Which exercise testing protocol is most appropriate for a deconditioned patient with chronic disease?

The Naughton Protocol is particularly suited for deconditioned patients with chronic disease due to its gradual and adjustable nature. This protocol features a low initial workload that increases slowly, which is essential for individuals who may have compromised physical capabilities or significant symptoms related to their chronic conditions.

The ramping increments of intensity allow for closer monitoring of the patient's response to exercise, providing ample opportunity to assess tolerance without pushing the individual too hard too quickly. This approach mitigates the risk of adverse events, making it a safe and effective option for this population.

In contrast, the other protocols, such as the Bruce, Balke, and Ellestad, typically start at higher workloads or increase intensity more rapidly, which may not be appropriate or safe for deconditioned individuals. These alternatives might lead to early exhaustion, discomfort, or even exacerbate existing chronic conditions, making the Naughton Protocol the most suitable choice in this scenario.