1 2 4 5 PET 4551 Exercise Testing and Prescription Study Guide Exam 2 Know previous study guide What are some of the benefits of regular physical activity We first need to understand what physical activity is because it is different from exercise Physical activity is any bodily movement produced by the skeletal muscles that results in increased energy expenditure It is made up of cardiovascular fitness muscular strength and endurance flexibility and body composition o Increased functional capacity o Weight control o Improved glucose tolerance and insulin sensitivity o Reduces blood pressure in persons with hypertension o Lower blood lipids o Increase HDL o Increased fibrinolytic capacity o Control of coronary vasospasm o Improved endothelial function 3 When should you stop a stress test Drop in SBP of 10 mmHg with increase in work load Onset of angina like symptoms No increase of HR Excessive rise in BP SBP 250 mmHg or DBP 115 Shortness of breath wheezing leg cramps claudication Noticeable change in heart rhythm Signs of poor perfusion light headedness confusion pallor nausea cold and clammy skin cyanosis Technical difficulties Subject s desire to stop ST segment elevation 1 0 mm Increasing nervous system symptoms dizziness What are some field tests that we use to measure cardiorespiratory fitness Treadmill cycle and arm ergometry bench field tests walking running What are some of the advantages and disadvantages of submaximal testing Advantages o Inexpensive o Minimal training of personnel o Can do mass testing o The test is shorter o Test is safer since no max required o No physician if at low risk o VO2 max can still be estimated o HR and BP monitored o Useful in documenting changes in intervention programs Disadvantages o Max HR BP RPP not measured o VO2 max not directly measured o Diagnostic value errors range from 10 20 o True max HR not obtained for exercise Rx 6 Identify sources of errors that are involved in submaximal testing poor heart rate measurement alterations in heart rate behavior smoking prior exercise environment additional stresses noises poor extrapolation subject cannot follow metronome 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 and work rate o Only linear between 110 and 150 bpm The max HR for a given age is uniform o Max HRs can be higher or lower than age predicted rate Mechanical efficiency is similar for everyone o Some people are better on a bike than the treadmill What is meant by steady state The HR does not change by more than 5 bpm 8 9 What is the Rating of Perceived Exertion Scale A scale from 6 20 that determines how the person feels o Eg A 20 would mean they are having a hard time and they are probably The scale is also based on heart rates 60 200 HR and the way they feel when hurting exercising 10 Know general procedures for submaximal testing cycle and bench step Cycle o YMCA protocol 3 minute stages Take HR each minute and BP at third minute HR must be between 110 and 150 for 2 consecutive stages Is HR is not steady state must continue for an extra minute Proceed to stages until 85 max HR is reached Determine work load rpm resistance flywheel Bench Step test o step up and down standard height block o step to metronome men 96 bpm women 88 bpm o at the end of three minutes take HR 11 Know systolic diastolic and mean arterial pressure Know how to calculate MAP PP and RPP MAP 100 bpm MAP 100 bpm o 1 3 SBP DBP DBP o 1 2 SBP DBP DBP PP SBP DBP RPP HR SBP 100 12 Know how to calculate the heart rate reserve from the Karvonen Formula Be able to calculate intensity or target heart rate 220 age max HR Max HR resting heart rate heart rate reserve Karvonen o HR reserve training resting HR target HR If submax HR is at 85 max For an absolute VO2 test max HR is at 70 Recovery 60 70 Aerobic zone 70 80 Anaerobic zone 80 90 13 Know how to calculate relative or absolute VO2 Relative VO2 is measured in ml kg min o At same relative intensity o If there is an increase in their VO2max then there will be an increase in workload Absolute VO2 measured in L min or ml min o This is at any given time trained or untrained o Same amount of stress but at trained level can be handled better 14 Know the different ECG leads chest leads limb leads precordial extremity unipolar bipolar Bipolar leads not actual leads placed on body but are made up of two leads o Lead I aVL aVR o Lead II aVF aVR o Lead III aVF aVL Unipolar leads o aVR o aVF o aVL o V1 o V2 o V3 o V4 o V5 o V6 Precordial leads o Aka chest leads o V1 V6 Extremity limb leads o Extremity are placed on the actual limbs limb leads are places on the torso in positions to mimic extremity leads it is simpler and used when the subject will exercise o Lead I III o aVR aVL and aVF 15 Know how to calculate heart rate Age predicted HR 220 age 16 Know how to calculate work load in kgm min or watts Watt kg m min 6 12 17 Know equation for VO2max and cardiac output CO SV x HR VO2max CO x avO2diff 18 Why does heart rate increase when one goes from the supine position to standing HR increases while SV decreases when standing from a supine position because the blood must now be pumped to your extremities and head which means the HR must increase to pump more blood out quick enough 19 What happens to systolic BP diastolic BP heart rate RPP PP and MAP when you start exercising Increases in o HR increases when above 50 60 of VO2max o Systolic BP o CO o RPP o VO2 o SV increases up to 50 60 then HR increases o MAP Decreases in o Diastolic BP may decrease but usually stays the same 20 Know who needs to get a stress test and who does not If you are suspected of having coronary artery disease or an irregular heart rhythm arrhythmia 21 What is a MET Used to express the energy cost of an activity 1 MET 3 5 ml kg min 22 Know how to use the metabolic equations See example problems and solutions online practice them don t just look at the answers Tips o There will be 3 equations on the exam o Number 2 3 6 and 8 are similar to what she will ask o Be able to work backwards o Need to know ALL conversions but equations will be given o Make sure you understand what the question is asking for o Flywheel will be Monarch with 6 m rev 23 Know the difference between left atrial enlargement and right atrial enlargement First understand enlargement …
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