scholarly journals Exercise Prescription Guidelines for Cardiovascular Disease Patients in the Absence of a Baseline Stress Test

2020 ◽  
Vol 7 (2) ◽  
pp. 15
Author(s):  
Megan Mytinger ◽  
Rachael K. Nelson ◽  
Micah Zuhl
Keyword(s):  
Perceived Exertion ◽  
Exercise Prescription ◽  
Stress Test ◽  
Evidence Based ◽  
Peripheral Artery ◽  
Core Component ◽  
Graded Exercise Test ◽  
Disease States ◽  
Graded Exercise ◽  
Artery Disease

Aerobic exercise is a core component of cardiac rehabilitation (CR). Leading organizations recommend that the exercise prescriptions should be based on a symptom limited baseline graded exercise test (GXT). However, recent evidence suggests that only ~30% of CR clinics perform baseline GXTs. Consequently, exercise prescriptions including exercise progression in CR are not following standard exercise prescription guidelines. Therefore, the purpose of this review is to provide clinicians with evidence-based techniques for prescribing exercise in the absence of a baseline GXT. Intensity indicators (e.g., heart rate, perceived exertion) are reviewed, along with special exercise considerations for various disease states (e.g., heart failure, peripheral artery disease, and coronary artery disease). Baseline exercise testing remains the gold standard approach for prescribing exercise among heart disease patients, however, clinicians must be prepared to safely develop and monitor patients when a baseline GXT is not performed.

A New Method for Prescribing Exercise: Three-Point Ratings of Perceived Exertion

1996 ◽  
Vol 82 (1) ◽  
pp. 139-146 ◽  
Author(s):  
Christopher C. Dunbar ◽  
Michael I. Kalinski ◽  
Robert J. Robertson
Keyword(s):  
Perceived Exertion ◽  
Exercise Prescription ◽  
Cycle Ergometer ◽  
New Method ◽  
Clinical Settings ◽  
Ratings Of Perceived Exertion ◽  
Graded Exercise Test ◽  
Treadmill Speed ◽  
Graded Exercise ◽  
The Mean

An accurate exercise prescription for ratings of perceived exertion has previously depended on data from a maximal graded exercise test during which RPE was measured. In many clinical settings RPE is not measured; in many fitness settings maximal testing is not feasible. A new method using treadmill speed or power output of a cycle ergometer at an RPE of 13 from a submaximal test which can be used in these situations is described. We evaluated the accuracy of this method at 50%, 60%, 70%, and 85% VO2max. A total of 160 target RPEs were developed using traditional procedures and the new method. No significant differences between RPEs obtained with the two techniques were found. The mean difference was less than one unit of RPE. It appears that the new method is valid for intensities of 50% to 85% VO2max and that data from either the cycle ergometer or the treadmill can be used to prepare exercise prescriptions.

Three-Point Method of Prescribing Exercise with Ratings of Perceived Exertion is Valid for Cardiac Patients

1996 ◽  
Vol 83 (2) ◽  
pp. 384-386 ◽  
Author(s):  
Christopher C. Dunbar ◽  
William W. Edwards ◽  
E. L. Glickman-Weiss ◽  
Patricia Conley ◽  
Antonio Quiroz
Keyword(s):  
Cardiac Rehabilitation ◽  
Phase Ii ◽  
Perceived Exertion ◽  
Exercise Prescription ◽  
Point Method ◽  
Cardiac Patients ◽  
Ratings Of Perceived Exertion ◽  
Graded Exercise Test ◽  
Standard Procedures ◽  
Graded Exercise

It is often difficult to use heart rate to prescribe exercise for cardiac patients due to the effects of medications and procedures such as cardiac transplantation. Ratings of Perceived Exertion (RPE) is the preferred method of regulating exercise intensity in these situations. An RPE-based exercise prescription has previously depended on perceptual data from a maximal Graded Exercise Test (GXT). Recently, using 13 healthy subjects, we validated a Three-point RPE for prescribing exercise using RPE which can be used when ratings from a GXT are not available. Currently, we examined the accuracy of this method for developing target RPEs for patients in Phase II cardiac rehabilitation. Such target RPEs did not differ from those obtained using standard procedures. We conclude that the Three-point Method is valid for preparing RPE-based exercise prescriptions for Phase II cardiac rehabilitation patients.

Development of an On-Water Graded Exercise Test for Flat-Water Sprint Kayak Athletes

2019 ◽  
Vol 14 (9) ◽  
pp. 1244-1249 ◽  
Author(s):  
Chelsie E. Winchcombe ◽  
Martyn J. Binnie ◽  
Matthew M. Doyle ◽  
Cruz Hogan ◽  
Peter Peeling
Keyword(s):  
Oxygen Consumption ◽  
Exercise Test ◽  
Repeated Measures ◽  
Perceived Exertion ◽  
Intraclass Correlation ◽  
Rating Of Perceived Exertion ◽  
Stroke Rate ◽  
Repeated Measures Design ◽  
Graded Exercise Test ◽  
Graded Exercise

