6. Lab-based physiological ax for OA

Question 1

3 synonyms of cardiorespiratory function

Answer 1

Aerobic fitness
Aerobic endurance
Cardiorespiratory endurance

Question 2

Define cardiorespiratory function (CRF)

Answer 2

Overall function of the cardiovascular and respiratory systems

Question 3

What is included in the cardiovascular systems and respiratory systems?

Answer 3

Cardio: heart and blood vessels
Respiratory: lungs and airways

Question 4

Two good reasons for testing CRF?

Answer 4

• Baseline values
• Key determinant of maintaining independent living

Question 5

2 methods to measure CRF in a lab setting?

Answer 5

Direct method
Indirect method

Question 6

What is the direct method?

Answer 6

Measurements taken during maximal-intensity exercise test

Question 7

Advantages of the direct method

Answer 7

More accurate (typical 3% error)
Better estimation of desired exercise intensity

Question 8

Disadvantages of direct method

Answer 8

Require expensive & sophisticated equipment
Higher risk of adverse events (more stress on participant)
Physician supervision can be required

Question 9

What is the indirect method?

Answer 9

Measurements taken without the use of sophisticated equipment
Equations are used to estimate VO2 level

Question 10

Advantages of indirect method

Answer 10

Easier to make measurements (lower risk for technical issues, test is shorter, test is less expensive)

Question 11

Disadvantages of indirect method

Answer 11

Less accurate (typical error is 5-7% in CRF max prediction)

Question 12

Name the 4 possible equipment for submaximal CRF tests

Answer 12

Treadmill
Leg ergometer
Arm ergometer
Recumbent stepper

Question 13

Implications of using treadmill for submaximal testing

Answer 13

• expensive
• not portable
• more difficult to measure BP accurately
• may not be appropriate for OA (balance, gait or weight problems)

Question 14

Preferred testing equipment method for OA with balance, gait or weight problems

Answer 14

Leg cycle ergometer

Question 15

VO2max is average ___ lower on leg cycle vs treadmill

Answer 15

10%

Question 16

Preferred testing equipment method for OA with balance gait or weight problems + impaired motor coordination in upper or lower limbs

Answer 16

Recumbent stepper

Question 17

Disadvantages of recumbent stepper

Answer 17

• Not necessarily functional exercise
• Expensive+ not portable
• Difficult to take BP during test
• Quite recent = limited protocols for testing

Question 18

Can you design your own testing protocol for OA?

Answer 18

Yes, especially for sub-max effort

Question 19

Equipment method ideal for OA with difficulty in ambulation

Answer 19

Arm cycle ergometer

Question 20

Advantages of arm cycle ergometer

Answer 20

Can be portable
Relatively inexpensive

Question 21

Disadvantages of arm cycle ergometer

Answer 21

Localized muscle fatigue
Lack of functional specificity
Difficult to take BP during test

Question 22

For testing protocols, OA participants must reach ± ___ of max age-predicted HR

Answer 22

75%

Question 23

Accuracy for predicting VO2 max based on assumption that HR increased at ___ (same, slower or faster rate)

Answer 23

SAME rate

Question 24

Test recommended for OA by ACSM (treadmill test)

Answer 24

Modified Balke-Ware treadmill test

Question 25

Why is the Modified Balke-Ware treadmill test recommended?

Answer 25

Uses a slow & constant walking speed with small increases in grade every minute

Question 26

Modified Balke-Ware treadmill test is most appropriate for OA with:

Answer 26

Good ambulation (Walking) + stroke and parkinson's

Question 27

How can you make it better for fit OA if you are using the Modified Balke-Ware treadmill test

Answer 27

- Increase walking speed - Increase grade increments

Question 28

7 reasons for stopping test in OA

Answer 28

- Angina-like symptoms (chest pain, pressure of discomfort) - Participant is not sweating, light-headed, confused of unsteady, pale, blue lips - BP drops below 20 mmHg from rest - No increase in systolic BP with exercise intensity - Excessive rise in BP 250/115 mmHg - Participants requests to stop - Failure of testing equipment

Question 29

Clinical significance of OA having a lower 75% max HR vs YA

Answer 29

CRF tests for OA do not have to be as vigorous and demanding as with YA (especially if OA is deconditioned)

Question 30

What is the typical walking speed of OA and younger adults?

Answer 30

OA: 4.5 to 4.8 km/h YA: 5.3 to 5.4 km/h

Question 31

EQUATION FOR CALCULATION OF OXYGEN CONSUMPTION (ESTIMATION)

Answer 31

VO2 = 0.1 x speed + 1.8 x speed x grade + 3.5

Question 32

Speed is in what units

Answer 32

Meter/min

Question 33

Why is balance testing important in OA?

Answer 33

Because seniors have a higher risk of falling

Question 34

The ability to control the body's center of mass relative to the base of support, whether the base is stationary of moving

Answer 34

Balance

Question 35

Max distance and OA can move beyond a centered position without altering the BOS is referred to as

Answer 35

Limits of stability

Question 36

___ and ___ in OA are considered as main features of independent living and performance of basic and instrumental ADLs

Answer 36

Balance and fear of falling

Question 37

4 measurements of balance

Answer 37

1. Static balance 2. Dynamic balance 3. Reactive balance 4. Sensory integration & organization

Question 38

Ability to maintain the COM directly over the BOS

Answer 38

Static balance

Question 39

Difference from OA and YA in static balance

Answer 39

Greater postural sway (movement over their BOS) in OA than YA

Question 40

Ability to control the COM while leaning through or moving beyond the LOS

Answer 40

Dynamic balance

Question 41

What happens if the OA moves beyond their LOS and don't adjust their BOS?

Answer 41

They fall

Question 42

What 3 things does the dynamic balance assessment measures?

Answer 42

- Distance reached forward, backward, laterally and diagonally - Time of reaction - Movement accuracy

Question 43

Ability to respond automatically to a loss of balance

Answer 43

Reactive postural control

Question 44

How do you evaluate reactive postural control?

Answer 44

Perturbation is elicited through moving (motorized) force plate and the participant has to respond quickly with counter movement opposite to the direction of plate movement

Question 44

What does the test measures in sensory integration and organization? (2)

Answer 44

1. How well each sensory system is functioning 2. How well the participant maintains upright balance when the information coming from the 3 systems is not in agreement

Question 44

Ability to integrate and organize sensory information provided by the visual, somatosensory and vestibular systems

Answer 44

Sensory integration and organization

Question 45

Review slide 39 of ppt

Answer 45

image of 6 possible perturbations in sensory integration and organization