As highlighted in Chapter 5 of your course text, clinical exercise testing is conducted for numerous reasons. The purpose for exercise testing, the client’s history and characteristics, as well as the desired outcomes, should be considered before choosing a test modality and protocol.
After studying Chapter 5 and reviewing the Introduction to Cardio Pulmonary Exercise Testing video, address the following elements:
- Select two specific purposes for conducting clinical exercise testing and explain each briefly.
- For each chosen purpose, summarize the type of clients and their characteristics (i.e., gender, age, history, diagnoses, symptoms), warranting the administration of clinical exercise testing.
- Assess one exercise test modality and its common uses.
- Appraise the need for an exercise protocol and the rationale for individualizing it.
Support your work with your course text and at least one additional scholarly source. Your initial post should be at least 250 to 300 words in length.
Guided Response: Respond to a minimum of two peers by Day 7. Each reply should be a minimum of 100 words in length and supported by one scholarly source. Assume you are currently training your peers in the administration of exercise testing. In your first peer reply, explain one absolute indication to terminate testing. In your second peer reply, focus on a relative indication to abort testing.
Replies
Scott Shields
Jun 10, 2021 at 11:39 AM
Week 3- Discussion 1
Purposes for Clinical Exercise Testing
Clinical Exercise Testing (CET) includes the diagnosis, measurement and evaluation of physiological responses or symptoms during clinical exercise testing. The most common type of Clinical Exercise testing is Cardiac Stress testing. The main reason for administering the Cardiac test is to improve diagnosis and better management of those that suffer a myocardial infarction. It can also determine when an individual can resume work or engage in physical activity. According to (Choudhary & Choudhary, 2008) CET enables a general assessment of integrated physical activity responses which cannot be accurately measured and diagnosed using singular organs systems when at rest, maximum oxygen uptake remains the best model for determining exercise capacity.
Another reason for the use of CET is to access exercise capacity in individuals suffering from Chronic Obstructive Pulmonary disease (COPD). This disease causes inflammation and obstruction of airflow. Symptoms of COPD are breathlessness, coughing and wheezing. COPD is usually the result of prolonged exposure to gases, particles and cigarette smoke (COPD – Symptoms and causes, n d).
Characteristics and Risk Factors
Heart disease is the primary cause of myocardial infarctions (heart attack) which occurs when the heart doesn’t get a sufficient amount of blood. Individuals that suffer from hypertension, high levels of cholesterol, type II diabetes and obesity are at increased risk of suffering a heart attack. Heart disease risk factors are further increased if you’re a male, are over 65 regardless of age, and area predisposed either by race or heredity. Other risk factors consist of tobacco and alcohol usage, lack of physical activity, stress, diet, and nutrition (American Heart Association, 2016). These risk factors warrant a clinical exercise test as it would indicate if a sufficient amount of blood is reaching the heart and if the arteries are working properly.
Chronic Obstructive Pulmonary disease (COPD) a respiratory disease and is the main cause of airway blockage and breathing difficulty. COPD usually includes both emphysema and chronic bronchitis. COPD affects mostly women aged 65-75 years old and occurs in people with a history of asthma and smoking (CDC, 2019). COPD symptoms are exacerbated during exercise which is one rational for clinical exercise testing of those with moderate COPD. This allows medical researchers to evaluate physiological responses and better treat those that suffer from Dyspnoea (shortness of breath) when exposed to physical activity (O’Donnell et al., 2016). The Cardiopulmonary Exercise test that would be used would measure the exchange of gases and the maximal amount of oxygen uptake.
Exercise Test Modality and Common Uses
Treadmills are used for the diagnosis and evaluation of cardiovascular stress while undergoing electrocardiography and monitoring of blood pressure (“Treadmill Stress Testing: Background, Indications and Contraindications, Technical Considerations,” 2020). Treadmills enable the doctor to determine if any symptoms are related to the heart and the volume of blood flow to the heart as the exercise intensity is increased.
Another type of exercise test is “Step Testing” which can be used to measure the Heart rate when stepping up and down at a fixed level or time period. Step testing can be done by most people and usually the provider can provide fast results after the test.
