Preview
Hüseyin Akbulut, MSc (2026). Naughton Protocol — Protocol, Norms and Application. Sporeus. Retrieved, July 9, 2026. https://sporeus.com/en/egzersiz-testleri-en/naughton-protocol/
2 min read
Measures: Düşük kondisyonlu ve kardiyak hastalarda egzersiz kapasitesi
Table of Contents
Difficulty: Easy | Category: Aerobic
Protocol
The Naughton Protocol, developed by Naughton et al. in 1964, is a treadmill exercise test designed for cardiac patients and individuals with low fitness. It progresses very slowly with gradual increases in both speed and grade every 2 minutes. Preparation: ECG electrodes and blood pressure cuff are fitted. The treadmill is set to 1.6 km/h on level ground. The participant should be prepared for mild symptoms, and emergency equipment must be on hand. Protocol Stages: – Stage 1: 1.6 km/h, 0% grade, 2 minutes – Stage 2: 1.6 km/h, 3.5% grade, 2 minutes – Stage 3: 3.2 km/h, 0% grade, 2 minutes – Stage 4: 3.2 km/h, 3.5% grade, 2 minutes – Stage 5: 3.2 km/h, 7% grade, 2 minutes – Stage 6: 4.8 km/h, 0% grade, 2 minutes – Stage 7: 4.8 km/h, 3.5% grade, 2 minutes – Subsequent stages continue with 3.5% grade increments. Data Recording: Heart rate, blood pressure, ECG, and RPE are recorded at each stage. The test is immediately terminated if abnormal cardiac response or symptoms develop. Calculation: Standard ACSM metabolic formulas are applied to calculate MET values from speed and grade at each stage. Post-Test: Cool-down is performed for 3 minutes at low speed on level ground. ECG monitoring continues. The patient and clinician evaluate the results together.Formula
MET = ACSM walking formula: VO₂ = 0.1×speed_m/min + 1.8×speed_m/min×grade + 3.5
Equipment Required
koşu bandı, EKG monitörü, kan basıncı manşeti, kalp atım hızı monitörü
Normative Values (Age: 50-70 (kardiyak hasta))
| Classification | Male | Female |
|---|---|---|
| Excellent | >7 MET | >6 MET |
| Good | 5-7 MET | 4-6 MET |
| Average | 3-5 MET | 2.5-4 MET |
| Below Average | 2-3 MET | 1.5-2.5 MET |
| Poor | <2 MET | <1.5 MET |
Practical Applications
The Naughton protocol is ideal for initial assessment in cardiac rehabilitation programs, postoperative functional capacity measurement, and safe stress testing in elderly sedentary individuals.Limitations
Progresses too slowly for healthy and fit individuals; does not yield meaningful results in these groups. Clinical supervision and ECG monitoring are mandatory.Related Tests: Modified Balke Protocol, Bruce Protocol, 6-Minute Walk Test
Sources: Naughton J et al., 1964, Am J Cardiol; ACSM Guidelines, 2021
References
- Naughton J, Balke B, Nagle F. (1964). Refinements in method of evaluation and physical conditioning before and after myocardial infarction. American Journal of Cardiology, 14: 837-843. doi:10.1016/0002-9149(64)90011-6
- Pollock ML, Bohannon RL, Cooper KH, Ayres JJ, Ward A, White SR, Linnerud AC. (1976). A comparative analysis of four protocols for maximal treadmill stress testing. American Heart Journal, 92(1): 39-46. doi:10.1016/S0002-8703(76)80401-2
- American College of Sports Medicine. (2021). ACSM’s Guidelines for Exercise Testing and Prescription (11th ed.). Philadelphia: Wolters Kluwer.
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Key Facts
Protocol The Naughton Protocol, developed by Naughton et al. in 1964, is a treadmill exercise test designed for cardiac patients and individuals with low fitness. It progresses very slowly with gradual increases in both speed and grade every 2 minutes. Preparation: ECG electrodes and blood pressure cuff are fitted. The treadmill is set to 1.6 km/h on level ground. The participant should be prepared for mild symptoms, and emergency equipment must be on hand. Protocol Stages: - Stage 1: 1.6 km/h, 0% grade, 2 minutes - Stage 2: 1.6 km/h, 3.5% grade, 2 minutes - Stage 3: 3.2 km/h, 0% grade, 2 minutes - Stage 4: 3.2 km/h, 3.5% grade, 2 minutes - Stage 5: 3.2 km/h, 7% grade, 2 minutes - Stage 6: 4.8 km/h, 0% grade, 2 minutes - Stage 7: 4.8 km/h, 3.5% grade, 2 minutes - Subsequent stages continue with 3.5% grade increments. Data Recording: Heart rate, blood pressure, ECG, and RPE are recorded at each stage. The test is immediately terminated if abnormal cardiac response or symptoms develop. Calculation: Standard ACSM metabolic formulas are applied to calculate MET values from speed and grade at each stage. Post-Test: Cool-down is performed for 3 minutes at low speed on level ground. ECG monitoring continues. The patient and clinician evaluate the results together. Formula
MET = ACSM walking formula: VO₂ = 0.1×speed_m/min + 1.8×speed_m/min×grade + 3.5
Equipment Required
koşu bandı, EKG monitörü, kan basıncı manşeti, kalp atım hızı monitörü
