Using exercise tolerance test as a stress test for the excercise enthusiast and gym goer

 

Current researches in medical science have proven an age-old knowledge that exercise is a proven way of combating many of the diseases that are assailing humankind, including Ghanaians. Adults are advised to be active to a moderate intensity for at least 150 minutes per week. Additionally, the weight of evidence which suggests that physical inactivity is harmful to health or that physical activity is beneficial to the treatment of a range of medical conditions is rapidly expanding.

With media reportage on events culminating to the untimely demise of our former Vice-President, His Excellency, Kwesi Amissah Arthur (May his soul rest in peace) still fresh on our minds; and as we bemoan our lack of proper emergency services including ambulances, lack of cardiopulmonary resuscitation training (CPR) and automated external defibrillator (AED) at many institutions and offices,

one pauses to ask the question, “How can one exercise safely?

This question has become necessary because many of us have either registered with many fitness centers and gymnasiums or working out on our own as a way of emphasizing their social status or genuinely wants to reap the benefits of regular exercises. Whatever the reason for choosing this path, it’s imperative that one assesses their health status before, during and after engaging in any exercise regimen. This is because many have hidden cardiovascular issues that have not been diagnosed prior to engaging in them. And even if they have any such diagnosis, no proper evaluation has been done to assess their functional capacity as regards their cardiopulmonary and musculoskeletal preparedness for such engagement.

Therefore, as a preventive measure, Exercise Tolerance Test is always recommended.

Exercise Tolerance Test, as the name suggests, assesses an individual’s ability to tolerate increased intensity of exercise while monitoring the heart. It evaluates:

Cardiovascular disease severity, if you have any.

Presence of coronary artery disease (negative test= low probability of CAD, positive test=high probability of CAD)

Disease prognosis (using duke treadmill test score) and

Determines functional capacity, especially for exercise prescription.

How is the test performed?

An individual is required to exercise at progressively greater increments of work, by varying the speed and grade of a treadmill, or the speed and resistance to pedaling an Upper Extremity or cycle ergometer. Heart rate & rate of perceived exertion are taken at every minute & blood pressure is taken at every stage (every 3 minutes.

The contraindications include a drop in systolic blood pressure > 10mmHg, angina, dizziness, ataxia, cyanosis, pallor, sustained ventricular tachycardia

Who Can Perform this Test?

Any qualified and well trained Physical therapist or Physician can do such an evaluation for any individual within 30-45min.s

This and more advanced alternative measure such as the Bruce Protocol which involves walking on a treadmill while being monitored by electrodes, ventilation volumes & gas exchange values are taken before, during, and after exercise have proven to save many lives and given them the confidence to engage in a more active lifestyle.

I believe prevention is always a better alternative to finding the cure for any condition.

Author: Dr. Benjamin Opoku-Bediako, PT, DPT.