PED 401—Graded Exercise Testing

Mr. KriewitzSp. 2014

ACSM-CHAPTER ONE Please see appendix F for certifications Mission is to increase public fitness-

Surgeon General’s 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

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

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

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

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

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

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

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