Exercise Testing in Laryngectomized Patients | 219 9 participant’s estimated fitness level25. Patients were encouraged to push themselves maximally during the CPET. Indications for terminating CPET were chest pain, ischemic ECG changes, sudden pallor, signs of respiratory failure, and patients’ wish to stop. Before the test, it was explained to patients that symptoms such as muscle fatigue and exhaustion are not reasons for stopping, but normal responses to the effort on the CPET. VO2 peak was obtained by taking the average value over the last 30 seconds of the exercise test. Anaerobic threshold was determined by using the V-slope method26. The two exercise tests were conducted with the same test protocol and under similar testing conditions, with the only difference being the HME in use. See figure 2 for the study set-up with a patient during CPET. Figure 2. CPET set-up. A study participant* connected to a breathing gas analyzer while seated on the exercise bicycle. *The participant gave permission to use his picture in this article, see signed contract appendix A
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