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What is the overall purpose of PPHS?

So that exercise is safe and effective
To determine if medical screening is required



A type of PA consisting of planned, structures and repetitive bodily movement done to improve and/or maintain one or more components of physical fitness



Ability to carry out daily tasks with vigor and alertness without undue fatigue and with ample energy to enjoy leisure-time pursuits and meet unforeseen emergencies


What are the purposes of fitness testing?

Collecting baseline data
Provides data to develop individualized plans
Allows for comparison for follow up eval
Acts as a motivational tool


How should order of fitness teas be set up?

Minimize getting up and down
Resting should be taken first then height weight and body comp depending on what measurements will be taken
Allow for ample testing times


What is the ideal environment for exercise testing?

Explain everything clearly
Don't rush
Quiet and private area, should be comfortable
Everything should be prepped
Comfortable place for testing measurements
Administrators should be relaxed and confident
Personnel should be trained for emergencies


Protest guidelines for submax bike test

No eating for 4 hours
No strenuous exercise for at least 24 hours
No caffeine for 12-24 hours
No nicotine for 3hours and alcohol for 24
Consult administrator regarding meds


Protest guidelines for submax treadmill test

No food, alcohol or nicotine for 3 hours
Participants should be rested, no exercise day of assessment
Clothing should be loose and allow freedom of movement
Bring all medications
Ensure normal hydration
Should be aware that they may be fatigued and need a driver


Parts of informed consent

Purpose and explanation of test
Attendant risks and discomforts
Responsibilities of the participant
Benefits to be expected
Use of medical records
Freedom of consent


What is the difference between max and submax test

Max is true max "stress test"
Submax is estimate with determined end point


Submax data collection

Heart rate every minute
Bp at end of each stage (3 min)
Looking for 2 consecutive hr between 110-150 in diff stages (bike)
Looking for 85% of max (treadmill)


When does data get collected/test end in max test?

HR Every minute
Bp at end of every stage (3 min)
Going until they can't go anymore


Naughton protocol

Huge steps
Better for younger/active people


Ellestad protocol

One incline for a while with different speeds
Better for older/deconditioned people


Balke-ware protocol

Tiny steps
Better for older/reconditioned athletes


Describe RPE scale

6 very light
20 hardest thing ever


Where is v1 placed

4th intercostal space just to the right of the sterna border


Where is v2 placed

4th intercostal space just to the left of the sterna border


Where is v3 placed

At the midpoint of a straight line between v2 and v4


Where is v4 placed

On the midclavicular line in the 5th intercostal space


Where is v5 placed

On the anterior axillary line and horizontal to v4


Where is v6 placed

On the midaxillaty line and horizontal to v4 and v5


Signs or symptoms of cardiovascular, metabolic disease, and renal disease

Pain or discomfort in the chest, jaw, arms, or other strands that may result from myocardial ischemia
Shortness of breath at rest or with mild exertion
Dizziness or syncope
Orthopnea or paroxysmal nocturnal dyspnea
Ankle edema
Palpitations or tachycardia
Intermittent claudication
Known heart murmur
Unusual fatigue or shortness of breath with usual activities


Components of medical history

Medical diagnosis and procedures
Previous exam findings like murmurs etc
Lab findings like plasma glucose, etc
History of symptoms
Recent illness or hospitalization
Orthopedic problems like arthritis
Medication use
Drug and alcohol use
Work history
Family history


CAD risk factors

Age: men over 45 and women over 55
Family history: heart disease before 55 in first degree male relative and 65 in first degree female
Cigarette smoking: current smoker or previous in past 6 months
Obesity: BMI greater than 30
Hypertension: systolic blood pressure over 140 and diastolic above 90
Dyslipidemia: LDL greater than 130
Diabetes: fasting plasma glucose over 126


Negative CAD risk factor

HDL over 60


Blood pressure classifications

Average: 120/80
Stage one hypertension: 120-130 sbp and 80-89 dbp
State 2: over 160sbp or over 100dbp


Potential sources of error when measuring bp

Inaccurate sphygmomanometer
Improper cuff size
Auditory acuity of technician
Rate of inflation or deflation of cuff pressure
Experience of technician
Fault equipment
Improper stethoscope placement or pressure
Not having the cuff at heart level
Background noice
Reaction time of technician
Allowing patient to hold on to things


General indications for stopping an exercise test

Onset of angina and angina like symptoms
Shortness of breath, wheezing, leg cramps, or claudication
Failure of testing equipment
Failure of HR to increase with increased exercise intensity


Absolute contraindications

Ongoing unstable angina
Active endocarditis
Decompensated heart failure


Relative contraindications

Acquired advanced or complete heart block
Recent stroke or transient ischemia attack
Mental impairment with limited ability to cooperate


Absolute indications for terminating exercise test

Moderate to severe angina
Technical difficulties monitoring the ECG or systolic blood pressure
Central nervous system symptoms (ataxia, dizziness)
Signs of poor perfusion


Relative indications or terminating an exercise test

Increasing chest pain
Fatigue, shortness of breath, wheezing, leg cramps or claudication
Exaggerated hypertensive response (systolic more than 250 or diastolic more than 115)