CHAPTER 4: Assessing Cardiorespiratory Fitness

Flashcards for Chapter 4: Assessing Cardiorespiratory Fitness, covering terminology, test types, procedures, and considerations for specific populations.

VO2max

Maximal oxygen uptake; the maximal ability of the heart, lungs, and blood to deliver O2 to working muscles during dynamic exercise.

VO2peak

The highest O2 consumption achieved during an exercise test; may be higher, lower, or equal to VO2max.

Absolute VO2

VO2 measured in L/min or ml/min without reference to body mass, representing the energy cost of non-weight-bearing exercises.

Relative VO2

VO2 expressed relative to body mass (ml/kg/min), representing the energy cost of weight-bearing exercises and allowing comparison of cardiorespiratory fitness (CRF) across body sizes.

Gross VO2

Total oxygen consumption including both resting and exercise O2 consumption.

Net VO2

Oxygen consumption attributed solely to exercise, excluding resting O2 consumption.

Maximal exertion test

An exercise test where VO2max is measured directly, typically requiring expensive equipment and trained personnel.

Submaximal exertion test

An exercise test where VO2max is estimated via the test result, often using multistage (graded) protocols, and can be estimated fairly well.

Primary VO2max attainment criterion

A plateau in O2 consumption (VO2 increase ≤ 150 ml/min), typically verified by a bout at a supramaximal load.

Secondary VO2max attainment criteria

Indicators for VO2max attainment including HR failing to rise with increasing workload, RPE > 17 on Borg 6-20 scale, blood lactate > 8 mmol/L, and RER > 1.15.

Procedures for Exercise Testing

Steps including pretest guidelines, informed consent and screening, baseline hemodynamic assessment, RPE scale familiarization, warm-up, continuous monitoring (RPE, hemodynamics, client physical appearance/symptoms), and cool-down.

Reasons to Terminate an Exercise Test

Includes end of protocol, equipment malfunction, client request, signs or symptoms indicating a need to stop, or reaching a predetermined end point (for submaximal tests).

Maximal Exercise Test Protocols

Methods chosen based on the client’s primary exercise modality (e.g., stationary bike or treadmills), using graded (stages) or ramp (continuous changes in intensity) designs, or self-paced protocols targeting RPE.

Common Treadmill Maximal Exercise Test Protocols

Standard examples include the Bruce, Modified Bruce, Balke, and Naughton protocols.

Common Stationary Bike Maximal Exercise Test Protocols

Standard examples include the Åstrand, Fox, and MacArdle et al. protocols.

Submaximal Exercise Test Protocols (purpose)

Used to estimate VO2max by calculating the VO2 required for a specific level of exertion, often relying on ACSM metabolic equations and requiring steady-state heart rates.

Adjusting Workload (Treadmill)

For treadmill protocols, workload can be adjusted by changing speed, incline, or by using RPE for clamped protocols.

Adjusting Workload (Stationary Bike)

For stationary bike protocols, workload can be adjusted by changing cadence, resistance, or by using RPE for clamped protocols.

Cycle Ergometer Testing Procedures

Steps include checking calibration, knowing pedaling cadence and resistance requirements, establishing warm-up/cool-down requirements, setting proper seat/handlebar height, instructing the client, and unloading resistance post-test.

Bench Stepping Maximal Exercise Tests (challenges)

Considered a less desirable modality due to unequal work distribution (up vs. down), difficulty standardizing workload (discrepancies in step height, cadence, body mass, and leg length), and the need to increase intensity with faster cadence or increased step height.

Recumbent Stepper Maximal Exercise Test

A standard graded exercise test protocol (e.g., using NuStep TRS 4000), typically resulting in lower HRmax and VO2max compared to treadmill tests due to the seated posture.

Submaximal Exercise Test Protocols (monitoring)

Cost- and time-effective alternatives to maximal testing that require continuous monitoring of heart rate (HR), blood pressure (BP), and Rating of Perceived Exertion (RPE).

Assumptions of Submaximal Exercise Tests

Four key assumptions: steady-state HR is attained and maintained; a linear relationship exists between HR and VO2 (between 110 and 150 bpm); mechanical efficiency is constant for everyone; and HRmax is similar for all of the same age.

Age-Predicted HRmax (APHRmax)

Equations used to estimate maximal heart rate based on age, with common examples including (220 – age), Tanaka et al. (208 – [0.7 x age]), Gellish et al. (207 – [0.7 x age]), and Fairbarn et al. equations specific to men and women.

Importance of Accurate HRmax Determination

Crucial for HR-based test termination, HR-based extrapolation to APHRmax and VO2max, and establishing targeted aerobic exercise prescriptions, best achieved using an HR monitor validated against an ECG.

Treadmill Submaximal Exercise Tests (Multistage model)

A method to estimate VO2max requiring two stages with steady-state HRs between 115 and 150 bpm, often involving slope-based calculations or four stages of metabolic gas collection for PRETs.

Treadmill Submaximal Exercise Tests (Single-stage model)

A method to estimate VO2max requiring one stage with a steady-state HR between 130 and 150 bpm, often using sex-specific calculations or specific walking/jogging protocols.

Cycling Submaximal Exercise Tests (Multistage model)

A method to estimate VO2max requiring two consecutive stages with steady-state HRs between 110 bpm and 85% APHRmax, often involving graphing methods with extrapolation or four stages of metabolic gas collection for PRETs.

Cycling Submaximal Exercise Tests (Single-stage model)

A method to estimate VO2max requiring one stage with a steady-state HR between 130 and 150 bpm, often utilizing nomograms or specific cycling protocols.

Common Bench Stepping Submaximal Protocols

Includes numerous protocols like Åstrand-Rhyming, Queens College, STEP Tool, and Webb, which can sometimes require a significant level of effort.

Additional Modes for Submaximal Testing

Various options beyond treadmills and bikes, such as stair climbing, recumbent stepper, rowing ergometer, elliptical cross-trainer, distance run/walk, jogging, shuttle running, walking, and stepping.

Exercise Testing for Children

Often prefers treadmill (e.g., modified Balke protocol) over bike (e.g., McMaster cycling protocol), and includes field tests like run/walks, shuttle runs, Yo-Yo Intermittent Recovery, and Kasch Pulse Recovery Test.

Exercise Testing for Older Adults

Requires modified protocols for treadmills, cycle ergometers, recumbent steppers, and stationary stepping, often involving extended warm-up/cool-down, stage extension for steady state, and field tests like self-paced stepping or timed walking/stepping.