Week 6- Exercise Testing Flashcards
PART 1
PART 1:
What is exercise testing?
A noninvasive procedure that evaluated an individual’s capacity for dynamic exercise.
Outcomes of Exercise Testing Information Provided:
- _______/________ information
- Define exercise/functional __________.
- Provides _______/________ data.
- Provides guidance in ______________.
- diagnostic/prognostic
- exercise/functional capacity
- baseline/follow-up
- directing exercise training program
- At what age should men and women be exercise tested?
- Who else should be be exercise tested?
-Men >45, Women >55
- Family Hx of CVD
- Cigarette Smoking
- Sedentary Lifestyle (not meeting exercise guidelines for previous 3 months)
- Obesity
- HTN
- Dyslipidemia
- Prediabetic
Exercise Testing ABSOLUTE Contraindications. (9)
- Recent significant change in resting ECG***
- Unstable angina***
- Uncontrolled cardiac dysrhythmias***
- Uncontrolled symptomatic HF
- Acute PE or pulmonary infarction***
- Severe symptomatic aortic stenosis
- Acute myocarditis/pericarditis
- Suspected/known dissecting aneurysm
- Acute systemic infection***
Exercise Testing RELATIVE Contraindications. (10)
- L main coronary stenosis
- e- imbalance
- Moderate stenotic valvular heart disease
- Severe untreated arterial HTN (SBP >200, DBP >120)
- HCM
- Uncontrolled metabolic disease (DM)
- High degree AV block
- Tachy/bradycardia
- Advanced/complicated pregnancy
- Abnormal increase in weight in past 2 days with stable HF
ABSOLUTE Contraindications to STOP Exercise:
- Onset of _______.
- Suspicion of ________.
- Drop in SBP >___mmHg with increased work rate.
- SBP >____mmHg and/or DBP >____mmHg.
- Serious _________.
- Significant _________ HTN.
- Signs of poor ________ including pallor, cyanosis, cold and clammy skin.
- SOB, wheezing, leg cramps, or claudication.
- Technical inability to monitor ECG.
- Patient request.
- angina or angina-like symptoms
- MI
- SBP >10mmHg
- SBP >250mmHg and/or DBP >115mmHg
- serious arrhythmias
- pulmonary HTN
- poor perfusion
What are some signs of poor perfusion? (3)
- pallor
- cyanosis
- cold and clammy skin
RELATIVE Contraindications to STOP Exercise:
- Failure of _______ to increase with increasing exercise intensity.
- Change in heart _______.
- Patient request.
- Severe fatigue.
- Failure of testing equipment.
- Ventricular aneurysm.
- HR
- heart rhythm
“No exercise testing required before walking, flexibility, or resistance training. Follow ACSM guidelines for exercise testing before _______-________ ________ exercise training.”
-mod-vig aerobic
Submaximal Exercise Test:
- Patient achieves a predetermined _________ exertional level and then test is stopped.
- May be symptom limited or have a predetermined end point (___% HRmax).
- These tests tend to be ______, ________ protocol.
- No expired gas analysis performed.
- VO2max OR VO2peak is typically _________ from the results of the test
- submaximal
- 85% HRmax
- ramped, progressive protocol
- extrapolated
PART 2: BRUCE PROTOCOL & 6MWT
PART 2: BRUCE PROTOCOL & 6MWT
- What is the Bruce Protocol?
- Is it a direct indicator of VO2max?
- The Bruce Protocol is a standard test in cardiology and is comprised of multiple exercise stages of three minutes each.
- No, but we can ESTIMATE peak VO2.
What information can we derive from the Bruce Protocol Test if expired gases are not analyzed? (4)
- ) Stage completed
- ) Exercise duration
- ) HR/RPE/Dyspnea at FIXED WORK LOADS (each stage = a fixed work load)
- ) Estimated VO2max
What are (3) methods to estimate age specific HR?
Traditional Method
-220-age
Tanaka Method
-207-(0.7*age)
Inbar Method
-205.8-(0.685*age)
- What provides the best available approximation of VO2max?
- How is it calculated?
- Heart Rate Reserve (HRR)
- HRR = Estimated HRmax-HRrest
What are the (3) instances where the Bruce Protocol is stopped?
- ) Achieve age-predetermined HR (85% HRmax)
- ) Volitional fatigue
- ) Patient choice
What (3) things at measured at each stage of the Bruce Protocol?
- ) HR
- ) RPE
- ) BP
What is another exercise test commonly used?
6MWT
What (6) measurements need to be made during an assessment of exercise capacity?
- BP
- HR
- RR
- RPE
- Rating of breathlessness (during and at end)
- Arterial O2sats
Are there age matched healthy normals for the 6MWT?
Yes (males and females)
What is the purpose of the 6MWT?
Used to establish status and to set goals.
What was the 6MWT originally developed for?
Functional capacity
What is the MCSD for the 6MWT?
54-80m
PART 3: STRENGTH AND POWER
PART 3: STRENGTH AND POWER
What are some ways to measure strength? (4)
- MMT
- 1RM
- Hand-held dynamometer
- Isokinetic machines
Power:
- Power = _____ * ______
- Reflects a combination of _______ and ________.
- Tests will have a _______ and ______ component.
- Power = Force * Velocity
- strength and endurance
- force and time
What are some tests utilized to measure power? (3)
- Peak Cycling Test
- Stair Climb Test
- 30s Sit to Stand
Which is better in determining functional status and independently predicted functional dependency even after accounting for additional neurophysiological and health status indicators? (Power, Strength, Aerobic Capacity)
POWER
