1. INTRODUCTION TO ASSESSMENT OF AEROBIC FUNCTION Gilbert O. Madriaga, PTRP Department of Physical Therapy College of Allied Medical Professions University of the Philippines MANILA June 2009

2. Objectives 1. Define aerobic function. 2. Explain the importance of assessment of aerobic function. 3. Identify assessment procedures that may be used to assess for aerobic function. 4. Classify these assessment procedures according to the ICF 5. Discuss how each of the following assessment procedures can be used to assess for aerobic function. 1. Vitals signs 2. Cardiac and cardiovascular assessment 3. Pulmonary assessment 4. Fitness testing 6. Determine when to perform assessment for aerobic function

3. Physical fitness and physical activity Physical fitness  the ability to carry out daily tasks with vigor and alertness, without undue fatigue and with ample energy to enjoy leisure- time pursuits and meet unforeseen emergencies Physical activity  any bodily movement produced by the contraction of skeletal muscle that increases energy expenditure above a basal level. (Physical Activity Guidelines Advisory Committee Report, 2008)

4. Aerobic function  Ability of the body to utilize oxygen in activities of daily living (ADL)

5. Maximum oxygen consumption (VO 2 max ) measure of the body’s capacity to use oxygen. maximum amount of oxygen consumed per minute when the individual has reached maximum effort. mL/kg per minute dependent on  transport of oxygen,  oxygen-binding capacity of the blood,  cardiac function,  oxygen extraction capabilities,  muscular oxidative potential.

6. Myocardial oxygen consumption (mVO2) measure of the oxygen consumed by the myocardial muscle. The need or demand for oxygen is determined by the  heart rate (HR),  systemic blood pressure,  myocardial contractility,  afterload

7. Myocardial oxygen consumption (mVO2) The ability to supply the myocardium with oxygen is dependent on: the arterial oxygen content (blood substrate), hemoglobin oxygen dissociation, coronary blood flow, which is determined by  aortic diastolic pressure  duration of diastole, coronary artery resistance,  collateral circulation

8. What body systems are responsible for aerobic function?

9. Respiratory system

10. Cardiac and Cardiovascular system

11. ICF Health Condition ( disorder/disease ) Environmental Factors Personal Factors Body function&structure (Impairment ) Activities (Limitation) Participation (Restriction)

12. ICF code b455 Exercise tolerance functions  Functions related to respiratory and cardiovascular capacity as required for enduring physical exertion.  physical endurance,  aerobic capacity,  stamina and  fatiguability b4551 Aerobic capacity  Functions related to the extent to which a person can exercise without getting out of breath

13. ICF code b410 Heart functions  Functions of pumping the blood in adequate or required amounts and pressure throughout the body.  functions of heart rate,(b4100) rhythm (b4101) and output;  contraction force of ventricular muscles (b4102);  functions of heart valves;  pumping the blood through the pulmonary circuit;  dynamics of circulation to the heart;  impairments such as tachycardia, bradycardia and irregular heart beat and as in heart failure, cardiomyopathy, myocarditis and coronary insufficiency,

14. ICF code b420 Blood pressure functions  Functions of maintaining the pressure of blood within the arteries.  functions of maintenance of blood pressure;  increased and decreased blood pressure;  impairments such as in hypotension, hypertension and postural hypotension

15. b440 Respiration functions  Functions of inhaling air into the lungs, the exchange of gases between air and blood, and exhaling air.  functions of respiration rate, rhythm and depth;  impairments such as apnoea, hyperventilation, irregular respiration, paradoxical respiration and bronchial spasm and as in pulmonary emphysema.

16. b445 Respiratory muscle functions  Functions of the muscles involved in breathing.  functions of thoracic respiratory muscles;  functions of the diaphragm;  functions of accessory respiratory muscles b450 Additional respiratory functions  Additional functions related to breathing, such as coughing, sneezing and yawning.  functions of blowing, whistling and mouth breathing

17. b5500 Body temperature  Functions involved in regulating the core temperature of the body.  impairments such as hyperthermia or hypothermia

19. Assessment of aerobic function VS Pulmonary Assessment Cardiac and Cardiovascular Assessment Fitness Testing

20. Assessment of aerobic function is influenced by: age, gender, heredity, inactivity, and disease

21. Psychological issues in exercise testing MENTAL ENERGY Undivided attention and positive mental attitude is essential in ensuring optimum physical performances Effective concentration will help to maintain sound technique, while enabling participants to conserve energy.

22. Psychological issues in exercise testing MOTIVATION Exercise testing has a strong association with intrinsic motivation. Attribution theory  people who score higher than anticipated on exercise tests can become more motivated and more committed, while those who score lower than anticipated can become less motivated and less committed.

23. Psychological issues in exercise testing STRESS and ANXIETY Psychological aspects of physiological assessment should be understood by the PT and the participant as well The very thought of exercise testing can create anxiety in most patients