Tests of repetition maximum (RM) are safe for people with cancerwithout bony metastases. You may choose to do a 1 RM or multiple RM/ estimated 1RM test. If you choose to do an estimated 1RM test, you can calculate your starting intensity using the Byrziki equation:
1RM = Weight ÷ ( 1.0278 – ( 0.0278 × Number of repetitions )
To perform RM testing, you will need a pin loaded weights machine. Chest press and leg press are commonly used in RM testing but you can perform this test for any muscle group
Familiarise patient with equipment
Complete a warmup set of submaximal repetitions of the movement you want to determine the RM
Determine the 1 RM (or multiple RM) within four trials with rest periods of at least 2 minutes between trials
Progressively increase weight 5-10% for upper or 10-20% for lower body exercise until a second repetition (or selected number of repetitions) cannot be completed (10 RPE).
You may ask the patient how hard the weight is being lifted on a scale from 0 (light as a feather) to 10 (heavy as a ton of bricks) after each trial to help determine the weight progression
(adapted from ACSM Guidelines for Exercise Testing and Prescription 10th Ed.)
Source: PRESTO Trial, funded by MRFF
An advantage of the 1RM test is that it is quicker than an estimated 1 RM and there is no need for calculations. However, the 1RM may not be appropriate where patients are very deconditioned, unfamiliar with gym equipment or have other musculoskeletal problems preventing safe completion.
RM testing should be avoidedat the affected siteswhere patients have bony metastases or known or suspected osteoporosis. (e.g. avoid leg press for people with pelvic or femur metastases). Other sites without lesions can be tested (e.g. 1RM chest press for people with only lower limb metastases).
Check your individual site protocols whether medical clearance is required for testing.