Evaluating Exercise Capacity Flashcards
Define exercise
Purposeful, structured activity that involves gross muscular activity to improve physical condition (e.g. jogging, stretching)
Define physical activity
A holistic term that includes all (purposeful and incidental) muscular activity of all intensities (e.g. walking, stairs)
Define activities of daily living
Basic independent self-care tasks done on a daily basis that require coordination, strength and range of motion
What affects the efficiency gas exchange
Ventilation perfusion mismatch
What are the 3 main tests done for evaluating exercise capacity
Cardiopulmonary exercise test
Six minute walk test
Incremental shuttle walk test
How is a cardiopulmonary test carried out
A cycle ergometer or treadmill is used
Intensity is increased incrementally
ECG, ventilation, oxygen and carbon dioxide are routinely measured
What are some advantages of a cardiopulmonary test
Quantifies performance in relation to metabolism
Precise and reproducible
Continuous monitoring for safety
What are some disadvantages of a cardiopulmonary test
Requires skilled technical support (calibration and
Very expensive (initial & ongoing costs)
Needs dedicated space
How is a six minute walk test carried out
Uses a 20-30 m flat course (e.g. corridor)
Objective is to cover greatest distance as possible in six minutes
Externally timed by assessor
Sub-maximal test
Secondary variables may be ‘perceived exertion’ scales, heart rate and pulse oximetry
What are some advantages of a six minute walk test
Patient-driven pace – speeding up, slowing down & rest OK
Cheap to deploy
Validated in many clinical populations
What are some disadvantages of a six minute walk test
Requires a significant unobstructed course, it often undertaken in a public hospital corridor
The pace is not regulated
How is a incremental shuttle walk test carried out
Uses a 10 m circuit
Externally paced by an audio recording (like bleep test)
Each minute has one extra length than the previous minute (e.g. minute 1 = 3 lengths of 20s; minute 2 = 4 lengths of 15s)
Primary outcome is total distance walked before volitional end
Secondary variables may be ‘perceived exertion’ scales, heart rate and pulse oximetry
What are some advantages of a incremental shuttle walk test
Cheap to deploy
Validated in many clinical populations
The external pacing helps some to achieve maximum levels
What are some disadvantages of a incremental shuttle walk test
Requires an unobstructed course, it is often undertaken in a public hospital corridor
For some the incremental nature is difficult (min. speed 1.8km/hour)
Ceiling effect of 1020 m
Patient can be penalized for poor pace management
What scale is used to assess degree of breathlessness?
MRC dyspnoea scale
