Exercise for Diagnosis - Principles of Exercise Testing Flashcards
Why is exercise testing used in a clinical setting?
Can indicate pathology
How is the change in the notion that rest is good for you reflected?
Active rehabilitation
Pre-habilitation
What are major foci of exercise tests?
Cardiovascular
Pulmonary
What aspect of exercise is a vital sign and predictor of mortality?
Exercise capacity
How could the effectiveness of therapy be shown in an exercise test?
Improvement in exercise capacity
Why is treadmill walking often used in exercise tests?
Activity most people accustomed to
What are the limitations of using treadmill walking in exercise tests?
Need balance
Risk of falling off
What is an advantage of treadmill walking over using a cycle ergometer in exercise tests?
Don’t get as much localised muscle fatigue
What are the advantages of using a cycle ergometer in exercise tests?
Quantify workload quite easily
Independent of body mass
Collapse on cycle not nearly as catastrophic as on treadmill
What are the general principles of the modified Bruce protocols?
Allow period of warm up
Progressively load physiological system
Patient limited by motivation and fatigue
Compare motivation and fatigue in exercise tests between elite athletes and patients
Highly motivated elite athletes go as long as they can
Patients often symptom limited
Get best result if limitation is due to fatigue, no matter your test subject
What is the ramp exercise protocol?
Bike programmed to slowly increase ramp
What is the change in VO2 with a ramp exercise protocol?
Increases linearly
When is the ramp exercise protocol best used?
For measuring VO2 max because without large step, which can load muscle and cause premature fatigue
Why might a step exercise protocol be used?
In sports science setting might use this because also measuring lactate
What is heart rate a measure of?
Cardiac function
What is lactate a measure of?
Oxidative capacity of muscle
Compare lactate production between normal and heart patients
Heart patients produce lactate much earlier in exercise test
Where are indirect exercise tests useful?
In remote areas
What are some examples of indirect exercise tests?
Walk/run tests
Beep test
Harvard step test
What are some factors influencing walk/run tests?
Partly determined by muscle mass
Large part determined by cardiorespiratory fitness
What is the principle behind the Harvard step test?
If you know someone’s body mass, and height of step > can work out power output
Compare to heart rate at end of test
When is heart rate higher in exercise tests?
Dehydrated
Hot
When is heart rate lower in exercise tests?
On beta-blockers
What are some reasons for testing cessation?
Fatigue/exhaustion Drop in blood pressure Moderate to severe angina Ataxia, dizziness, syncope Dysrhythmias ST segment changes Shortness of breath beyond normal exercise norms
What is endurance capacity related to?
Oxidative capacity of muscle more than VO2 max
What is the relationship between lactate threshold and time to fatigue in well-trained cyclists?
Higher lactate threshold, greater time to fatigue
What is the relationship between lactate threshold and glycogen use in well-trained cyclists?
Higher lactate threshold, lower glycogen use
What is the relationship between muscle mass and all-cause mortality, particularly in the older age group?
Lower muscle mass, higher all-cause mortality
