Exercise Testing

Question 1

Who should go through exercise testing?

Answer 1

1. men > 45
2. women > 55
3. smokers
4. sedentary lifestyle
5. obese
6. HTN
7. dyslipidemia
8. prediabetic

Question 2

Absolute CI to participation in exercise testing

Answer 2

1. recent significant changes in resting ECG
2. unstable angina
3. uncontrolled cardiac dysrhythmias
4. uncontrolled symptomatic HF
5. acute PE or pulm infarct
6. severe symptomatic aortic stenosis
7. acute myocarditis/pericarditis
8. symptomatic severe aortic stenosis
9. suspected or known dissecting anuerysm
10. acute systemic infection w/ fever, body aches, or swollen lymph nodes

Question 3

Relative CI to exercise

Answer 3

1. L main coronary stenosis
2. electrolyte abnormalities
3. mod stenotic valvular heart disease
4. severe untreated arterial HTN
5. HCM
6. uncontrolled metabolic disease
   High deg AV block
7. tachy/bradycardia
8. advanced/complicated pregnancy
9. abnormal increase in body mass previous 2 days w/stable CF

Question 4

severe arterial HTN at rest

Answer 4

SBP: > 200 mmHg
DBP: > 120 mmHg

Question 5

Absolute CI when indicate you should stop exercise testing

Answer 5

1. onset of angina
2. suspicion of MI
3. drop in SBP >10 w/increase in work rate
4. SBP falls below prior testing
5. SP > 250 and/or DP >115
6. serious arrhythmias
7. significant pulmonary HTN
8. Poor Perfusion: pallor, cyanosis, cold/clammy skin
9. SOB, leg cramps, claudication
10. Patient Request!!
11. tech inability to monitor ECG

Question 6

Relative CI indicating you should stop exercise testing

Answer 6

1. failure of HR to increase
2. change in heart rhythm
3. severe fatigue
4. failure of testing equipment
5. ventricular aneurysm

Question 7

submax exercise testing

Answer 7

• patient achieves predetermined exertional level, then stop
• ramped, progressive protocol
• no expired gas analysis performed
• VO2 max or VO2 peak can be extrapolated from the test

Question 8

how long is each stage of the bruce protocol?

Answer 8

3 minutes

Question 9

during the bruce protocol, when are physiological measurements taken and then gradient is elevated?

Answer 9

last 30 seconds of each stage

Question 10

Bruce Protocol: What info can be derived if expired gases are NOT analyzed?

Answer 10

1. stage completed
2. exercise duration
3. HR/RPE/Dyspnea at fixed work loads (stage)

Question 11

How to estimate VO2peak from Bruce Protocol in Women

Answer 11

(4.38xTime) - 3.9

Question 12

How to estimate VO2peak from Bruce Protocol in men

Answer 12

(2.94xtime) + 7.65

Question 13

Tanaka estimation for age specific HR

Answer 13

207 - (.7 x age)

Question 14

Estimating HRR

Answer 14

HRR = (estimated HRmax - HRrest)

Question 15

When to stop modified bruce protocol

Answer 15

1. achieved pre-determined HR
2. 85% of HRmax
3. Volitional fatigue
4. Patient choice

Question 16

Bruce Protocol: What should be measured at each stage

Answer 16

HR
RPE
BP if possible

Question 17

6MWT:

physiological measurements that need to be made during assessment of exercise capacity

Answer 17

1. BP (pre and post)
2. HR (pre and post)
3. RR (pre and post)
4. RPE (during and post)
5. Rating of breathlessness (during and post)
6. arterial O2 saturation

Question 18

MCSD for 6MWT must be between

Answer 18

54 and 80 m

Question 19

Examples of Submax exercise tests

Answer 19

1. single stage submax treadmill walking test
2. astrand and rhyming cycle ergometer test
3. 2MWT
4. mod shuttle walking test
5. bag and carry test
6. physical function ICU test

Question 20

Methods of assessing strength

Answer 20

• MMT
• 1 rep max
• hand held dynamometer
• isokinetic machines

Question 21

1 rep max

Answer 21

• max weight person can lift 1 time through FULL ROM with GOOD FORM
• make sure to ask RPE and use to assess subjective effort
• increase weight for next trial by 4-6 lbs
• 30 sec between trials and alternate UE and LE
• over when patient can’t complete ROM

Question 22

predicting 1 rep max

Answer 22

10 reps resulting in fatigue / .75

Question 23

power

Answer 23

amount of work produced per unit of time

P=force x velocity

Question 24

Power tests

Answer 24

• peak cycling
• stair climb
• 30 sec repeated STS
• TUG
• TUDS
• 5xSTS
• stair climbing power test

Question 25

stair climbing power test

Answer 25

determine time required to climb 10 stairs as quickly and as safely as possible

Question 26

T/F: Strength and high-velocity resistance training in healthy, well-functioning older adults significantly and similarly improved muscle power and muscle strength.

Answer 26

True

Question 27

T/F: Peak muscle power was inferior to muscle strength in determining functional status

Answer 27

False independently predicts functional dependency, even after accounting for neuropsychological and health status indicators

Question 28

What amount of aerobic, resistance, or combined training can significantly improve physical function?

Answer 28

3x/week x 8-12 weeks