Exercise protocol
Exercise Protocol consists of using a standardized system of instructions or rules that is distributed and applied across the spectrum for certain exercise testing. The Bruce Protocol is used during the cardiac stress test. It enables the clinician to determine the level of exertion in direct relation to the amount or increments of work to be performed. This is based upon the speed of the treadmill and the grade that it’s elevated to during the test. The “Bruce Protocol is the extensively used protocol across America (ACSM, 2018).
References
Choudhary, S., & Choudhary, S. (2008). Exercise testing in assessment and management of patients in clinical practice – Present situation. Lung India, 25(3), 111. https://doi.org/10.4103/0970-2113.59592
COPD – Symptoms and causes. (n.d.). Mayo Clinic. Retrieved June 9, 2021, from https://www.mayoclinic.org/diseases-conditions/copd/symptoms-causes/syc-20353679#:~:text=Chronic%20obstructive%20pulmonary%20disease%20(COPD)%20is%20a%20chronic%20inflammatory%20lung
American Heart Association. (2016). Understand Your Risks to Prevent a Heart Attack. Www.heart.org. https://www.heart.org/en/health-topics/heart-attack/understand-your-risks-to-prevent-a-heart-attack
Centers for Disease Control and Prevention. (2019). CDC – basics about COPD – chronic obstructive pulmonary disease (COPD). Centers for Disease Control and Prevention. https://www.cdc.gov/copd/basics-about.html
O’Donnell, D. E., Elbehairy, A. F., Faisal, A., Webb, K. A., Neder, J. A., & Mahler, D. A. (2016). Exertional dyspnoea in COPD: the clinical utility of cardiopulmonary exercise testing. European Respiratory Review, 25(141), 333–347. https://doi.org/10.1183/16000617.0054-2016
American College of Sports Medicine. (2018). ACSM’s guidelines for exercise testing and prescription (10th ed.). Retrieved from https://redshelf.com/
Thomas Lyons
Jun 10, 2021 at 2:12 PM
Clinical Exercise Testing
Purposes for Conducting Clinical Exercise Tests
Two specific purposes for conducting clinical exercise testing (CET) are to monitor patients to observe physiological responses to increasing or sustained metabolic demand and determine the diagnosis and prognosis through an evaluation of physiological responses to exercise. (ACSM, 2018). An appropriate clinical exercise test is specialized for each patient as they have unique characteristics. These tests are most commonly conducted for the diagnosis and evaluation of ischemic heart disease, a disease characterized by plague building up around the inner walls of the arteries of the heart resulting in narrowed arteries and reduced blood flow to the cardiac muscles. During these clinical exercise tests, exertion will require greater blood flow.
Characteristics and Risk Factors
This form of clinical exercise testing is commonly conducted on patients who may be concerned with their health, but may not possess any medical history. Tests conducted have no specific target groups and can range from children to elderly persons, regardless of gender, however, it is highly recommended for patients who may have life threatening illness, diseases or other health conditions. For a patient with a condition such as diabetes with accompanied symptoms like blurry vision, weight loss, feelings of exhaustion, or living a sedentary lifestyle, greater risks can be prevalent. Although these tests can be conducted through different methods, this research is assessed to reveal the development of physiological responses.
Exercise Test Modality
The most frequently used testing modality in clinical exercise testing is the Bruce protocol treadmill test, or the exercise stress test. This is a supervised test where your exercise tolerance is evaluated through different stages of difficulty. This exercise stress test is a cardiological test that measures a heart’s ability to respond to external stress in a controlled clinical environment. (Cardiac Stress Tests, 2019).
The Need for an Exercise Protocol
An exercise protocol is very necessary when addressing a patient’s health as there are standards that should be reached and rules that should be followed for different, specific tests. By having clients fill out medical history forms, healthcare workers have a greater outlook on the health conditions a patient may have, in order to construct a practical exercise regimen specialized for the individual.
References
American College of Sports Medicine. (2018). ACSM’s guidelines for exercise testing and prescription (10th ed.). Retrieved from https://redshelf.com/
Cardiac Stress Tests | Fairbanks, A. K. | N. S. (2019, August 9). Cardiac Stress Tests: Fairbanks, AK. Nick Sarrimanolis, MD. https://www.drnicksarrimanolis.com/services/cardiac-stress-tests/.
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