4 - Aerobic Exercise Testing and Cardiorespiratory Fitness

Ex. Phys exam 2

applications of exercise testing

diagnosis, prognosis, therapeutic applications, including exercise prescription

what is the order fitness components should be assessed?

1. resting measurements

2. cardiorespiratory fitness

3. muscle strength

4. muscle endurance

5. muscle flexibility

for diagnostic exercise testing use _____ test

Graded Exercise

Symptom-Limited Graded Exercise Test (GXT-SL) common purposes:

assess myocardial ischemia, assess ventricular arrhythmia

who is tested in a Symptom-Limited Graded Exercise Test?

Patients with a high probability of disease

for prognosis testing use _____ test

Low-Level Graded Exercise Test (LL-GXT)

who is tested with GXT-LL (Low-Level Graded Exercise Test)?

mainly post-MI patients and those with known heart disease.

therapeutic applications for exercise testing includes:

exercise tests, max tests, occupational health assessment, etc.

who is tested for therapeutic application exercise tests?

anyone

what is the gold standard for cardiorespiratory fitness?

VO2max

how is VO2 measured?

direct and indirect calorimetry

indirect calorimetry

measures respiratory gases

direct calorimetry

measures body’s heat production to calculate energy expenditure

what is the most precise-non-invasive method for measuring gas concentrations?

metabolic cart

(T/F) equation based estimates are less error prone than other methods

F

what VO2max estimate method is most suitable in clinical practice?

equation based estimates, metabolic cart is used when exact measurement is needed

types of test protocols:

submaximal and maximal

submaximal test stages

single-stage, multi-stage

maximal test stages

multi-stage, “ramped”protocols that increase intensity progressively until exhaustion.

submaximal exercise testing can include ____ to allow for efficient testing in groups.

field tests

submax testing is more practical than max testing, especially in ____ or _____ individuals.

weak, deconditioned

underlying assumptions about submax tests

include that heart rate response is linear to exercise intensity (work rate) and that the subject is NOT on HR altering meds

when to terminate a submax test?

70% of HRR or 85% of HRmax is reached

the general procedures for submax protocols in a multi-stage test is to use ___ min stages with increments in work rate of ____ METS. Want to test ____ work rates

2-3, 1-3, 3-4

“ramp” method in max testing involves more frequent smaller incremental increases and steady state (is/is not) achieved

is not

advantages of ramp max testing

avoids large and unequal increments in workload, easier to individualize the test protocol, uniform increases in hemodynamic response, more accurate estimates of exercise capacity

when to conclude max exercise testing?

when 1 or more VO2max criteria are met

what is the targeted test duration of max testing?

8-12 min

what is the VO2max criteria?

• volitional fatigue/exhaustion

• plateau in VO2 despite increasing workload

• age predicted HRmax is reached

• RER >1.1

• blood lactate >8 mmol

testing modes include:

• treadmill

• cycle ergometer

• step

• field test

indications for cycle ergometry tests

balance or gait deficits present, orthopedic conditions prevent walk,running, simultaneous cardiac imaging

indications for arm ergometry

walk/run/cycling are contraindicated, repetitive UE tasks performed during ADL’s

(T/F) cycling tests may end prematurely due to localized fatigue and may have a lower VO2max on bike

T

single stage step tests include:

• Astrand and Rhyming

• YMCA 3-Minute Step Test

• Queens College Step Test

multi stage step tests include

• Canadian Home Fitness Test

• Chair Step Test

(T/F) Step test disadvantages are that they can be too intense, have a fall risk, and underestimate fitness in short/obese people

T

(T/F) Field tests are easy to monitor and often not maximal

F, difficult and often maximal due to lack of pacing

pre-test instructions:

• abstain from eating ___ hours before testing

• no strenuous exercise within ___hrs of test

• no ____-containing productions within 12-24 hrs of test

• no _____ within 3 hrs of test

• no alcohol within ___hr of test

• consult the test administrator/physician for advice on use of ____ before testing

4, 24, caffeine, nicotine, 24, medications

(T/F) there is no need to obtain resting vitals before aerobic exercise testing

F, should obtain

When should vital signs/subjective ratings be taken during aerobic exercise testing? (HR, BP, RPE, ECG, respiratory gases)

during each stage

what is the Borg scale?

RPE scale ranging from 6-19

(T/F) it is okay for an individual with ongoing unstable angina to do a SL-GXT

F

(T/F) tachyarrhythmias with uncontrolled ventricular rates is an absolute contraindication to SL-GXT

F, it is a relative contraindication

(T/F) recent stroke or transient ischemia attack is an absolute contraindication to SL-GXT

F, it is a relative contraindication

(T/F) an exercise test should be stopped at the onset of angina/angina-like symptoms

T

(T/F) SOB, wheezing, leg cramps, or claudication should not be an indication to stopping an exercise test

F

(T/F) Physical or verbal manifestations of severe fatigue are not a reason to stop exercise test

F

(T/F) absolute indications to terminate SL-GXT for cardiorespiratory patients is a drop in SBP >10mmHg despite an increase in workload when accompanied by other evidence of ischemia. (when not accompanied is a relative indication)

T

(T/F) an SpO2≤80% is an absolute indication to stop exercise test in cardiorespiratory patients

F, it is a relative indication

(T/F) SOB, wheezing, leg cramps, or claudication is an absolute indication to stopping an exercise test in cardiorespiratory patients

F, it is a relative indication