Cardiopulmonary exercise testing Flashcards
NOT CV Compromised
12 minute run
- Beep test
- Arm Ergometer
- YMCA
- Step Test
CV Compromised
- 6 minute walk test (6MWT)
- Incremental shuttle walk test (ISWT)
- IUULEx
EXERCISE CAPACITY TESTS
Require less expensive equipment, less skill and faster to administer
Dependent on an individuals motivation – not a VO2max ‘test’, but
requires maximal effort
12 MINUTE RUN - procedure
- Explain the test requirements – objective is to cover as much distance in 12 mins as possible. Encourage patient to pace themselves.
- Dynamic warm up
- Record laps during the test 0 it is ok to walk, but running is preferable
- Monitor the patient for signs and symptoms that would stop the test
- Notify participant of elapsed time regularly – count down last minute
- At 12 minutes blow whistle – ask participant to stop and walk to nearest marker and then march on spot
- Record distance covered
- Allow 5 minutes walking around track/stretches
12 min run
Use distance covered to calculate estimated VO2max (ml/kg/min) using the following equation:
Note: Cannot predict VO2max if distance covered is less than 1.71km
Use distance covered to compare to normative values:
12 min run advantages
Able to test many people at once
• Limited equipment needed
• Can estimate VO2max
12 min run disadvantages
Requires maximal effort – motivation may influence results
• Unable to monitor BP and HR individually
• May be unsuitable in sedentary individuals (minimal distance to cover)
6 min walk
Test involves walking continuously around a 60m circuit with the aim to
cover as much distance as possible in 6 minutes.
If the patient stops during the test:
• Measure SpO2 and HR
• Ask patient why they stopped – eg breathlessness, tired, leg pain
• Give the following instruction “Begin walking as soon as you feel able” – repeat every 15 secs as needed.
Outcome measure: Distance walked. This can be expressed as absolute distance or percent predicted (%).
6 min walk advantages
Easier to administer, more reflective of ADL activities than other tests
• Can be used for patients with respiratory and cardiac condition (self-paced)
• Familiar activity – walking
• Minimal clinically significant difference – 54 m
• A distance walked of <350m is associated with increased mortality in patients with COPD, chronic heart failure and pulmonary arterial hypertension (Rasekaba et al.)
6 min walk dis.
Can be influenced by many factors – need to standardise testing protocol (tester instructions/encouragement, track set up, medications, other typical pre-test criteria)
• Learning effect – need to have at least 2 attempts.
• Does not calculate VO2max (other than in those awaiting lung transplant)
MULTISTAGE SHUTTLE RUN TEST (MSRT)
Valid estimate of VO2max in children and youth, although less accurate in older individuals
• Can predict VO2max but equations need to be specific for gender and age – so will not be used in this practical.
• Run between markers in time with recorded beeps from a CD (or App)
• Starts 8.5km/hour – increases by 0.5 km/hr each minute
MULTISTAGE SHUTTLE RUN TEST (MSRT) procedure
• Subjects must have one foot on or behind the starting lines before
the beep to complete a shuttle.
• If not, they are given one attempt to catch up with the pace.
• If the beep is missed on two consecutive shuttles, the test is stopped.
• Record the level/shuttle reached
MULTISTAGE SHUTTLE RUN TEST (MSRT) advantages
- Externally paced
- Minimal equipment needed
- Suitable for very fit individuals
- Suitable for large groups
MULTISTAGE SHUTTLE RUN TEST (MSRT) disadvantages
Need the recording
• Area
• Not suited for CV compromised individuals – test to exhaustion
• Requires self-motivated individuals
INCREMENTAL SHUTTLE WALK TEST (ISWT)
When you hear 3 beeps, instruct the patient to “increase your speed now”
• Stop criteria are similiar to beep test – 2 consecutive shuttles missed
INCREMENTAL SHUTTLE WALK TEST (ISWT) - advantages
- Externally paced
- Correlated with VO2max
- Can use in CV compromised patients, although this would be a level up from a 6MWT
INCREMENTAL SHUTTLE WALK TEST (ISWT) - disadvantages
- Need 2 tests to allow for learning effect
* Equipment needed - CD
Submaximal tests
- Treadmill
- Cycle ergometer
- Step test
- Arm tests
Exercise capacity tests
12 Minute Run Test
- 6 Minute Walk Test
- Incremental Shuttle Walk Test
- Beep Test
OUTCOME MEASURE
is the result of your exercise test.
• It is the value that you will compare between multiple tests to evaluate
whether change has occurred.
• It is the end-point value – i.e. after all equations have been used
It is NOT your pre- or post-test measures
Bruce protocol
Protocol can be used for maximal or submaximal testing
• For submaximal testing – testing is stopped when 85% age predicted
HRmax is reached.
• Incremental exercise test with increasing workloads at pre-determined
speeds/treadmill inclination
Workload (speed and inclination) is increased every 3 minutes until 85% HRmax is reached. Record the time taken to reach target HR.
Outcome measure = estimated VO2 max
treadmill benefits
Can be used with both maximal and submaximal tests
• Estimates VO2max
treadmill negs
Cost/equipment required
• Requires participant to have sufficient dynamic balance to walk/run at pre-
determined speed
• Can only test one individual at a time
• Difficult to take physiological measures if required during test e.g. BP
YMCA Cycle Ergometer Test
estimates VO2 max which is compared to normatives
