Kin 450- Advanced Fitness Appraisal Certified Exercise Physiologist (CEP) Preparation: Lab #7 – Stress Test


Kin 450- Advanced Fitness Appraisal

Certified Exercise Physiologist (CEP) Preparation

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Lab #7 – Stress Test

Equipment

 

  • Treadmill
  • ECG monitor and electrodes or heart rate monitors
  • Blood pressure equipment

Objectives

In this exercise students will:

  1. Perform the Bruce Treadmill Test
  2. Parameters to be measured: ECG, Workload, Duration, Signs and Symptoms, Heart Rate and Blood Pressure

Introduction

In this lab you will perform an indirect maximal predictive test to gain a greater understanding of maximal testing procedures and protocols.  There are advantages and disadvantages inherent in all testing, regardless of whether they are submaximal, maximal, predictive, direct, or indirect. Of most importance, maximal predictive tests are more valid than submaximal tests but less suitable for sedentary populations. Other factors to consider include equipment requirements, complexity, cost, versatility and appropriateness for large groups, and population to be tested (eg. healthy, unhealthy, recreational, elite). Maximal predictive tests are based upon the linear relation between power output and VO2 (Figure 1). Thus, if maximum power output is measured, then VO2max can be estimated.

Figure 1: The linear relationship between walking or running speed and VO2.

Practical Component of Laboratory

 

Part 1 – Bruce Treadmill Test

The Bruce Treadmill Test is an incremental maximal test used to predict relative VO2max. It can be used for most populations, including athletes, healthy college-aged, normal population, and unhealthy persons with cardiovascular disease. It is a multi-level test that was initially developed to detect chest pain and discomfort in patients to provide evidence of possible heart attacks or ischemic heart disease (Bruce, 1963).

Procedures:

  1. Pre screening forms and risk stratification have been completed
  2. Participant Instructions: Pre test controls are adhered to, that is, HR < 100 bpm, resting BP <144/94, be free of acute infection, abstain from alcohol for at least 6 hours prior to the test, abstain from smoking for at least 2 hours prior to the test, abstain from caffeine products for at least 6 hours prior, avoid a heavy meal within 3 to 4 hours of the test, avoid vigorous exercise within 6 hours of the test
  3. Lab conditions should be standardized – temp as close to 18 to 20 degrees C, adequate ventilation, absence of spectators, regularly calibrated treadmill
  4. Knowledge of relative and absolute contraindications to exercise testing
  5. Prep a 12 lead ECG
  1. Record resting heart rate
  2. Record resting blood pressure

Heart Rate Determination:

Heart rate can be determined using ECG tracings if the paper speed is known.  Standard paper speed is 25 mm per second.  This results in 1500 “small blocks”           per minute or 300 “large blocks” per minute being recorded.  To measure:

REGULAR SINUS RHYTHM

You can use the R-R Method

  • R-R Method (using large boxes)

(300) / (# of large boxes between adjacent R peaks (R interval)) = HR in bpm

  • Example: if there are 3 large blocks between 2 adjacent R peaks the heart rate is 100 bpm. If there are 5 large blocks between 2 adjacent R peaks, the heart rate is 60 BPM

 

  • R/R Method (using small boxes)

(1500) / (# of small boxes between adjacent R peaks (R interval)) = HR in bpm

 FOR IRREGULAR SINUS RHYTHM

You can use the Six-Second Method:

  • Select a six second section from the strip and count the number of COMPLETE QRS complexes then add a zero to get a rough estimate of HR (BPM).
    • Example: 6 complete QRS complexes is 6 x 10 = 60 bpm

Have your subject complete the Bruce treadmill protocol by increasing both the speed and incline (% grade) of the treadmill as per protocol.

Procedure for the test:

  • Start the treadmill at the speed of the 1st stage of the Bruce protocol.
  • Instruct the client to straddle and then step on the treadmill while holding the handrail. As the client becomes familiar with the speed and treadmill have the client release their hands from the handrails.
  • Adjust the incline to the appropriate % grade for the 1st stag of the protocol.
  • Once at the correct % grade, record warm-up heart rate and start exercise time.
  • Record heart rate at the end of each minute of exercise.
  • Record RPE and BP at the last 15 seconds of each stage (every 3 minutes). BP may be too difficult to measure past the third stage of this protocol.
  • Motivate the client to continue until he/she reaches volitional fatigue.
  • Monitor subjective symptoms
  • When the client requests to stop, stop the treadmill, and record total exercise time for the protocol.
  • Start the treadmill and adjust the speed for cool down, e.g. 2 or 3 MPH. Allow the client to continue walking for 2 – 5 minutes.
  • Record HR at each stage, and record BP, and post-exercise at 1, 3 and 5 minutes.

