The Bruce protocol is a standardized diagnostic test used in the evaluation of cardiac function and physical fitness, developed by American cardiologist Robert A.

The test is easy to perform in a medical office setting, does not require extensive training or expensive equipment, and it has been validated as a strong predictor of clinical outcomes.

Bruce's first reports on treadmill exercise tests, published in 1949, analyzed minute-by-minute changes in respiratory and circulatory function of normal adults and patients with heart or lung disease.

[8][9] In 1950 Bruce joined the University of Washington, where he continued research on the single-stage test, particularly as a predictor of the success of surgery for valvular or congenital heart disease.

In the initial paper, Bruce reported that the test could detect signs of such conditions as angina pectoris, a previous heart attack, or a ventricular aneurysm.

Bruce and his colleagues also demonstrated that exercise testing was useful in screening apparently healthy people for early signs of coronary artery disease.

[citation needed] The Modified Bruce protocol starts at a lower workload than the standard test and is typically used for elderly or sedentary patients.

[citation needed] ref: ACSM's Health-Related Physical Fitness Assessment Manual Maximum heart rate (MHR) is often calculated with the formula 220-age, which is quite inaccurate.