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1B Cardiorespiratory > Evaluating Exercise Capacity > Flashcards

Evaluating Exercise Capacity Flashcards

1
Q

what is the difference between exercise, physical activity and activities of daily living?

A

exercise= purposeful, structured activity that involves gross muscular activity to improve physical condition

physical activity= holistic term that includes all muscular activities of all intensities

AODL= basic independent self-care tasks done on a daily basis that require coordination, strength and range of motion

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2
Q

what factors affect the capacity to exercise within the body?

A
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3
Q

what can exercise limitations be caused by?

A

deficits in several systems

  • Neurological
    • Motor control, coordination
  • Respiratory
    • Ability lung ventilate, pulmonary perfusion, gas exchange between lungs and blood
  • Cardiovascular
    • Ability heart to receive blood from lungs and pump muscles
  • Muscular
    • Local perfusion, muscle cell enzymes
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4
Q

what is affected when there is a ventilation-perfusion mismatch?

A

impact removal CO2 and oxygenation

efficient gas exchange needs maximum V/Q coupling

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5
Q

what changes in lungs when there is less ventilation?

A

Ppl is more negative

greater transmural pressure gradient

alveoli larger + less complient

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6
Q

what happens in the lungs when there is more ventilation?

A

Ppl is less negative

smaller transmural pressure gradient

alveolar small & more compliant

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7
Q

what happens when there is a lower perfusion flow rate?

A

lower intravascular pressure

less recruitment

greater resistance

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8
Q

what happens when there is a higher perfusion flow rate?

A

higher intravascular pressure

more recruitment

less resistance

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9
Q

where are ventilation and perfusion greatest?

A

at base of lungs

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10
Q

where is V/Q lowest?

A

at base of lungs

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11
Q

what are the tests used to evaluate exercise capacity?

A

cardiopulmonary exercise test

6-minute walk test

incremental shuttle walk test

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12
Q

what is the cardiopulmonary exercise test?

A
  1. Uses cycle ergometer or treadmill
  2. Intensity incremental
  3. Undertake under clinical supervision
  4. ECG, ventilation, O2 and CO2 measured routinely
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13
Q

what are the outputs of the cardiopulmonary exercise test?

A

Peak VO2 primary outcome

ECG changes monitored

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14
Q

what are the advantages of the cardiopulmonary exercise test?

A
  1. Quantifies performance in relation to metabolism
  2. Precise and reproducible
  3. Continuous monitoring for safety
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15
Q

what are the disadvantages of the cardiopulmonary exercise test?

A
  1. Requires skilled technical support
  2. Very expensive
  3. Needs dedicated space
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16
Q

what is the 6-minute walk test?

A
  1. 20-30m flat course
  2. Objective to cover greatest distance as possible in 6 minutes
  3. Externally timed by assessor
  4. Sub-maximal test
17
Q

what are the outputs of the 6-minute walk test?

A
  1. Primary outcome is total distance walked in 6 minutes
  2. Secondary variables
    1. Perceived exertion scales, Heart rate, Pulse oximetry
18
Q

what are the advantages of the 6 minute walk test?

A
  1. Patient-driven pace
  2. Cheap to deploy
  3. Validated in many clinical populations
19
Q

what are the disadvantages of the 6 minute walk test?

A
  1. Requires significant unobstructed course
  2. Pace is not regulated
20
Q

what is the incremental shuttle walk?

A

10m circuit

externally paced by audio recording

each minute has one extra length than previous minute

21
Q

what are the outputs of the incremental shuttle walk test?

A

primary= total distance walked before volitional end

secondary= perceived exertion scales, heart rate and pulse oximetry

22
Q

what are the advantages of the incremental shuttle walk test?

A
  1. Cheap to deploy
  2. Validated in many clinical populations
  3. The external pacing helps some to achieve maximum levels
23
Q

what are the disadvantages of the incremental shuttle walk test?

A
  1. Requires unobstructed course
  2. For some incremental nature is difficult
  3. Ceiling effect of 1020m
  4. Patient can be penalised for poor pace management
24
Q

what is used to calculate degree of breathlessness?

A

MRC dyspnoea scale

25
Q

how can exercise testing be used in clinical populations?

A
  • Exercise tests can be used to monitor disease severity/ progression and response to treatment
  • An assessment for ambulatory oxygen could be carried out using 6MWT
  • If patient is stable pulmonary rehabilitation may be prescribed to increase exercise capacity
26
Q

what is required to prescribe long term oxygen therapy (LTOT)?

A

use >15 hours/day

this would include measure of blood gasses

27
Q
A

1B Cardiorespiratory (15 decks)

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