1. Pediatric Exercise Research Center
Terminology Harmonization in Exercise Medicine and Exercise Science
Dan M. Cooper MD ● Professor of Pediatrics and Bioengineering ● Associate Vice Chancellor, Translational Science ● PI UCI NIH Clinical Translational Science Award ● UC Irvine Health
Pediatric Exercise Research Center

2. Project Need - What Need is the Project Addressing
A healthy 9-year-old boy (LEFT PANEL) and an elderly adult with peripheral vascular disease (RIGHT PANEL) undergoing CPET.

3. For both children and adults, there remain many discrepancies in terminology and data procedures.
As a consequence, the benefit of exercise biomarkers for a wide range of disease across the lifespan has not been realized.

4. Physical inactivity Reduced physical fitness
Environment (obesity)
Chronic disease
Disability
Paucity of interventions specifically designed for inactive youth
Physical
inactivity
Sedentary
lifestyle
Reduced
physical fitness
Immediate health
impairment
active play
screen time
Health impairment across the lifespan
relentless
deconditioning
chronic inflammation

5. How to assess physical fitness in the laboratory?

6. VO2max ∆VO2/∆HR Anatomy of Cardiopulmonary Exercise Testing
Oxygen
Uptake
(V̇O2)
Work rate input
∆VO2/∆HR
Time (or HR, gas exchange, etc.)

7. Long Term Goals
To work with clinical experts in Exercise Medicine and Sciences in partnership with Standards Development Organizations to create a national standardized set of terminologies.
To ensure that the harmonized terminologies reflect the needs and interests of health care providers who use exercise testing in the clinical setting, as well as those of translational researchers engaged in more basic investigations of the biologic responses to physical activity.
To ensure that the harmonized terminologies are rapidly incorporated into standards that inform and govern usage in the EHR, thereby contributing to a learning health system.

8. Examples of exercise biomarker nomenclature prioritized by 38 experts for harmonization from 27 terms considered as essential in interpreting exercise and physical activity testing.
Terminology
Priority
VO2max or peak 1
Fitness 2
Habitual Physical Activity 3
Body Composition 4
Exercise Prescription 5
Anaerobic Threshold 6
Work efficiency 7
Gas exchange slopes 8
HR Variability 9
CPET Protocols 10
Field testing 11
Recovery times 12
Oxygen pulse 13
Oxygen deficit 14
Wingate test 15

9. Involvement of the Research and Clinical Community- Organization List
Shlomit Aizik, PhD, Director, Pediatric Exercise and Genomics Research Center, UC Irvine
Peter Brubaker, PhD, Professor, Health and Exercise Science, Wake Forest University; Executive Director, Healthy Exercise & Lifestyle Program (HELPS).
Bareket Falk, PhD, Professor of Kinesiology, Brock University; Editor-in-Chief of the journal Pediatric Exercise Science.
Martha Gulati, MD, Professor of Cardiology, University of Arizona, Phoenix
Helge Hebestreit, MD, Professor of Pediatrics, University of Wurzburg, Germany
John Jakicic, PhD, Professor and Chair of the Department of Health and Physical Activity at the University of Pittsburgh.
Wendy Kohrt, PhD, Professor of Medicine in the Division of Geriatric Medicine at the University of Colorado Anschutz Medical Campus; Director of Research for Geriatric Medicine and the Director of the IMAGE research group (Investigations in Metabolism, Aging, Gender, and Exercise).
Jonathan Myers, PhD, Director, Exercise Research Laboratory, VA Palo Alto Health Care System; Clinical Professor, Stanford University.
Kathy Sietsema, MD, Professor of Medicine and Chief of the Division of Respiratory & Critical Care Physiology & Medicine at Harbor-UCLA Medical Center.

10. Abdulmalik Shakir
Anita Walden

11. Status of the Project
Biweekly phone calls
Face-to-face meeting
Homework

13. A look at the Data Elements