An exercise test is a diagnostic technique that examines the body’s reactions of adaptation to physical activity in laboratory conditions.
Exercise test results allow the patient’s fitness to be compared to the average with respect to age and sex as well as to one’s own results in case of repeated testing.
An exercise test is a part of a health examination package.
Spordimeditsiini SA offers ECG exercise tests and cardiopulmonary exercise tests performed by a SEM doctor who is assisted by a nurse.
During the preparation for an exercise test, disposable electrodes are attached to the subject’s chest; for a cardiopulmonary test, a mask is put on their face, and all of the above is connected to the equipment.
Depending on the patient’s preferences, previously conducted exercise tests, the subject’s health condition and the type of sport they do, the test with incrementally increasing exercise load is performed either on a stationary exercise bicycle ergometer (VEM) or on a treadmill.
The doctor constantly monitors cardiovascular adaptation processes during exercise and recovery in a 12-lead ECG, records the heart rate (HR) at various levels of load during the test (in healthy patients, the HR is the same as pulse rate [PR], i.e., the pulse) and measures blood pressure (RR).
The exercise test is stopped upon achieving maximum results or in case the subject’s health condition indicators or general state worsen.
After the exercise test, the SEM doctor summarizes the results of the health examination, which are used as the basis of the evaluation of the athlete’s performance capability indicators. The overview of the health examination and its results can be of use to the trainer preparing an individual workout plan.
During an ECG exercise test (ECGET) cardiovascular processes of adaptation to physical activity and recovery are monitored, and performance capability is evaluated. The test allows deviations in the functioning of the cardiovascular system to be identified.
ECGET is included in versions A and B of adults’ health examination packages and version A of health examination packages for young athletes.
Stationary exercise bicycle ergometer (VEM):
Treadmill:
* In case of an ECG exercise test, maximum oxygen consumption VO2 max is calculated indirectly.
A cardiopulmonary exercise test (CPET) is a diagnostic test technique, which allows circulatory, respiratory and muscle metabolism to be evaluated as a whole during exercise. In addition to monitoring cardiovascular processes of adaptation, changes in the respiratory function as well as inhaled oxygen and exhaled carbon dioxide are continuously recorded by means of a facemask and gas analyser.
CPET is included in versions C and D of adults’ health examination packages and version B of the health examination packages for young athletes.
Treadmill:
Lactate, also known as lactic acid, is the end product of carbohydrate metabolism, which accumulates in the body as the result of intensive muscle work. The better one’s fitness level and muscle performance, the higher the load at which lactic acid begins accumulating.
Fitness beginners and competing athletes alike can determine recommended exercise intensity zones, i.e. aerobic and anaerobic threshold heart rate, by means of the lactate test. Theoretically, aerobic threshold heart rate is the one at which lactate concentration reaches 2 mmol/l, and anaerobic threshold heart rate is that at 4 mmol/l of lactate.
More precise aerobic and anaerobic heart rate values can be determined individually on the basis of the lactate curve, where the lactate concentration values measured at various load levels are indicated on one axis, and load values (heart rate, speed/angle or power in W) are indicated on the other axis.
At the same time, it should be noted that it will not always be possible to extrapolate the results obtained in laboratory conditions to actual training situations due to the nature of various sports. Still, training effectiveness can be monitored by means of repeated tests performed in standard laboratory conditions.
Lactate concentration in capillary blood (fingertip blood test) is determined by the nurse, and the results of the test requiring one needle prick will be available within seconds.
Lactate concentration may be determined during an ECG exercise test or cardiopulmonary exercise test, but the most precise information about aerobic and anaerobic processes is provided by the lactate test combined with a cardiopulmonary exercise test.
Lactate testing is included in versions B and D of health examination packages. Young athletes undergo this test as necessary.
Exercise tests cannot be performed during illnesses, so it is important that you are well when you come for your exercise test. In case of an acute illness, at least two weeks must pass before the exercise test after you recover.
The exercise test must be postponed in case of the following contraindications:
PWC170 (Physical Working Capacity) is calculated by a formula and shows physical exercise capacity at the heart rate of 170 beats per minute. The PWC170 indictor can also be used as a characteristic of cardiac economy.
MET (Metabolic Equivalent of Task) is calculated by a formula and shows the number of times by which the subject is able to increase oxygen consumption compared to resting consumption. The higher the MET, the better endurance, i.e., aerobic capability.
1MET = 3.5 ml O2 min/kg.
The METs measured on the basis of various records of tests on the VEM and treadmill vary.
VO2 max (peak) or peak oxygen uptake VO2 peak (ml min/kg) is the maximum amount of oxygen that the body is able to consume. Maximum oxygen consumption (peak oxygen uptake) characterises the body’s tolerance to prolonged effort. The higher maximum oxygen consumption, the better endurance, i.e., aerobic capacity.
Aerobic threshold (AeT): oxygen consumption (%O2) is the highest at the level of aerobic threshold, and this is when the initial ventilation increase takes place.
Exercise intensity below or at the level of aerobic threshold mainly develops basic endurance, and this is when fats are the primary source of energy. Training in the aerobic threshold zone improves the body’s capability of prolonged low-intensity work, expands the network of minor blood vessels (capillaries) and improves heart and muscle oxygenation.
Patients with good basic endurance generally have better health and better prospects of athletic development.
Anaerobic threshold (AnT): anaerobic threshold is characterised by a drop in oxygen consumption (%O2) and significant ventilation increase. Exercising in the anaerobic threshold zone trains the heart, affects aerobic metabolism, and increases maximum oxygen consumption (VO2 max). When exercise intensity is above the anaerobic threshold, lactate (lactic acid, the end product of carbohydrate metabolism), which causes muscle fatigue, starts accumulating in muscles.
Pulmonary ventilation is air movement through airways in and out of the lungs. Ventilation depends on the strength of respiratory muscles, lung elasticity and patency of airways.