aerobic assessment Flashcards

1
Q

assessing energy systems

A
  • high power/short capacity: anerobic alactic + lactic
  • lower power/low capacity : aerobic
  • the power and capacity of energy supply is dependent on the intensity and duration of the exercise bout
  • we can only assess which energy system predominates
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2
Q

power vs. capacity

A
  • power is the maximum rate at which energy can be utilized
  • capacity is the total number of work that can be performed
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3
Q

interpreting aerobic system function (vo2)

A
  • it is important for performance (aerobic sports) and health
  • VO2 is a strong predictor of morbidity + mortality
  • comes from how much work an individual can do in daily life
  • high aerobic capacity is important for ADLs
  • there is a difference in O2 in relation to exercising at different altitudes
  • harder to exercise at high altitudes
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4
Q

first laboratory exercise test

A
  • measured increased consumption of “vital air” during sustained exercise
  • continuation of work = more vital air
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5
Q

how vo2 max was born

A
  • demonstrated that oxygen uptake increased linearly with running speed but eventually reaches a maximum beyond which no effort can drive it
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6
Q

why is the aerobic system important

A
  • important for performance for aerobic sports and health
  • can somewhat predict success in endurance activities
  • can sometimes indicate the ability to recover from task
  • has been linked to increased risk for a variety of diseases
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7
Q

assessing aerobic power

A
  • gold standard is considered to be the maximal oxygen consumption test or VO2 max test
  • single best measure of overall aerobic fitness
  • defined as the maximum rate at which O2 can be inspired, transported and utilized to perform muscular work
  • defined by the Fick equation
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8
Q

Fick equation

A
  • difference between arterial + venous blood in circulation X Cardiac output
  • best way to calculate VO2
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9
Q

absolute vo2

A
  • total volume of O2 taken up by the body in L/min
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10
Q

relative Vo2

A
  • volume of O2 taken up by the body per unit of body weight (ml/kg/min)
  • try to use lean body mass in this equation as it is more accurate
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11
Q

metabolic cart

A
  • a metabolic measurement system
  • is the “gold standard”
  • measures how much O2 goes in and out of the system (inspired vs expired)
  • volume of breath
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12
Q

treadmill Vo2 measurement

A
  • calibrated modality
  • uses more muscle mass than the other modalities = higher volume
  • considered the “gold standard” machine for elicitin vo2 max
  • elicits Vo2 max 5-11% higher than cycling
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13
Q

fatigometer

A
  • Harvard lab experiment
  • tested how work activities affected individuals
  • engaged both upper and lower limbs
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14
Q

similarities between the 9 treadmill protocols

A
  • incremental increases in workload
  • workload increased by grade (inclination)
  • stages at 2 minutes usually indicate steady state
  • total time is usually 12 minutes
  • all test aerobic power
  • protocols that increase speed only are NOT recommended
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15
Q

speed only vs grade only vo2 max

A
  • speed mean vo2 max = 46.2 ml/kg/min
  • grade mean vo2 max = 62.6 ml/kg/min
  • gives a higher outcome so many tests use grade (25%)
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16
Q

modifications for Vo2 max tests

A
  • slower initial speed for inexperienced
  • can start with walk and increase speed first and then % grade after
  • many different starting protocols are available
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17
Q

end of test criteria for VO2 max tests

A
  • peak and plateau less than 150ml/min in O2 consumption with an increase in work rate
  • a respiratory exchange ratio greater than 1.15 (anerobic metabolism)
  • achievement of predicted maximum HR (HR max)
  • venous lactate concentration greater than 8mM
  • RPE greater than 17 (6-20 original) or to 10
  • giving up by choice / exhaustion
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18
Q

contraindications of a VO2 max test

A
  • drop in systolic BP of 10mmHg with increase in workload or dizziness , near fainting
  • hypertensive response (blood pressure >250/115mmHg) (usually in high risk patients)
  • chest pain or angina
  • signs of poor perfusion (blueness in lips and whiteness in the face
  • abnormal ECG recording
  • cramping, extreme fatigue
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19
Q

“true” Vo2 max

A
  • must utilize a large overall muscle mass
  • requires working against gravity (non body mass supported)
  • this is accomplished on a treadmill most of the time
  • can get higher Vo2 maxes with different ergometers
20
Q

“peak” vo2 max

A
  • all other exercises machines/modalities
  • supramaximal load
  • 1 main stage at a higher intensity to see if you actually reached peak or not
21
Q

is the test data valid?

A
  • machine needs to be calibrated correctly + normative values
  • post gas check (gas analyzers)
  • do the parameters follow the desired trends
  • VE, FECO2, FEO2, VO2- are these close to expected/normative values?
22
Q

variability in VO2 max testing

A
  • Katch: roughly 3-5 ml/kg/min for a 50 ml/kg/min individual
  • thoden: +- 3 ml/kg/min for athletes
  • reliability: test retest r=0.96 for rowing Vo2 max
23
Q

vo2 max testing in the field

A
  • running , swimming, vo2 master face mask with high validity
24
Q

what if you don’t have a metabolic cart for Vo2 testing?

