m−2 ); BF, body fat (%); FM, fat mass (kg).

Table 3. Running prediction equations in a full form.

Category Multiple Regression Equation MAE Adjusted R2

−3.59[11.10]SE − 0.09[0.05]SE x C VEAT + 0.10[0.06]SE x C fRAT + 0.002[0.002]SE x C VO2ATA −
VO2AT 0.21[0.16]SE x C Lacmax + 0.06[0.03]SE x C HRmax + 0.43[0.05]SE x C VO2RCP + 12.46[7.90]SE x 2.05 0.59
C RERmax − 0.04[0.03]SE x Age

59.44[16.41]SE − 1.21[0.40]SE x C VO2AT − 0.24[0.09]SE x C VEAT + 0.17[0.13]SE x C HRAT +

HRAT 0.01[0.04]SE x C VO2ATA + 0.27[0.22]SE x C HRRCP + 0.05[0.03]SE x C PAT − 0.44[0.28]SE x C VO2max 4.66 0.63
+ 0.34[0.17]SE x C HRmax + 0.81[0.39]SE x C VO2RCP − 1.36[0.48]SE x BMI + 0.56[0.23]SE x BF
Int. J. Environ. Res. Public Health 2022, 19, 1830 6 of 11

Table 3. Cont.

Category Multiple Regression Equation MAE Adjusted R2

13.88[2.60]SE + 0.43[0.14]SE x C VO2AT − 0.22[0.07]SE x C VEAT + 0.28[0.11]SE x C fRAT +
VO2RCP 0.03[0.02]SE x C VEmax + 0.04[0.01]SE x C PAT − 0.15[0.09]SE x C fRRCP + 0.30[0.10]SE x C VO2max + 2.18 0.73
0.06[0.04]SE x C VERCP
HRRCP 12.83[2.11]SE + 0.60[0.04]SE x C VO2max + 0.03[0.01]SE x C PAT 2.28 0.71
101.31[26.95]SE − 1.12[0.32]SE x C VO2AT − 0.16[0.09]SE x C HRAT − 0.07[0.02]SE x C VEma +
0.01[0.002]SE x C VO2ATA + 9.70[7.73]SE x C RERAT + 0.30[0.16]SE x C HRRCP − 40.07[25.14]SE x
VO2max 3.25 0.78
C RERRCP − 0.39[0.20]SE x C VO2max + 0.63[0.13]SE x C HRmax + 0.84[0.28]SE x C VO2RCP −
0.13[0.05]SE x Age − 1.11[0.34]SE x BMI + 0.32[0.17]SE x BF
28.49[5.23]SE + 0.39[0.15]SE x C VO2AT − 0.06[0.03]SE x C HRAT − 0.21[0.08]SE x C fRAT −
HRmax 0.003[0.001] x C VO2ATA − 0.03[0.01] x C PAT − 0.14[0.06] x C fRRCP + 0.49[0.09]SE x C VO2max − 2.38 0.74
0.07[0.03]SE x Age
112.46[29.03]SE − 0.58[0.26]SE x C VO2AT + 0.07[0.06]SE x C VEAT − 0.06[0.02]SE x C VEmax +
8.49[7.51]SE x C RERAT − 57.77[27.32]SE x C RERRCP + 0.51[0.26]SE x C Lacmax + 0.82[0.05]SE x 3.27 0.80
C HRmax + 0.26[0.21]SE x C VO2RCP − 0.14[0.05]SE x Age − 0.77[0.32]SE x BMI + 0.35[0.16]SE x BF

Abbreviations: MAE, mean absolute error; VO2AT , relative VO2 at AT (mL·min−1 ·kg−1 ); SE, standard error;
−1
C VEAT , cycling pulmonary ventilation at AT (L·min ); C fRAT , cycling respiratory rate at AT (breaths per minute);
· −1 ); Lac −1
C VO 2ATA , cycling absolute VO2 at AT (mL min C max , cycling maximal lactate concentration (mmol·L );
−1 −1
C HRmax , cycling maximal heart rate (bpm); C VO2RCP , cycling relative VO2 at RCP (mL·min ·kg ); C RERmax ,
cycling maximal respiratory exchange ratio; age, age (years); HRAT , heart rate at AT (bpm); C VO2AT , cycling
relative VO2 at AT (mL·min−1 ·kg−1 ); C HRAT , cycling heart rate at AT (bpm); C HRRCP , cycling heart rate at
RCP (bpm); C PAT , cycling power at AT (watt); C VO2max , cycling relative maximum VO2 (mL·min−1 ·kg−1 ); BMI,
body mass index (kg·m−2 ); BF, body fat (%); VO2RCP , relative VO2 at RCP (mL·min−1 ·kg−1 ); C VEmax , cycling
maximal pulmonary ventilation (L·min−1 ); C fRRCP , cycling respiratory rate at RCP (breaths per minute); C VERCP ,
cycling pulmonary ventilation at RCP (L·min−1 ); HRRCP , heart rate at RCP (bpm); C RERAT , cycling respiratory
exchange ratio at AT; C RERRCP , cycling respiratory exchange ratio at RCP; VO2max , relative maximum VO2
(mL·min−1 ·kg−1 ); HRmax , maximal heart rate (bpm).

