Central European Journal of Sport Sciences and Medicine


ISSN: 2300-9705    eISSN: 2353-2807    OAI    DOI: 10.18276/cej.2026.1-02
CC BY-SA   Open Access   DOAJ  DOAJ  DOAJ

Issue archive / Vol. 53, No. 1/2026
Mechanisms of Exercise Limitation during Incremental Testing in Postmenopausal Obesity: A Cardiopulmonary Case Series

Authors: Matteo Pusceddu ORCID
Department of Human Sciences and Promotion of Quality of Life, San Raffaele Open University, 00166 Rome, Italy

Faranak Balaghi Inaloo ORCID
Department of Exercise Physiology, Faculty of Sports Sciences, Hakim Sabzevari University, Sabzevar, Iran
Keywords: obesity postmenopausal women incremental exercise testing cardiopulmonary exercise testing metabolic response respiratory exchange ratio
Whole issue publication date:2026
Page range:9 (17-25)
Cited-by (Crossref) ?:

Abstract

Background: Obese postmenopausal women are at high risk for cardiometabolic disease, yet the specific physiological patterns of their exercise intolerance remain poorly described. Emerging evidence suggests that this intolerance reflects the combined effects of reduced cardiovascular reserve, impaired metabolic flexibility, and autonomic dysregulation, which may be detectable using cardiopulmonary exercise testing (CPET). This case series aimed to characterize the cardiorespiratory and metabolic responses to graded exercise in this population. Case summary: We present nine sedentary, obese postmenopausal women (mean age 56.78±9.02 years; BMI 33.87±3.8 kg/m²) who underwent maximal cardiopulmonary exercise testing using graded cycle ergometry. Key parameters (VO₂, VCO₂, respiratory exchange ratio (RER), heart rate (HR), and O₂ pulse) were recorded at rest (Rest.3), the anaerobic threshold (AT), maximum workload (Wmax), and at 1 (Rec.1) and 3 (Rec.3) minutes into recovery. Results revealed severely impaired functional capacity, with peak oxygen uptake (VO₂max) ranging from (4±1) to (16±3) ml/kg/min. Key findings included profound metabolic inflexibility (high resting and recovery RER) and delayed heart rate recovery, indicative of autonomic dysfunction. Conclusion: This case series highlights a triad of physiological impairments including reduced cardiovascular reserve, metabolic inflexibility, and autonomic dysfunction that contribute to severe exercise intolerance in obese postmenopausal women. These findings support the clinical value of CPET for identifying individual-specific physiological limitations and guiding personalized exercise interventions in this high-risk population.
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