PET 4551 Exercise Testing and Prescription Study Guide Exam 2 1 Know previous study guide If you like you can buy it http moolaguides com notes individual listing 2529 2 What are some of the benefits of regular physical activity Physical activity lowers LDL Triglycerides Catecholamine Increases HDL Improves body composition 3 When should you stop a stress test 1 Drop in SBP of 10 mmHg with increase in workload 2 Onset angina or angina like symptoms 3 Failure of heart rate to increase 4 Excessive rise in BP SBP 250 mmHg or DBP 115 mmHg 5 Shortness of breath wheezing leg cramp claudication 6 Noticeable change in heart rhythm 7 Signs of poor perfusion light headiness confusion pallor nausea cold and clammy skin cyanosis 8 Technical difficulties 9 Subject s desire to stop 10 ST segment elevation or depression 1mm 11 Increasing nervous system symptoms dizziness NOTE A test should be terminated if the client reaches 85 of max HR if it is a sub max because after this point it is no longer considered a sub max effort 4 What are some field tests that we use to measure cardiorespiratory fitness 1 Endurance runs mile run 12 min run or 1 5 mile run for someone who is in cardiorespiratory fitness and has the ability to perform large muscles dynamic moderate and high intensity fitness for prolonged periods of time 2 Walks Rockport walking test 6 min or 1 mile walk test for someone of poor cardiovascular shape 3 Stepping 5 What are some of the advantages and disadvantages of submaximal testing Advantages of Submaximal Testing Inexpensive 1 2 Personnel require minimal amount of training 3 Allow for mass testing 4 Test itself is shorter in duration 5 Safer since it does not require maximal exertion 6 No physician needed if low risk 7 VO2max can be estimated 8 Heart rate and BP are monitored 9 Useful in documenting changes due to intervention programs Disadvantages of Submaximal Testing 1 Maximal HR BP RPP no gas exchange is being measured are not measured 2 VO2max not directly measured 3 Limited diagnosis value errors range from 10 20 4 True maxHR is not obtained from exercise prescription 6 Identify sources of errors that are involved in submaximal testing KNOW THIS 1 Age predicted maximal HR 220 age True heart rate not known 2 Variability in mechanical efficiency on an ergometer some people will be more efficient 3 Variability in submaximal HR at the same work rate on different days 4 The possibility of the break in linearity of HR and VO2 as the values approach maximum NOTE that on field tests they could turn into maximal tests depending if the client is really out of shape 7 What are the four assumptions we make when doing submaximal testing 1 Assumption that a steady state HR is obtained for each exercise work rate 2 Assumption that a linear relationship exists between HR and workload VO2max 3 Assumption that the maximal HR for a given age is uniform 4 Assumption that mechanical efficiency is similar for everyone 8 What is meant by steady state Steady State during the ergometer test in each 3 minute work stage a steady state HR is required which is defined as a HR at the end of the second and third minute of each stage that does not increase more than 5 bpm 9 What is the Rating of Perceived Exertion Scale RPE can be a valuable indicator for monitoring an individual s exercise tolerance RPE scale was developed to allow the exerciser to subjectively rate his or her feelings during exercise taking in account personal fitness level environmental conditions and general fatigue levels Rating can be influenced by psychological factors mood states environmental conditions exercise modes and age which reduce its utility The scale is from 6 20 10 Know general procedures for submaximal testing cycle and bench step Procedure for Submaximal Testing Cycle 1 Proper position on cycle 2 50 rev min rpm 3 Pre exercise BP and HR 4 Calculate 85 of HRmax or 70 HRR heart rate reserve HRR HRmax Resting HR 5 Must stay bellow these values to ensure the test is submaximal 6 Warm up no resistance 7 Follow flow chart for each stage 8 HR monitored at the end of each minute during the stage 9 Steady state HR last two within 5 bpm must be reached before workload is increased 10 Blood pressure monitored in the last minute of the stage 11 Perceived exertion monitored towards the end of the last minute 12 Test is completed when there are two steady state HR at separate workload between 110 and 150 13 Have the subject cool down following the test 14 Graph data to estimate VO2max Procedure for Bench Step 1 Metronome 2 Bench 3 Stopwatch 3 minutes 4 Not rest periods allowed 5 Stop subject standing get pulse within 5 seconds then take 15 second HR multiply by 4 6 Take BP 11 Know systolic diastolic and mean arterial pressure Know how to calculate MAP PP and RPP Systolic Blood Pressure SBP maximal pressure in the arteries during contraction of the heart measured by the onset of sound It s indirect measure of cardiac output Diastolic Blood Pressure DBP minimum pressure in the arteries during the relaxation of the heart complete disappearance of sound It s indirect measure of total peripheral resistance Mean Arterial Pressure MAP average BP in the arterial system Direct Measure of MAP MAP Cardiac Output CO x Total Peripheral Resistance TPR Indirect Measure of MAP o HR 100 b min o HR 100 b min MAP 1 3 SBP DBP DBP MAP 1 2 SBP DBP DBP Rate Pressure Product indirect measure of myocardial oxygen consumption Pulse Pressure SBP DBP HR SBP mVO2 100 12 Know how to calculate the heart rate reserve from the Karvonen Formula Be able to calculate intensity or target heart rate Heart Rate Reserve from the Karvonen Formula Intensity or Target Heart Rate HRR HRmax Resting HR Target HR HRmax Resting HR Resting HR 13 Know how to calculate relative or absolute VO2 Absolute VO2 L min Relative VO2 ml Kg min Absolute Vo2 doesn t take their weights into consideration so it s in L min Relative Vo2 is in the person s kg so it s a relative value NOTE Rule of thumb to check yourself is absolute Vo2 is usually 1 5 L min and relative can go as high as 90 ml kg min only 1 or 2 recorded values this high 14 Know the different ECG leads chest leads limb leads precordial extremity unipolar bipolar Six Extremity Leads measure in the frontal plane I II III aVR aVL aVF o Bipolar extremity leads I II III Lead I LA RA Lead II LL RA Lead III LL LA o Unipolar extremity leads aVR aVL aVF If biphasic in the EKG that means that the angle of deviation is perpendicular to that
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