Therapeutic Exercise: Energy Systems and Assessment
Metabolic Equivalent of Tasks (METs) (what is 1 MET equal to? exercise at 4 METS equals to? 8 METS)
1 MET= 3.5 mL/kg/min of O2 consumption exercise at 4 METS= 14 mL of O2 consumed per kg per min exercise at 8 METS: 28 mL/kg/min O2 consumed
What system is used for the following situations: 1) burst of intense activity leading to increased mm strength and stronger tendons/ligs 2) intense activity for 1-2 minutes using anaerobic power 3) large mm group, less than max intensity for 3-5 minutes using slight aerobic/endurance capabilities 4) submax intensity for more than 30 minutes to develop endurance
1) ATP-PC system 2) ATP-PC and anaerobic systems 3) all systems 4) high percentage of aerobic system
Oxygen Consumption (what aspects are important for proper exercise and oxygen utilization?)
O2 uptake by lungs, V:Q ratio, cardiac function, delivery of O2, extraction of O2, utilization of O2 by tissue
Max Oxygen Consumption (VO2max) (equation for VO2max? equation for aerobic capacity?)
VO2max= CO x (O2a-O2v) Aerobic Capacity= (SV x HR) x (O2 uptake by muscles)
Some contraindications for exercise testing
acute MI, unstable angina, unstable arrhythmia, respiratory failure, SpO2 less than 88%, syncope to name a few
VO2max (moderately high VO2 max i.e. more than 41 in males and more than 36 in females is associated with...10% increase in VO2max is associated with...)
associated with reduced risk of DMII, higher cognitive function, reduced risk of infection, increased metabolic rate, reduced risk of some CA. 10% increase in VO2max is associated with 15% decline in risk of MI
Indications for CPET
evaluation of dyspnea, cardiopulm rehab, pre-op evaluation and risk stratification, prognostic of life expectancy, determine disability, fitness evaluation, confirm dx, and assess response to therapy
Examples of CPET include...
field tests and GXT
Aerobic System (main fuel source? O2 required? max capacity and max power, predominates over other systems after how much time? how many molecules of ATP produced with this system?)
glycogen, fats, and proteins are main fuel source. O2 is required and max capacity is great and max power is small. predominates over other systems after 2 minutes of exercise. 36 molecules of ATP produced per molecule of energy source
MET scale (light intensity, moderate, and vigorous)
light: less than 3 moderate: 3-6 vigorous: more than 6
Anaerobic Glycolytic System (what is main fuel source? O2 required? what's produced? max capacity and max power, used for energy in...how long is this used for in ex?)
main fuel source is glycogen, no O2 required and lactic acid is produced. max capacity is intermediate and max power is also intermediate. energy for moderate intensity and short duration. used for 10 sec-2 minutes
Cardiopulmonary Exercise Testing Process (monitor via...measure at...start at...maintain to...how is testing change throughout process? stop when...some precautions to note)
monitor via EKG, spirometry, VS response. measure at rest, during, and post. start at prescribed workload and maintain to steady-state HR (achieved when working at consistent intensity for about 3 min). may increased speed or incline of TM or resistance on ergometer. stop when s/s occur, see change in EKG, or meet limits of protocol. precautions include monitoring VS, appearance, and RPE
ATP-PC System (what is main fuel source? O2 required? max capacity and max power, source for...where is phosphocreatine made? what is the creatine phosphate shuttle?)
phosphocreatine is main fuel source, no O2 is required and max capacity is small and max power is great. used for energy in short, quick bursts. phosphocreatine is made in the liver and transported to the muscles via the bloodstream for storage. the creatine phosphate shuttle facilitates transport of high energy phosphate from mitochondria.
GXT (stands for...when is speed/grade/resistance increased? what protocol is most common? when is speed/grade increased?)
stands for graded exercise test. measures responses at each stage of test. Bruce protocol is most common and consists of increased speed and grade every 3 minutes over 5 stages (1.7 mph to 5 mph, with 10% incline to 18% incline)
Field Tests (what two field tests can be used to measure CP health?)
time to run 1.5 miles or distance run in 12 min
Max Oxygen Consumption (VO2 max) (unit of measure? sitting at rest what is oxygen consumption norm? highest ever measured for humans? this is impacted by...)
units: mL (of O2)/ kg (BW)/min (of activity). sitting at rest: 3.5 mL/kg/min highest ever measured for humans: 97.5 mL/kg/min impacted by gender, age, training, and disease
Cardiopulmonary Exercise Testing (CPET) (use this to calculate and measure...compare to...)
used to calculate VO2max, measure VS response (i.e. ID HRmax), and compare to norms