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PED 401—Graded Exercise Testing. Mr. Kriewitz Sp. 2014. ACSM-CHAPTER ONE. Please see appendix F for certifications Mission is to increase public fitness-Surgeon General’s Report Expanded emphasis from formalized exercise prescription to physical activity
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PED 401—Graded Exercise Testing Mr. Kriewitz Sp. 2014
ACSM-CHAPTER ONE • Please see appendix F for certifications • Mission is to increase public fitness-Surgeon General’s Report • Expanded emphasis from formalized exercise prescription to physical activity • Deviation from exercise for a training response to activity for health • Anything is better than nothing and the more you do the more fit you become
PHYSICAL ACTIVITY VS EXERCISE • Physical Activity is movement that substantially increases expenditure • Exercise is a subclass of PA that is repetitive and geared toward improving or maintaining an aspect of physical fitness
BENEFITS OF ACTIVITY/EXERCISE • Lower minute ventilation, myocardial 02, RHR, RBP, LDL, body fat, intra-abdominal fat and insulin levels, morbidity, mortality, and anxiety and depression • Increased Max V02, capillary density, lactate threshold, level for onset of disease symptoms, HDL, improved glucose tolerance, enhanced self-esteem and performance related to work and fun-Box 1-1 in book
RISKS ASSOCIATED WITH EXERCISE TESTING • Risks are lowered considerably when: • we know circumstances not conducive to testing • when to terminate a test • being prepared for any emergency that might arise • do not concern yourself with the statistics surrounding this issue
RISK ASSOCIATED WITH VIGOROUS EXERCISE • Cardiovascular complications are transiently increased • In the absence of pathology the risk is very low • Risk increases among people with CV disease so you must evaluate the risk/benefit ratio • Generally speaking, benefits are greater than absolute risks
ISSUES OF CONCERN IN SCREENING • Who should be tested • What test should be done • Physician supervision • Even in diagnostic testing, mild to moderate lesions are missed and plaque rupture can occur during exercise
RECOMMENDATIONS TO REDUCE COMPLICATIONS DURING EXERCISE • Medical clearance and maximal testing and screening for older ( men 45 or older, women 55 or older) adults, high risk or with disease • On site medical supervision and treatment if necessary • Emergency plan • Patient education about HR response
Mild to moderate intensity • Use telemetry on selected patients • Emphasize warm-up and cool-down • Minimize competition • Close supervision during cool-down • Take precautions in the heat and cold