The Super Mario Way: Assessing the Suitability of Trampoline Jumping for Cardiopulmonary Exercise Testing and Developing an Appropriate Testing Protocol

Background: Cardiopulmonary exercise testing (CPET) of children can be difficult, since they often lack the coordination for treadmill testing and are too small for cycle ergometry. Previous alternative testing methods using mobile equipment outdoors have proven to be successful. However, motivation and safety issues necessitate new and alternative approaches. The objective of this study was to assess the suitability of trampoline jumping as a modality for CPET compared to traditional treadmill tests as well as developing an appropriate testing protocol. We tested adults for safety reasons.

Method: Thirty young healthy adults (17 males, 13 females) with a mean age of 23.9 years were recruited to perform a treadmill test and a trampoline test with a minimum of one week apart. The running test started at 4 km/hour, increasing the speed by 2 km/h every two minutes until exhaustion. The jumping test was performed using a portable CPET device. The testing protocol with five 2-minute levels started with slow walking in place and ended with maximum intensity jumping. Samples for capillary blood gas analysis were taken after each test to determine blood lactate levels. In both tests, portable ECG-devices were used to measure the heart rate (HR).

Results: The statistical results are represented in Table 1. The peak oxygen uptake (VO₂ peak) on the trampoline did not differ significantly from the treadmill. The maximum HR (HR max) was significantly lower while jumping than running. The maximum RER (RER max) on the trampoline was significantly lower than on the treadmill. Lactate levels after jumping did not differ significantly from running.

Table 1	Trampoline	Treadmill	Two-tailed p
VO2 peak (mL/min/kg)	43.42	43.85	0.561
HR max (bpm)	181.64	189.68	0.007
RER max	1.04	1.12	< 0.001
Lactate (mmol/L)	10.18	11.06	0.626

Conclusion: The trampoline seems to be an adequate alternative for the treadmill as both tests produce comparable results. Due to the lower maximum RER measured during the trampoline tests, it can be assumed that even higher performance values are possible on the trampoline. We are planning the implementation of the test protocol in children and patients with congenital heart disease.