Exercise Capacity Flashcards

1
Q
  1. Define exercise

2. Give examples

A
  1. Purposeful, structured activity

Involves gross muscular activity to improve physical condition

  1. E.G. jogging, stretching, weight training
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2
Q
  1. Define physical activity

2. Give examples

A
  1. A holistic term that includes all (purposeful
    + incidental) muscular activity of all intensities
  2. E.G. walking, stairs
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3
Q

Define activities of daily living.

A

Basic independent self-care tasks done on a daily basis that require co-ordination, strength + range of motion

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4
Q

What is needed between ventilation and perfusion for efficient gas exchange?

A

Maximum coupling is needed between ventilation and perfusion for efficient gas exchange

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5
Q

Maximum coupling is needed between ventilation and perfusion for efficient gas exchange.

Inadequacy of either V or Q will have a significant impact on 2 factors.

What are these 2 factors?

A
  1. Removal of CO2

2. Blood oxygenation

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6
Q

Exercise limitation can be caused by deficits in several systems of the body.

Name 2.

A

E.G.

  • Neurological
  • Respiratory
  • Cardiovascular
  • Muscular
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7
Q

Exercise limitation can be caused by deficits in several systems of the body.

One of these systems is the neurological system.

Give an example of a type of deficit that could cause exercise limitation.

A

E.G. deficits in motor control

E.G. deficits in co-ordination

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8
Q

Exercise limitation can be caused by deficits in several systems of the body.

One of these systems is the respiratory system.

Give an example of a type of deficit that could cause exercise limitation.

A

E.G. deficits in ability for lungs to ventilate

E.G. deficits affecting pulmonary perfusion

E.G. deficits in gas exchange between lungs + blood

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9
Q

Exercise limitation can be caused by deficits in several systems of the body.

One of these systems is the cardiovascular system.

Give an example of a type of deficit that could cause exercise limitation.

A

E.G. deficits in ability for heart to receive blood from lungs

E.G. deficits in heart’s ability to pump oxygenated blood to working muscles

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10
Q

Exercise limitation can be caused by deficits in several systems of the body.

One of these systems is the muscular system.

Give an example of a type of deficit that could cause exercise limitation.

A

E.G. deficits in local perfusion

E.G. defects in muscle cell enzymes

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11
Q

What is cardiopulmonary exercise testing?

A

A technical, high-precision and relatively expensive way of assessing exercise capacity

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12
Q

What is involved in the cardiopulmonary exercise test?

A
  • Uses a cycle ergometer or treadmill
  • Intensity is incremental
  • Undertaken under close clinical supervision in a controlled environment
  • ECG, ventilation, O2 and CO2 routinely measured
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13
Q

What are the outputs of the cardiopulmonary exercise test?

A
  • Lots of data
  • Peak VO2 usually the primary outcome
  • ECG changes monitored throughout
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14
Q

Discuss the advantages [3] and disadvantages [3] of the cardiopulmonary exercise test.

A

Advantages
[+] Quantifies performance in relation to metabolism

[+] Precise + reproducible

[+] Continuous monitoring for safety

Disadvantages
[-] Requires skilled technical support (calibration)

[-] Very expensive (initial + ongoing costs)

[-] Needs dedicated space

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15
Q

Exercise capacity can be evaluated in clinical populations.

Give 3 methods of doing so.

A
  1. Cardiopulmonary exercise test
  2. Six-minute walk test (6MWT)
  3. Incremental shuttle walk test
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16
Q

What is the six minute walk test (6MWT)?

A

Way of assessing exercise capacity

Basic protocol that can be undertaken with basic space, kit + personnel

Involves walking over 20-30m flat course and recording distance covered over 6 mins

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17
Q

What does the six minute walk test (6MWT) involve?

A
  • Uses a 20-30m flat course (e.g. a corridor)
  • Objective = cover greatest distance possible in 6 mins
  • Externally timed by assessor
  • Sub-maximal test
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18
Q

What is the primary outcome of the cardiopulmonary exercise test?

A

Peak VO2 = usual primary outcome

19
Q

What equipment is used in a cardiopulmonary exercise test?

A

Cycle ergometer or treadmill

also ECG, equipment for O2/CO2 monitoring

20
Q

What is the objective of the six minute walk test (6MWT)?

