PED 401

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PED 401Graded Exercise Testing

• Mr. Kriewitz
• Sp. 2014

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ACSM-CHAPTER ONE

• Please see appendix F for certifications
• Mission is to increase public fitness-Surgeon
  Generals Report
• Expanded emphasis from formalized exercise
  prescription to physical activity
• Deviation from exercise for a training response
  to activity for health
• Anything is better than nothing and the more you
  do the more fit you become

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PHYSICAL ACTIVITY VS EXERCISE

• Physical Activity is movement that substantially
  increases expenditure
• Exercise is a subclass of PA that is repetitive
  and geared toward improving or maintaining an
  aspect of physical fitness

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BENEFITS OF ACTIVITY/EXERCISE

• Lower minute ventilation, myocardial 02, RHR,
  RBP, LDL, body fat, intra-abdominal fat and
  insulin levels, morbidity, mortality, and anxiety
  and depression
• Increased Max V02, capillary density, lactate
  threshold, level for onset of disease symptoms,
  HDL, improved glucose tolerance, enhanced
  self-esteem and performance related to work and
  fun-Box 1-1 in book

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RISKS ASSOCIATED WITH EXERCISE TESTING

• Risks are lowered considerably when
• we know circumstances not conducive to testing
• when to terminate a test
• being prepared for any emergency that might
  arise
• do not concern yourself with the statistics
  surrounding this issue

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RISK ASSOCIATED WITH VIGOROUS EXERCISE

• Cardiovascular complications are transiently
  increased
• In the absence of pathology the risk is very low
• Risk increases among people with CV disease so
  you must evaluate the risk/benefit ratio
• Generally speaking, benefits are greater than
  absolute risks

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ISSUES OF CONCERN IN SCREENING

• Who should be tested
• What test should be done
• Physician supervision
• Even in diagnostic testing, mild to moderate
  lesions are missed and plaque rupture can occur
  during exercise

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RECOMMENDATIONS TO REDUCE COMPLICATIONS DURING
EXERCISE

• Medical clearance and maximal testing and
  screening for older ( men 45 or older, women 55
  or older) adults, high risk or with disease
• On site medical supervision and treatment if
  necessary
• Emergency plan
• Patient education about HR response

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• Mild to moderate intensity
• Use telemetry on selected patients
• Emphasize warm-up and cool-down
• Minimize competition
• Close supervision during cool-down
• Take precautions in the heat and cold