Bruce and Balke-Ware treadmill protocol

Purpose of test:

To assess cardio-respiratory endurance.

Equipment required:

• Treadmill with speed and grade of slope adjustment

• Rating of Perceived Exertion (RPE) Scale

• Scales

• Measuring tape

• Heart rate (HR) monitor (optional if the treadmill can monitor heart rate)

• Sphygmomanometer to measure blood pressure (BP)

Test procedure:

Record the baseline heart rate and blood pressure, as well as basic information including

age, height, and weight. Calculate the predicted maximum heart rate and then 75% of the

maximum heart rate. Allow the client to familiarise themselves with walking on a treadmill

before conducting the test.

Note: See ‘Heart Rate’ test for calculations to predict maximum heart rate.

Set the initial treadmill speed at 3.3 mph (5.31 kph) and the gradient at 0%, and then

instruct the client to start walking. Increase the gradient to 2% at the end of the first minute,

and then increase by 1% at the end of every minute therea!er. At the end of every minute,

record the heart rate and the RPE. If possible, measure blood pressure at the end of every 2

minutes. Continue to monitor the client’s appearance and expressions for the duration of the

test (Maud & Foster, 2006). If the client reaches an incline of 25%, then gradually increase

the speed by 0.2 mph (0.32 kph) per minute.

The test is terminated when the client reaches 75% of their maximum heart rate, when the

client asks to stop, or when any of the indicators below are present.

‘Reasons for terminating the test include:

• Client experiences angina-like symptoms

• Client’s BP drops below 20 mmHg from the BP value recorded at rest or shows no increase

in systolic BP with increased exercise intensity.

• Client has an excessive rise in systolic BP over 260 mm Hg and/or a diastolic BP over 115

mm Hg.

• Client is not sweating; feels light-headed, confused, or unsteady; looks pale, or has blue


• Client’s heart rate does not rise with increased exercise intensity.

• Client has a noticeable change in heart rhythm.

• Client requests to stop.

• Client shows physical or verbal signs of severe fatigue.

• Failure of the testing equipment.’

(Jones & Rose, 2005; adapted from American College of Sports Medicine’s (ACSM)

Guideline for exercise testing and prescription (6th ed., 2000).

Note: If the test is terminated due to any of the above the reasons, immediately remove the

client from the treadmill.

Upon completion of the test, heart rate and RPE need to be recorded immediately and the

grade of the treadmill returned to 0%. The client is then instructed to walk for a further 4

minutes, and heart rate and RPE are recorded at the end of each minute of recovery.

The following equation can be used to estimate VO2 max in millilitres per kilogram per minute

(–1.min–1) at the target heart rate (75 % of the predicted maximal heart rate):

VO2 max (–1.min–1) = (0.1 x speed) + (1.8 x speed x grade) + 3.5

Note: Speed is expressed in metres per minute, and the grade is expressed as a decimal

fraction, for example, 10% grade is 0.1 (Jones & Rose, 2005).

The following equation can also be used to determine VO2 max; VO2 max norms for the

following equation are shown in Table 2:

VO2 max (–1.min–1) = 11.12 + (1.15 x time) (Neiman, 2007).


American College of Sports Medicine (ACSM). (2006). ACSM’s guidelines for exercise testing

and prescription (7th ed.). Munice, IN: Lippincott Williams & Wilkins.