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Узнать больше an account? Click here to sign up. Download Free PDF. Exercise Standards for Testing and Training A Scientific Statement From the American Heart Association. Ross Arena. Download Download PDF Sownload PDF Package Download Full PDF Package This Paper. A short summary of this paper. Download Download PDF. Download Full PDF Package. Trjal PDF. AHA Scientific Statement Exercise Standards for Testing and Training A Scientific Statement From the American Heart Association Gerald F.

Odf, MD, FAHA, Chair; Philip A. Ades, MD, Co-Chair; Paul Kligfield, MD, FAHA, Co-Chair; Ross Ttial, PhD, PT, FAHA; Gary J. Balady, MD, FAHA; Vera A. Bittner, MD, MSPH, FAHA; Lola A. Coke, PhD, ACNS, FAHA; Jerome L. Fleg, MD; Daniel E. Forman, MD, FAHA; Thomas C. Gerber, MD, PhD, FAHA; Martha Gulati, MD, MS, Pdf expert trial expired free download Kushal Madan, PhD, PT; Jonathan Rhodes, MD; Paul D.

Thompson, MD; Mark A. Williams, PhD; on behalf of the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee of the Council on Clinical Cardiology, Council on Nutrition, Physical Activity and Metabolism, Council on Cardiovascular and Stroke Nursing, and Council on Epidemiology and Prevention Table of Contents Evaluation and Exercise Prescription in Exercise Testing.

These exercise standards are intended for Drugs and Electrolytes in Exercise Testing. Because of an Exercise and Health. The revision deals with basic Healthy Individuals.

The American Heart Association makes every effort to avoid any actual or potential conflicts of dowmload that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.

This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on February 1, To purchase additional reprints, call or e-mail kelle. ramsay wolterskluwer. The American Heart Association requests that this document be cited as follows: Fletcher GF, Ades PA, Kligfield P, Arena R, Balady GJ, Bittner VA, Coke LA, Fleg JL, Forman DE, Gerber TC, Gulati M, Madan K, Rhodes J, Thompson PD, Williams MA; on behalf of the American Download codec windows maker free Association Exercise, Expegt Rehabilitation, and Prevention Committee of the Council on Clinical Cardiology, Council on Nutrition, Physical Activity and Metabolism, Council on Cardiovascular and Stroke Nursing, and Council on Epidemiology and Prevention.

Exercise standards for testing and training: a scientific statement from the American Heart Association. Expert peer review of AHA Scientific Statements is conducted by the AHA Office of Science Operations. org DOI: Static provide justification for certain consensus recommendations isometric exercise results in no movement of the limb.

The based on expert opinion. metabolic classification refers primarily to the availability of With regard to a literature search for this revision, no spe- oxygen for the contraction process and includes aerobic oxygen cific strategy or formal data quality assessment was used. Each available or anaerobic without oxygen processes. Accordingly, references were and anaerobic metabolism, and depending on the contribution selected by the group on eexpert basis of personal experience or of each, the physiological responses can be significantly readily available publications and databases.

The cited refer- different. Current clinical exercise testing dlwnload manifest a exppired represent a consensus of the writing group. predominant dynamic—aerobic endurance component. allows the pdf expert trial expired free download supervisor to determine appropriate methodol- Maximum arteriovenous oxygen difference has a physiologi- ogy and to select test end points that maximize test safety and cal limit of 15 to 17 mL Pdf expert trial expired free download per mL blood. As a pdv obtain needed diagnostic and prognostic information.

increasingly on assessment of cardiovascular downloar, not sim- At fixed, mild-to-moderate submaximal workloads fee ply detection of pdf expert trial expired free download obstruction. beyond which muscles cannot derive all required energy from oxygen utilizationsteady-state conditions usually are reached within 3 to 5 minutes after the onset of exercise, and pdf expert trial expired free download Physiology of Exercise Testing quently, HR, cardiac output, blood pressure, and pulmonary Aerobic exercise, progressively increasing to maximal ventilation are maintained at reasonably constant levels.

However, in addition to exercise, the cardiovascular vasoconstriction in most circulatory body systems, except in response to physiological stress is also commonly evaluated exercising muscle and in the cerebral and coronary circulations. through the use of pharmacological stress agents. Total calculated this term no longer remains precise. The following section pdf expert trial expired free download resistance decreases, while systolic blood pressure, will focus specifically on exercise as a means to provoke mean arterial pressure, and pulse pressure usually increase.

cardiovascular and pulmonary stress. Diastolic blood pressure pdf expert trial expired free download remain unchanged or decrease to a small degree, each of which is considered a normal response.

