Exercise Testing and Prescription Flashcards Preview

PTRS 825 Final Exam > Exercise Testing and Prescription > Flashcards

Flashcards in Exercise Testing and Prescription Deck (61)
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1

Training

Series of practices, the object of which is to render a man or animal as completely and quickly as possible, fit for the performance of a given work

2

Physical Activity

Bodily movement produced by skeletal muscles that result in energy expenditure

3

Exercise

Subset of physical activity that is planned, structured and repetitive and has a final or an intermediate objective the improvement or maintenance of physical fitness

4

VO2 Peak

Limited by subject tolerance, which may or may not be physiological max

5

ACSM Recommendation

30 min of moderate physical activity on most/all days of week
4/10 adults work in light activity jobs (US spend 70% of their time sitting)
Total screen time > 8 hr/day

6

Excuses for Physical Activity (Young)

Time
Fatigue
Active at work
Lack of results
Cost
Lack motivation

7

Excuses for Physical Activity (Older)

Fear of falling
Inertia/never tired
Negative affect
Time
Physical ailments

8

Excuses for Physical Activity (Universal)

Fear of looking stupid
Being watched
Physiologic changes

9

Getting Patients Physical Activity

Education: disease/dx/disability
Prescription: FITT
Testing: medical eval, submax test

10

Pre-Exercise Assessment

Risk classification - high needs med eval
Exercise limitation/modification - HR/BP, blood sugar, orthopedic/neuro issues
Baseline for comparison
Test or not to test: sub vs max, sensitive vs specific, not necessary to low/mod activity

11

Graded Exercise Testing

Monitor HR, BP, EKG, VO2 while incrementally increasing workload

12

GXT Outline

1. Assess resting values
2. 1-2 min warm up
3. Measurements at regular intervals
4. Extend stage to reach steady stat if necessary
5. Cool down until close to baseline

13

GXT Normal Responses

Linear increase with SBP and HR proportionate to workload
Min change in DBP
Shortened QT interval
Reduced R wave amp
ST-segment elevation

14

GXT Abnormal Responses

No increase in HR or SPB with increasing workload
SBP > 250, DBP > 120
ST segment depression (MI?)
Increased R wave amp
V-tach or multiple PVC

15

Treadmill vs Cycle Ergometer vs Stepper for GXT

Treadmill yields higher VO2, higher risk of falling
BW has decreased effect on cycle ergometer

16

Sub-Max Testing Assumptions

Linear relationship between HR and VO2
Max HR at give age is uniform
HR at given workload varies according to fitness level
Steady state HR obtained at each level
Mechanical efficiency is uniform

17

Sub-Max Advantages

Safe
Controlled pace
Not population specific
Quick
Easily to administer
Inexpensive

18

Sub-Max Disadvantages

Indirect measure of VO2
Estimation of max HR may be inaccurate

19

Sub-Max General Rule

Under predicts older/deconditioned subjects
Over predicts younger/well-conditioned subjects

20

Sub-Max Cycle Ergometer Tests

YMCA (3-4 3 min stages, 110-115 HR at 2 workloads)
ACSM bike test
Astrand rhyming (6 min, single stage)

21

Sub-Max Treadmill Tests

Submax Bruce - larger work increment, appropriate for young/healthy subjects
Balke-Ware - smaller work increments (

22

Direct Calorimetry

Measures heat expenditure to determine EE
Ambient air - expired air = oxygen consumption

23

Indirect Calorimetry

Uses RER to calculate EE

24

RER

Ratio between CO2 release and O2 consumed
0.7 - primary fuel from fat
1 - primary fuel from carbs
0.78-0.8 - resting
1.05-1.15 - max

25

Max Exercise Testing Assumptions

Test progresses until subject reaches volitional exhaustion
Subject is motivated and able to provide max effort

26

What is "Max"

Plateau in VO2 with increasing workload
RER > 1.05
Blood Lactate > 8mmol/L (most reliable but difficult to assess)
Max HR
RPE

27

Max Testing Advantages

Accuracy

28

Max Testing Disadvantages

Higher risk
Time intensive
Resource intensive
Expensive

29

Principle of Individuality

Respond to exercise differently

30

Principle of Specificity

More pervasive than given credit
Done in home, they might do better