Cardiorespiratory Fitness
The definition of Cardiorespiratory Endurance
What is the ability to perform dynamic exercise involving large muscle groups at a moderate to high intensity for a long period of time?
These four (4) items should be completed prior to initiation of an exercise test.
What are
1. timely delivery of pre-test guidelines
2. informed consent and health screening
3. baseline hemodynamic assessment
4. familiarization with the RPE scale
The purpose of a clinical exercise test.
What is to observe the physiologic responses to increasing or sustained metabolic demand?
What is unstable ischemic, rhythm, or hemodynamic conditions.
Other conditions in which the risk of the test exceeds the benefits of the test?
≈10 beats × min−1 per 1 MET
What is the normal HR response to incremental exercise?
This is the highest O2 consumption measured during an exercise test.
What is VO2 peak?
These four (4) items are essential components of the exercise test.
What are
1. a proper warm up
2. technician monitors RPE & hemodynamics throughout the test and recovery
3. technician monitors client's physical appearance and symptoms
4. a proper cool down
These are other names for a clinical exercise test.
What are
1. graded exercise test
2. exercise stress test or exercise tolerance test (ETT)
3. cardiopulmonary exercise test (CPX or CPET)
These professionals may perform clinical exercise tests
Who are
Clinical exercise physiologists
Nurses
Physical Therapists
Physician Assistants?
The condition described by a failure to achieve > 85% of age-predicted HRmax in the presence of maximal effort and it's implication
What is chronotropic incompetence & and increased risk of morbidity and mortality?
What is VO2max or maximal oxygen consumption?
These are considered the best testing protocols, with the Bruce, Balke, and Astrand as examples.
What are multi-stage or graded exercise testing protocols?
Presence of disease or abnormal physiologic response; Risk for an adverse event; Blood pressure changes, and peak exercise capacity.
What are Diagnosis, Prognosis, and Evaluation of the physiologic response to exercise?
What are those suggestive of
myocardial ischemia
inadequate blood perfusion
inadequate gas diffusion
Limitations in pulmonary ventilation?
This is a surrogate for myocardial oxygen uptake (MVO2) and is calculated by multiplying the values for HR and SBP that occur at the same time during rest or exercise
What is the rate-pressure product (RPP or double product)?
Rest + exercise O2 consumption and O2 consumption of exercise only, respectively.
What is Gross VO2 and Net VO2?
These signs of poor perfusion would be general indications for stopping an exercise test.
What are lightheadedness, confusion, nausea, cold & clammy skin?
Known obstructive left main artery stenosis
Tachyarrhythmias with uncontrolled ventricular rates
Resting hypertension with systolic > 200 mm Hg or diastolic > 110 mm Hg
What are relative contraindications to symptom-limited maximal exercise testing?
These variables are recorded at the following intervals:
1. during the last 5-10 seconds of each minute
2. the last 30-60 seconds of each stage
3. the last 5-10 seconds of each stage
4. as observed
What is
1. heart rate
2. blood pressure
3. EGC & RPE
4. Signs and symptoms
The ability to positively identify individuals who truly have IHD;
The ability to correctly identify individuals who do not have IHD;
How accurately a test result correctly identifies the presence or absence of IHD
What is Sensitivity, Specificity, and Predictive Value respectively?
This is the expression of the energy cost of weight-bearing exercises while this is the expression of the energy cost of non-weight-bearing exercises.
Primary and Secondary criteria to determine attainment of VO2 max.
What are
1. Plateau in O2 consumption (VO2 increase < 150 ml/min) - primary
2. HR fails to rise with increased workload, RPE >17, RER >1.10 - 1.15, and Blood lactate > 8.0 mmol/L
Uncontrolled cardiac arrhythmia with hemodynamic compromise
Acute pulmonary embolism, pulmonary infarction, or deep vain thrombosis (DVT)
Acute myocardial infarction within 2 days
What are absolute contraindications to symptom-limited maximal exercise testing?
A drop in SBP >10 mm Hg despite an increase in workload when accompanied by other evidence of ischemia
Exaggerated hypertensive response (SBP > 250 mm Hg or DBP > 115 mm Hg)
What is an absolute indicator for terminating a symptom-limited maximal exercise test & what is a relative indicator for terminating a symptom-limited maximal exercise test?
Potential outcomes from the diagnostic calculations for the detection of Ischemic Heart Disease (IHD)
What are true positive, false positive, true negative, and false negative?