Slide 1Benefits of Regular Physical ActivityExercise Testing ModalitiesWho do we conduct Fitness Tests?Maximal Oxygen Uptake (VO2 Max) TestingSubmaximal TestsField TestsMass TestingAdvantages to Submax TestingDisadvantages to Submax TestingSlide 11Contraindications to Exercise Testing AbsoluteContraindications to Ex testing RelativeIndications for Stopping a TestAssumptions Made in Testing (4)A linear relationship exists between HR and work load…More Individualized TestsWhat is meant by steady state?Cycle Ergometer ProcedureBench Step ProcedureWhat is the Rating of Perceived Exertion Scale?How to calculate MAP, PP and RPPHRR from the Karvonen formulaWhat is a MET?Steps To Solving Metabolic EquationsSlide 26Difference between L and R Atrial EnlargementDifference between L and R ventricular hypertrophyEnlargement and HypertrophyHow to Determine Axis OrientationArrhythmiasFour Basic Types of ArrhythmiasNormal Sinus RhythmDifferent Pacemakers and the Rhythm Strips They CreateSinus PacemakerAtrial PacemakerJunctional PacemakerVentricular PacemakerConduction BlocksFirst Degree AV BlockSecond Degree AV Block2nd Degree AV Block Cont’dThird Degree AV BlockRight Bundle Branch BlockLeft Bundle Branch BlockArrhythmias of Sinus OriginEctopic Supraventricular ArrhythmiasEctopic RhythmsHow to Identify an Ectopic RhythmFour Types of Sustained Supraventricular Arrhythmias1. Paroxysmal Supraventricular Tachycardia (PVST)2. Atrial Flutter3. Atrial FibrilationAnother Example of Atrial Fibrilation4. Multifocal Atrial Tachycardia (MAT)Wandering PacemakersSlide 57Ectopic Ventricular ArrhythmiasPremature Ventricular ContractionVentricular TachycardiaVentricular FibrillationsAccelerated Idioventricular RhythmTorsade de PointesRules of MalignancyWhat is a carotid massage?Muscular StrengthIsometricConcentric ContractionFactors that Determine the Rate and Strength GainsOverloadReversibilityHypertrophyTime Course of Strength TrainingACSM Guidelines for Strength Benefits for Healthy AdultsStrength TestingEndurance TestingFlexibilityBenefits of FlexibilityTypes of StretchingFlexibility TestingBody Composition MeasurementUnderwater WeighingError with Body Composition MethodsSkinfold MeasurementSkinfold SitesBioelectrical Impedance AnalysisAnthropometric MeasurementsNew Criteria for Waist CircumferencesEx Rx for Aerobic BenefitsEx Rx for FlexibilityStretching ExamplesEx Rx for Strength TrainingExamples of Strength Training ExercisesTEST TWOMarch 27th, 2014Benefits of Regular Physical ActivityDecrease In: •Blood pressure•Cholesterol•Body sugar•Body fat•Risk of CHD•Risk of diabetes•Risk of some cancers•Risk of stroke•Stress•Depression and anxietyStudy Guide Question 2Increase in: •VO2 max•Speed•Agility•Coordination•Technique•performanceExercise Testing Modalities•Treadmill •Cycle •5-25% less than treadmill•Arm ergometer •20-30% less than treadmillWho do we conduct Fitness Tests?•To educate participants about their fitness levels•To get data that will provide in the development of exercise prescriptions•To obtain baseline data so comparisons can be made at a later date•As a motivation tool for establishing goals•To use as a stratifying risk-diagnostic toolMaximal Oxygen Uptake (VO2 Max) Testing•Functional capacity•Equipment to conduct the test is expensive•Trained personnel required•It is time consuming •Need motivated subject•Moderate and High Risk individuals NEED A PHYSICIAN PRESENT!Submaximal Tests•Field Tests (Walking or Running)•Can tests a greater amount of people at one time•Cycle Ergometers•More individualized•Use for those at MODERATE RISK•Bench Test•Can be individualized•Heart Rate and BP not taken during test, ONLY AFTERField Tests•Step Tests•Queens College Step Test•Fixed Distance Tests•1-mi walk test•1.5-mi run/walk test•Fixed Time Tests•12-min walk/run testStudy Guide Question 4Mass Testing•Endurance Runs •Mile run, 12 minute run•Walks•Rockport Walking Test•6 minute or 12 minute walk•Stepping •Queens College Step TestAdvantages to Submax Testing•Inexpensive•Personnel required need a minimal amount of training•Allows for mass testing•The actual test is a shorter duration than maximal exercise testing•It is safer because it does not require maximal exertion•Do not need a physician if LOW or MODERATE risk•Vo2 Max can be ESTIMATED•HR and BP are monitored•Useful in documenting changes due to intervention programsStudy Guide Question 5Disadvantages to Submax Testing•Maximal HR, BP, and RP are not measured•VO2 max is NOT DIRECTLY measured•Limited diagnostic value errors range from 10-20%•True max HR is not obtained for exercise prescriptionStudy Guide Question 5Sources of Error in Submaximal Testing(when predicting VO2 max)•Any errors in the measurement of workload (including using an ergometer that was not properly calibrated)•Error in measurement of heart rate•PRIMARY SOURCE OF ERROR: associated with age-predicted max HR. •Second source of error: variability in mechanical efficiency on an ergometer. Some people are more efficient (meaning they require less O2 to perform at a given work rate). •Third source of error: variability in submaximal HR at the same work rate on different days. •Fourth source of error: results from the possibility of a break in linearity of HR and VO2 as the values approach maximum. Some individuals have larger increases in VO2 compared to the increase in HR as they approach maximumStudy Guide Question 6Contraindications to Exercise Testing Absolute•Change in resting ECG•Ischemia, MI, already had a heart attack•Unstable Angina•Cannot test until angina is controlled•Uncontrolled arrhythmias•Aortic Stenosis•Cant get blood flow out of thick aorta•Uncontrolled symptomatic heart failure•Swelling in ankles, shortness of breath, dizzy•Acute pulmonary embolus•Dissecting aneurysm•Acute myocarditis or pericarditis•Infection in the heart•Acute systemic infection•Fever and infections… wait until they get betterStudy Guide Question 35Contraindications to Ex testing Relative•Left main coronary stenosis (thickening of L artery)•Moderate stenotic valvular heart disease•Electrolyte abnormalities (diabetes/dialysis/kidney probs)•Severe arterial hypertension at rest•SBP >200, DBP >110•Tachyarrhythmia or bradyarrhythmias (irregular HRs)•Cardiomyopathy (can lead to heart failure)•Neuromuscular, rheumatoid
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