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Martin Gorshkov
Martin Gorshkov

Sport And Exercise Physiology Testing Guideline...

Sport and exercise physiologists are called upon to carry out physiological assessments that have proven validity and reliability, both in sport-specific and health-related contexts. A wide variety of test protocols have been developed and refined. This book is a comprehensive guide to these protocols and to the key issues relating to physiological testing.

Sport and exercise physiology testing guideline...

With contributions from leading specialist sport, exercise and clincial physiologists, and covering a wide range of mainstream sports, special populations, and ethical, practical and methodological issues, these volumes represent an essential resource for sport-specific and clinical exercise testing in both research and applied settings.

Since its first published edition more than 30 years ago, the BASES (British Association of Sport and Exercise Sciences) Physiological Testing Guidelines have represented the leading knowledge base of current testing methodology for sport and exercise scientists. Sport and exercise physiologists conduct physiological assessments that have proven validity and reliability, both in laboratory and sport-specific contexts. A wide variety of test protocols have been developed, adapted and refined to support athletes of all abilities reach their full potential. This book is a comprehensive guide to these protocols and to the key issues relating to physiological testing.

Andy Jones is Professor and Chair of Applied Physiology at the Children's Health and Exercise Research Centre at the University of Exeter. He is internationally recognised for his research in respiratory physiology (particularly pulmonary gas exchange responses to exercise) and elite sports performance physiology (particularly in relation to endurance athletes).

The Sport and Exercise Scientist (TSES) is BASES quarterly publication. All BASES members receive 4 printed issues of the publication every year, which is packed full of industry news, features and the latest sport and exercise science research.

With contributions from many leading specialist physiologists, and covering a wide range of mainstream sports, special populations, and ethical, practical and methodological issues, these volumes represent an essential resource for sport-specific and clinical exercise testing in both research and applied settings.

An elite athlete can be defined generally as an athlete with several years of experience in a particular sport or sports who has competed successfully against other high level performers and trains year-round at a high level; an elite athlete generally trains at least 5 days per week, averaging close to 2 hours per day throughout the year 30. In addition to aerobic training, elite athletes in most sports also participate in resistance training to increase muscular strength and endurance; however, this training was not considered a safe activity in early guidelines for exercise during pregnancy because of potential injury and possible fetal heart decelerations resulting from Valsalva maneuvers. Consequently, there is sparse literature on this topic 30. It is prudent for elite athletes who wish to continue strenuous activity during pregnancy to have a clear understanding of the risks, to obtain approval from their health care providers, and to consider decreasing resistance load compared with prepregnant conditions. High-impact activities with increased risk of blunt trauma should be avoided, and it also is important that the pregnant elite athlete avoid overheating when performing their sport or participating in intense training 30.

The current Guidelines for exercise and sports participation in individuals with CVD are the first of a kind by the ESC. Sports cardiology is a relatively novel and emerging sub-speciality, therefore the evidence base for the natural history of disease progression or risk of death during intensive exercise and competitive sport among individuals with CVD is relatively sparse.

The current Guidelines also draw upon existing ESC Guidelines for the investigation, risk assessment, and management of individuals with CVDs to aid physicians when prescribing exercise programmes or providing advice for sports participation.

Any person older than 35 years of age, particularly anyone overweightor with a history of high blood pressure and heart disease, shouldconsult a physician before undertaking any vigorous testing. Fitnesstesting should not be avoided, as for this population it can beuseful as a screening device and to help devise a program to suitspecial needs. For all participants that are not accustomed to exercise, it would be wise to conduct a PARQ - Physical Readiness Questionnaire.

We have over 400 fitness tests listed, so it's not easy to choose the best one to use. You should consider the validity, reliability, costs and ease of use for each test. Use our testing guide to conducting, recording, and interpreting fitness tests. Any questions, please ask or search for your answer. To keep up with the latest in sport science and this website, subscribe to our newsletter. We are also on facebook and twitter.

