In this sequel to 'Clinical exercise Physiology up to week 10', we delve deeper into the material. Because how can you use someone's sports level for treatment? As with the previous summary, this one is divided into weeks. The topics of the weeks match the lessons. The following components are cove...
Aim to measure during exercise testing → it’s all because of performance!
Patients are also familiar with success and failures.
Performance depends on:
-skills
-equipment (apparatuur)
-environment
-motivation
- fitness → fit to transfer energy into movement.
1. ATP – Pcr
2. Glycolisis
3. Aerobic
Common complaints: dyspnea, chest pain, fatigue.
Optimal training design.
Also depends on the activity.
, Fick’s law is necessary.
SV increases after period
of hard training.
Several tests:
- Cardio pulmonary exercise Testing (CPET)
o Measures different organ systems
▪ 3 min warming up
▪ 10 min incremental workload 5 – 30 W/min
▪ 3 min recovery (no load)
Measurements: VO2, VCO2, minute ventilation (Ve), tidal volume, breathing frequency, ECG, blood
pressure, bloodlactate levels, BORG-score (dyspnea and leg fatigue), pulse oximetry (SpO2) and
arterial blood gases.
Question: what is the limiting factor?
Some contradictions for participation in this
test because of the high risk on cardiovascular
events.
, - Astrand-Rhyming Cycle Ergometer Test (Astrand)
o Sub maximal exercise test
o Estemation of VO2 max
o Measures:
▪ Heart frequency
▪ Workload
The better the aerobic capicity, the steeper the line.
o Protocol:
▪ Reach workload (HF: 180 – age)
▪ Note workload
▪ Cycle for 6 minutes
▪ Note HF in last minute
- Six minute walk test
o Self paced walking test
o Outcome is distance (also depends on encouragement, encouragement is standard)
o Protocol:
▪ 10 min. seated rest
▪ 6 min walk on a flat hard surface on a 30 m course
▪ Pre and end evaluation of HF, pulse oximetry and perceived dyspnea
o Consequence self paced: learning effect. Perform more often → better energy
distribution. 1 or 2 learn sessions are advised before the ‘real’ test.
The lower the work rate, the longer the person
can sustain that activity.
Critical power → the work rate on which a patient
can keep continue exercising.
After training the work rate is higher and
the critical power has increased.
The delta time is different at different
work rates. (improvement)
, - Enduced shuttle walk test (ESWT)
o Sub-maximal exercise test
▪ Fixed pace (vast tempo)
▪ Outcome is time
o Protocol:
▪ Subject walks a 10 m course
▪ Pace (80% of peak pace) determined by audio signal
• Peak pace is predetermined by an incremental shuttle walk test
(ISWT)
▪ No encouragement
▪ Terminate on failing to make cone (before the next beep)
▪ Express results as time (min/secs)
o It is more easy to pick up effects of interventions
o The closer to the critical power, the longer the test takes. Post can even be
‘unstopable’ (therefore around 70% of highest intensity)
o Used for evaluation of pharmacological, surgical and therapeutic interventions.
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