6. Lab-based physiological ax for OA Flashcards
3 synonyms of cardiorespiratory function
Aerobic fitness
Aerobic endurance
Cardiorespiratory endurance
Define cardiorespiratory function (CRF)
Overall function of the cardiovascular and respiratory systems
What is included in the cardiovascular systems and respiratory systems?
Cardio: heart and blood vessels
Respiratory: lungs and airways
Two good reasons for testing CRF?
- Baseline values
- Key determinant of maintaining independent living
2 methods to measure CRF in a lab setting?
Direct method
Indirect method
What is the direct method?
Measurements taken during maximal-intensity exercise test
Advantages of the direct method
More accurate (typical 3% error)
Better estimation of desired exercise intensity
Disadvantages of direct method
Require expensive & sophisticated equipment
Higher risk of adverse events (more stress on participant)
Physician supervision can be required
What is the indirect method?
Measurements taken without the use of sophisticated equipment
Equations are used to estimate VO2 level
Advantages of indirect method
Easier to make measurements (lower risk for technical issues, test is shorter, test is less expensive)
Disadvantages of indirect method
Less accurate (typical error is 5-7% in CRF max prediction)
Name the 4 possible equipment for submaximal CRF tests
Treadmill
Leg ergometer
Arm ergometer
Recumbent stepper
Implications of using treadmill for submaximal testing
- expensive
- not portable
- more difficult to measure BP accurately
- may not be appropriate for OA (balance, gait or weight problems)
Preferred testing equipment method for OA with balance, gait or weight problems
Leg cycle ergometer
VO2max is average ___ lower on leg cycle vs treadmill
10%
Preferred testing equipment method for OA with balance gait or weight problems + impaired motor coordination in upper or lower limbs
Recumbent stepper
Disadvantages of recumbent stepper
- Not necessarily functional exercise
- Expensive+ not portable
- Difficult to take BP during test
- Quite recent = limited protocols for testing
Can you design your own testing protocol for OA?
Yes, especially for sub-max effort
Equipment method ideal for OA with difficulty in ambulation
Arm cycle ergometer
Advantages of arm cycle ergometer
Can be portable
Relatively inexpensive
Disadvantages of arm cycle ergometer
Localized muscle fatigue
Lack of functional specificity
Difficult to take BP during test
For testing protocols, OA participants must reach ± ___ of max age-predicted HR
75%
Accuracy for predicting VO2 max based on assumption that HR increased at ___ (same, slower or faster rate)
SAME rate
Test recommended for OA by ACSM (treadmill test)
Modified Balke-Ware treadmill test
Why is the Modified Balke-Ware treadmill test recommended?
Uses a slow & constant walking speed with small increases in grade every minute
Modified Balke-Ware treadmill test is most appropriate for OA with:
Good ambulation (Walking) + stroke and parkinson’s
How can you make it better for fit OA if you are using the Modified Balke-Ware treadmill test
- Increase walking speed
- Increase grade increments
7 reasons for stopping test in OA
- Angina-like symptoms (chest pain, pressure of discomfort)
- Participant is not sweating, light-headed, confused of unsteady, pale, blue lips
- BP drops below 20 mmHg from rest
- No increase in systolic BP with exercise intensity
- Excessive rise in BP 250/115 mmHg
- Participants requests to stop
- Failure of testing equipment
Clinical significance of OA having a lower 75% max HR vs YA
CRF tests for OA do not have to be as vigorous and demanding as with YA (especially if OA is deconditioned)
What is the typical walking speed of OA and younger adults?
OA: 4.5 to 4.8 km/h
YA: 5.3 to 5.4 km/h
EQUATION FOR CALCULATION OF OXYGEN CONSUMPTION (ESTIMATION)
VO2 = 0.1 x speed + 1.8 x speed x grade + 3.5
Speed is in what units
Meter/min
Why is balance testing important in OA?
Because seniors have a higher risk of falling
The ability to control the body’s center of mass relative to the base of support, whether the base is stationary of moving
Balance
Max distance and OA can move beyond a centered position without altering the BOS is referred to as
Limits of stability
___ and ___ in OA are considered as main features of independent living and performance of basic and instrumental ADLs
Balance and fear of falling
4 measurements of balance
- Static balance
- Dynamic balance
- Reactive balance
- Sensory integration & organization
Ability to maintain the COM directly over the BOS
Static balance
Difference from OA and YA in static balance
Greater postural sway (movement over their BOS) in OA than YA
Ability to control the COM while leaning through or moving beyond the LOS
Dynamic balance
What happens if the OA moves beyond their LOS and don’t adjust their BOS?
They fall
What 3 things does the dynamic balance assessment measures?
- Distance reached forward, backward, laterally and diagonally
- Time of reaction
- Movement accuracy
Ability to respond automatically to a loss of balance
Reactive postural control
How do you evaluate reactive postural control?
Perturbation is elicited through moving (motorized) force plate and the participant has to respond quickly with counter movement opposite to the direction of plate movement
What does the test measures in sensory integration and organization? (2)
- How well each sensory system is functioning
- How well the participant maintains upright balance when the information coming from the 3 systems is not in agreement
Ability to integrate and organize sensory information provided by the visual, somatosensory and vestibular systems
Sensory integration and organization
Review slide 39 of ppt
image of 6 possible perturbations in sensory integration and organization
