9/30c Aerobic Testing Lab (Examination, Evaluation, Intervention)

Question 1

Should all patients perform the same way on outcome measure tests?

Answer 1

NO, don’t expect the same performance

Question 2

Which is more challenging for a patient? 400 m walk test or 6 minute walk test?

Answer 2

400 meter is way more difficult for someone who has issues with walking

Question 3

can you make a direct exercise prescription based on a test?

Answer 3

yes

• use HR or perceived exertion as the intensity measure
• all of them are submaximal, so they aren’t endurance programs, it is all about safety
• in the next level of care they will get more involved with endurance training

Question 4

what are you evaluating during 6MWT?

Answer 4

the quality of movement
need to evaluate the way patient is walking
if patient starts talking to you, redirect them to the task
don’t cue patient during 6mwt
if patient’s gait is getting significantly worse, stop them

Question 5

6MWT and 400m walk test:

1. How could this test be used to monitor patient progress?
2. What additional data would you like to collect to make the test results more clinically useful?
3. Suggest patient scenarios in which this test may be useful or may not be useful.
4. Discuss the pros and cons of using an assistive device during this test.
5. Could you use the information from this test to make an exercise prescription? If so, how?

Answer 5

1. track baseline then revisit after 12 weeks
2. HR, BP, VO2max, 3-lead electrocardiogram, arterial saturation assessed using a pulse oximeter, cadence, ratings of fatigue and discomfort or pain
3. pain, difficulty walking, overweight, cane, walker
4. pros = it is easy to do anywhere, low cost
   cons = not 100% accurate, has a lot of subjectiveness behind it
5. yes, you could. Understand patient’s RPE from that exercise and prescribe accordingly

Question 6

Cycle Ergometer Test - Astrand Rhyming Cycle Ergometer:

1. Can the A-R protocol be used with patient populations? If so, what types of patients, if not, why not?
2. Can the A-R protocol be used to make exercise prescriptions? If so how?

Answer 6

1. yes

2. yes RPE

Question 7

Step Test:

1) What are the practical differences in the test protocols?
2) How do you begin to decide which test is most appropriate for a particular patient?
3) Are there other ways to test submaximal aerobic capacity that were not used today?
4) What would happen if you were examining a patient who could not walk for 6 minutes and you did not have access to a treadmill or a stationary cycle?
5) Would you assess their aerobic capacity and endurance?
6) How would you do it?
7) What would document?
8) What surprised you about the relationship between perceived exertion and actual exercise intensity?

Answer 7

1. the fast speed is better for more advanced athletes
2. understand patient limitations, conditions, and overall health
3. yes
4. you can have them do the step test
5. Yes
6. HR monitor, VO2 max
7. document HR, pain, pulse ox, pulse, level of completion, HRR
8. you may think that you are working very hard, but it may actually not be super high exercise intensity