Common Assessment of Cardiorespiratory Fitness Flashcards
VO2max Testing
Maximal oxygen uptake (VO2max) is gold standard for cardiorespiratory fitness measurements.
-mL/kg/min > mL/min
Not as functional to use for chronic conditions
-VO2peak test or submax VO2 will be used to estimate VO2max.
Submaximal VO2 Testing
Normally used in clinics due to not having access to VO2max equipment (such as metabolic carts).
Used for most populations that maximal testing would be considered unsafe.
-may not be as accurate for athletes, but still good.
Goal for submax testing is to determine HR responses to exercise and predict VO2max
-does not give true VO2max, just an estimate but gives an idea.
-can show more than just VO2max estimation which makes it versatile.
Benefits of Submax VO2 Testing
More clinically relevant.
Safer for most clinical populations.
Can be used on more clinical based equipment.
Opportunity to educate client on appropriate exercise intensities for them.
-easy to prescribe exercise related to the test.
Limitations of Submax VO2 Testing
Equations used to estimate VO2max (can under or overestimate VO2max).
-typically overestimates VO2
Assumes adequate HR response to work rate to accurately estimate VO2max.
More potential for ceiling or floor effect.
Not accurate for populations that use medications that alter HR.
General VO2 Testing Protocol
Discuss the test with the client and get informed consent.
Review pre-screening to determine if safe to complete.
Take resting measures (ie. HR, BP, O2%, RPE, ECG if possible).
Complete a 5 min warmup and get client comfortable with equipment.
Complete VO2 test based on specific test instructions (ie. take HR, O2%, and RPE each minute, take BP every 2 mins).
Complete 5-10 min active cool down (continue to measure vitals).
Complete 5-10 min passive cool down (continue to measure vitals).
Rating of Perceived Exertion Scales
Used more for clinical populations.
-better for populations that use medications that alter HR.
Can help clients understand exercise intensity for independent exercise without the need for HR monitoring.
Two types of scales = modified or Borg RPE.
Test Termination Criteria
Depends on test being used.
-predetermined end point
-volitional fatigue
-predicted Vo2max reached
-and more
Other criteria to stop test include…
-onset of angina or angina-like symptoms
-drop is SBP of >10 with an increase in work rate or if SBP decreases below the value obtained in the same position prior to testing
-excessive rise in BP: systolic BP >250 and/or diastolic pressure >115.
-shortness of breath, wheezing, leg cramps, or claudication.
-signs of poor perfusion: light-headedness, confusion, ataxia, pallor, cyanosis, nausea, or cold and clammy skin.
-failure of HR to increase with increased exercise intensity.
-noticeable change in heart rhythm by palpation or auscultation
-subject requests to stop
-physical or verbal manifestations of severe fatigue
-failure of the testing equipment
Estimated VO2
norms associated with age groups
look on slides for specifics
Cardiovascular
Refers to the heart and blood vessels (whole circulatory system) and how well they work at rest and exercise to move blood around the body.
Cardiorespiratory
Refers to the heart and respiratory pathways (lungs and tracheobronchial tree) and how well they work to move blood and oxygen around the body to working muscles.
Cardiopulmonary
Refers to the heart and lungs together and how well they work to bring oxygen into the body and circulate it to working muscles
Common Cardiorespiratory Tests
Field tests
Treadmill tests
Cycle ergometers
Step tests
*All of these are submax by nature
Field Tests
Anything not using treadmill.
Some tests include rockport 1 mile walk test, 1.5mile walk test, 6 min walk test, beep test, Cooper 12 min test.
Benefits of Field Tests
Easy to administer
Little equipment
Functional to population
Limitations of Field Test
Can be near maximal or maximal for some people (low aerobic fitness).
Harder to monitor vitals (HR and BP).
Estimation of VO2max.
NOT always appropriate for chronic condition populations as unable to monitor for test termination criteria.
Rockport 1 Mile Walk Test
Goal to get fastest time to walk 1 mile (1.6km).
Estimates VO2max for ages 20-60.
-equation associated with it
Not good to do on treadmill, must do outside or on track.
Procedure of Rockport Walk Test
Record weight (lbs) and explain procedure.
