Exercise Testing Modalities Treadmill Cycle 5 20 less than treadmill Arm ergometry 20 30 less than treadmill Contraindications to Exercise Testing Absolute Box 3 5 Change in resting ECG ischemia inadequate blood supply to heart MI heart attack ect Unstable angina chest pain Uncontrolled arrhythmias abnormal muscle contractions of heart Aortic stenosis narrowing Uncontrolled symptomatic heart failure Acute pulmonary embolus blood clot or fatty deposit that lodges and causes an Dissecting aneurysm excessive localized enlargement of an artery due to Acute myocarditis inflammation of heart muscle or pericarditis inflammation of obstruction weakening of arterial wall pericardium Acute systemic infection Contraindications to Exercise Testing Relative Box 3 5 Left main coronary stenosis narrowing Moderate stenotic valvular disease Electrolyte abnormalities Tachyarrhythmias or Brachyarrhythmias Cardiomyopathy chronic disease of the heart Neuromuscular rheumatoid disorders inflammation and pain of the joints Severe arterial hypertension at rest SBP 200mmHg DBP 110mmHg muscles or fibrous tissues High degree of AV block Ventricular aneurysm tearing in vessel Uncontrolled metabolic disease Chronic infectious disease Indications for Stopping a Test Box 4 5 Drop in SBP 10mmHg with increase in workload Onset of angina or angina like symptoms Failure of heart rate to increase with increasing exercise Excessive rise in BP SBP 250mmHg or DBP 115mmHg Noticeable change in heart rhythm Shortness of breath wheezing leg cramps claudication Signs of poor profusion light headedness confusion pallor nausea cold or clammy skin cyanosis Technical difficulties Subject s desire to stop ST segment elevation 1 0mm Increasing nervous system symptoms dizziness Clinical Stress Test Diagnostic Exercise Test Exercise Testing for Disease Severity Prognosis Exercise Testing after MI Functional Exercise Testing Purposes of Fitness Testing Educating participants about their fitness levels Get data that will provide in the development of exercise prescriptions To obtain baseline data so comparisons can be made at a later date Motivation tool for establishing goals Stratifying risk diagnostic tool Maximal Oxygen Uptake Functional capacity Equipment is expensive Trained personnel Time consuming Older individuals individuals at high risk will need physician present Subject needs to be motivated Submaximal Testing Field Tests walking running Cycle ergometer Treadmill Bench Step test Submaximal Test Advantages Inexpensive Personnel require minimal amount of training Allow for mass testing Test itself is shorter in duration No physician needed if low risk Safer since it does not require maximal exertion VO2 max can be estimated HR and BP are monitored Useful in documenting changes due to intervention programs Submaximal Test Disadvantages Maximal HR BP RPP are not measured VO2 max not directly measured Limited diagnostic value errors ranges from 10 20 True max HR is not obtained for exercise prescription Assumptions Made in Testing A steady state HR is obtained for each exercise work rate A linear relationship exists between HR and workrate The maximal HR for a given age is uniform Mechanical efficiency is similar for everyone Mass Testing Endurance run mile run 12 min mile Walks Rockport walking test 6 min or 12 min walk Stepping More individualized Cycle treadmill step test Measure HR and BP Need to try and standardize conditions o No exercise 24 hours prior o No caffeine drugs nicotine o Light meal 3 hours prior comfortable clothes o Good night s sleep same equipment o Thermoneutral environment o Specificity of training VO2max maximum amount of O2 your body can take in transport and use during exercise Relative VO2max measured in mL kg min used compare and determine fitness level takes bodyweight into consideration Absolute VO2max measured in L min used to determine caloric expenditure 5 kcals L of O2 does not take bodyweight into consideration We use metabolic equations to 1 Estimate VO2max 2 Estimate energy expenditure 3 Prescribe exercise programs 4 Lose weight Metabolic Equations Walking Running Leg Ergometer Stepping VO2 mL kg min 3 5 speed in m min 0 1 fractional grade speed in m min 1 8 VO2 mL kg min 3 5 speed in m min 0 2 fractional grade speed in m min 0 9 VO2 mL kg min 7 work rate in kg m min 1 8 body mass in kg VO2 mL kg min 3 5 1 33 1 8 step height in meters step rate 0 2 step rate equations will be given on exam Conversions 1L 1 000 mL 1 kg 2 2 lbs 1 mph 26 8 m min 1 MET 3 5 mL kg min 1 L O2 min 5 kcal min 1 in 2 54 cm 0 0254 m Monark Leg Ergometer fly wheel 6 m rev Watts kg m min 6 12 Cycle Ergometer 1 kg m min 6 rpm kp resistance on the bike 6 is a constant for the cycle ergometer it is the distance in meters travelled per revolution Steps to Solving Metabolic Equations 1 Write Equation 2 Determine what you want to know find 3 Write down all given values and conversions 4 Determine what values you need to find in order to get you to the answer If missing two variables in the equation you have to find one variable before using equation 5 Use equation and conversions chart to get your answer Example How long would a 145lb woman have to run for at 6 0 mph at a 2 grade to expend 500 kcals 1 VO2 3 5 speed in m min 0 2 grade speed 0 9 2 How long Time 3 145lbs 65 909kg 6 0mph 160 8 m min 2 grade 0 02 Kcals 500 4 VO2 3 5 160 8m min 0 2 0 02 160 8m min 0 9 VO2 3 5 32 16 2 8944 VO2 38 55mL kg min 38 55 mL kg min 2 54 L min 5 kcal 12 704 L min 500 12 704 L min 39 36 min 39 minutes and 22 seconds 65 909 kg 1 000 2 54 L min Definitions through full ROM 1 Muscular strength 1RM the maximal amount of weight that can be lifted one time 2 Muscular Endurance a submaximal amount of weight that can be lifted over a period of time i e sit ups pushups empty barbell bench press 3 Power ability to exert force rapidly P work time 4 Flexibility ability to move the joint through a full range of motion 5 Isometric same length i e hand grip dynamomter measuring strength at a fixed position Isotonic same tension i e free weights dumbells Isokinetic same velocity controls the speed i e rehab machines biodex 6 7 8 Concentric length of the muscle shortens should last 2 3 seconds 9 Eccentric length of the muscle increases where stimulus occurs for muscle protein synthesis should last 3 4 seconds Factors that Determine the Rate Strength Gains 1 Overload muscles increase strength when contract at near maximal tensions greatest strength gains
View Full Document
Unlocking...