A widely used exercise test is performed on a treadmill. Since exercise has been used as a diagnostic tool, there have been many different protocols for how to conduct a test on different equipment. The most commonly used protocol for treadmill exercise testing performed today is the Bruce protocol, as 82% of cardiology divisions surveyed reported using the Bruce protocol (Ashley, Myers, and Froelicher 2000). This protocol was developed by Robert Bruce in 1963. The Bruce protocol involves several stages of testing; each phase of the test runs for three minutes before moving on to the next phase. The speed and incline of the treadmill increase in each phase. The speeds for each stage are as follows: 1.7, 2.5, 3.4, 4.2, 5.0, 5.5, and 6.0 miles per hour. Along with speed, the slope increases relative to the horizontal plane as follows: 10, 12, 14, 16, 18, 20 and 22% slope (Weber & Janicki 1986). The advantage of the Bruce protocol is offset by the fact that many participants are unable to complete a phase because they have cardiovascular problems and find this level of intensity too difficult (Ashley, Myers, and Froelicher). Due to the difficulty of Bruce's treadmill protocol, the Ramp test was developed and introduced in 1991. This protocol is conducted by taking the subject from rest to maximal effort through a linear increase in exercise over a period of approximately 10 minutes (Ashley, Myers, & Frölicher, 2000). The Duke Treadmill Score is an equation used to calculate the 5-year mortality rate. This is achieved by examining three different variables: ST-segment depression, exercise capacity, and the presence of angina. The equation is as follows: DTS = EXmin – (5 x STdev) - (4 x ANGex). This equation will give you a typical score between -25 and +15 low rating