Types of Exercise The pulmonary vascular bed can pdf expert trial expired free download as much as a Exercise involves muscle activity that has both mechanical 6-fold increase in cardiac output without a significant increase dynamic, static and metabolic aerobic, anaerobic properties. in transpulmonary gradient.

In normal subjects, this is not a Dynamic isotonic exercise, which causes movement of the limiting determinant of peak exercise capacity. A nor- endowment and level of training. mal systolic blood pressure response to progressive exercise is dependent on both sex higher in males and age troal with HR Response advancing age.

cise is an increase in HR that is attributable to a decrease in After maximum exercise, freee blood pressure usu- vagal tone, followed by an increase in sympathetic pddf. This postexercise hemodynamic response highlights degree of variability exists among subjects of identical age the importance of an active cool-down period when possible. Moreover, the HR eterization to obtain coronary arterial and venous oxygen content.

response is generally continuous with increasing workload. An However, myocardial oxygen uptake can be estimated during accelerated HR response to standardized submaximal workloads clinical exercise testing by the product of HR and systolic blood is observed after fere bed rest, indicating trlal physical pressure double product or rate—pressure product and ranges conditioning also plays a role in the HR pdf expert trial expired free download, which from the 10th percentile value of 25 to a 90th percentile value also can change in response to anemia, metabolic disorders, of 40 at peak exercise.

A linear relationship downllad between variable vascular volume or triial resistance, or ventricular myocardial oxygen uptake and coronary blood flow. During dysfunction. These conditions themselves do not appear to affect exercise, coronary blood flow increases as much as 5-fold above maximal HR unless capacity for exercise intensity becomes the resting value.

A subject with obstructive CAD often cannot limited. Conversely, a lower-than-expected incremental rise in provide adequate coronary blood flow to the affected myocardial HR during a progressive exercise test could be attributed to an tissue to meet the metabolic demands of the myocardium during enhanced level of fitness and left ventricular LV pdf expert trial expired free download. As exercise; consequently, myocardial ischemia occurs.

Myocardial will be discussed in detail, inadequate HR edpert to exercise ischemia usually occurs at the same rate—pressure product rather pdf expert trial expired free download на этой странице a marker not only for sinus node dysfunction but also for than at the same external workload eg, exercise test stage.

It is considered the best measure of cardiovascular fitness the cardiac response to expjred. Other factors that can influence and exercise capacity. The decline of HR myocardial ischemia, and associated symptomatology. has consistently demonstrated prognostic value. Submaximal посмотреть еще uptake is most frequently vascular resistance. whereas diastolic pressure usually remains about the same dosnload To meet the metabolic demand of dynamic exercise, oxygen is moderately decreased because of vasodilatation of the vas- uptake quickly increases, achieving steady state, as previ- cular bed.

In addition, the development of In most cases, the ventilatory threshold is highly reproducible, signs or symptoms associated with the need for pdf expert trial expired free download test although it might not be achieved or readily identified in some termination, such frde angina pectoris, hypertension, or cardiac patients, particularly those with very poor exercise capacity.

be compared with average normal values by age and sex. exercise habits, heredity, and cardiovascular clinical status. Vo2max is equal to the product of maximum cardiac output Absolute and Relative Contraindications to Exercise and maximum arteriovenous oxygen перейти на страницу. Assessment of this balance oxygen difference at peak exercise.

Because the arteriovenous requires knowledge of the purpose of the test for the individ- oxygen difference at peak exercise reaches a physiological tgial ual subject or patient and what expirdd or sign end points and usually varies little across a wide spectrum of cardiovascular will be for the individual test. function, most expieed the clinical variation in the oxygen pulse at Absolute Contraindications peak exercise is therefore attributable to variation in the forward stroke triak at peak exercise.

Reprinted from Fleg JL et al. for the test is not clear, the referring free should be con- be instructed to resume medication if rebound phenomena tacted for further information. Routine medications may be taken with small amounts correlation with test findings.

of water. Subjects with a history of worsening the nature of the progressive exercise, symptom and sign unstable angina or decompensated heart failure should not end points, and possible complications.

undergo exercise testing until their condition stabilizes. pressure responses to exercise. If ischemia does not occur, A resting supine standard lead ECG should be obtained the diagnostic value of the test for detection of CAD is before exercise to compare to previously obtained standard limited. No formal guidelines for tapering or holding ECGs to determine if changes have frre over time.

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