physicla or verbal manifestation of severe fatigue
RPE (rate of perceived exertion) 14-15/20
What is rate of perceived exertion (RPE)?
how difficult a pt feels a task is
make sure they understand this is cardiovascullarly NOT musculoskeletal pain
What are 3 safety considerations?
enough space so if the pt falls, injuries are minimized
PT's current on CPR
ready for emergency situations
What are 3 ways to ensure validity/reliability of a test?
make sure the pt understands the test
encourage the pt
may need to give pt a practice test to ensure they fully understand
What does the YMCA ergometer test and who is it designed for?
estimate VO2 max
What do you calculate max HR as for the YMCA bike test, and why do you calculate it?
max HR= 85% (220-age) x.85
don't want the HR to go higher than that
Prior to testing what do you need to do as a PT for the YMCA bike test?
(have already went through risk factors, signs/symptoms, consent, risk stratification on a different day)
adjust seat height so knees are at 10' flexion
get resting HR and BP on bike
warm up at 50 rpm
What position is the individual supposed to be on the bike for the YMCA bike test?
seat height adjusted so knees at 10' flexion
How does stage 1 of the YMCA bike test work?
EVERYONE starts at the same workload for stage 1
.5kp, 25 wattes, speed=50rpm, 150kpm/min
How is the workload of the subsequent stages of the YMCA bike test based?
off the HR at the end of stage 1
What is the procedure for each stage of the YMCA bike test?
Take the HR at the end of 2nd and 3rd min, if the HR is less than 5bpm apart then you have reached steady state and can continue to next stage, if GREATER than 5bpm pt has not reached steady state and have to continue another minute
Meausre BP and PRE in 3rd minutes
When does the YMCA bike test end?
When 2 HR's between 110-150 have been recorded in 2 different stages
OR if the pt cannot reach steady state within a stage after 4 minutes the test is too difficult
What are some assumptions for tests that estimate VO2 max?
linear relationship between HR and work rate
steady state HR obtained in each stage
max HR for a given age is uniform
mechanical efficiency is the same for everyeone
Why is the linear relationship between HR and work load not always true in tests that estimate VO2 max?
beta blockers and Ca++ channels blockers may blunt HR response