Exam 2 Slideshow 2 Sept. 30th Flashcards
Common Exercise Test Protocols Treadmill - 4
- Balke and Ware
- Standard Bruce
- Modified Bruce
- Naughton
VO2max =
What happens to the graph when it reaches VO2max =
maximal oxegen uptake
Plateau
The Oxygen Transport System factors that affect VO2max are (in order)
Pulmonary ventilation, Hemoglobin
concentration, blood volume and cardiac output, Peripheral blood flow, Aerobic metabolism
VO2 Peak is
Highest O2 consumption during exercise test regardless of whether a plateau is reached
What is the units of Absolute Vo2?
What does Absolute Vo2 measure?
Measure in L/min or ml/min
■ Provide a measure of “energy cost of non-weight-bearing exercises.”
What are the units for Relative Vo2?
What kind of exercises is Relative Vo2 for?
Relative to body mass: ml/kg/min
■ Always for weight-bearing exercises
● Net vs. Gross Vo2
○ Gross Vo2
■ Rest + Exercise O2 consumption
○ Net Vo2
■ O2 consumption of exercise only
What is the primary criteria needs to be met to attain a Primary Vo2 max?
■ Plateau in o2 consumption
■ Vo2 increases ≤ 150 ml/min
■ Verified by bout at submaximal load
What is the Secondary Vo2 max attainment criteria?
● HR fails to rise with increasing workload
● RPE> 17 borg 6-20 Scale
● Blood Lactate > 8 mmol/L
● RER> 1.15
Procedures for Exercise Testing
- Timely delivery of protest guidelines
- Informed consent and screening procedure - Baseline hemodynamic assessment
- Familiarization with RPE Scale
- Warm-up
- Monitor RPE and hemodynamics throughout the test and recovery
- Monitor client’s physical appearance and symptoms
- Cool down
Five Reasons to Terminate an Exercise Test
- End protocol
- Equipment malfunction
- Client asks to stop
- Signs or symptoms indicating need to stop
- Reached predetermined endpoint (submaximal Vo2 test)
Do we need to know these??????
General Indications for Termination
- Onset of angina or angina-like symptoms
- Drop of BP more than or equal to 10mmHg
- Excessive rise in BP- Systolic >250 and Diastolic pressure > 115 mmHg
- Shortness of Breath, wheezing, leg cramps, Claudication
- Signs of poor perfusion
- Failure of HR to rise with increased exercise intensity
- Noticeable change in heart rhythm
- Client Request to stop
- Physical or verbal manifestations of severe fatigue
- Failure of the testing equipment
Naughton Protocols
How does it increase?
Increases 3.5% every 2 min
To be able to use eqautions on charts with grade and all that the test must be at
Steady state
Cadence is
Revolutions per minute
Testing with Cycle Ergometers
Before the Test (In Advance) -
Afterward -
In advance -
- Check calibration
- Know cadence & resistance
requirements (especially changes)
- Establish warm-up and cool-down
requirements
- Set proper seat height & handlebars
Afterward -
- Unload any resistance on flywheel
Power = F v = F (d/t) = load (kg) x flywheel “travel” (m/rev) x cadence (rev/min)
Power is the
Units?
rate of doing work
Power = Kg m/min
Units for Power for a Cycle Erogmeter is
Power = Kg m/min
For Steady State ONLY
Bench Stepping Maximal Exercise Tests is the……
and why
- Least desirable modality for
max exercise testing
This is why:
- Unequal distribution of work
- Hard to standardize workload; differences in the following:
- Step height; Stepping cadence;
- Body mass; Leg length
Concentric Muscle action takes more
muscle action than eccentric muscle action
Bench Stepping Maximal Exercise Tests
increase intensity with
- Faster stepping cadence
- Increased step height
Submaximal Exercise Test Protocols are used to……..
estimate VO2max
HR max determination is important:
HR-based extrapolation to
APHR (Age predicted Heart Rate Max) max and VO 2max
Extrapolate
IMPORTANT
Submaximal Exercise Test Protocol Assumptions
Assumptions:
- Steady-state HR attained and maintained at each stage
- Linear relationship: HR and VO2 (between 110 and 150 bpm)
- Mechanical efficiency constant for everyone (output/input)
- HR max is similar for all of same age
HRmax determination is important because;
HR-based extrapolation to APHRmax and Vo2 max
Ask him what they are measuring???
