1 Cardiorespiratory Fitness Purpose of Evaluation • educate client about current fitness levels relative to age and sex • Inspire individuals to take action to improve their health-related physical fitness • Use data to develop an individualized exercise program • identify areas of health/injury risk and possible referral to the appropriate health professional • to establish goals and provide motivation • to evaluate effectiveness of exercise program
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1 Cardiorespiratory Fitness Purpose of Evaluation educate client about current fitness levels relative to age and sex Inspire individuals to take action.
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Cardiorespiratory Fitness Purpose of Evaluation
• educate client about current fitness levels relative to age and sex
• Inspire individuals to take action to improve their health-related physical fitness
• Use data to develop an individualized exercise program
• identify areas of health/injury risk and possible referral to the appropriate health professional
• to establish goals and provide motivation• to evaluate effectiveness of exercise program
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Fig. 1. The movement continuum, illustrating the different focus of sedentary physiology and exercise physiology. METs, metabolic equivalent tasks.
Prolonged uninterrupted sitting, independent of physicalactivity may be a risk factor for chronic disease.
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Fig. 3. Illustration of accelerometer data portraying an active couchpotato (moderate to vigorous intensity physical activity meetingguidelines considered ‘‘physically active’’ but also a high level ofsedentary behaviour) versus an active non-couch potato (similar levelof moderate to vigorous intensity physical activity but low levelof sedentary behaviour). (From Dunstan et al. 2010a, reproducedwith permission of Touch Briefings, European Endocrinology,Vol. 6, p. 21, # 2010.)
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Fig. 4. Portrayal of significantly different patterns of breaks in sedentarytime, based on accelerometer data from 2 different individuals(a ‘‘prolonger’’ and a ‘‘breaker’’). (From Dunstan et al. 2010a,reproduced with permission of Touch Briefings, European Endocrinology,Vol. 6, p. 21, # 2010.)
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Pretest and Safety Procedures• we have already discussed screening in this area
(HR, BP, observation)• note the very cautious stance in the USA
(everyone over 45 should have physician supervised graded exercise test)
• written emergency procedures• written consent
• Cardiovascular responses to Acute exercise are described on the following slides
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•Cardiac output - rises with work rate–Rest 5 L/min; Max 20 L/min
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•Heart rate increases linearly with work rate and O2 consumption–Max HR = 220 - Age (one standard deviation is +/- 12bpm)
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•Stroke volume rises with exercise to maximum at ~50% •Rest 60-100ml; exercise 100-120 ml
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Blood Pressure - Systolic increases linearly with intensity (max 190 - 220 mmHg) -Diastolic may increase slightly (+ 10 mmHg) or not change
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(a-v)O2 difference - Rest 5 ml/dl; Max 15 ml/dl
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Blood flow to working muscle increases with exercise- from 20% to 85% of Q
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Oxygen Consumption• Maximal oxygen consumption is most widely
recognized measure of cardiopulmonary fitness• VO2 Max - highest rate of O2 use that can be
achieved at maximal exertion– Fick Equation - VO2 = HR X SV X (a-v) O2
– Table 3.3 ACSM– Absolute VO2- L/min or ml/kg/min (relative to body weight)– Relative VO2- given as % of VO2 max
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Oxygen Consumption• Direct measurement of maximal oxygen uptake is the most accurate - Douglas Bag
– Can also be estimated from peak work rate– Treadmill speed and grade, cycle work rate
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O2 consumption Sub max estimates
• sub-maximal tests have four assumptions– Linear relationship between HR and O2 uptake
• Valid between 110 and 150 bpm
– Linear relationship between O2 uptake and workload
– That the max HR at a given age is uniform– That the mechanical efficiency (O2 uptake at a
given workload) is the same for everyone
• Not entirely accurate - can result in 10-15% error in estimating VO2 max– Tend to overestimate in highly trained,
underestimate in untrained
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Sub-maximal Tests
We have done (or will do) the following sub-max tests
• YMCA sub-maximal bicycle test• Sub-maximal step test (mCAFT)• Rockport Fitness Walking Test• Cooper test• 1.5 mile test
Caution client to stop if feeling dizzy, nauseous, very short of breath…
• An MET is the average amount of oxygen consumed while at rest. It is used a lot in ACSM exercise prescription guidelines.
• MET = 3.5 ml / kg min
• Capacity to increase work rate above rest is indicated by number of METs in max test– Sedentary can increase to 10, an athlete up to 23 MET
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Cardiorespiratory Capacities
METs* VO2max (ml/kg/min)
Athlete 16-20+ 56-70+
Active 10-15 35-53
Sedentary 8-10 28-35
Cardiac Patient
- Class II 5-7 18-25
- Class III 3-5 11-18
- Class IV <3 <11
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Stress Tests• Bruce protocol is a maximal stress test
– 3 min stages on treadmill• Increase speed and percent grade (~3.5 MET / stage)
– Used as a diagnostic test for coronary heart disease and estimating VO2 max
• must be cautious as Coronary Heart Disease is the #1 killer in Canada– if client has positive PAR-Q or is over 45 in the states
need physician to be present
• ECG (electrocardiograph) is used during stress test, as 30% with confirmed CAD have normal resting ECG – but 80% of these abnormalities will show during the
stress of exercise
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Why Use Stress Tests?
• To establish, from ECG, a diagnosis of heart disease and to screen for "silent" coronary disease in seemingly healthy individuals.
• To reproduce and assess exercise-related chest symptoms.
• To screen candidates for preventive and cardiac rehabilitative exercise programs.
• To detect abnormal blood pressure response • To define functional aerobic capacity and
evaluate its degree of deviation from normal standards.
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Exercise-Induced Indicators of CHD
• Angina Pectoris present 30% of time.• Electrocardiographic Disorders