testing

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Exercise testing

Laboratory exercise testing:

W170 and maximal tests

W170

Exercise test estimating theoretical physical working capacity at hear rate of 170 beets/min.

The test is looking for a theoretical load (P) [W] which should be produced by tested person at his (her) HR

170 beets/min.

Physiological principle:

A linear relation (positive correlation) between HR and intensity of exercise (load) in a range from 120 to 170 (180) beets/min.

Note: There is no change in systolic volume from 120–170 (180) beets/min and therefore cardiac output depends only on heart rate. Systolic volume rises till 120 beets/min, from

170–180 beets/min slightly decreases (short diastole).

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W170

Next characteristics:

1) It is one of the oldest sub-maximal tests evaluating fitness level, an effect of a training or impact of a rehabilitation intervention….

2) There was a hypothesis of strong correlation of the test with an aerobic power (VO

2 max). However, current findings show, that the test is valid only for common population (mainly for men). It is not suitable for athletes.

3) HR 170 beets/min is approximately the value when is a healthy young man reaching his anaerobic threshold. For the elderly or ill

(who has reduced HRmax and HR at AnT) is sometimes used modification of the test W150 či W130.

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W170

Equipment: - cycle ergometer

- HR monitor

Protocol:

1) 2(sometimes 3–4) stages. There can be 1 min long optional pause between stages.

2) duration of each stage 4–6 min (reaching of steady state)

3) measurement of HR at the end of each stage (during last 15 s)

4) load [W] should increase HR:

- at the end of the 1. stage: 120–140 bpm

- at the end of the 2. stage: 140–160 bpm

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W170

Determination of the load [W] per kg of weight:

1. stage

2. stage

♂ ♀ and children trained

1,5 W/kg 1 W/kg ≥ 2 W/kg

2 W/kg 1,5 W/kg ≥ 2,5 W/kg

Final power depends on pedal rate as well. The pedal rate should be kept in the range ±5 revolution/min.

Optimal pedal rate for sedentary is 60 rev/min (55–65), for trained higher

(even 85–95). The higher is load, the higher should be pedal rate.

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W170

Protocol (♀ 60 kg):

[W]

90 W

60 W

125 bpm

HR 1

1. stage

2. stage

145 bpm

Result of the test:

1) 60 W = 125 bpm

2) 90 W = 145 bpm

3) x W = 170 bpm

HR 2

[min]

5 min 5 min

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×

×

Calculation of W170 (extrapolation)

140

×

×

Calculation of W170 (extrapolation)

Result of the test:

1) 60 W = 125 bpm

2) 90 W = 145 bpm

3) 140 W = 170 bpm

Index W170:

140 W : weight (60) = 2,33 W/kg

140

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Population norms:

W170

(Heller, 2005)

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Comparison of a untrained (N) and a trained (T) with use of three stages

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W170

To create a line, two points are enough. It means to realize W170, two exercise stages should be enough too. There are some authors who recommend at least three stages. More stages reduce the risk of error.

×

×

×

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W170

Note:

If the HR at the end of the first stage is lower than 120 bpm, there may be a risk of major error. The reason is linearity from 120 to

170…..

In this case it is useful to add the third stage.

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W170

W170 test can be use for evaluation of working capacity at higher HR as well. However, by reason of above mentioned problems of linear relation… there is at HR higher than 170-180 bpm increase in error of the evaluation.

W170 test can be use for indirect determination o aerobic power:

1) Realization of standard test and determination of load at HRmax which can be calculated from formula 220-age

2) Determined load is used in formula (Bunc, 1989):

VO

2 max (ml/min) = 10.88 × [W] + 411

- This formula can be used for load from 100 to 400 W, with considered error 10%.

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Indirect determination of VO

2 max for ♀ 60 kg, 20 year

W at HRmax?

1) 220-20= 200 bpm

2) 190 W = 200 bpm

×

×

VO

2

VO

2 max = 10.88 × [W] + 411 max = 10.88 × 190 + 411

VO

2 max = 2478 ml/min

2478 : weight (60 kg)

VO

2 max = 41,3 ml/kg/min

140 190

Maximal exercise test

Laboratory tests when the load is gradually increasing till maximum.

The main aim is to measure maximum oxygen consumption (aerobic power) - VO

2 max(peak). It means to evaluate efficiency of cardiovascular system and estimate working capacity or working tolerance.

Sometimes is called spiroergometri.

A working capacity is a load reached immediately before appearance of the signals of ischemia on EKG record, which are the reasons to stop the test. A working tolerance is the highest load at the maximum, when the criteria for termination of the test were reached.

