What Is the Bruce Protocol?

The Bruce protocol is a stress test performed on a treadmill to evaluate patients with potential heart disease. The function of the heart and lungs is assessed before, during and after the administration of the stress test with a progressively increased treadmill incline and speed. Athletes implement this treadmill test to determine fitness by calculating the volume of oxygen consumed during exercise at maximum capacity.

History

• At the University of Washington, American cardiologist Dr. Robert A. Bruce published the established standards of this multistage test in 1963. The test presented a solution of analyzing heart and lung function for patients while undergoing physical exercise. Prior to the Bruce protocol, overly strenuous stair step tests were employed, proving to be too much of a strain for less than healthy individuals.

Procedure

• Electrodes are attached to the chest, hips and shoulders of a patient to provide information on heart and blood vessel activity while walking on the treadmill. The incline and speed of the treadmill are increased every three minutes through a total of seven stages. At the onset, the treadmill is set at 1.7 mph at a 10 percent incline. After three minutes, speed is increased to 2.5 mph and the incline is adjusted to a 12 percent grade. Throughout the remaining stages, the speed and incline are elevated with similar increases every three minutes. Blood pressure is monitored at each stage. Oxygenation of the blood is also sometimes reviewed.

Function

• This treadmill test is beneficial in the evaluation of the physical condition of the lungs, heart and blood vessels. The stress test can identify chest pain or discomfort (known as angina pectoris), prior heart attack and possible ventricular aneurysm (or a bulge in the wall of one of the lower chambers of the heart). Athletes utilize the Bruce protocol to calculate general endurance during extensive exercise by applying an equation to measure the maximum amount of oxygen one uses in one minute based on body weight.

Theory

• In one of Dr. Bruce's studies, 63 percent of the participants reported that as a result of the test, they had chosen to change unhealthy behaviors. Modification of risky life practices presents a benefit of the protocol over and above the identification of potential cardiac impairment.

Warning

• Performance of the Bruce protocol by athletes is not advised without a professional trainer or qualified medical person in attendance. The test is extreme, designed for the participant to continue to a point of complete fatigue, which is exhibited by disabling pain or physical exhaustion.