User's Manual

72 - K4 b
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User Manual
Recommendations for the exercise testing
The evaluation of the cardiorespiratory function
The physical training requires the interaction of physiological mechanisms that allow
the cardiovascular and respiratory systems to supply the increasing demand of energy
due to the contraction of the muscles.
During the training the systems are both engaged, an adequate answer to the effort is the
measure of theirs health state.
The increase of the metabolic rate, during the exercise, needs an appropriate increase of
oxygen in the muscles. At the same time, the CO
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muscles production must be removed
in order to avoid the lactic acid making.
To satisfy the increase in the gas exchange, necessary to the muscles during the
exercise, is requested the intervention of many physiological mechanisms. This process
involves lungs, the pulmonary circulation, the heart and the peripheral circulation.
Precautions
The physician has the responsibility that the patient subjects to the test is a suitable
person able to execute an effort test.
Laboratory
The room, in which the test is performed, must be big enough to contain the whole
necessary equipment, allowing an easier accessibility to the patient in case of
emergency.
In the room should be placed a thermometer and a hygrometer; the heart frequency and
the perceived values of the effort rise as much as the ambient temperature increases, and
the variability of the cardiovascular response grows for humidity values higher of 60%.
Generally it is considered 22°C the temperature adequate for the test execution, even for
short efforts, values till 26°C can be considered acceptable in presence of an efficient air
ventilation.
Ending the test
The patient should be monitored with ECG for at least 8 minutes, in resting conditions
or until he returns to the pre-exercise conditions.
Preparing the patient
To enhance the value of a diagnostic test it’s very important patient collaboration. In
most cases a well-informed patient will make a better effort (in relation to his
conditions) and will allow a reliable interpretation of the test. For this reason every
ergometric test must be preceded from a precise training of the patient.
Before testing
The physician applying the exam must be provided with a written request including a
brief description of the diagnosis (confirmed or suspected ), the request’s reason and the
patient therapy carried out showing the dose and time of the drug assumption.
To standardise the response to the test and reduce the patient’s anxiety it’s suggested to
provide him either written (before the exam) or oral (at the same time of the test)
information. At the scheduling time detailed instructions should be delivered to the
patient, consisting in smoke and food abstinence three hours before an ergometric test,
or eight hours before a scintigraphic test.
Test are usually executed supporting the therapeutic outline in progress, but sometimes
it could be necessary to stop some drugs, such as b-block or calcium antagonist, which
could impair the effort response reducing the diagnostic accuracy of the exam.
The patient must wear comfortable suit and gymnastic shoes and two hours before test
stop any kind of drugs, eat light and avoid coffee and smoke.