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Questions and Answers
What is a primary reason submaximal exercise testing is preferred over maximal testing in clinical settings?
What is a primary reason submaximal exercise testing is preferred over maximal testing in clinical settings?
The original Borg Scale for perceived exertion ranges from 0-10.
The original Borg Scale for perceived exertion ranges from 0-10.
False
What should be documented at the time of assessment during submaximal exercise testing?
What should be documented at the time of assessment during submaximal exercise testing?
All medications
The Borg Scale for perceived exertion is used to monitor and prescribe exercise intensity, with its original range being from ______ to ______.
The Borg Scale for perceived exertion is used to monitor and prescribe exercise intensity, with its original range being from ______ to ______.
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Match the following conditions with their indications for exercise testing:
Match the following conditions with their indications for exercise testing:
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What characteristic defines a maximal exercise test?
What characteristic defines a maximal exercise test?
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The cardiopulmonary exercise test (CPET) can help identify cardiovascular compromise only at low levels of exercise.
The cardiopulmonary exercise test (CPET) can help identify cardiovascular compromise only at low levels of exercise.
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What additional analysis does a CPET include compared to a regular exercise stress test?
What additional analysis does a CPET include compared to a regular exercise stress test?
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A systolic blood pressure (SBP) of _____ mm Hg is considered hypertensive.
A systolic blood pressure (SBP) of _____ mm Hg is considered hypertensive.
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Match the following aspects of CPET with their descriptions:
Match the following aspects of CPET with their descriptions:
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What does the respiratory exchange ratio (R) primarily indicate?
What does the respiratory exchange ratio (R) primarily indicate?
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The stroke volume decreases during intense exercise.
The stroke volume decreases during intense exercise.
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What typically happens to systemic blood pressure as exercise intensifies?
What typically happens to systemic blood pressure as exercise intensifies?
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During upright exercise, stroke volume is estimated using the _________.
During upright exercise, stroke volume is estimated using the _________.
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Match the physiological response to exercise with its expected behavior:
Match the physiological response to exercise with its expected behavior:
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Which of the following factors does NOT need to be considered when deciding on an exercise test?
Which of the following factors does NOT need to be considered when deciding on an exercise test?
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Tidal volume tends to level off at about 40% of the individual's vital capacity during exercise.
Tidal volume tends to level off at about 40% of the individual's vital capacity during exercise.
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What is the typical rise in systolic pressure at peak exercise in normal individuals?
What is the typical rise in systolic pressure at peak exercise in normal individuals?
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What is the minimum important distance (MID) for patients with coronary artery disease (CAD) in the six-minute walk test (6MWT)?
What is the minimum important distance (MID) for patients with coronary artery disease (CAD) in the six-minute walk test (6MWT)?
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The Incremental Shuttle Walk Test (ISWT) is more frequently used in cardiac rehabilitation programs compared to the six-minute walk test (6MWT).
The Incremental Shuttle Walk Test (ISWT) is more frequently used in cardiac rehabilitation programs compared to the six-minute walk test (6MWT).
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What percentage change in distance is calculated in the six-minute walk test (6MWT)?
What percentage change in distance is calculated in the six-minute walk test (6MWT)?
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The sit to stand test (STST) is valuable for _____ activities and requires minimal equipment.
The sit to stand test (STST) is valuable for _____ activities and requires minimal equipment.
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Match the following tests with their descriptions:
Match the following tests with their descriptions:
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What is the purpose of giving medication during the cardiac stress test?
What is the purpose of giving medication during the cardiac stress test?
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The six-minute walk test (6MWT) can be done outdoors without any standardization.
The six-minute walk test (6MWT) can be done outdoors without any standardization.
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In the Incremental Shuttle Walk Test (ISWT), what is one criterion for test termination?
In the Incremental Shuttle Walk Test (ISWT), what is one criterion for test termination?
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What is the primary purpose of exercise testing?
What is the primary purpose of exercise testing?
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VO2 max is the amount of oxygen consumed at peak exercise.
VO2 max is the amount of oxygen consumed at peak exercise.
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What does the Fick equation help to calculate?
What does the Fick equation help to calculate?
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The average sedentary male achieves a VO2 max of about _____ mL/kg/min.
The average sedentary male achieves a VO2 max of about _____ mL/kg/min.
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Which system is NOT directly evaluated during exercise testing?
Which system is NOT directly evaluated during exercise testing?
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Oxygen consumption is solely dependent on age and gender.
Oxygen consumption is solely dependent on age and gender.
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Name one factor that affects VO2 max.
Name one factor that affects VO2 max.
