UNIT 3: Week 3 Content
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What populations have an increased risk of exercise related adverse cardiovascular events
-sedentary people -those with underlying CV disease -participating in vigorous intensity exercise
What are some mitigation strategies to avoid exercise related adverse cardiovascular events
-pre-participation health screening -gradual, progressive transitions from being sedentary to being physically active
What are the two different types of pre-participation health screening
-self-guided -professional-guided
What are examples of self guided pre-participation screens
-PAR-Q+ -PAR-medX+
What are some examples of professional-guided pre-participation health screening
-ACSM pre-participation screening algorithm -medical history
What are the self-guided pre-participation health screening tools designed to do
-decrease barriers to participation -decrease risk of false positive screening
What is the purpose of the self-guided pre-participation tools
-screens for major signs and symptoms of cardiovascular, metabolic, or renal conditions
What are some major signs and symptoms of CV, metabolic and renal disease
-pain/discomfort in chest, neck, jaw, arms -SOB at rest or with mild exertion -dizziness or syncope -orthopnea -ankle edema -papitations or tachycardia -intermittent claudication -known heart murmur -unusual fatigue or shortness of breath with usual activities
What is included in the ACSM pre-participation screening algorithm
-participation in regular exercise -presence of known health condition -presence of signs/symptoms -desired level of exercise intensity
What would serve as medical clearance to begin exercise
-referral from physician
What are some examples of submaximal cardiorespiratory fitness tests
-astrand-rhyming single stage cycle ergometer test -1 mile walking test
What are some examples of maximal clinical exercise tests
-bruce treadmill protocol -CPET
Why do pts perform submaximal fitness tests
-predict fitness -set goals -prescribe exercise
Why do pts perform maximal exercise tests
-directly measure fitness -evaluate physiologic response to exercise -develop prognosis of risk adverse events
What are some cardiorespiratory fitness testing absolute contras
-acute myocardial infarction within 2 days -ongoing unstable angina -uncontrolled cardiac arrhythmia -active endocarditis -symptomatic severe aortic stenosis -decompensated heart failure -acute pulmonary embolism -acute myocarditis or pericarditis -acute aortic dissection -physical disability that precludes safe and adequate testing
What are some cardiorespiratory fitness testing relative contras
-resting heart rate over 100 bpm -resting hypertension with systolic over 140 or diastolic over 90 -known obstructive left main coronary artery stenosis -moderate to severe aortic stenosis with uncertain relationship to symptoms -tachyarrhythmias -acquired advanced or complete heart block -recent stroke or transient ischemia attack -mental impairment with limited ability to cooperate -uncorrected medical conditions
What are some pre test instructions to give to patients
-avoid stimulants 2 hours prior -avoid alcohol 6 hours prior -avoid vigourous exercise 24 hours before -cancel test if feeling unwell -take usual medications as prescribed by their physician
What type of VO2 is measured in maximal exercise tests
-VO2 max
Why are most maximal tests often discontinued prematurely
-due to symptoms
When do most clinicians terminate maximal exercise tests
-85% predicted HR -ST segment elevation
What type of VO2 is measured when maximal exercise tests are discontinued due to signs/symptoms
-VO2 peak
What population are maximal exercise tests most often used in
-mostly used when medically indicated or for athletic performance
How to submaximal exercise tests predict VO2 max
based on correlations with: -physiologic responses to submax exercise -field test performance -time to volitional fatigue on standardized tests
What is one of the risks of estimated VO2 max
-under or overestimations