Purpose: To determine the reliability and validity of a power-prescribed on-water (OW) graded exercise test (GXT) for flat-water sprint kayak athletes. Methods: Nine well-trained sprint kayak athletes performed 3 GXTs in a repeated-measures design. The initial GXT was performed on a stationary kayak ergometer in the laboratory (LAB). The subsequent 2 GXTs were performed OW (OW1 and OW2) in an individual kayak. Power output (PWR), stroke rate, blood lactate, heart rate, oxygen consumption, and rating of perceived exertion were measured throughout each test. Results: Both PWR and oxygen consumption showed excellent test–retest reliability between OW1 and OW2 for all 7 stages (intraclass correlation coefficient > .90). The mean results from the 2 OW GXTs (OWAVE) were then compared with LAB, and no differences in oxygen consumption across stages were evident (P ≥ .159). PWR was higher for OWAVE than for LAB in all stages (P ≤ .021) except stage 7 (P = .070). Conversely, stroke rate was lower for OWAVE than for LAB in all stages (P < .010) except stage 2 (P = .120). Conclusions: The OW GXT appears to be a reliable test in well-trained sprint kayak athletes. Given the differences in PWR and stroke rate between the LAB and OW tests, an OW GXT may provide more specific outcomes for OW training.

Prediction of peak oxygen uptake from sub-maximal ratings of perceived exertion elicited during a graded exercise test in obese women

2009 ◽  
Vol 46 (6) ◽  
pp. 1150-1153 ◽  
Author(s):  
Jeremy B. J. Coquart ◽  
Christine Lemaire ◽  
Alain-Eric Dubart ◽  
Claire Douillard ◽  
David-Pol Luttenbacher ◽  
...  
Keyword(s):  
Oxygen Uptake ◽  
Exercise Test ◽  
Perceived Exertion ◽  
Peak Oxygen Uptake ◽  
Obese Women ◽  
Ratings Of Perceived Exertion ◽  
Graded Exercise Test ◽  
Graded Exercise

The efficacy of the self-paced V̇O2max test to measure maximal oxygen uptake in treadmill running

2013 ◽  
Vol 38 (12) ◽  
pp. 1211-1216 ◽  
Author(s):  
Alexis R. Mauger ◽  
Alan J. Metcalfe ◽  
Lee Taylor ◽  
Paul C. Castle
Keyword(s):  
Oxygen Uptake ◽  
Maximal Oxygen Uptake ◽  
Perceived Exertion ◽  
The Self ◽  
Rating Of Perceived Exertion ◽  
Treadmill Running ◽  
The Novel ◽  
Balanced Design ◽  
Graded Exercise Test ◽  
Graded Exercise

The novel self-paced, cycle-based maximal oxygen uptake (V̇O2max) test (SPV) has been shown to produce higher V̇O2max values than standard graded exercise test (GXT) protocols. This study sought to ascertain whether these observations would also be apparent in a self-paced, treadmill-based test design. Fourteen trained male runners performed a standard GXT on a motorised treadmill and a self-paced V̇O2max test on a nonmotorised treadmill in a counter-balanced design. The GXT included a plateau verification and was designed to last between 8 and 12 min. The self-paced test included 5 × 2 min stages and allowed participants to set their own running speed based on fixed increments in rating of perceived exertion. Significantly higher V̇O2max values (t[13] = 3.71, p = 0.003) were achieved in the self-paced test (64.4 ± 7.3 mL·kg−1·min−1) compared with the GXT (61.3 ± 7.3 mL·kg−1·min−1), and 13 of the 14 participants achieved the same or higher V̇O2max values in the self-paced test. Higher (p = 0.01) maximum heart rates were observed in the GXT (191 ± 10 beats·min−1 vs. 187 ± 7 beats·min−1), but no differences were observed in any other recorded variables. The self-paced V̇O2max test may provide a more valid means of measuring V̇O2max than the GXT and suggests that a V̇O2 plateau during a GXT does not always signify achievement of a definitive V̇O2max. These results provide further support that self-paced V̇O2max testing produces higher values for maximal oxygen uptake.

Effect of precooling on physical performance in multiple sclerosis

2000 ◽  
Vol 6 (3) ◽  
pp. 176-180 ◽  
Author(s):  
A T White ◽  
T E Wilson ◽  
S L Davis ◽  
J H Petajan
Keyword(s):  
Perceived Exertion ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Rating Of Perceived Exertion ◽  
Physical Work ◽  
Heat Sensitivity ◽  
Graded Exercise Test ◽  
Graded Exercise ◽  
Clinical Signs And Symptoms ◽  
Physical Comfort

Many individuals with MS experience heat sensitivity that may be associated with transient increases in the frequency of clinical signs and symptoms. Although physical activity may be beneficial for those with MS, induced thermal loads may preclude participation in exercise and other daily activities. This project was designed to evaluate the effects of precooling on physical function. Six thermosensitive MS patients were studied. Participants performed a graded exercise test to determine maximal oxygen uptake (VO2max) on a combined arm-leg ergometer. Thermal load was induced by 30 min of exercise under noncooled and precooled conditions at a workrate corresponding to 60% VO2max. Precooling consisted of 30 min lower body immersion in 16-178C water. Fatigue and 25-ft walk performance were assessed before, immediately after, and 30 min following exercise. No treatment differences in VO2 were observed. Rectal temperature, heart rate, and rating of perceived exertion (RPE) were significantly lower during the precooled exercise trial compared to the noncooled trial. Immediately following exercise, 25-ft walk performance and fatigue scores showed significantly greater deterioration in the noncooled condition. Precooling was effective in preventing gains in core temperature with physical work and may allow heat-sensitive individuals with MS to exercise with greater physical comfort.

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