 
© 2010 by Sports Medicine Research Center, Tehran University of Medical Sciences, All rights reserved. 
ORIGINAL ARTICLE
41 
             A Regression Equation for the Estimation of Maximum Oxygen 
Uptake in Nepalese Adult Females 
Pinaki Chatterjee*1,2, PhD; Alok K Banerjee2,  PhD; Paulomi Das3,4, PhD; Parimal Debnath4, PhD 
1. Department of Physiology, SR 
College of Dental Sciences 
and Research, Faridabad, India  
2. Department of Physical 
Education, Kalyani 
University, Kalyani, West 
Bengal, India 
3. Department of Physiology, 
Nepalgunj Medical College, 
Chisapani, Banke, Nepal 
4. Department of Physical 
Education, Jadavpur 
University, Kolkata, India 
* Corresponding Author; 
Address: Reader & HOD, 
Department of Physiology, S. R. 
College of Dental Sciences and 
Research, Faridabad, India 
 
E-mail: pnkchatterjee@yahoo.com 
 
Received: Jun 09, 2009  
Final Revision: Jul 21, 2009 
Accepted: Oct 21, 2009 
 
Key Words: Cardiovascular 
fitness; VO2max; Beep test; 
Indirect measurement; 
Sedentary 
 
Abstract 
Purpose: Validity of the 20-meter multi stage shuttle run test (20-m 
MST) has not been studied in Nepalese population. The purpose of 
this study was to validate the applicability of the 20-m MST in 
Nepalese adult females. 
Methods: Forty female college students (age range, 20.42 ~24.75 
years) from different colleges of Nepal were recruited for the study. 
Direct estimation of VO2 max comprised treadmill exercise 
followed by expired gas analysis by scholander micro-gas analyzer 
whereas VO2 max was indirectly predicted by the 20-m MST. 
Results: The difference between the mean (±SD) VO2 max values of 
direct measurement (VO2 max=32.78 +/-2.88 ml/kg/min) and the 
20-m MST (SPVO2 max = 32.53+/-3.36 ml/kg/min) was statistically 
insignificant (P>0.1). Highly significant correlation (r=0.94, P<0.01) 
existed between the maximal speed of the 20-m MST and VO2 max. 
Limits of agreement analysis also suggest that the 20-m MST can be 
applied for the studied population. 
Conclusion: The results of limits of agreement analysis suggest that 
the application of the present form of the 20-m MST may be 
justified in the studied population. However, for better prediction 
of VO2 max, a new equation has been computed based on the 
present data to be used for female college students of Nepal. 
    Asian Journal of Sports Medicine, Vol 1 (No 1), March 2010, Pages: 41-45 
 
INTRODUCTION 
irect measurement of maximum oxygen uptake 
(VO2 max) is recognized as the best single index 
of aerobic fitness[1]. But the test of the direct 
measurement of cardiorespiratory endurance (VO2 
max) itself is difficult, exhausting and often hazardous 
to perform regardless the type of ergometer used [2]. 
Since the direct testing procedure is rather complicated 
on larger populations, several indirect running and 
walking field tests have been developed. Scientists 
often calculate VO2 max with indirect protocols[3]. It 
has been stated that equations for predicting VO2 max 
indirectly using field tests are very sensitive to 
populations tested on. Therefore, before applying any 
D 
 
