Clinical Aspects of Fitness and Human Performance Exam 3

Indications for clinical exercise Testing (Why do we need them?)

• Diagnosis of CVD - presence of disease; cause of symptoms

• Evaluation of CVD - response to exercise, impact of intervention

• Prognosis - identifies likely outcome, help Doc determine follow-up

• Developing exercise prescription

• Quantification of change in exercise capacity due to exercise training

• Return to work after cardiac event

• Pre-Operative testing

Absolute contraindications to exercise testing

• Recent significant change in resting or acute cardiac event

• Unstable angina

• Uncontrolled cardiac dysrhythmias causing symptoms or hemodynamic compromise (ST segment depression or elevation, arrhythmia causes malfunction in heart (drop in Hr, BP, etc.)

• symptomatic severe aortic stenosis (valve calcifies and hardens causing increase risk in MI)

• Uncontrolled symptomatic heart failure

• Suspected or known dissecting aneurysm

• Acute systemic infection, accompanied by fever, body aches, or swollen lymph gland

Relative contraindications to exercise testing

• Left main coronary stenosis

• Moderate stenotic valvular heart disease

• Severe arterial hypertension at rest (e.g., systolic BP >200 mmHg or diastolic BP >110 mmHg)

• Tachyarrhythmias or bradyarrhythmias

• Neuromuscular, musculoskeletal, or rheumatoid disorders that may be exacerbated by exercise

• Uncontrolled metabolic disease (e.g., diabetes, thyrotoxosis, or myedema)

Why is the participants willingness to participate so important? What can it impact?

The willingness of the participant will impact greater max exertion and engagement (so you want the patient as willing as possible). You want to stress the importance of reaching volitional fatigue.

Submaximal Exercise testing protocols (GXT)

Test terminated when patient

• achieves a pre-determined MET level

• Achieved a percent of maximal HR (85% age predicted maximal HR)

Symptom-limited Exercise testing protocols (GXT)

Test terminated when onset of symptoms that put client at risk from further medical problems

Maximal Exercise testing protocols (GXT)

Test terminated when patient reaches maximal level of exertion without being limited by symptoms

A general interview is part of the GXT protocol. What are some important things to review with the patient before starting the exercise test.

You want to review the patients medical history, allergies, new medications, and exercise history. You want to emphasize the reason for the test