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What is the primary purpose of a CPET in patients with heart failure?
What is the primary purpose of a CPET in patients with heart failure?
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A pharmacologic stress test involves physical exercise.
A pharmacologic stress test involves physical exercise.
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What is the maximum VO₂ during rest for the measured patient?
What is the maximum VO₂ during rest for the measured patient?
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A nuclear stress test uses _______ dye to show blood flow to the heart.
A nuclear stress test uses _______ dye to show blood flow to the heart.
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What is the heart rate of the patient at maximum exercise?
What is the heart rate of the patient at maximum exercise?
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Match the following stress test types with their main characteristics:
Match the following stress test types with their main characteristics:
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What is the lactate level at maximum exercise according to the data provided?
What is the lactate level at maximum exercise according to the data provided?
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The patient's oxygen saturation level was lower at maximum exercise compared to rest.
The patient's oxygen saturation level was lower at maximum exercise compared to rest.
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Study Notes
Introduction to Exercise Testing
- Presented by Dr. Sherif Osama Elabd, lecturer at physical therapy, faculty of physical therapy, May University.
- Date of presentation: 11/26/2024
What is Exercise Testing?
- Exercise testing analyzes how the cardiovascular and ventilatory systems respond to exercise stress.
- It's used to assess both the diagnostic and prognostic aspects by evaluating the pulmonary, cardiovascular, hematopoietic, neuropsychological, and skeletal muscle systems.
- Exercise testing assesses exercise performance, functional capacity, and exercise intolerance.
- It helps identify exercise-related symptoms.
Cardiac and Respiratory Response to Exercise
- Ventilation delivers oxygen to alveoli and removes carbon dioxide.
- Gas exchange moves oxygen from alveoli to blood and carbon dioxide from the blood to alveoli.
- Hemoglobin helps transport oxygen to tissues.
- Exercising tissues receive oxygenated blood and carbon dioxide is delivered to the lungs.
- Muscles use oxygen to generate ATP for contraction.
Maximum Oxygen Consumption (VO2max)
- VO2max measures oxygen use by tissues per minute at peak exercise.
- The Fick equation calculates VO2max (VO2 = Q × (CaO2 - CvO2)).
- CaO2 is arterial oxygen content, while CvO2 is the mixed venous oxygen content.
- Q is cardiac output.
- Average VO2max varies based on age, gender, and fitness level.
- Sedentary males typically have a VO2max of 35-40 mL/kg/min, while females have approximately 27-30 mL/kg/min.
Metabolic Equivalent (MET)
- MET is defined as oxygen consumption during rest, equal to 3.5 ml O₂ per kg body weight per minute.
- Various activities have corresponding MET values.
- Values vary based on activity intensity, age, and fitness.
Maximum Heart Rate
- Maximum heart rate is the highest heart rate during maximal exercise (estimated using age).
- Target heart rate zones for moderate and vigorous exercise intensities are explained.
Exercise Responses in Normal Individuals
- PaCO2 (partial pressure of carbon dioxide) remains relatively constant during exercise until the ventilatory threshold.
- PaO2 (partial pressure of oxygen) remains relatively stable.
- Arterial pH decreases slightly as exercise progresses.
- Other exercise-related responses such as cardiac output, heart rate, minute ventilation, oxygen saturation (SaO2), and oxygen consumption (VO2) increase.
- Respiratory exchange ratio (R) increases.
Exercise Testing Considerations
- Primary purpose of the test needs to be considered.
- Clinical risk profile of the patient.
- Evaluation setting of the test.
- Research or service evaluation requirements.
Indications of Exercise Testing
- Diagnostic and prognostic assessment for cardiovascular and pulmonary diseases, unexplained dyspnea, exercise prescription, assessment of therapeutic intervention efficacy.
Contraindications for Exercise Testing
- Absolute contraindications involve conditions where testing is unsafe (e.g., recent MI).
- Relative contraindications indicate caution and that the test should be performed with extreme caution (e.g., unstable angina, high-degree heart block).
Types of Exercise Tests
- Exercise stress test (EST)
- Cardiopulmonary exercise test (CPET)
- Pharmacologic stress test
- Nuclear stress test
- Six-minute walk test (6MWT)
- Incremental shuttle walk test (ISWT)
- Sit-to-stand test (STST)
Procedures, preparation, and protocol for each test are also included
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Description
This quiz explores the fundamentals of exercise testing, focusing on how the cardiovascular and respiratory systems respond to physical stress. Gain insights into diagnostic and prognostic evaluations related to pulmonary and cardiovascular functions, as well as exercise performance and intolerance.