 
Chatterjee P, et al 
Vol 1, No 1, March 2010 
42 
indirect protocol for prediction of VO2 max, the 
validity of the test should be established in a particular 
population. The 20-meter multistage shuttle run test 
(20-m MST); [4,5], popularly known as Beep test, is 
often used worldwide for measurement of aerobic 
capacity [6,7,8,9,10]. But in Nepal, the scientists have not 
yet used this test. Cooper et al,[11] studied the 
repeatability and criterion related validity of the 20-m 
multistage fitness test as a predictor of maximal 
oxygen uptake in active young men. Suminski et al,[12] 
established the validity of the 20-m MST for measuring 
aerobic fitness of Hispanic youth of 10 to 12 years of 
age. Chatterjee et al, [13,14] studied the validity of 20-m 
MST in junior Taekwondo players and male university 
students of India. However, the validity and suitability 
of this test have not been studied in any Nepalese 
population until now. Nepal is the neighboring country 
of India, but a point to be noted here is that there are 
racial differences as well as differences in habitual 
activities and that the people of Nepal live at high 
altitudes.  
   A recent study suggests that gender-distinctive 
equations provide more accurate prediction of VO2 
max from 20-m MST [15]. For this reason, only female 
adults were recruited as subjects in the mentioned 
study and not males. Keeping in view all these facts, 
the present study was undertaken with an objective to 
assess the applicability of the 20-m MST to predict 
VO2 max in female college students of Nepal. 
METHODS AND SUBJECTS 
Subjects: 40 female college students from different 
colleges of Nepal were volunteered for the study. The 
subjects had the mean age of 22.04 yr., height of 
157.41 cm, and weight of 49.83 kg. The experimental 
protocol was fully explained to the participants and 
they underwent familiarization trial of the beep test few 
days before the actual test. They had a light breakfast 
2-3 hours before the test and refrained from any 
energetic physical activity for that period. The 
participants had no history of any major disease and 
did not follow any physical-conditioning program, 
except from some recreational sports. The tests were 
demonstrated 
to 
the 
subjects 
before 
actual 
administration and they agreed to sign a statement of 
informed consent. All institutional policies concerning 
the human subjects in research were followed. The 
tests for all the subjects were done in the morning so 
that diurnal variation can be avoided, if there was any. 
Experimental 
Design: 
Maximum 
oxygen 
consumption of each subject was determined by both 
indirect and direct methods at an interval of 4 days by 
random sequencing. Indirect one in the half of the 
subjects followed the direct method whereas indirect 
one was followed by direct method in the other half of 
the subjects. This was done so to avoid any possibility 
of bias. Subjects were asked to take complete rest at 
least for half an hour prior to the exercise, so that 
pulmonary ventilation and pulse rate might come down 
to a steady state [16]. 
Prediction of maximum Oxygen uptake capacity by 
the 20-m MST: Subjects started running back and 
forth a 20-m course and must touch the 20-m line. The 
initial speed was 8.5 km/hr. The speed got 
progressively faster (0.5 km/hr every minute), in 
accordance with a pace dictated by a sound signal on 
an audiotape. Several shuttle runs made up each stage. 
The subjects were instructed to keep pace with the 
signal for as long as possible. When the subjects could 
no longer follow the pace, the last stage announced was 
used to predict the maximal oxygen uptake using the 
equation of Leger et al.[5].  The equation: 
Y= -27.4+6.0X, Where Y= VO2 max (ml/kg/min) & 
X= Maximal shuttle run speed (km/hr) 
Direct measurement of maximum oxygen uptake 
capacity: The subjects walked on a treadmill to warm 
up at a speed of 4 km/hr at a 4.5 inclination for five 
minutes [17]. Running at a constant speed of 7 km/hr for 
a maximum duration of 5 min followed this. The 
inclination gradient was increased successively from 
4.5 until the subject was unable to continue the task. In 
no case did it exceed 7.5 inclinations. The criteria to 
reach maximum state were exhaustion and withdrawal 
from running within the scheduled 5-min time period, 
when the heart rate reached the predicted maximum 
heart rate and when a further increase of inclination did 
not bring about any significant rise in oxygen 
uptake[16]. 
 