 

The Bruce Treadmill Protocol

  • Stage 1: 3 min @ 1.7 mph, 10% grade
  • Stage 2: 3 min @ 2.5 mph, 12% grade
  • Stage 3: 3 min @ 3.4 mph, 14% grade
  • Stage 4: 3 min @ 4.2 mph, 16% grade
  • Stage 5: 3 min @ 5.0 mph, 18% grade
  • Stage 6: 3 min @ 5.8 mph, 20% grade
The Bruce Treadmill Test Protocol
Level Time (mins) Speed (km/hr) Grade (%)
1 0 2.74 10
2 3 4.02 12
3 6 5.47 14
4 9 6.76 16
4 12 8.05 18
5 15 8.85 20
6 18 9.65 22

  Table 1: Bruce Treadmill Test Protocol with speed performed in km/hr.

 

Name: Zac Tucker Age: 22
Resting HR: 110 Resting BP: 130/70
Workload Time Heart Rate Blood Pressure RPE
Stage 1

 

1:00 110  
2:00 118 135/70  
3:00 120   7
Stage 2

 

4:00 126 140/70  
5:00 130  
6:00 138 147/70 9
Stage 3

 

7:00 150  
8:00 165 150/70  
9:00 173   11
Stage 4

 

10:00 180 167/68  
11:00    Test stopped @11:12  
12:00    
Stage 5

 

13:00      
14:00      
15:00      
Stage 6

 

16:00      
17:00      
18:00     18-19
Recovery   Workload Heart Rate Blood Pressure
1:00 1.2 mph 131 149/68
2:00 124
3:00    
4:00      
5:00      
6:00      

 

Note: Bp should <99 before client can go

METS LEVEL: 10.1 = ~ 35 ml/kg/min (relative VO2 max)

Stop the test if: Can’t get Bp, abnormal ECG, pain, symptomatic (ex.cyanosis,angina), wants to stop, Bp cut off 200/110 (absolute), etc.

 

 

 

 

LAB ASSIGNMENT                                                                           Marks:                        /23

 

 

  • Calculate predicted VO2max (mL•kg-1min-1) for your participant using the Prediction Equation. Show your work. (1 mark)

Male: VO2max = 14.76 – (1.379 x time, min) + 0.451 (time2, min) – 0.012 (time3, min)

Female: VO2max = 4.38 x (time, min) – 3.9 ( Zac Tucker )

 

 

 

 

 

 

 

 

  • In this lab you have been exposed to only one of a multitude of predictive protocols for estimating VO2 Would you choose the Bruce treadmill test to measure the aerobic fitness of each of the following individuals? If you decide the test is not appropriate, please discuss which test you would recommend. For each client justify your answer. (3 marks)
    1. Sedentary 53 year old male Professor, with borderline hypertension (142/92).
  1. Young (17 year old hockey player)
  2. 75 year old apparently healthy female
  • For the client that you tested, review the exercise blood pressure values. Discuss the normal response blood pressure has with exercise.  In this test, was the exercise blood pressure response normal.  (1 marks).
  • Discuss the steps necessary to complete a 12 lead prep (2 marks)

 

 

  • For the attached information sheet, review the exercise blood pressure values. Discuss the normal response blood pressure has with exercise.  In this test, was the exercise blood pressure response normal?  (2 marks).
  • For the attached information sheet, calculate predicted VO2max (mL•kg-1min-1) using the prediction equations. Show your work (1 mark)

 

Men:  VO2max = 3.88 + (0.056*(test duration in seconds))

 

Women: VO2max = 1.06 + (0.056 * (test duration in seconds))

 

  • For the client (on the information sheet) that was tested using the Bruce Treadmill Test you have calculated a predictive VO2max score. How does this VO2 compare to normative data? Also, what would you recommend your client do in terms of an exercise program to improve his VO2max?  Use the FITT principle. Be specific. (10 marks)

 

  • During your test, what would you do if your: (3 marks)

 

  1. HR monitor quit working?

 

  1. ECG quit working?

 

  1. Observed ECGs you were not quite sure of?

 

Mr. Bruce Age: 62 Resting HR: 75 Resting BP: 138/78  
Workload Time Heart Rate Blood Pressure RPE Recovery Workload Heart Rate Blood Pressure
Stage 1

1.7mph

10%

1:00 79     1:00 3.0mph 150  
2:00 84     2:00 3.0mph 133  
3:00 85 148/82 11 3:00 2.5mph 110  
Stage 2

2.5mph

12%

4:00 93     4:00 Rest 90 150/88
5:00 98     5:00      
6:00 100 158/82 12 6:00      
Stage 3

3.4mph

14%

7:00 127      
8:00 133      
9:00 139 172/86 15  
Stage 4

4.2mph

16%

10:00 150      
11:00 158      
12:00 162 190/90 17  
Stage 5

5.0mph

18%

13:00        
14:00        
15:00        
Stage 6

5.8mph

20%

16:00        
17:00        
18:00        

 

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Simply Click ORDER NOW and enter your paper details. Our support team will review the assignment(s) and assign the right expert whose specialization is same as yours to complete it within your deadline. Our Editor(s) will then review the completed paper (to ensure that it is answered accordingly) before we email you a complete paper 

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