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Maximal exercise test

The sources of the load:

cycle ergometer

treadmill

arm ergometer

Next equipment:

HR monitors

unit for pulmonary gas exchange (PGE) measurement

analyzers for measurement of O

2 a CO

2 in inspired and expired air

(importance of calibration one time per day- mixture of gases: e.g. CO

2

%, O

2

– 15 %, rest N

2

)

– 5

flow sensor measuring volume of inspired and expired air

(importance of calibration before every measurement)

Every devises are controlled from one PC = spiroergometrics unit

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Spiroergometrics unit

Mixture of calibration gases

Calibration pump

PC

Unit for PGE measurement

EKG

Suction pump for EKG

Suction electrodes EKG

HR receiver

Unite for pulmonary gas exchange measurement

Measurement of O

2 consumption and CO

2 production

- from difference in concentration in inspired and expired air

Measurement of ventilation

- calculation from breathing frequency and tidal volume

Tested person wears mask or mouthpiece with clamp

Mouthpiece – discomfort, but lower death space

Maska – comfortable (breathing via nose), but bigger death space

(accumulation of CO

2

) + leaking.

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*

Air sampling for CO

2 a O

2 analysis

Information about volume of inspired and expired air

Mast fit.

Flow sensor working on principle different pressure in the front of and behind of membrane.

Disinfection and calibration prior to each measurement.

Maximal exercise test

Increase in the load:

continual (ramp) test

[W]

[W/kg]

O

2

There is steples increase in the load [W] till maxima.

Problem: delay in O

2 consumption

VO

2 load. does not correspond with the

[min]

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Maximal exercise test

Increase in the load:

gradual (step) test

[W]

[W/kg]

There is gradual increase in load [W] with use of steps from low values to maxima:

[min]

0,5; 1; 2–5 min.

O

2 consumption corresponds to the load at the end of each step

(reaching steady state)

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Maximal exercise test

Increase in the load:

Every minute (step) increase about o 1/3 W/kg of waight. VO

2 should not increase between steps more than 3 METs.

♂ 75 kg = 25 W/min

♀ 60 kg = 20 W/min

Total duration of the test should be from 8–12 min.

If the test is shorter or longer, VO

2 max values are lower.

Generally – for sedentary, obese and elderly, tests should e longer with lower increase in load)

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Maximal exercise test

Increase in the load :

Sedentary male:

Wmax = 175 (around). If increase about 25W/min, duration will be 7 minutes.

Trained cyclist

Wmax = 550 (or more). If increase about 25W/min, duration will be 22 minutes.

Solution: higher increase (30 W) + change in exercise protocol:

1) 4–5 min warming-up at constant low intensity

2) test starts at the load corresponding with load at individual anaerobic threshold

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Maximal exercise test

Sedentary: 7 steps x 25 W = 175 W

175 W

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Maximal exercise test

Trained would need by 22 steps x 25 W = 550 W

Problem: 1) Long duration

2) Low (boring) intensity at the beginning

ACCORDINGLY

550 W

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Maximal exercise test

Trained would need by 22 steps x 25 W = 550 W

Problem: 1) Long duration

2) Low (boring) intensity at the beginning

ACCORDINGLY

550 W

Minute long brake, not necessary

W at AnT

Test:

3 –8 min

4 –5 min

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Maximal exercise test

How to estimate AnT?

THAN

1) Based on population norms...

2) By using W70 test, which could serve as a warming-up at the same time

550 W

W at AnT test:

3 –8 min

4 –5 min

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Maximal exercise test

How to estimate AnT?

Using W170 test as a warming-up before test to maximum

W 170

Test:

3 –8 min

550 W

2. step

1. step

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Maximal exercise test

Chosen monitored parameters:

1) Heart rate (HRmax, HR at AnT) and saturation

Saturation

HR

A saturation means percentage of saturation of blood bye

O

2 from maximum possible amount.

It is at the rest about

98% and decreases during exercise. It can be lower than 90% at maximum exercise.

Digital pulse oxymetere

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Maximal exercise test

Chosen monitored parameters:

1) Heart rate (HRmax, HR at AnT) and saturation

2) Power – P (Wmax, W at AnT)

Work = force acting upon a distance

= [N × m] = [J] power = work for time

= [Nm/s] = [W]

Or …

P = F × v

[W = Nm/s] force speed

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Maximal exercise test

Chosen monitored parameters:

1) Heart rate (HRmax, HR at AnT) and saturation

2) Power – P (Wmax, W at AnT)

The values of Wmax/kg:

3,5

2,8 trained

≥6–9

KVS illnesses od 0,5

See next table:

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Maximal exercise test

Chosen monitored parameters:

1) Heart rate (HRmax, HR at AnT) and saturation

2) Power – P (Wmax, W at AnT)

