HES 211 Foundations of CRF Testing PDF

HES 211 Foundations of CRF (cardiorespiratory fitness) testing October 17, 2024 6:42 PM 1. Describe a typical rationale and basic considerations for CRF testing 2. Describe contraindications to CRF testing 3. Describe the different types of CRF tests 4. Describe the advantages/disadvantages of t...

HES 211 Foundations of CRF (cardiorespiratory fitness) testing October 17, 2024 6:42 PM 1. Describe a typical rationale and basic considerations for CRF testing 2. Describe contraindications to CRF testing 3. Describe the different types of CRF tests 4. Describe the advantages/disadvantages of the different types of CRF tests 5. Describe how exercise intensity differs during different types of CRF tests 6. Describe various tools to assess intensity and when to use them 7. Describe CRF test termination criteria Factors to consider when deciding whether to test or not What is a CRF going to tell me about this individual and how am I going to use the results? Will the test results be beneficial to their long term health/fitness/prognosis/QOL What tools do I have to increase safety/reduce risk? Individuals perception of exercise and motivation Is education needed about the risks/benefits In many situations, the benefits outweigh the risks assuming you select and execute a safe test with effective monitoring However you might have to put in some work to get there… trust, empathy, rapport So we test! Factors to consider when selecting/building a safe effective test Factors to consider - contraindications Absolute A recent significant change in the resting electrocardiogram suggesting significant ischemia, recent myocardial infarction (within 2 d), or other acute cardiac event Unstable angina Uncontrolled cardiac dysrhythmias causing symptoms or hemodynamic compromise Symptomatic severe aoeric stenosis Uncontrolled symptomatic heart failure Acute embolus or pulmonary infarction Acute myocarditis or pericarditis Suspected or known dissecting aneurysm Acute systemic infection, accompanied by fever, body aches, or swollen lymph glands. Relative Left main coronary stenosis Moderate stenotic valvular heart disease Electrolyte abnormalities (e.g. hypokalemia, hypomagnesemia) Severe arterial hypertension (i.e. SBP of >200 mmHg and/or a DBP of >110 mmHg) at rest Tachydysrhythmia or bradydysrhythmia Neuromotor, musculoskeletal, or rheumatoid disorders that are exacerbated by exercise High degree atrioventricular block Ventricular aneurysm HES 211 Exercise Testing Page 1  Ventricular aneurysm Uncontrolled metabolic disease (e.g. diabetes, thyrotoxicosis, myxedema) Chronic infectious disease (e.g. human immunodeficiency virus) Mental or physical impairment leading to inability to exercise adequately Types of tests field tests- pros and cons Pros ○ High practicality ▪ Low: cost, resources, trained personnel, time ○ Familiarity for many ○ Group testing - efficient Can have mod/high correlation to VO2max - i.e. reasonable validity and reliability but… HES 211 Exercise Testing Page 2  ○ Can have mod/high correlation to VO2max - i.e. reasonable validity and reliability but… it depends Cons ○ Monitoring challenges ▪ i.e. no monitoring ○ Assumptions ▪ i.e. running at a constant speed ○ Predictions of VO2 ▪ i.e. efficiency ○ Environmental issues ▪ i.e. often highly competitive - good for everyone? Lab tests pros and cons Pros ○ Generally better test quality ○ Controlled environment ○ Better monitoring/risk reduction ○ Produces more data ▪ HR, BP, RPE, symptoms etc ▪ Useful in ex rx Cons ○ Equipment needs ▪ Access, maintenance, quality control ○ Trained personnel ○ Inorganic environment ▪ Specificity issues ○ Time demands ○ Psychological impact HES 211 Exercise Testing Page 3 Other considerations Age/demographic information, ability ○ Does test relate to a typical activity Modality ○ Bike vs TM vs field vs arm erg vs other? Test quality ○ Valid and reliable? Number of individuals to test ○ 1-1 clinical scenario vs football team with 1 hr Estimated fitness level ○ Can they walk for 6 mins? 5 MET min? consider bike? Current health status ○ Exercise inducaed asthma and mouthpiece?? Other monitoring requirements HES 211 Exercise Testing Page 4  ○ Other monitoring requirements CVD risk factors ○ Level of supervision required? Time Practicality - equipment, cost, personnel, access, other resources Constant load CRF tests Purpose of constant load CRF test is to measure physiological response necessary to support work at a pre-determined workload While external work rate may be constant, the internal response is varied; integrative response to support fatiegue resistance and power output endurance Intensity dependent: whether a steady state is achieved (and different for each var) HES 211 Exercise Testing Page 5 Cardiopulmonary exercise test (CPET) - graded Increase intensity, measure body response to load Measures expired air: gas content HES 211 Exercise Testing Page 6