EXSS 376L: PHYSIOLOGICAL BASIS OF HUMAN PERFORMANCELAB EXPERIENCE 4: SUBMAXIMAL AEROBIC TESTINGAdditional Study Resource: ACSM’s Guidelines for Exercise Testing and Prescription. 7th Ed. 2006; The Y’s Way to Physical Fitness, 1982; Heyward 2006, pp 80 PURPOSE:1. To become familiar with sub-maximal exercise testing via two commonly usedprotocols: the YMCA Bicycle Ergometer Protocol and Queens College 3-minuteStep Test and to compare predicted/estimated VO2max results between and withinsubjectsEQUIPMENT NEEDED:- Body weight scale- Cycle Ergometer- Metronome- 16.25” Bench Step- RPE Scales- Stopwatches- Polar HR Monitor- Blood pressure cuff and stethescopeINTRODUCTIONMaximal oxygen consumption (VO2max) is used to evaluate an individual’saerobic capacity and fitness. Higher VO2max values are generally associated with greateraerobic fitness. There are many methods to estimate VO2max, the most accurate being amaximal test. However, maximal tests are not always the most practical and can beexpensive and dangerous for certain populations. In these cases, or in other cases where amaximal test is not practical, submaximal tests are often used. The YMCA BicycleErgometer Test and the Queens College 3-minute Step Test are two commonsubmaximal protocols. Prior to any performing any exercise tests, certain precautions must be taken toreduce the risk to clients/subjects. First, there should always be an emergency plan inplace, and all technicians should be aware of this plan and trained to use it1. In this lab,there is an emergency phone available in the laboratory, and the instructor is trained inAdult CPR/AED and First Aid. All potential subjects must first be evaluated for anycontraindications to exercise testing. A listing of absolute and relative contraindicationscan be found below in Table 1 from the ACSM Guidelines. In addition, each member ofthe class must always be sure to monitor all subjects, continuously ask how they arefeeling, and help them down from any apparatus used in class. Additional precautionarymeasures taken in class include constant monitoring of heart rate (HR) and bloodpressure (BP). We will use Borg’s RPE scale to monitor how subjects are feeling atregular intervals throughout the test. Do not forget to monitor the subject during the cooldown and recovery period. Occasionally, cardiovascular complications can occur afterexercise, so it is essential to continue to ask how subjects are feeling and look for signs ofillness (ACSM, Table 2). Contraindications to Exercise Testing** Absolute- A recent significant change in the resting ECG suggesting significant ischemia, recent myocardial infarction (within 2 days) or other acute cardiac event.- Unstable angina- Uncontrolled cardiac arrhythmias causing symptoms or hemodynamic compromise- Severe symptomatic aortic stenosis- Uncontrolled symptomatic heart failure- Acute pulmonary embolus or pulmonary infarction- Acute myocarditis or pericarditis- Suspected or known dissecting aneurysm- Acute infections Relative*- Left main coronary stenosis- Moderate stenosis valvular heart disease- Electrolyte abnormalities (e.g., hypokalemia, hypomagnesemia) - Severe arterial hypertension (i.e., systolic BP of >200 mmHg and/or diastolic BP of >110 mmHg) at rest- Tachyarrhythmias or Bradyarrhythmias- Hypertrophic cardiomyopathy and other forms of outflow tract obstruction- Neuromuscular, musculoskeletal, or rheumatoid disorders that are exacerbated by exercise- High-degree atrioventricular block- Ventricular aneurysm- Uncontrolled metabolic disease (e.g., diabetes, thyrotoxicosis, or myxedema)- Chronic infections disease (e.g., mononucleosis, hepatitis, AIDS) *Relative contraindications can be superseded if benefits outweigh risks of exercise. Insome instances, these individuals can be exercised with caution and/or using low-levelend points, especially if they are symptomatic at rest.**Taken from ACSM's Guidelines for Exercise Testing and Prescription. 7th edition. General Indications for Stopping an Exercise Test in Low-Risk Adults* ** - Onset of angina or angina-like symptoms- Significant drop (20mmHg) in systolic blood pressure or a failure of the systolic blood pressure to rise with an increased exercise intensity.- Excessive rise in blood pressure: systolic pressure >260mmHg or diastolic pressure >115mmHg- Signs of poor perfusion: light-headedness, confusion, ataxia, pallor, cyanosis, nausea, or cold and clammy skin- Failure of heart rate to increase with increased intensity- Noticeable change in heart rhythm- Subject requests to stop- Physical or verbal manifestations of severe fatigue- Failure of the testing equipment *Assumes that testing is non-diagnostic and is being performed without direct physicianinvolvement or electrocardiographic monitoring. For clinical testing, other criteria areused. **Taken from ACSM's Guidelines for Exercise Testing and Prescription. 7th edition. Participant education is another important factor in ensuring a good, safe test. For thisreason, all subjects must be informed of everything that is going on during the test. Thisincludes statements such as “Ok, we’re going to increase the resistance a little bit now,”and continuously communicating with subjects about how they are feeling. Beforeanything is changed during a test, subjects must be informed as to what is happening.Good communication is critical in any laboratory situation. SUBMAXIMAL VS. MAXIMAL EXERCISE TESTING Submaximal tests can highly correlate with maximal tests, in that they can be used toaccurately predict VO2max. Submaximal tests make the following assumptions1: - A steady-state heart rate is obtained for each exercise work rate. - A linear relationship exists between heart rate and work rate. - The maximal heart rate for a given age is uniform - Mechanical efficiency (i.e., VO2 at a given work rate) is the same foreveryone.Steady-state heart rate can be easily evaluated by measuring heart rate during everyminute of the test. If the heart rate changes by more than 5 bpm during the last minuteof a stage, the stage is extended until heart rate becomes steady. Maximal heart rate ispredicted using the 220-age formula. Because this is only an estimation based onpopulation norms, it is not 100% accurate for every individual. Even so, it provides agood safe estimation and is useful in club/personal