Maximal (Clinical) Exercise Testing Exam 2

Question 1

What are the 3 Purposes of Testing?

Answer 1

-Diagnosis
-Prognosis
-Evaluation of Cardiorespiratory Fitness & Physiological Responses to Exercise

Question 2

Diagnostic Tool

Answer 2

-Utilized to help diagnose patients with ischemic heart disease (IHD) includes(CHeartD & CArteryD)
-Monitor for ischemia, electrical abnormalities, or other exertion-related signs/symptoms includes(ECG, Hemodynamics “HR & BP”, Signs/Symptoms, Gas Exchange & Ventilatory Responses)

Question 3

Prognostic Tool

Answer 3

-Often used after a CV event
-Provide information for exercise prescription
-Evaluation of current treatment
-Help determine if further treatment is necessary

Question 4

Evaluation Tool

Answer 4

-Determine hemodynamic responses to exercise
-Determine CRF (VO2max)
-Increase in CRF are important in all populations

Question 5

Maximal Testing Exercise Mode: Treadmill

Answer 5

-Most common modality used for testing
-Higher physiological stress & O2 consumption than cycling
-Avoid client holding handrails unless necessary

Question 6

Maximal Testing Exercise Mode: Cycling

Answer 6

-Advantages compared to treadmill include: less cost, less space needed, less noise, & less client movement
-Disadvantages compared to treadmill include: can result in 5-20% lower, unfamiliar mode for many people

Question 7

Bruce Treadmill Maximal Exercising Protocol

Answer 7

-Most common treadmill protocol
-Large increments(2-3 METs per stage) increasing speed & grade
-Can be difficult for older/unfit individuals

Question 8

Naughton Treadmill Maximal Exercising Protocol

Answer 8

-Smaller increments(<_1MET per stage) constant speed, increasing grade
-Better for older, deconditioned, chronic disease clients

Question 9

Ramp Treadmill Maximal Exercising Protocol

Answer 9

-Constant progressive increase in intensity(speed and/or grade increases)

Question 10

Standard Measurements During Maximal Exercising Testing

Answer 10

-Electrocardiogram
-Heart Rate
-Blood Pressure
-Signs & Symptoms
-RPE
-Expired Gas & Ventilatory Response can be added

Question 11

Normal HR Response in Maximal Testing

Answer 11

-1 MET increase = about 10 bpm increase
-Steady decline back to baseline during recovery

Question 12

Abnormal HR Response in Maximal Testing

Answer 12

-Chronotropic Incompetence
-Failure to increase HR properly during exercise
-Failure to reach ≥ 85% age-predicted HRmax

Question 13

Normal BP Response in Maximal Testing

Answer 13

-SBP:1MET increase = about 10 mmHg increase
-DBP: No change or slight decrease
-Progressive SBP decline back to baseline in recovery

Question 14

Abnormal BP Response in Maximal Testing

Answer 14

-Drop in SBP (> 10 mmHg) or failure of SBP to increase despite increase in intensity
-Large changes in DBP (> 10 mmHg)
-Hypertensive Response (Males: SBP ≥ 210 mmHg, Females: SBP ≥ 190 mmHg)

Question 15

Evaluation of Exercise Capacity

Answer 15

High exercise capacity = high cardiac output (Q) capabilities

Question 16

Predicting/Estimating Exercise Capacity

Answer 16

-Use maximum workload achieved to calculate VO2max
-Can be problematic from a clinical perspective (standard error is ± 1 MET)

Question 17

Measurement in Exercise Capacity

Answer 17

-Use metabolic cart to measure VO2max & ventilatory responses
-Improves accuracy of data
-Certain physiological variables can help determine if VO2max was truly achieved (Blood Lactate, RPE, Respiratory Exchange Ratio, Failure of HR to increase w/ intensity, & Plateau in VO2 w/ increased intensity