KSU KSU Exercise Testing Exercise Testing Protocol Protocol Hazzaa Hazzaa M. Al M. Al-Hazzaa Hazzaa, Ph Ph D, FACSM D, FACSM Professor & Director Professor & Director Exercise Physiology Laboratory Exercise Physiology Laboratory King Saud University King Saud University Tel (office): Tel (office): 4678411 4678411 Lab: Lab: 4678406 4678406 http://faculty.ksu.edu.sa/hazzaa http://faculty.ksu.edu.sa/hazzaa 514 RHS 514 RHS - Fall 2010 Fall 2010
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Exercise ModeExercise Mode-- Treadmill versus Bicycle.Treadmill versus Bicycle.
Continuous versus discontinuous exercise test Continuous versus discontinuous exercise test protocol.protocol.
Some exercise protocols are designed for Some exercise protocols are designed for clinical exercise testing and others for functional clinical exercise testing and others for functional capacity or capacity or cardiorespiratorycardiorespiratory fitness.fitness.
Maximal versus Maximal versus submaximalsubmaximal exercise.exercise.
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Common Graded Common Graded Exercise Testing Exercise Testing
Cardiac IschemiaCardiac IschemiaChanges in the Changes in the Conduction of Conduction of
the Heartthe HeartVentricular Ventricular EctopiesEctopies
Changes in Changes in DepoDepo//RepolarizationRepolarization
of Cardiac Cellsof Cardiac Cells
Myocardial Myocardial ExcitationExcitation
Stop of muscle Stop of muscle contractioncontraction
Venous Venous DilationDilation
Reduced Reduced Venous ReturnVenous Return
Reduced BPReduced BP
Reduced COReduced CO
Reduced Heart Reduced Heart PerfusionPerfusion
Anaerobic Anaerobic ThresholdThreshold
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Definition of Anaerobic Threshold Definition of Anaerobic Threshold (AT)(AT)
The exercise VOThe exercise VO22 (& work rate) above which (& work rate) above which anaerobic energy production starts to progressively anaerobic energy production starts to progressively increase, with consequential increase in increase, with consequential increase in lactate/lactate/pyruvatepyruvate ratio, and a net increase in lactate ratio, and a net increase in lactate production at the site of production at the site of anaerobiosisanaerobiosis..
Wasserman et al., Wasserman et al., 19991999
Gas exchange is also affected by increases in Gas exchange is also affected by increases in COCO22 output & minute ventilation as a result of output & minute ventilation as a result of HCOHCO33-- buffering of lactic acid.buffering of lactic acid.
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VOVO22 & HR responses during steady state treadmill & HR responses during steady state treadmill test for a young athlete (test for a young athlete (21 21 yearyear--old) old)
Anaerobic Threshold Determination by Anaerobic Threshold Determination by the Vthe V--Slope MethodSlope Method
VO2
VC
O2 AT
SS11
SS22
S1 = < 1S2 = > 1
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Maximal Graded Ergometer Test for a Healthy Saudi MaleMaximal Graded Ergometer Test for a Healthy Saudi MaleAge = Age = 23 23 yrs; Wt = yrs; Wt = 7171..3 3 kg; Ht = kg; Ht = 171 171 cm cm
AT determined by An Increase in AT determined by An Increase in VentilatoryVentilatory Equivalent Equivalent of Oof O22 (VEVO(VEVO2 2 without an increase in VECOwithout an increase in VECO22
AT determined by An Increase in AT determined by An Increase in VentilatoryVentilatory Equivalent Equivalent of Oof O22 (VEVO(VEVO2 2 without an increase in VECOwithout an increase in VECO22
Casaburi, et al, JAP, Casaburi, et al, JAP, 19891989
COCO22
Mean and lower Confidence Limits for PredictedMean and lower Confidence Limits for PredictedAT/Predicted Peak VOAT/Predicted Peak VO2 2 in adults (%)in adults (%)
Impaired peripheral chemosensitivity with Impaired peripheral chemosensitivity with an associated high airway resistance.an associated high airway resistance.
Wasserman et al., Wasserman et al., 19991999
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Factors affecting Anaerobic Threshold
Physical TrainingNutrition
Muscle Fiber TypesUsed Protocol
Health Status:• Affecting blood carrying capacity.• Blood flow to the muscles.
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What are the reasons for AT Improvement after What are the reasons for AT Improvement after TrainingTraining
Increased blood flow in the muscles after training. Increased blood flow in the muscles after training.
Increased muscle’s ability to oxidized Increased muscle’s ability to oxidized pyruvatepyruvateand FFA.and FFA.
Delay of the fast twitch muscle fibers recruitment.Delay of the fast twitch muscle fibers recruitment.
Wasserman et al., Wasserman et al., 19991999
All these factors are related to muscle metabolism(Local/peripheral factors)
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Oxygen Uptake: Oxygen Uptake: from Rest to Maximal Exercisefrom Rest to Maximal Exercise
VOVO22 increases from increases from 250 250 ml/min at rest to ml/min at rest to 22..55--3 3 l/min l/min at maximal exercise (at maximal exercise (1010--12 12 fold increase). fold increase).
CO increases from about CO increases from about 5 5 l/min at rest to l/min at rest to 2020--25 25 l/min l/min at max exercise (at max exercise (44--5 5 fold increase) .fold increase) .
Explain how is this happening?Explain how is this happening?
What accounts for the differences?.What accounts for the differences?.