 
Vol 1, No 1, March 2010 
Validity of 20-m MST
 
43 
     Low resistance high velocity Collin’s Triple “J 
type” plastic valve was used for the collection of gas 
by open circuit method[16]. The valve was connected 
with the Douglas bag (150-liter) and the expired gas 
was collected in the second minute of the exhausting 
final workload 
if 
signs 
of 
severe 
exhaustion 
supervened. No gas collection was made in the first 
minute of the workload. The expired gas measured in a 
wet gasometer (Toshniwal, Germany CAT No. C G 
05.10) and the aliquots of gas samples were analyzed 
in a Scholander micro gas analysis apparatus following 
the standard procedure [18]. 
Statistical Analyses: The aired t-test, Pearson’s 
product moment correlation, linear regression statistics 
and Bland and Altman approach for limit of agreement 
were adopted for statistical analyses of the data. 
Statistical package for Social Sciences (SPSS) MS 
windows Release 11.5 was used for statistical analyses. 
    To determine validity of the results, repeatability 
was investigated where 22 subjects performed the test 
(20-m MST) twice. The results showed non-significant 
bias between the two applications of the 20-m MST 
(mean of the difference +/- standard deviation of the 
difference = -0.13±1.8 ml/kg/min; t = -0.32; P=0.7 
with 95% limits of agreement). 
RESULTS 
Means 
and 
standard 
deviations 
of 
physical 
characteristics, predicted VO2 max (SPVO2 max) by 
20-m MST and directly measured VO2 max of the 
participants are presented in the table 1. 
    No significant variation was observed (P>0.1) 
between the values of directly measured and predicted 
VO2 max. The mean difference between VO2 max and 
SPVO2 max was 0.27 ml/kg/min with 95% confidence 
interval of -0.11 to 0.66 ml/kg/min. This indicates that 
20-m MST predicted the maximum oxygen uptake 
capacity between -0.11 to 0.66 ml/kg/min. The 
standard error when predicting the VO2 max from 
shuttle run test was 0.53. 
   Analysis of data by Bland and Altman[19] method of 
approach for limits of agreement between SPVO2 max 
and VO2 max reveals that limits of agreement are –2.15 
to 2.69 (Fig 1). These parameters are small enough for 
the 20-m MST to be used confidently in place of the 
direct method. Limits of agreement analysis suggest 
that application of the present form of the 20-m MST 
should be justified for the studied population.  
     Highly significant correlation (r=0.94, P<0.01) 
existed between the maximal speed of the 20-m MST 
and VO2 max.  
DISCUSSION 
The following equation, derived on the basis of present 
data will better predict the aerobic fitness in female 
college students of Nepal: 
Y= - 15.207 + 4.806 X 
Where Y= VO2 max (ml/kg/min) and 
Table 1: Physical parameters, predicted and measured VO2 max of the subjects (N=40) 
Parameter  
Minimum 
Maximum 
Mean 
Std. Deviation 
Age (yr.) 
20.42 
24.75 
22.04 
1.14 
Height (cm) 
154.10 
160.30 
157.41 
1.79 
Weight (kg) 
42.50 
57.20 
49.83 
4.21 
VO2 max‡ (ml/kg/min) 
26.90 
38.00 
32.78 
2.88 
SPVO2 max* 
(ml/kg/min) 
26.60 
38.60 
32.53 
3.36 
Speed (km/hr) 
9.00 
11.00 
9.99 
0.56 
 
 
‡VO2 max: maximum oxygen uptake /   * SPVO2 max: predicted VO2 max 
 
 
Chatterjee P, et al 
Vol 1, No 1, March 2010 
44 
-3
-2
-1
0
1
2
3
0
10
20
30
40
50
Average of VO2 max (ml/kg/min) obtained from two methods
Difference between VO2 max and SPVO2 
max (ml/kg/min)
Mean +2SD = 
2.69,
  
   Mean =0.27,
Mean- 2SD =-2.15
 
Fig. 1: Plotting of difference between VO2 max values against their means 
(Bland and Altman method of approach) 
X= Maximal shuttle run speed (km/hr) 
Using the above new equation the limits of agreement 
between directly measured VO2 max and predicted VO2 
max from the 20-m MST (SPVO2 max) are -2.01 to 
2.03. The result suggests that better limits of agreement 
exist between the two methods when this newly 
developed equation is used for prediction of VO2 max 
from the 20-m MST.  
     Therefore, from the present observations it is 
concluded that the 20-m MST is recommended as a 
valid method to evaluate aerobic fitness in terms of 
VO2 max among female adults (age 20.42~24.75 yr.) of 
Nepal.  
   A recent study has indicated that there are sport-
specific differences when predicting VO2 max results 
yielded from the MST [20]. In another recent study by 
Cetin et al. on Taekwondo athletes, the authors 
concluded that VO2 max can be predicted from shuttle 
run test scores, but not as indicated with the test 
package. In order to obtain the true scores, one must 
apply a regression equation[21]. Studies by Chatterjee et 
al. on two different population of India also suggested 
separate regression equations for prediction of VO2 
max in a particular population[13,14]. In our present 
study too, it is found that 20-m MST can be used in the 
studied population, but for better prediction a new 
regression equation has been derived. 
CONCLUSION 
The regression equation developed on the basis of 
present data is recommended to be used for the 
population studied. This is likely to be the most useful 
method when a large number of subjects are to be 
evaluated without the help of a well-equipped 
laboratory, with fewer expenses and within a short 
period of time. In a country like Nepal where 
laboratory facilities for direct evaluation of aerobic 
fitness is scanty, this method may be of great 
importance. Efforts should be taken to validate the 
applicability of 20-m MST in different Nepalese 
population including various sports disciplines. 
 
 
Vol 1, No 1, March 2010 
Validity of 20-m MST
 
45 
ACKNOWLEDGMENTS 
The authors thank to all the subjects of this study and 
the authorities of their respective colleges for their all-
out cooperation during the study.  
Conflict of interests: None declared 
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A regression equation for the estimation of maximum oxygen uptake in nepalese adult females.
Chatterjee, Pinaki,Banerjee, Alok K,Das, Paulomi,Debnath, Parimal