Die Fahrradergometrie in der arbeitsmedizinischen Vorsorge

A sufficiently high level of physical performance is of elementary importance for many occupational groups for coping with the daily work requirements. These include the fire brigade, police, military and also those employed in the construction industry, mining and agriculture. For the examination of the physical performance (bicycle) ergometry is available to the occupational physician as a standardized investigation, which is feasible under practical conditions.

Taking the national and international guidelines and current scientific literature into consideration, the knowledge, prerequisites, indications and contraindications of ergometry that are necessary for the occupational physician are summarized. The recommendations for implementation are presented. Abort criteria in cases of pathological abnormalities or when the maximum workload is reached are listed. The advantages and disadvantages of gradual vs. ramp loading are shown. In addition to the physiologically expected reactions in this stress test, the limited sensitivity and specificity of ergometry for the diagnostics of coronary heart disease are discussed using examples of false positive and false negative ergometry examinations for men and women aged 50–59 years with unclear chest pains. Moreover, the different forms of ergometry and the partially limited comparability with each other and with real working conditions make the validity of bicycle ergometry for assessing the physical performance of a test person more difficult, since only the specific bicycle ergometric performance is tested. Therefore, despite the low complication rates in healthy and young volunteers, the use of bicycle ergometry in preventive occupational healthcare should not automatically be used in the assessment of physical performance for a subject’s employment in a particular workplace.