Clinical Testing Insights: Threshold Identification

Flashcards on Clinical Testing Insights: Threshold Identification

What measure of expired air is an indicator of the transition from aerobic to anaerobic metabolism?

Increase in ventilation/breathing rate

What detects the change in ventilation?

Chemoreceptors

The heart, with circulation, couples gas exchanges of muscle respiration with the .

Lungs

Changes in what do chemoreceptors detect?

CO2 and O2 (amongst other things!)

Changes in what do baroreceptors detect?

Blood Pressure

What does CPET stand for?

Cardio-Pulmonary Exercise Testing

What variables does CPET focus on?

Gaseous exchange variables

Besides gaseous exchange variables, what else is CPET usually completed with?

ECG, HR, BP, RPE and SpO2

What do Clinical Exercise Physiologists (CEPs) specialize in?

Exercise testing and assessment, alongside the design, delivery and evaluation of evidence-based exercise interventions.

What is the scope of practice for CEPs?

From apparently healthy individuals to those with chronic and complex conditions, along the care pathway from primary prevention, through acute management, to rehabilitation and maintenance.

List 3 reasons why CPET is used.

Differential diagnosis, disability evaluation, intervention assessment.

Why else is CPET used?

Rehabilitation prescription, medical intervention suitability, pre-operative risk.

CPET data can be used to identify if a patient is limited due to which 5 things?

Circulatory, Ventilatory, Coronary disease, Low fitness, and Poor effort

Give examples of what the 9-panel plots include.

Oxygen Uptake (VO2), Carbon Dioxide Production (VCO2), Ventilation (VE), Heart Rate, Fuel Usage (RER), Oxygen Saturation (SaO2)

What term do clinicians use instead of VO2 max when a patient is symptom-limited?

VO2 peak

What is the point above which further increases in intensity/work rate are increasingly sustained through anaerobic metabolism called?

Anaerobic Threshold

What happens to Minute ventilation (VE) during exercise?

Adapts to energy needs, meeting demands for VO2 and CO2 elimination (VCO2).

What does Ve/VO2 measure?

At the transition point (VT or AT), Ve increases exceeds the rate of rise in VO2 so Ve/VO2 increases

What does Ve/VCO2 measure?

At the transition point (VT or AT), Ve increases in proportion to increases in VCO2 but remains constant or falls slightly

What is the cut-off for a normal Ventilatory Efficiency Slope (Ve/VCO2)?

≤ 34

What does a Ventilatory Efficiency Slope (Ve/VCO2) of >34 indicate?

POOR PROGNOSIS

What is the mismatch of ventilation in/out of the lungs WITH perfusion of O2 in the heart/tissues called?

Physiological dead space