Pulmonary Exercise Testing Should Be Goal Oriented

          Performance testing can take on many different looks depending on what you are wanting to measure. For example, if you are looking to improve cardiorespiratory efficiency, VO_2max testing is typically used. If you are looking to measure speed, you may use a field test such as a 10yrd dash. Either way you look at it something needs to be measured in order to see if there is any improvement.

            Baseline performance testing should be an important element when managing exercise capacity and exercise tolerance in youth and adults with pulmonary conditions. Performance testing provides the ability to provide in-depth information through quantifiable data to components of an individual’s exercise capabilities. Testing creates a foundational platform to develop a multistage exercise training program to ensure the highest quality of care is being used to guide the training program.

            Performance testing is not obsolete in the pulmonary world and, in some form or fashion, is used in inpatient care and pulmonary rehab. The 6-Minute Walk Test, 3-Minute Step Test, and Shuttle Test have been used as gold standard measurements when cardiopulmonary exercise testing (CPET) isn’t available. Another more commonly used form of measurement in the exercise world is the use of qualitative measures, like the Borg Scale or Rate of Perceived Exertion scale (RPE). These qualitative measurements provide us with information about how a person is/was feeling during/after the workout. These subjective scales are great for understanding the emotional state of the person. Nonetheless, the subjective feedback doesn’t necessarily align with what is intrinsically occurring with the cardiorespiratory system or the musculoskeletal system when training is actually going on. There is an unclear theory about the body having a “central governor” (coined by Tim Noakes) that regulates performance outputs. These outputs are regulated by the brain and how the perception of training, or how an individual feels, plays an important role in how much performance the human body will give. A great example is someone during the last leg of a race. When you are on the home stretch of a run, it feels as if you have been running for what seems like forever and your body is aching, your feet are hurting, joints screaming and you just want to finish, but suddenly you see the finish line with people cheering and out of nowhere, you get a sudden burst of energy and your off! You’re sprinting through the finish line, then finally collapsing into your friend’s or family member’s arms after you’ve conquered your quest to finish the race. The question is; where did that energy come from? You were exhausted, your legs were giving out, and then all of a sudden you were sprinting as if you were in the Olympics chasing down Usain Bolt.

            Perception is not necessarily reality and the subjective feedback of the client who is training is very important in understanding the overall picture of how well training is going, yet it only sheds light on the acute emotional state of what exercise is doing for the individual. The mental component impacts to training is big and clients should feel great after their workout, but having a client feeling great shouldn’t be the only standard exercise professionals hold their exercise programing standards to.

             Research has shown that structured exercise programs have a positive impact on the lifespan of children and adults with pulmonary conditions (Hebestreit, 2010). Physical fitness has been associated with decreased hospital visits in pulmonary population (Spruit, 2016). This means there is an opportunity for exercise professionals who specialize in pulmonary conditions to help increase quality of life and improve the overall health in individuals fighting pulmonary conditions through exercise prescription. Performance testing allows the exercise specialist a common ground to discuss their goal and how to obtain those goes through specific types of exercise training. It can build transparency and help educate the individual on types of training that can be beneficial for their health. Performance testing can also lead to advancing how exercise training is prescribed in the pulmonary community. Trial and error is the only way to advance exercise science and conducting simple exercise test over a period of time can give great insight to the impact exercise has on underlying health issues.

            On the other hand, time and money can play a big factor in what exercise test are actually done. Exercise professionals can’t just take every individual through every fitness test that is out there and nor should they. Performance testing should mirror what the individual’s goals are. For example, you wouldn’t put an athlete getting ready for the Iron Man through a 10yrd dash field test to gather data on how to improve aerobic capacity 4-weeks before the event. The testing doesn’t line up with the goal and understanding this can help find the right test.

     References

Hebestreit, H., Kieser, S., Junge, S., Ballmann, M., Hebestreit, A., Schindler, C., & Kriemler, S. (2010). Long-term effects of a partially supervised conditioning program in cystic fibrosis. European Respiratory Journal, 578-583.

Spruit, M. A., Burtin, C., De Boever, P., Langer, D., Vogiatzis, I., Wouters, E. F., & Franssen, F. M. (2016). COPD and exercise: does it make a difference? Breathe 12(2).

For more exercises content check out our YouTube Channel: Cystic Fibrosis Fitness Institute 

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