PET 4551 Exercise Testing and Prescription Study Guide Exam 2 Know previous study guide 1 2 What are some of the benefits of regular physical activity ACSM book Improvements in cardiovascular and respiratory function o Increased maximal oxygen uptake resulting from both central and peripheral adaptations o Decreased minute ventilation at a given absolute submaximal intensity o Decreased myocardial oxygen cost for a given absolute submaximal intensity Reduction in cardiovascular disease risk factors o Reduced resting systolic diastolic blood pressure o Increased serum high density lipoprotein cholesterol and decreased serum triglycerides o Reduced total body fat reduced intra abdominal fat Decreased morbidity and mortality o Primary prevention o Higher activity and or fitness levels are associated with lower death rates from coronary artery disease o Higher activity and or fitness levels are associated with lower incidence rates for CVD CAD stroke Type 2 diabetes mellitus metabolic syndrome osteoporotic fractures cancer of the colon and breast and gallbladder disease Other benefits o Decreased anxiety and depression o Improved cognitive function o Enhanced physical function and independent living in older individuals 3 When should you stop a stress test Drop in SBP 10 mmHg with increase in workload Onset of angina or angina like symptoms Failure of heart rate to increase Excessive rise in BP SBP 250 mmHg or DBP 115 mmHg Shortness of breath wheezing leg cramps claudication Noticeable change in heart rhythm Signs of poor perfusion light headedness confusion pallor nausea cold clammy skin cyanosis Technical difficulties Subject s desire to stop ST segment elevation 1 0 mm What are some field tests that we use to measure cardiorespiratory fitness p 76 ACSM 4 p 114 116 lab manual all determine VO2 max Queens College Step Test men 24 step min women 22 step min 3 mins long 15 sec pulse rate taken 5 secs after the test 1 mile walk test for sedentary unable to run clients time 15 s pulse taken 1 5 mile run test done in shortest amount of time 12 min walk run test cover maximum distance 6 min walk test best for rehabilitation patients 5 What are some of the advantages and disadvantages of submaximal testing Advantages o Inexpensive o Personnel require minimal amount of training o Allow for mass testing o Test itself is shorter in duration o Safer since it does not require maximal exertion o No physician needed if low risk o VO2 max can be estimated o HR and BP are monitored o Useful in documenting changes due to intervention programs Disadvantages o Maximal HR BP RPP are not measured o VO2 max not directly measured o Limited diagnostic value errors range from 10 20 o True max HR is not obtained for exercise prescription 6 Identify sources of errors that are involved in submaximal testing No exercise 24 hrs prior No caffeine drugs nicotine could increase HR Light meal 3 hours prior comfortable clothes same time pre and post tests Good night sleep sleep deprivation can increase HR Same equipment pre and post tests Thermoneutral environment hot environment can increase HR Specificity of training 7 What are the four assumptions we make when doing submaximal testing A steady state HR is obtained for each exercise work rate A linear relationship exists between HR workrate The maximal HR for a given age is uniform Mechanical efficiency is similar for everyone 8 What is meant by steady state lab manual A heart rate 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 ACSM Used to measure the intensity of an exercise by the client scale 6 20 6 no exertion at all 13 somewhat hard 10 Know general procedures for submaximal testing cycle and bench step o Metronome o Bench o Stopwatch 3 minutes o No rest periods allowed o Stop subject standing find pulse within 5 secs then take a 15 sec HR 17 very hard 20 maximal exertion Bench step test multiply by 4 o Take BP Cycle ergometer o Proper position on cycle o 50 rev min rpm o Pre exercise BP and HR o Warm up no resistance o Follow flow chart o 150 kg min resistance to start with for everyone o Objective to get 2 steady state HRs between 110 150 bpm 11 Know systolic diastolic and mean arterial pressure Know how to calculate MAP PP and RPP Systolic BP maximal pressure in the arteries during contraction of the heart Diastolic BP minimum pressure in the arteries during relaxation of the heart Mean Arterial Pressure MAP an average arterial pressure during one cardiac cycle Direct measure of MAP o MAP CO x TPR Indirect measure of MAP Pulse Pressure o PP SBP DBP o When HR 100 bpm MAP 1 3 SBP DBP DBP o When HR 100 bpm MAP 1 2 SBP DBP DBP Rate Pressure Product indirect measure of myocardial oxygen consumption o RPP HR x SBP 100 12 Know how to calculate the heart rate reserve from the Karvonen Formula Be able to calculate intensity or target heart rate Maximum heart rate 220 age Heart rate reserve HRR maximum HR resting HR Target HR HRR x intensity resting HR 13 Know how to calculate relative or absolute VO2 lab manual Relative VO2 L min Absolute VO2 ml kg min 14 Know the different ECG leads chest leads limb leads precordial extremity unipolar bipolar Chest Precordial leads horizontal plane o V1 V2 V3 V4 V5 V6 Limb Extremity leads frontal plane o I II III aVR aVL aVF o aVR aVL aVF V1 V2 V3 V4 V5 V6 Unipolar Bipolar o I II and III 15 Know how to calculate heart rate Small box method o 1500 of small boxes between R wave Large box method 6 second method o 300 of small boxes between R waves o Count cardiac cycles in a 6 second interval and multiply by 10 16 Know how to calculate work load in kgm min or watts p 120 lab manual Work output kg m min resistance kp x revolutions per min rpm x flywheel distance m rev 1 watt kg m min 6 12 17 Know equation for VO2max and cardiac output VO2max CO x a v O2 difference CO HR x SV 18 Why does heart rate increase when one goes from the supine position to standing When someone stands gravity helps carry the blood to their heart decreasing their stroke volume Standing HR increases SV decreases Supine HR decreases SV increases 19 What happens to systolic BP diastolic BP heart rate RPP PP and MAP when you start exercising SBP increases DBP constant decreases Heart rate increases RPP increases PP increases MAP increases 20 Know who needs to get a stress test and who does not Before starting o Moderate exercise program high risk clients o Vigorous
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