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 Regular physical activity is associated to a higher level of Cardiorespirtory Fitness CRF and health With regular physical activity people have greater independence less risk of CVD and decreases our risk of adverse symptoms 3 When should you stop a stress test During a submax test we stop when The subjects heart rate increases above 85 of the age predicted HRmax or if we see other signs of maximum effort If there s a rise in BP we should stop as this can be dangerous i e SBP 250 mmHg and DBP 115 mmHg Drop in SBP 10 mmHg with an increase in work rate or if SBP decreases below value obtained in same position prior to testing SOB wheezing cramps claudication Onset of angina chest pain or angina like symptoms Signs of poor perfusion light headed confused ataxia pallor cyanosis nausea cold and clammy skin Failure of HR to increase with increased exercise intensity Noticeable change in heart rhythm by palpitation or auscultation Subject requests to stop Physical or verbal manifestations of severe fatigue Testing equipment failure 4 What are some field tests we use to measure cardiorespiratory fitness Field Tests These are advantageous as they allow us to assess large groups of people at one time are efficient inexpensive and require little if any equipment Bench Step Test This test requires that the individual step up and down on a standardized step height of 16 25 in for 3 minutes There is a step rate of 24 steps min leading to a beat of 96 bpm for actual step cadence in males and 22 steps min leading to a beat of 88 bpm for the step cadence for females At the end of this 3 minutes a 15sec pulse is taken to determine recovery heart rate Fixed Distance Test this test requires the client to complete the distance in the shortest time 1 5 mi Run Walk possible either by running the whole distance if possible or combining running and walking We estimate VO2 from the following equation 1 VO2 ml kg 1 min 1 3 5 483 1 5mitime min this is generally done for those who are sedentary or irregularly active The 1 mi Walk candidate would walk briskly around a measured course for this test We would have to measure HR body weight and clock time to estimate CRF We estimate VO2 from the following VO2 ml kg 1 min 1 132 853 1692 wt 3877 age 6 315 gender 3 2649 time 1565 HR Fixed Time Test 12 min run walk test this test requires the client to cover the maximum distance in 12 min by walking running or using a combination of both We estimate VO2 from the following VO2 ml kg 1 min 1 distance meters 504 9 44 73 5 What are some of the advantages and disadvantages of submaximal testing Advantages Inexpensive Personnel require minimal amount of training Allow for mass testing Test itself is shorter in duration No physician needed if low risk VO2max can be estimated Heart rate and BP are monitored in multi stage tests Useful in documenting changes due to intervention programs Safer since it does not require maximal exertion Disadvantages Maximal HR BP RPP are not measured VO2max not directly measured Limited diagnostic value errors range from 10 20 True max HR is not obtained for exercise prescription or it is not accurate We are essentially estimating based off a formula 6 Identify sources of errors that are involved in submaximal testing These errors are related to our assumptions Age predicted HR max may not be close to what the estimated value I e heat or medications like Beta blockers can affect HR and we may not get a linear relationship between HR and work rate Additionally motivation and pacing abilities in our tests may affect our CRF All of the Disadvantages listed in the previous question are regarded as sources of error 2 7 What are the four assumptions we make when doing submaximal testing 1 There is a Steady State HR obtained for each stage 2 There is a linear relationship between HR and work rate 3 Minimal difference between actual and predicted HRmax 4 Mechanical efficiency is the same for everyone VO2 at a given work rate is the same 5 Subject is not on medications caffeine ill or under large amounts of stress 8 What is meant by steady state Steady State HR is HR that remains within 5 bpm at the last minute of a work stage This is when our body has completely adapted to the stage 9 What is the Rating of Perceived Exertion Scale This scale has the participant label a number dictating the amount of exertion they feel they are putting out i e 17 this means the exercise is very hard The RPE is also a relative indicator of heart rate if we take the number the participant selects and multiply by 10 10 Know general procedures for submaximal testing cycle and bench step Cycle Ergometer 1 Obtain resting HR and BP prior to exercise in the exercise posture 2 Familiarize client with the ergometer 3 Begin with a 2 3 min warm up to acquaint client with ergometer 4 Follow a specific protocol of 2 3 min stages with appropriate increments in work rate 5 Measure HR at least twice during each stage near the end of the 2nd and 3rd minute of each stage Steady state HR should be reached before workload is increased If the client has not reached steady state the stage should be continued for another minute 6 BP should be monitored in the last minute of the stage 7 RPE should be monitored near the end of the last minute of each stage 8 Record client symptoms and appearance in each stage 9 Test should be terminated when the subject reacts 70 of HRR or 85 of age predicted HR fails to conform to the exercise test protocol requests to stop or has adverse symptoms Bench Step for women 1 The metronome will be set to a cadence of 4 times the step rate so 96 bpm for men and 88 bpm 2 The subject will step up and down on a standardized step height of 16 25 in for 3 min 3 At the conclusion of 3 min the client stops and palpates the pulse while standing within the first 5s A 15 sec pulse count is then taken and multiplied by four to determine heart rate in bpm 4 VO2 is then estimated by formula 3 11 Know systolic diastolic and mean arterial pressure Know how to calculate MAP PP and RPP Pulse Pressure mmHg SBP DBP PP This looks at our heart fxn Mean Arterial Blood Pressure mmHg This is the average amount of pressure in the circulation at any given time This deals with all the blood in the cardiac cycle and is a look at the amount of volume in the arteries Direct measure CO TPR MAP TPR
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