Exercise Capacity Flashcards

1
Q

What is exercise?

A

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

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2
Q

What is physical activity?

A

a holistic term that includes all (purposeful and incidental) muscular activity of all intensities.

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3
Q

What are activities of daily living?

A

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

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4
Q

What happens if there is a deficiency in either ventilation or perfusion?

A

a significant impact on CO2 removal and blood oxygenation

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5
Q

How do you evaluate exercise capacity in clinical populations?

A
  • cardiopulmonary exercise test
  • 6 minute walk test
  • incremental shuttle walk test
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6
Q

What is involved in a cardiopulmonary exercise test?

A
  • use a cycle ergometer or treadmill
  • under close clinical supervision in a controlled environment
  • ECG, ventilation, O2 and CO2 routinely measured
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7
Q

What are the outputs of a cardiopulmonary exercise test?

A
  • ECG changes monitored throughout

- peak VO2 (usually primary outcome)

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8
Q

What are the advantages of doing a cardiopulmonary exercise test?

A
  • quantifies performance in relation to metabolism
  • precise and reproducible
  • continuous monitoring for safety
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9
Q

What are the disadvantages of doing a cardiopulmonary exercise test?

A
  • requires skilled technical support (calibration)
  • very expensive (both initial and ongoing costs)
  • needs a dedicated space
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10
Q

What is involved in a 6 minute walk test?

A
  • uses a 20-30m flat course
  • aim: cover the greatest distance as possible in 6 minutes
  • externally timed by assessor
  • sub-maximal test
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11
Q

What are the outputs of a 6-minute walk test?

A
  • total distance walked in 6 minutes (primary outcome)

- perceived exertion scales, heart rate and pulse oximetry

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12
Q

What are the advantages of doing a 6-minute walk test?

A
  • patient-driven pace (speeding up, slowing down and rest is ok)
  • cheap to deploy
  • validated in many populations
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13
Q

What are the disadvantages of doing a 6-minute walk test?

A
  • requires a significant, unobstructed course - often a corridor
  • unregulated location
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14
Q

What is involved in an incremental shuttle walk test?

A
  • uses a 10m circut
  • externally paced by an audio recording (like a bleep test)
  • each minute has one extra length than the previous one
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15
Q

What are the outputs of an incremental shuttle walk test?

A
  • total distance walked before volitional end (primary)

- percieved exertion scales, heart rate, pulse oximetry

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16
Q

What are the advantages of doing an incremental shuttle walk test?

A
  • cheap to deploy
  • validated in many populations
  • external pacing helps to achieve maximum levels
17
Q

What are the disadvantages of doing an incremental shuttle walk test?

A
  • requires an unobstructed course
  • often done in corridor
  • for some the incremental nature is difficult
  • ceiling effect of 1020m
  • patient can be penalised for poor pace management
18
Q

Which systems in which failure can lead to reduced exercise capacity?

A
  • neurological
  • respiratory
  • cardiovascular
  • muscular
19
Q

How can neurological deficits lead to a reduced exercise capacity?

A
  • motor control

- co-ordination

20
Q

How can respiratory deficits lead to a reduced exercise capacity?

A
  • ability of ventilation
  • pulmonary perfusion
  • gas exchange
21
Q

How can muscular deficits lead to a reduced exercise capacity?

A
  • local perfusion

- muscle cell enzymes

22
Q

What are exercise tests used for?

A

to monitor disease severity/progression and response to treatment

23
Q

What is the impact of supplemental oxygen on exercise capacity?

A

can improve exercise capacity

- doesn’t always relieve breathlessness

24
Q

How is the output of a CPET/CPEX represented?

A
  • nine-panel chart

- relationship between key measured and derived variables