A
  • a variety of protocols and formulas exist to predict vo2 max
  • can be either maximal or submaximal
  • use some sort of physiological performance indicator in a formula to provide predicted or peak VO2 max
25
Q

maximal VO2 tests

A
  • pushing people to Vo2 max but not measuring VO2
  • leger
  • bruce + modified bruce
  • balke
  • cooper
26
Q

indirect calculations of VO2

A
  • ones for running, walking , leg cycling , arm cycling, stepping
27
Q

other maximal indirect tests

A
  • multi-staged
  • treadmill preferred (5-11 % higher than the bike)
  • good estimation of true vo2 max
  • protocol can be adapted for many populations
28
Q

the Bruce treadmill test

A
  • a continuous, progressive exercise test to fatigue
  • correlated well to actual Vo2 max
  • starts at 10% grade and 1.7 mph, increase speed at grade every 3min
  • time to exhaustion is recorded
29
Q

calculating vo2 max from the Bruce test

A
  1. using a nomogram which aligns exercise time with predicted , based on time lasted within test
  2. using participant specific equations ( males, females, and cardiac patients/elderly)
30
Q

the Naughton Treadmill test

A
  • a continuous progressive exercise test to fatigue (volitional exhaustion)
  • specific to higher risked individuals
  • starts at 05 grade and 1.0mph
  • increase speed at 2 min (2mph) and grade (+3.5%) every 2min
  • time to exhaustion is recorded
31
Q

cycle ergometry

A
  • can be continuous or discontinuous
  • minimize fatigue and rest stage
  • max power output (W) attained is used to estimate VO2
32
Q

leger 20 meter shuttle run test

A
  • Vo2 max -24.4 + 6.0 (MAS)
  • MAS = max aerobic running speed in km/hr
33
Q

cooper 12 min run test

A
  • Vo2 max = 22.35 x distance (m) - 11.288
34
Q

submaximal tests for VO2 max

A
  • uses more information and have to calculate where they would end up at max
  • mCAFT
  • YMCA
  • Astrand
  • PWC
  • ACSM
  • Ebelling
  • Rockport
35
Q

why use predictive submaximal VO2 max tests

A
  • safe, avoids a maximal cardiovascular stress, usually for lower risk individuals
  • relatively inexpensive
  • less sophisticated equipment required
  • less expertise required
  • more conductive to “mass” testing
  • some test protocol durations are shorter than maximal protocols
36
Q

what are submaximal tests for predicting VO2 max based on

A
  • the positive linear relationship between power output, increased VO2 and HR
  • the assumption that MAX HR can be predicted similar in all individuals
  • assumption that variability in heart rate (day-day) is minimal
  • the assumption that efficiency of exercise is similar between individuals at max
  • best predictive power using HR occurs between HR’s 120-170b/min
37
Q

predicting VO2 max using a multi-stage equation

A
  • using weight, heart rate and , age
    1. determine power output for each stage (VO2 = watts/body mass x 11 + 3.5)
    2. determine slope for line of best fit (b = vo2 submax 2 - vo2 submax 1) / (HR2-HR1)
    3. determine VO2 max
38
Q

predicting vo2 max by graphing

A
  • use metabolic equations to calculate VO2 for each stage
  • Plot HR (end stage; 3rd min only) vs calculated VO2 and extrapolate to age predicted HRmax
  • use line of best fit
39
Q

ebbeling treadmill test

A
  • single stage protocol designed for healthy adults (20-59 yrs)
  • 4 min warm up at 2-4.5 mph & 0% grade
  • HR should be btw 50-70% of HR max
  • individual exercised for an additional 4 minutes at 5% grade (same speed at warm-up)
  • equation used speed, HR, age, and sex
40
Q

rockport 1-mile walk test

A
  • created for males and females from 20-69
  • may be more appropriate for older and sedentary populations
  • one mile (1.6 km) track (not treadmill) is required
  • instruct the patient to walk the 1 mile as quickly as possible w/o speed walking
  • measure HR at end of test
  • need weight (lbs), age, sex, time, HR
41
Q

general protocol for submaximal tests

A
  • warm-up for 5 min at low intensity
  • 20-30% HR reserve or 35-45% of age-predicted Max HR
  • monitor HR, BP, RPE, symptoms prior to, during and after exercise ( 1, 3, 5 min)
  • most protocols do not include post-exercise monitoring recommendation in their description
  • critical competency
    warm/cool-down (active recovery for 5-10 min)
42
Q

critical competency

A
  • ability to measure resting and post-exercise blood pressure
  • ability to measure resting, steady state exercise, and post-exercise heart rate via palpation
43
Q

limitations to submaximal tests

A
  • other factors affecting HR (anxiety, temp, caffeine, talking, body position)
  • achievement of steady state (some individuals need longer stages to reach steady state)
  • age predicted maxHR formulas have a degree of error, 220-age does not hold up in all populations
  • 208 - 0.7 x age in yrs is more accurate
  • predicted HR max can vary 10-12 beats
    -over/underestimation for athletes, sedentary , and older populations
44
Q

stress tests

A
  • tests cardiac function by increasing HR and myocardial contractility
  • best way to look at issues within the heart
  • when you exercise , HR increases and so does contractility, and BP
  • the heart then has to work against a higher BP which increase stroke rate + cardiac work + increased O2
45
Q

incremental exercise protocol

A
  • 12-lead ECG and BP measurements
  • looking for heart abnormalities
  • subjective symptoms ( borg, angina, claudication scale)
  • claudication scale determines artery pain = poor perfusion
46
Q

why have a stress test

A
  • completed as a part of an annual checkup or physical used for screening as part of physician screening
  • prognostic: assessing patients with risk factors
  • diagnose : coronary artery disease & symptoms such as chest pain, shortness of breath or lightheadedness
  • functional: to assess a procedure that may be used to improve coronary artery circulation
  • functional: to determine a safe level of exercise for rehab or daily living , includes all individuals, included lower and below test intensities