Exercise Testing

1
Exercise Testing PrescriptionPart B

• Natalia Fernandez, PT, MS, MSc, CCS
• University of Michigan Health Care System
• Department of Physical Medicine and
  Rehabilitation.

2
Exercise Prescription

• Exercise Prescription is based on
• Test Interpretation -Persons Initial Fitness
• Goal of training
• Intensity
• Duration
• Frequency
• Mode

3
(No Transcript)
4
Exercise Prescription Principles
5
(No Transcript)
6
(No Transcript)
7
(No Transcript)
8
CDC Handout on Moderate and Vigorous Intensity
Activities
9
Exercise Prescription
Fitness Health Severely Deconditioned
Sport or Competition 10 METS 30-45 Min 3-5 Days per week 70-85 HR Max RPE 13-17 Health 8-10 METS Accumulate 30-60 Min Most Days per Week 50-70 HR Max RPE 11-13 Build Stamina lt4-5 METS Tolerated Activity 3-5 Minutes Several Times per Day lt50 of HR Max Gradual ? time
10
Exercise Prescriptions Training HR Rate
Range-Methods

• Age Adjusted Predicted Training Heart Rate Range
• 220- age x (.50 to .70)
• HRR Heart Rate Reserve/Karvonen Method
• HR threshold HR rest 0.60 (HR max - HR rest)

11
Methods of Prescribing Exercise Intensity
12
Level of Intensity
13
(No Transcript)
14
(No Transcript)
15
Cardiovascular Adaptations

• Pulmonary Function (TV RR)
• Body Composition
• Body Heat Transfer
• Performance Changes
• Psychological Benefits
• Immune Function
• All cause mortality
• Disease Risk Profile

• Heart Size
• Plasma Volume
• Heart Rate
• Cardiac Output
• Oxygen Extraction
• (a-v O2 difference)
• Blood Flow Distribution
• Blood Pressure

16
Reversibility Principle

• Training is transient reversible
• Detraining occurs rapidly
• Saltin et al., 1968
• 25 ? VO2 max following 20 days of bedrest
• in 5 college aged students

17
Reversibility Principle

• Detraining Consequences
• Cardiac output ? 8-10
• Stroke Volume ? 10-13
• ? HR 4
• Plasma Volume ? 12
• a-v O2 difference ? 2-7
• CP ? 27
• ATP ? 15
• Muscle glycogen ? 50
• Oxidative enzymes ? 29-32
• Lactate Threshold ? 7-18
• Lipolysis ? 52

18
Energy Conversions

• Power
• 1 Watt 6 Kg meters/minute
• 1 Watt 6 kpm
• 425 kpm 1 Kcal
• 5 Kcals 1 L O2
• Exercise Time and Energy Cost for Health (150
  kcals per day)
• 150kcals/METSminutes of exercise
• E.g. 150kcals/5 mets 30 minutes of exercise

19
Submaximal Exercise Testing

• Submaximal Exercise Testing Clinical Application
  and Interpretation, Vanessa Noonan and Elizabeth
  Dean, Physical Therapy, 200080 782-807.

20
References

• ACSMs Guidelines for Exercise Testing and
  Prescription. 9th Ed. 2013.
• Monitoring Clinical Responses to Exercise, Joanne
  Watchie
• American Physical Therapy Association
  Cardiovascular Pulmonary Section
• Essentials of Cardiopulmonary Physical therapy,
  Ellen Hillegrass, 3rd Ed, 2011.
• ACLS Provider Manual Supplementary Material, 2006
  American Heart Association.