Phys Lab

Low = increased risk of CVD and premature mortality Direct determination via a maximal exercise test and measuring expired expired gases - O2, Co2 and gas volumes (indirect calorimetry) Not suitable for individuals with high risk CVD Lack of specialist equipment or trained personel Cost of equipment and need for system calibration

The Bruce treadmill protocol - maximal graded exercise test The Astrand - Ryhming cycle ergometer test - submaximal test The Chester Step Test - submaximal test Questionnaire (no exercise)

Complete a PAR-Q (physical activity readiness questionnaire) Informed consent form sign 1) Ensure that the treadmill or ergometer is safe 2) Describe all procedures fully to the participant and provide a written summary (Participant Information Sheet) 3) Familiarise the participant with all equipment to be used] 4) Give the participant opportunity to ask questions 5) Ensure that the participant knows that it is his/her responsibility to inform the experimenter if they are in difficulties during the test. 6) Watch the patient closely during and 10 minutes afterwards 7) Give the participant time to warm up and cool down after exercise behave calmly Use simple language

Maximal exercise stress test. Performed until exhaustion or signs and symptoms. Duration used to predict VO2 max. Every 3 minutes (to end of 27), % grade increased from 10 by 2 and speed increased by .8-1.5km/h. Non invasive Suspected heart disease patients Can give overestimation if heavy use of handrail

HR, rating of perceived exertion (RPE), ECG, BP, clinical signs and patient symptoms. Often difficult to measure obs

Using equation Fraction of a minute needs to be calculate (

Submaximal stress test Heart rate is used to predict VO2 max when working at a set heart rate. A nomogram is uses gender, HR and Work load to calculate VO2 max. This is then multiplied by a correction factor to adjust for age The participant works at 50rpm for 6 minutes. HR is taken at minute 5 and minute 6 and an average is taken. Unconditioned male uses 300 or 600 kg.m.min-1 = 50-100Watt Conditioned male 600-900= 100-150 Female = 300-450 cond female = 450-600 Stop at 70%HR reserve / 85% HRmax. Goal to get HR between 125-170 PES used also

1) steady state heart rate is reached for each exercise work rate 2) Linear relationship between WR and HR 3) Predicted and actual max HR are minimal difference 4) Mechanical efficiency is the same for everyone 5) No caffeine, drugs, stress, dehydration, hot as all of these affect heart rate

flywheel reveloves at 6m per revolution. 50RPM. 1kg x 6 x 50 = 300kg.m.min

Step in time to muscle Low resource, don’t need specialists/ ergometers 5 x 2min stages

CD player (metronome), HR monitor, stop watch, graph paper/nomogram, Borg 6-20RPE scale, steps

30cm <40 regular MVPA performed 25cm >40 regular MVPA performed 20cm <40 little or no activity/ moderatel overweight 15cm >40 little or no activity/ moderately overweight >60 then 15-20cm

Measure resting HR Ask age Calculate predicted max HR Explain -step on and off in time with tape -Every 2 mins HR and RPE will be checked and pace will increase -Can change lead leg - Continue until 80% or RPE >=14 -Tired, dizziy, faint, breathless then stop Demonstrate technique

Start stopwatch Ensure timing is correct Ensure patient doesn have hands on knees Take HR and RPE Repeat 3 levels are needed for valid outcome

Plot HR on graph paper taking into accont height Draw linear line of best fit (do not use if <50% heart rate max) INterpolate maximal O2 from age predicted max HR

Used questionaires e.g. CHarles. Uses sex, BMI, age, Percieved fitness and percieved PA PFA - Percieved functional ability based on pace at which you could run 1 mile continuously (not too fast or slow) - just right for you = 1-13 Also pace at which could run/ walk 3 miles without getting out of breath or overly fatigued 1-13 PA-R habitual PA 1-10 based on light, mod, vig activity average over last 6 months

Forms and sheets ready Calibrate equipment Organsie so that same muscle group is not stressed continually Consent form Maintain temp 20-22 and humidity <60% Obtain HR, BP, height, weight, body comp Note use of BBs or drugs with HR effect

Allow HR and BP to return to baseline

Ability to perform large muscle dynamic MV intensity exercise for prolonged periods of time

CO and arterial to venous pressure gradient

O2 consumption at a steady state

Peak = not O2 steady state - most pulmonary/ CVS patients

4-hrs after MI

due to environment, diet and behaviour e.g. allow a practice to reduce effects of anxiety. Avoid caffeine. Allow HR to reach steady state