L291 Exercise For Diagnosis - Principles of Exercise Testing

Question 1

Why might we do cardiopulmonary exercise testing? (give a few examples)

Answer 1

1. exercise capacity / fitness
2. disease risk
3. differential diagnosis
4. assessment of severity of disease
5. pre-operative risk
6. disability evaluation
7. rehabilitation / exercise prescription
8. effectiveness of therapy

Question 2

Principle for exercise testing

Answer 2

All principles same: progressively load until individual reaches limitation

Question 3

Limitations to maximal capacity achieved through testing

Answer 3

1. Fatigue
2. Self
3. ST depression/chest pain

Question 4

Bicycle odometer: advantages (2)

Answer 4

1. Can easily quantify ex workload

2. Many identifiable measures

Question 5

Criticism of bicycle of odometer

Answer 5

Often local muscles fatigue before proper CV testing -

because you’re selectively using e.g. quads

Question 6

Bruce protocol: what is it?

Answer 6

• Treadmill test of CV function

Question 7

Criticism of Bruce protocol

Answer 7

↑ load fairly quickly - might cause fatigue before adequately testing CV system

Question 8

Incremental exercise intensity - what kind of increments are better/worse?

Answer 8

Sharp step-wise increases might not be as effective a protocol as gentle incline increase because sharp steps mean indv higher chance of self-limitation (perceived difficulty)

Question 9

How might we determine VO2max vs VO2peak?

Answer 9

• There are various criteria that might help us determine this
• E.g. blood lactate, age-predicted max HR or RR

Question 10

Examples of indirect ex tests (list a few)

Answer 10

1. Walk / run tests e.g. 6/12 min walk test
   
   2. 20 m shuttle run (“beep test”)
   3. Prediction from submaximal HR responses
   4. Harvard step test
   5. VO2 – HR relationships during cycling
2. PWC150 / PWC170

Question 11

What are thePWC150 / PWC170 tests?

Answer 11

• Predict power output at projected HR (150/170 bpm)

Question 12

Endurance capacity: muscle oxidative capacity vs VO2 max influence

Answer 12

capacity more related to muscle oxidative capacity than VO2max

Question 13

muscle oxidative capacity: lactate threshold vs VO2 max influence

Answer 13

muscle oxidative capacity closely correlated with lactate threshold (less so with VO2 max)

Question 14

Muscle strength testing: give some examples

Answer 14

• 1 RM (repetition maximum)
• Maximum voluntary contraction (MVC)
• Isometric
• Concentric / eccentric
• Isokinetic