Evaluating Exercise Capacity

Question 1

define exercise

Answer 1

Purposeful, structured activity that involves gross muscular activity to improve physical condition (e.g. jogging, stretching)

Question 2

define physical activity

Answer 2

A holistic term that includes all (purposeful and incidental) muscular activity of all intensities (e.g. walking, stairs)

Question 3

define activities of daily living

Answer 3

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

Question 4

list examples of pathophysiologies that impact exercise capacity

Answer 4

restrictive lung disease e.g. asthma

SA node dysfunction, complete AV block, cardiomyopathy, aortic stenosis, bronchospasm

Question 5

list factors affecting exercise capacity (breathing)

Answer 5

inspired O2
airway calibre
diffusion distance
pulmonary compliance and elastence

Question 6

list factors affecting exercise capacity (blood)

Answer 6

MCH
RBC count
Hb
pulmonary perfusion
venous return
arterial blood pressure
blood viscosity

Question 7

list factors affecting exercise capacity (heart)

Answer 7

valve structure
myocardial contractility
myocardial thickness
myocardial perfusion
conduction system

Question 8

list factors affecting exercise capacity (periphery)

Answer 8

capillary density
mitochondrial density
local vasodilation
perfusion of the digestive system
oxidative enzyme concentration

Question 9

list three test that can be used to evaluate exercise capacity

Answer 9

cardiopulmonary exercise test
six-minute walk test
incremental shuttle walk test

Question 10

what is involved in a cardiopulmonary exercise test?

Answer 10

Uses a cycle ergometer or treadmill, intensity is incremental, under close clinical supervision in controlled environment

Question 11

what is routinely measured in the cardiopulmonary test?

Answer 11

ECG, ventilation, O2 and CO2 routinely measured

Question 12

what is the primary outcome of the cardiopulmonary test?

Answer 12

peak VO2

ECG changes

Question 13

list advantages of the cardiopulmonary test

Answer 13

Quantifies performance in relation to metabolism
Precise and reproducible
Continuous monitoring for safety

Question 14

list disadvantages of the cardiopulmonary test

Answer 14

Requires skilled technical support (calibration and
Very expensive (initial & ongoing costs)
Needs dedicated space

Question 15

what is involved in a 6 minute walk test?

Answer 15

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

Question 16

what is the primary outcome of the 6 minute walk test?

Answer 16

total distance walked in six minutes

Question 17

what are the secondary outcomes of the 6 minute walk test?

Answer 17

‘perceived exertion’ scales, heart rate and pulse oximetry

Question 18

list advantages of the 6 minute walk test

Answer 18

Patient-driven pace – speeding up, slowing down & rest OK
Cheap to deploy
Validated in many clinical populations

Question 19

list disadvantages of the 6 minute walk test

Answer 19

Requires a significant unobstructed course, it often undertaken in a public hospital corridor
The pace is not reregulated

Question 20

what is involved in a incremental shuttle walk test?

Answer 20

Uses a 10 m circuit
Externally paced by an audio recording (like bleep test)
Each minute has one extra length than the previous minute

Question 21

what is the primary outcome of the incremental shuttle walk test?

Answer 21

total distance walked before volitional end

Question 22

what are the secondary outcomes of the incremental shuttle walk test?

Answer 22

‘perceived exertion’ scales, heart rate and pulse oximetry

Question 23

list advantages of the incremental shuttle walk test

Answer 23

Cheap to deploy
Validated in many clinical populations
The external pacing helps some to achieve maximum levels

Question 24

list disadvantages of the incremental shuttle walk test

Answer 24

Requires an unobstructed course
For some the incremental nature is difficult (min. speed 1.8km/hour)
Ceiling effect of 1020 m
Patient can be penalised for poor pace management

Question 25

exercise tests can be used for?

Answer 25

to monitor disease severity / progression and response to treatment

Question 26

long term oxygen therapy is defined as?

Answer 26

> 15 hours / day