A Note on RPE
Standard (Borg)
OMNI
Know what each are measuring and all that
Standard (Borg): Has to do with heart rate
Scales: 6(no exertion)-20(max exertion) & 0-10
OMNI: Walking, Running and Biking
Scale: 0-10, pictures discriptors
Treadmill Sub-maximal Exercise Tests Stages - 2
1) Multistage Model
2) Single-stage model
Treadmill Sub-maximal Exercise Tests First Stage
1) Multistage Model
- Need two stages with HR 115 - 150 bpm determine slope and extrapolate to APHrmax
Need two consecutive stages.
Determine slope and extrapolate to APHR max
Treadmill Sub-maximal Exercise Tests Second Stage
2) Single-stage mode
Single-stage model
Need one stage with HR 130 – 150 bpm
Need one stage with steady-state
Nomograms
Cycling Sub-maximal Exercise Test for
Multistage Model
and
Single Stage Model
Multistage model -
Need two consecutive stages
with steady-state HRs between
110 bpm and 85% APHRmax
Single-stage model -
Need one stage with steady-state
HR between 130 and 150 bpm
Nomograms
Exercise Testing for Children
Treadmill preferred to bike modified Balke treadmill protocol Mcmaster cycling protocol field tests
Exercise Testing for Older Adults
Modify protocols
Extend warm-up and cool-down
Extend stage for steady state
Field tests
Self-paced stepping
Timed walking or stepping
Set initial intensity to 2-3 Mets
Reduce treadmill speed
Use 8-12 min for total test time
Five basic Elements of an Exercise Prescription
When we combined the middle three we come up with VOLUME
Mode
Intensity
Frequency
Duration
Progression
Parts of Cardiorespiratory Workout - Warm up
- 5-10 min
- Low to moderate intensity
- Increase blood flow
- Increase core temperature
- Decrease likelihood of Injury
- Reduce chance of cardiac arrhythmias
Parts of Cardiorespiratory Workout - Endurance Conditioning
Follow FITT-VP Principles
Difference between Max and Rest
F = Frequency
I = Intensity
T= Time
T= Type
V = Volume
P = Progression
20 - 60 min per session
- Depends on session
Minimum single bout duration= 10 min continuous
Accumulate 30 min MIPA per day 20 min VIPA per day
Parts of Cardiorespiratory Workout - Cool Down
- Immediatley follows endurance conditioning
- Low intensity exertion
5-10 min
- HR and BP return to near pre - exercise levels
- Maintains venous return to heart
- Prevents blood pooling
- Counters post - exercise dizziness and fainting
- Prevents blood pooling
Parts of Cardiorespiratory Workout - Stretching
- 5-10 min
- Target Major muscle groups
- May reduce soreness and cramping
Parts of Cardiorespiratory Workout Components -
Warm - up
Endurance Conditioning
Cool - Down
Stretching
For Health and Fitness - Frequnecy
5 days/wk MIPA, 3 days/wk VIPA, or
combination thereof
For Health and Fitness - Intensity
- MIPA (3-6 MET; 40% to < 60% VO 2 R),
VIPA (>6 MET; 60% to < 89% VO 2 R), or
combination thereof - %HRR may be used instead of %VO2 R
For Health and Fitness - Time (Duration)
- ≥150 min/wk MIPA, 20-60 min/wk VIPA,
or combination thereof
For Health and Fitness - Type (Mode)
- Aerobic, large muscle groups
- Rhythmic action
- Little skill required
For Health and Fitness - Progression and Volume
Progression
* Increase per client ability to adapt
Volume
* 500-1,000 MET∙min∙wk–1
Setting Initial Exercise Intensity
To Improve CRF: 55% of reserve to 80% VO2R or HRR
MOREEEEEEE
KNOW WELL
Progression Exercise Overview (Steps)
Need to challenge the body to keep adapting
1) Initial conditioning (1-6 weeks)
Start MIPA at 3 days/wk, 20 min going to 30 min
VERY IMPORTANT
Goal: 55%-60%HRR for 30 continuous min
2) Improvement (4-6 months)
Frequency, Intensity, Duration adjusted independently
Goal: Sustain MVPA 20 to 60 min per session
3) Maintenance
Goal: maintain fitness level and weekly volume