Figure 1. Graphs of observed vs. predicted results using each of the formulae. Abbreviations: VO2AT ,
relative VO2 at AT (mL·min−1 ·kg−1 ); VO2RCP , relative VO2 at RCP (mL·min−1 ·kg−1 ); VO2max ,
relative maximum VO2 (mL·min−1 ·kg−1 ); HRAT , heart rate at AT (bpm); HRRCP , heart rate at RCP
(bpm); HRmax , maximal heart rate (bpm).
Int. J. Environ. Res. Public Health 2022, 19, 1830 7 of 11

Figure 2. Graphs of observed vs. predicted results using each of the formulae. Abbreviations: VO2AT ,
relative VO2 at AT (mL·min−1 ·kg−1 ); VO2RCP , relative VO2 at RCP (mL·min−1 ·kg−1 ); VO2max ,
relative maximum VO2 (mL·min−1 ·kg−1 ); HRAT , heart rate at AT (bpm); HRRCP , heart rate at RCP
(bpm); HRmax , maximal heart rate (bpm).

The simple equations for practical use (only HR and speed/power) are presented in
Tables 4 and 5.

Table 4. Simplified cycling prediction equations.

Category Multiple Regression Equation MAE Adjusted R2

HRAT 20.64[13.77]SE + 0.71[0.08]SE x R HRAT + 0.83[0.59]SE x R SAT 6.66 0.41
HRRCP 5.89[11.24]SE + 0.88[0.06]SE x R HRRCP + 0.52[0.41]SE x R SAT 4.63 0.65
HRmax 16.41[9.27]SE + 0.86[0.05]SE x R HRmax + 0.31[0.33]SE x R SAT 3.66 0.75
Abbreviations: MAE, mean absolute error; HRAT , heart rate at AT (bpm); SE, standard error; R HRAT , running
heart rate at AT (bpm); R SAT , running speed at AT (km·h−1 ); HRRCP , heart rate at RCP (bpm); R HRRCP , running
heart rate at RCP (bpm); HRmax , maximal heart rate (bpm); R HRmax , running maximal heart rate (bpm).

Table 5. Simplified running prediction equations.

Category Multiple Regression Equation MAE Adjusted R2

HRAT 73.98[9 .05]SE + 0.60[0 .07]SE x C HRAT − 0.04[0 .02]SE x C PAT 5.89 0.41
HRRCP 54.69[8 .33]SE + 0.76[0 .05]SE x C HRRCP − 0.03[0 .02]SE x C PAT 4.28 0.66
HRmax 30.84[8 .58]SE + 0.88[0 .05]SE x C HRmax − 0.02[0 .01]SE x C PAT 3.71 0.75
Abbreviations: MAE, mean absolute error; HRAT , heart rate at AT (bpm); SE, standard error; C HRAT , cycling heart
rate at AT (bpm); C PAT , cycling power at AT (watt); HRRCP , heart rate at RCP (bpm); C HRRCP , cycling heart rate at
RCP (bpm); HRmax , maximal heart rate (bpm); C HRmax , cycling maximal heart rate (bpm).
Int. J. Environ. Res. Public Health 2022, 19, 1830 8 of 11

The simplified formulae, obtained by removing nonsignificant variables, are presented

in the Supplementary Material (Supplementary Table S2. Additional cycling prediction
equations; Supplementary Table S3. Additional running prediction equations).

