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 ADL
Basic independent self-care tasks done on a daily basis that require coordination, strength and range of motion
What is ventilation perfusion matching?
Efficient gas exchange needs maximum coupling between ventilation and perfusion. Inadequacy of either V or Q will have significant impact on removal of CO2 & blood oxygenation. V = ventilation rate. Q = capillary blood flow.
What is involved in the cardiopulmonary exercise test?
A cycle ergometer or treadmill is used. Intensity is incremental. Undertaken under close clinical supervision in a controlled environment. ECG, ventilation, O2 and CO2 routinely measured.
What are the outputs of the cardiopulmonary exercise test?
Peak VO2 usually the primary outcome. ECG changes monitored throughout.
What are the advantages and disadvantages of the cardiopulmonary exercise test?
Advantages
Quantifies performance in relation to metabolism
Precise and reproducible
Continuous monitoring for safety
Disadvantages
Requires skilled technical support (calibration and
Very expensive (initial & ongoing costs)
Needs dedicated space
What is involved in the 6 minute walk test?
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.
What are the outputs of the 6 minute walk test?
Primary outcome is total distance walked in six minutes
Secondary variables may be ‘perceived exertion’ scales, heart rate and pulse oximetry
What are the advantages and disadvantages of the 6 minute walk test?
Advantages
Patient-driven pace – speeding up, slowing down & rest OK
Cheap to deploy
Validated in many clinical populations
Disadvantages
Requires a significant unobstructed course, it often undertaken in a public hospital corridor
The pace is not reregulated
What is involved in the incremental shuttle walk test?
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).
What are the outputs of the incremental shuttle walk test?
Primary outcome is total distance walked before volitional end
Secondary variables may be ‘perceived exertion’ scales, heart rate and pulse oximetry
What are the advantages and disadvantages of the incremental shuttle walk test?
Advantages
Cheap to deploy
Validated in many clinical populations
The external pacing helps some to achieve maximum levels
Disadvantages
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 penalised for poor pace management