A

To cover the greatest distance possible in 6 mins

21
Q

What are the outputs of the six minute walk test (6MWT)?

A

Primary outcome = total distance walked in 6 mins

Secondary variables may be ‘perceived exertion’ scales, heart rate + pulse oximetry

22
Q

What is the primary outcome of the six minute walk test (6MWT)?

A

Primary outcome = total distance walked in 6 mins

23
Q

What may the secondary variables of the six minute walk test (6MWT) be?

A

Secondary variables may be ‘perceived exertion’ scales, heart rate + pulse oximetry

24
Q

What may the secondary variables of the six minute walk test (6MWT) be?

A

Secondary variables may be ‘perceived exertion’ scales, heart rate + pulse oximetry

25
Q

Discuss the advantages [3] and disadvantages [2] of the six minute walk test (6MWT).

A

Advantages
[+] Patient-driven pace - speeding up, slowing down + rest ok

[+] Cheap to deploy

[+] Validated in many clinical populations

Disadvantages
[-] Requires a significant, unobstructed course (but is often undertaken in a public hospital corridor)

[-] The pace is not ‘reregulated’

26
Q

What is the incremental shuttle walk test?

A

Way of assessing exercise capacity

Basic protocol that can be undertaken with basic space, kit + personnel

Involves 10m circuit across which a patient must travel - increasing lengths across same interval of time

27
Q

What does the incremental shuttle walk test involve?

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

E.G. minute 1 = 3 lengths of 20s, minute 2 = 4 lengths of 15s

28
Q

What distance circuit does the incremental shuttle walk test use?

A

10m

29
Q

What distance flat course does the six minute walk test (6MWT) use?

A

20-30m

30
Q

What are the outputs of the incremental shuttle walk test?

A

Primary outcome = total distance walked before volitional end

Secondary variables may be ‘perceived exertion’ scales, heart rate + pulse oximetry

31
Q

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

A

Primary outcome = total distance walked before volitional end

32
Q

What may the secondary variables of the incremental shuttle walk test be?

A

Secondary variables may be ‘perceived exertion’ scales, heart rate + pulse oximetry

33
Q

Discuss the advantages [3] and disadvantages [4] of the incremental shuttle walk test.

A

Advantages
[+] Cheap to deploy

[+] Validated in many clinical populations

[+] The external pacing helps some to achieve maximum levels

Disadvantages
[-] Requires an unobstructed course (but is often undertaken in a public hospital corridor)

[-] For some, the incremental nature is difficult (min. speed 1.8km/hr)

[-] Ceiling effect of 1020m

[-] Patient can be penalised for poor pace management

34
Q

What does the acronym “IC” stand for?

A

Inspiratory capacity

the max. volume of air that can be inspired after reaching end of a normal quiet expiration

35
Q

What does the acronym “MVV” stand for?

A

Maximal voluntary ventilation

aka maximal breathing capacity - max. minute volume of ventilation that they can maintain for 12-15s

36
Q

What is the oxygen pulse?

A

VO2/heart rate

= ratio of O2 consumption:heart rate

= (v) of O2 ejected from ventricles with each heart beat

37
Q

What does the acronym “PETCO2” stand for?

A

End-tidal carbon dioxide partial pressure

Used to track PaCO2 in the arteries

38
Q

What does the acronym “PETO2” stand for?

A

End-tidal oxygen partial pressure

Refers to PO2 of exhaled gas

39
Q

What does the acronym “SBP” stand for?

A

Systolic blood pressure

40
Q

What does the acronym “SpO2” stand for?

A

Peripheral oxygen saturation

Measure of Hb carrying O2 in blood relative to amount of Hb not carrying O2

41
Q

What can exercise tests be used to monitor?

A

Inc.

  • Disease severity
  • Disease progression
  • Response to treatment
42
Q

How can supplemental oxygen impact:

a) exercise capacity?
b) breathlessness?

A

a) can improve exercise capacity

b) can help relieve breathlessness BUT doesn’t always do so

43
Q

How is the output of a CPET/CPEX often represented?

A

In a nine-panel chart

This chart details the relationship between key measured + derived variables

44
Q

In athletic populations, what 2 values is it especially useful to determine?

A
  • Maximal or peak cardiopulmonary performance

- Anaerobic threshold