Ask client to walk light-mod pace for 3 min as warm up, then direct to walk 1 Mile as fast as possible.
-they can stop and rest in between but the timer will keep going (not how many stops they take).
Record HR during final minute of walking with HR monitor or immediately after test is completed.
-peak HR
Use HR and time to determine VO2max with given calculation.
6 Minute Walk Test
Used to evaluate cardiorespiratory fitness as well as predicting morbidity and mortality rates.
Looking at walking/gait speed.
-slower gait speed = higher morbidity and mortality rates.
Can predict VO2peak but equation is not as valid or useful.
Clients completing <300m in 6min demonstrate poorer short-term survival vs those who complete >300m.
Useful for older populations or those with chronic conditions (ie. CVD, CHF, COPD, etc.).
-just need 30m distance
Procedure for 6Min Walk Test
Take resting vitals and explain test.
Client walks along predetermined track (ideally 30m or more in length) at their own pace.
-client can stop and rest when needed (timer will continue).
Record distance walked in 6 minutes.
Cooper’s 12 Min Walk/Run Test
Goal to complete furtherest distance in 12 mins.
-do on track or relatively flat area.
Estimate VO2max.
-VO2max (mL/kg/min) = (distance in m - 504.9)/44.73
-missing client body weight in equation.
-can be seen in a couple equations for submax VO2 test
-says its relative, but it is actually absolute.
Procedure for Cooper’s 12 Min Walk/Run Test
Take resting vitals and explain test to client.
Have client complete a 3-5 min warm up of light-mod activity.
At the end of the warmup, start the 12 min timer.
Record the distance completed in 12 min.
-clients can stop and rest if needed but keep the timer running.
Use the final distance to determine estimated VO2max.
Treadmill Tests
Used for submax and maximal VO2 tests.
Includes treadmill walk test, Bruce and Modified Bruce Treadmill Test, Graded Exercise Test (can be used with other equipment too).
Benefits of Treadmill Tests
Can be adjusted easily to any fitness level.
Can be used with running or walking with or without incline.
Functional to walking.
Limitations of Treadmill Tests
Some individuals may not be comfortable on a treadmill due to balance issues.
Expensive and not portable.
Difficult to measure BP and ECG.
Bruce Protocol Treadmill Test
Is a maximal stress test, commonly used with ECH stress testing.
Limitation is that it is not very clinically relevant because need a specific treadmill.
Procedure for Bruce Treadmill Test
Explain procedure and collect resting vitals, height, weight, age, etc.
Complete 3-5 min warm up of light-mod exercise on treadmill.
Follow the stages outline (on slide 41), each stage is completed for 3 mins.
Test is stopped when client can no longer continue or other predetermined termination criteria.
Use duration of test to determine VO2max via give calculations (on slide 41).
Modified Bruce Protocol Treadmill Test
Starts with a lower workload so more useful for older populations or sedentary clients.
Same procedure as Bruce Treadmill Test but starting stages are lower.
Idea is still to get to maximal level for client or volitional fatigue occurs.
Graded Exercise Treadmill Test
Could be used for maximal or submax VO2 testing.
If used for submax testing, must determine clients 85% HRmax or 70% HRR prior to test (ie. determine end point).
BUT certain calculations are needed based on speed, incline grades, activity, and extrapolated HRmax so not always the most accurate, straightforward or useful.
Recommend to use this type of test to determine exercise capacity using RPE scales, HR zones, and client feedback.
Procedure for Graded Exercise Treadmill Test
Complete warm up 3-5 min of light-mod exercise.
Increase either incline or speed (or both) every 3 minutes (or longer).
-steady state heart rate should be achieved before increasing workload (aim for 3 min stages and if heart rate differs between 2nd and 3rd minutes by >5bpm then add additional minutes as needed.
Continue stages until 85% of HRmax achieved (or another pre-determined termination criteria is met.
-use this test to help determine general aerobic capacity.
Chart on slide 44 with other machines you can do this test on.
Cycle Ergometer
Used for submax and maximal VO2 tests.
Include YMCA cycle ergometer test, wingate (measures anaerobic fitness), astrand-rhyming cycle test.
Benefits of Cycle Ergometer Tests
Can be adjusted easily to any fitness level.