Unexplained exertional dyspnoea or fatigue can arise from a number of underlying disorders and shows only a weak correlation with resting functional or imaging tests. Noninvasive cardiopulmonary exercise testing (CPET) offers a unique, but still under-utilised and unrecognised, opportunity to study cardiopulmonary and metabolic changes simultaneously. CPET can distinguish between a normal and an abnormal exercise response and usually identifies which of multiple pathophysiological conditions alone or in combination is the leading cause of exercise intolerance. Therefore, it improves diagnostic accuracy and patient health care by directing more targeted diagnostics and facilitating treatment decisions. Consequently, CPET should be one of the early tests used to assess exercise intolerance. However, this test requires specific knowledge and there is still a major information gap for those physicians primarily interested in learning how to systematically analyse and interpret CPET findings. This article describes the underlying principles of exercise physiology and provides a practical guide to performing CPET and interpreting the results in adults.

Cardiopulmonary exercise testing (CPET) is a maximal exercise test with concomitant gas exchange analysis that provides an integrative and comprehensive assessment of physiologic responses to exercise and cardiorespiratory fitness. In contrast to exercise ECG, the direct noninvasive determination of minute ventilation, heart rate and expired gases analysis (oxygen uptake and carbon dioxide output) at rest and during exercise provides accurate and reproducible data on the interaction of ventilation, gas exchange, and cardiovascular and musculoskeletal function, and enables determination of deviations from normal.

Use of CPET detects abnormalities in the functional capacity of these organ systems that are amplified or are only present during exercise (e.g., coronary arterial disease [CAD], right-to-left shunt [R-L shunt]) and helps to define the pathophysiology of exercise limitation. It is important to note that patient report of symptoms or stated levels of exercise intolerance correlate only modestly with resting functional and imaging tests [1,2,3]. As a result, CPET can be particularly valuable in identifying the source of exercise intolerance, monitoring disease progression, evaluating treatment responsiveness and providing information about prognosis.

The objective of this practical introduction is to describe the basic principles of exercise physiology and provide an easy-to-follow approach for those primarily interested in learning how to conduct, analyse and interpret CPET in their clinical practice. For further information, reference is given to the literature [3, 5,6,7, 10, 11, 15,16,17,18,19,20] and the updated reference work [1].

A basic working knowledge of exercise (patho)physiology and gas exchange is fundamental to understanding the pathophysiology of exercise intolerance and to the proper analysis and interpretation of CPET. Figure 1 illustrates characteristic alterations of key physiological parameters as exercise work rate is increased.

Principles of exercise physiology. The characteristic changes in key variables of ventilation, cardiocirculation and pulmonary gas exchange during progressive exercise are shown. Anaerobic threshold (AT) documents the transition to mixed aerobic-anaerobic metabolism, respiratory compensation point (RCP) documents the transition to predominant anaerobic metabolism. A more detailed description of Fig. 1 can be found in Additional file 1 (see Supplementary Information)

The ratio of ventilation (V) to perfusion (Q) is decisive for the quality of the gas exchange in the lungs. Pronounced ventilation/perfusion mismatch (V/Q) occurs in pulmonary disease, pulmonary vascular disorders and heart failure [21, 22]. Therefore, gas exchange measurements are central to the understanding of the pathophysiology of exercise limitation.

Measurement of the AT allows the objective assessment of aerobic metabolism at submaximal exercise levels. It can be automatically calculated by computer programme but needs to be cross-checked. A low AT indicates impaired cardiovascular transport of oxygen or poor muscular oxygen utilisation. By combining several methods (so-called 3- panel view (panels 3, 4, 7 [original version: panels 5, 6, 9]), AT can be determined in most cases and excludes non-physiologic hyperventilation as the origin of the V-slope inflection point [12]. Valid determination of AT is not always possible, as has been shown for very severe respiratory limitations (COPD, ILD) or significant heart failure when ventilation and/or perfusion can no longer be adequately increased in response to increasing exercise. Other reasons include an excessively steep/mild incremental ramp protocol or performance-reducing factors such as arthrosis, peripheral arterial disease or poor effort. We have not considered the second gas exchange threshold [respiratory compensation point (RCP)] due to its relatively low clinical worth. 041b061a72


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