4. Discussion
This is the first study to evaluate and model the transferability of the results between
CE and TE in triathletes with the use of multiple linear regression and RF modelling. It is,
therefore, impossible to offer a direct comparison of the results with previous literature.
The created models display a relatively high R2 , on average, explaining approximately 70%
of the differences between TE and CE.
The simplest formulae, using only HR and power/speed data, also demonstrated fair
accuracy, with MAE only slightly lower than the full equations. This offers a possibility
to easily estimate HR zones in running after performing a simple HRmax test on a cycle
ergometer or vice versa, depending on the available equipment. Such equations may be
especially useful for amateurs with limited resources and access to equipment.
The obtained MAE are considerably lower for most variables than the actual dif-
ferences between CE and TE, sometimes by more than 50%, for example, in the case of
HRAT . Therefore, the formulae offer an alternative to using both tests for triathletes, when
performing two tests would be too costly. The estimated values would improve precision
of exercise prescription, based on HRAT , HRRCP , or HRmax . When considering the precision
of the predictive algorithms, it is important to compare it with test–retest reliability of CPET
testing. While CPET is the gold standard in testing exercise capacity and considered highly
precise, even test results obtained using the same modality, performed by the same team, on
the same person, will inevitably vary. Decato et al. recently showed that the mean absolute
differences in the CPET results were 7.1% for peak VO2 (L·min−1 ), 2.5% for peak HR, 14.7%
for VO2 at lactate threshold (LT), and 9.2% for HR at LT, with coefficients of variation of
4.9%, 1.8%, 10.4%, and 6.6%, respectively [22]. Previous studies showed similar or higher
variance between repeated tests [22,23]. In a meta-analysis, conducted by Vickers et. al.,
the mean error for VO2max was 2.58 mL·kg−1 ·min−1 in the test–retest examination [24].
Considering these results, the MAE observed in this study appear to be acceptable, the
prediction error being similar to the test–retest measurement error, where the 5% error is
commonly accepted [25]. It is also worth noting that the variance is low for peak parameters
but much higher at the aAT and RCP thresholds, possibly due to the difficulty of reliably
establishing the exact threshold values. This could also explain the lower R2 and higher
MAE obtained in our study for submaximal, rather than for maximal parameters.
The lowest prediction accuracy was observed for CE HRAT . We speculate that this
might be because of the large variation of aerobic capacity in the population, as well as the
limited impact of cycling at the AT on the cardiovascular system, relative to the external
work performed, which is due to more isolated muscle effort in CE. Therefore, the AT
occurs at a lower effort, relative to peak, in effect being less predictable. This hypothesis
would require further research to support it. It is also possible that cardiac stroke volume
increases, relative to VO2max , may be different in CE and TE at different thresholds [26–29].
RF analysis revealed that the most important variable, in determining whether the re-
sults are generated from TE or CE, is VEAT . VEAT was also subsequently selected in several
of the predictive models, suggesting the importance of different breathing mechanics in
CE and TE. It has been shown that CE leads to a greater decrease in respiratory muscle
endurance than TE, and it has been suggested that the differences in breathing mechanics
may be due to different entrainment of breath in CE and TE [4,30]. Studies showed that
triathletes display higher entrainment of breathing in CE than TE and that entrainment
decreases with increasing load in CE [31]. The differences in the rates of ventilation may
also be due to the size of CO2 production, which is dependent on the number of active
muscles. Running involves more muscles in the torso and arms, which do not directly
contribute to locomotion, as is the case in cycling [26].
Int. J. Environ. Res. Public Health 2022, 19, 1830 9 of 11

Body fat was a significant factor in most of the predictive formulae. It has previously
been shown that body fat correlates negatively with aerobic capacity in TE testing (r = −0.89,
p < 0.001) [32]. It has also been shown that fatness is not directly related to VO2max but has
a detrimental effect on submaximal performance in TE [33]. There is little data about the
influence of fatness on VO2max in CE, compared to TE. Our results suggest that body fat
should have a significantly different effect on CE than on TE, perhaps due to the fact that the
additional fat mass increases the load on the treadmill, without contributing significantly
to oxygen consumption. Perhaps body fat might also impact breathing differently in TE
than in CE, as it has previously been shown that increased body fat is associated with lower
lung volumes [34].

5. Conclusions
CPET parameters can be accurately (accuracy similar to test–retest error) predicted for
a cycle ergometer test, based on treadmill test results and vice versa.
Maximum CPET parameters are more predictable than submaximal parameters.
Even when only HR and speed/power from one testing modality are available, HR
may be predicted with fair accuracy for the other testing modality.
Body fat significantly affects the prediction of almost all CPET parameters.
The limitations of the present study were the homogenous ethnicity and gender of
the participants (Caucasian males). It was not possible to test swimming, due to a lack of
equipment; designing models for swimming could be a future research direction.

Supplementary Materials: The following supporting information can be downloaded at: https:
//www.mdpi.com/article/10.3390/ijerph19031830/s1, Supplementary Table S1. CPET character-
istics; Supplementary Table S2. Additional cycling prediction equations; Supplementary Table S3.
Additional running prediction equations.
Author Contributions: Conceptualization, S.W., S.P. and D.Ś.; methodology, S.W, S.P. and Ł.T.;
software, I.C., P.S.K. and S.W.; validation, I.C. and S.P.; formal analysis, S.W., D.Ś., S.P. and I.C.;
investigation, S.W.; resources, S.W.; data curation, S.W. and I.C.; writing—original draft preparation,
S.P., P.S.K. and S.W.; writing—review and editing, S.W., S.P. and Ł.T.; visualization, I.C. and P.S.K.,
supervision, T.A. and D.Ś.; project administration, S.W. and D.Ś.; funding acquisition, D.Ś. and S.W.
All authors have read and agreed to the published version of the manuscript.
Funding: This research received no external funding.
Institutional Review Board Statement: The study was conducted according to the guidelines of the
Declaration of Helsinki and approved by the Institutional Review Board: Komisja Bioetyczna przy
Warszawskim Uniwersytecie Medycznym, AKBE/32/2021; date of approval: 15 March 2021.
Informed Consent Statement: Informed consent was obtained from all subjects involved in the study.
Data Availability Statement: The raw data supporting the conclusions of this article will be made
available by the authors, without undue reservation.
Conflicts of Interest: The authors declare no conflict of interest.

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