3) Lactate – for estimation of so called metabolic AnT

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Invasive estimation of AnT from level of a blood lactate

(Placheta et al, 2001)

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Maximal exercise test

Chosen monitored parameters:

1) Heart rate (HRmax, HR at AnT) and saturation

2) Power – P (Wmax, W at AnT)

3) Lactate – for estimation of so called metabolic AnT

4) Gas exchange (O

2 a CO

2

) and ventilation

CO

2

RQ = RQ of fats = 0,7. RQ of carbohydrates = 1

O

2

However during maximal exercise test RQ overlap level of 1. The reason is reduction of acidity with help of bicarbonates:

H + + HCO -

3

→ H

2

CO

3

→ H

2

O + CO

2

Note: H

2

CO

3

- carbonic acid

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[l]

Maximal exercise test

However during maximal exercise test RQ overlap level of 1. The reason is reduction of acidity with help of bicarbonates:

H + + HCO -

3

→ H

2

CO

3

→ H

2

O + CO

2

CO

2

O

2

Deflection point from linear trend between CO2 output and exercise intensity.

AnP

[W]

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Maximal exercise test

This deflection point represent anaerobic threshold, which is called as a respiration or ventilation AnT.

Similar increase (deflection point) can be seen on the curve of ventilation - because increase of pCO

2 in blood stimulates ventilation (due to chemoreceptors).

V

[l]

So called „talking“ test can be used for estimation.

Ventilation AnT

[W]

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Determination of ventilation AnT

(Tvent)

(Heller, 2005)

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V-slope method for determination of

AnT

Linear relation is disturbed for the benefit of CO

2 output.

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O

2

consumption during maximal test

(Heller, 2005) *

O

2

consumption during maximal test

Plateau in O

2 consumption

:

1) It is situation when VO2max is reached and next increase in exercise intensity does not cause father increase of it.

2) It is possible to sustain for seconds (trained longer).

3) It is evident among less then 50% tested. The most of the tested finish early from reason of uncomfortable filings.

4) It is one criteria for reaching maximum exercise intensity.

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Maximal exercise test is ended when the tested feels inability to continue - reaching volitional maximum

Maximum = at lest 18.

(Borg, 1982)

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Criteria of reaching maximum

1) Plateau in VO

2

.

2) RQ higher than 1.

3) Lactate is 1,5 min after cessation of exercise >8mmol/l

4) HRmax >85 % from predicted maximum

VO

2 max x VO

2 peak.

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Maximum test on treadmill

The example of the set used in our laboratory:

Tr. ♂

Tr. ♀ km/hour

% km/hour

%

7

0

8

0

4 min 1 min than increase every 30 s

7

5

8

5

10

5

11 12

5 5

13

5

14 15

5 5

15

7

8

5

9

5

10

5

11

5

12

7

12

9

12

11

Than increase in inclination about 2 %

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Receiver of HR.

Safety belt.

Maximum test on treadmill

Example of next protocols:

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Some parameters during maximal test

VCO

2

FIO

2

– volume of expired CO

2

, RER – respiration quotient, V – ventilation,

–FEO

2

– utilization of O

2 from ventilated air

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Some parameters during maximal test

V

E

VCO

VO

P

2

ETO2

2

– ventilation

– volume of expired CO

2

– volume of inspired O

2

– partial pressure of O

2 at the end of expiration

P

ETCO2

– partial pressure of CO

2 the end of expiration

LA

– level of lactate

HCO

3

– bicarbonate

R

– respiration quotient pH

– pH

W

– load

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Results of maximal exercise test

Results of maximal exercise test

Results of maximal exercise test

Results of maximal exercise test

VO2l/min

Measurement of VO

2 in the field conditions

A B

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Determination of VO

2 max from regression equation

(Jurča el al.)

1. Evaluation of physical activity

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Determination of VO

2 max from regression eguetion

(Jurča el al.)

2. Filing of different parameters

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Výpočet VO

2 max dle regresní rovnice (Jurča el al.)

3. Final evaluation of results

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Literature:

Heller, J. (2005). Laboratory Manual forHuman and Exercise Physiology.

Charales Univeristy in Prague: The Karolinum Press.

Maud,

C. Foster (Eds.). Psychological assessment of human fitness .

Champaign, IL: Human Kinetics.

Placheta, Z., Siegelová, J., Štejfa, M., Jančík, J., Homolka, P., & Dobšák, P. (2001).

Zátěžové vyšetření a pohybová léčba ve vnitřním lékařství . Brno: Masarykova

Univerzita.

Silbernagl, S., & Despopoulos, A. (1988/1993). Atlas fyziologie člověka

(E. Trávničková et al., Trans.). Praha: Grada.

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