Easier for older populations or those with balance issues (non-weight bearing).
Easier to take BP and ECG readings.
Limitations of Cycle Ergometer Tests
Needs regular calibrations.
Need cycle ergometer that measures power output.
Less familiar movement compared to walking.
More localized work to legs resulting in underestimation of VO2.
Specific RPM needed for most tests.
Less reliable for relative VO2 calculations (non-weight bearing mode).
YMCA Cycle Ergometer Test
Estimates VO2 max for ages 15-69.
-quite accurate for estimating VO2.
Uses 3 or more consecutive 3 min workloads.
-goal to get HR between 110bpm and 85% of HRmax for 2 consecutive workloads.
-not as useful for some clinical populations such as those with CVD, better for general population.
Need a cycle ergometer that can give workload and RPM.
Procedure for YMCA Test
Explain test and calculate 85% of HRmax.
Have client complete first workload at 150kpm/min at a pedalling rate of 50rpm for 3 minutes.
-record final HR in final 15s of each min,
-steady state HR is the average HR of the 2nd and 3rd min (if these mins differ by >5bpm then add an additional min).
HR of workload 1 determines load sequence for subsequent workloads (chart on slides).
Continue through workloads until client’s steady state HR is within 110bpm and 85% of HRmax.
Use given equation to determine VO2max.
Worksheet comes with the test (on slides)
Astrand-Rhyming Cycle Test
Single stage 6 min test at 50rpm.
Goal to obtain HR between 125-170bpm.
HR is taken in 5th and 6th min of work.
-average of these is used for VO2max with a nomogram.
-steady stage heart rate needed, add minutes until achieved.
Workloads chart on slides,
Nomogram used to determine absolute VO2 (L/min).
-on slides.
-where line intersects in middle of the two dots when line drawn between them is clients absolute VO2 then go to correction factor based on age.
-to get relative, times absolute by 1000 and then divide by weight.
Due to decreasing HRmax with age, VO2 needs to be corrected.
-correction factor table on slides.
Step Tests Benefits
Inexpensive, portable, and functional.
Easy for most populations.
Short duration and easy to follow protocols.
Use of post-exercise HR recovery results.
Step Tests Limitations
Estimation of VO2max
May have balance issue for older adults or those with lower limb joint issues.
Specific step cadence needed which may lead to maximal exertion or quick fatigue.
no BP or HR monitoring while stepping (only after).
Step Tests
Include mCAFT step test, YMCA 3min step test, AStrand and Rhyming Step test, Harvard Step test, and Queen’s College Step test.
Some tests look at heart rate recovery rather than HRmax.
-good to show how quickly heart is adapting to changes in activity.
mCAFT Step Test
Multistage step test that estimates VO2max for ages 15-69.
3 min stages (stage 1-8).
-starting stage differs on sex and age.
2 step sequence (1 step for stage 7 for men/stage 8 for women) on a 2 step platofrm (each step is 20.3cm tall).
HR is taken after each stage.
Continued until >85% HRmax is achieved.
Ending staged has related O2 cost which used in VO2max calculation.
-equation on slides.
Have them listen to recording
-different recording for men and women indicates cadence for step.
Procedure for mCAFT Step Test
Take weight and calculate 85 HRmax.
Determine starting stage.
Explain test and allow client to practice stepping sequence if needed.
-client may lead with any foot, do not run up steps, place both feet on top step and floor.
Have client complete first 3min stage with mCAFT music recording.
Take HR immediately after stage.
Continue to next stage until >85% HRmax is achieved, last stage is complete, or other termination criteria met.
Complete active and passive cool down in mode of choice.
Use final stage to determine O2 cost.
Use given calculation to estimate VO2max.
YMCA 3 min Step Test
Utilizes HR recovery to determine cardiorespiratory fitness.
-does not estimate VO2max.
Single step test using 30.5cm high step.
Step for 3 minutes at a rate of 24 steps per minute.
-use metronome to help with cadence (96bpm).
At end of 3 minutes, have client sit down and record HR immediately for 1 minute.
-use HR recorded at end of 1 min of rest and compare to norms tables to determine fitness level.
-can record with manual pulse counting or HR monitoring.
Take recovery HR and compare to normative tables (on slides).
