Exercise Testing Equipment

Electrocardiograph Instrument used for recording [blank_start]electrical[blank_end] activity of heart One millivolt produces a [blank_start]10[blank_end] mm vertical deflection on paper Proper speed on ECG recorder is [blank_start]25[blank_end]mm/sec During exercise testing: record during rest, exercise and recovery Used for monitoring during [blank_start]stress[blank_end] test Electrode is placed on the skin to conduct [blank_start]electric[blank_end] current from body to measuring device Leads display movement of electricity from one electrode to another [blank_start]12[blank_end] lead EKG uses [blank_start]10[blank_end] electrodes Limb leads should be placed on [blank_start]upper[blank_end] body for stability during exercise Ensure electrode stability 1. [blank_start]clean[blank_end] and shave site 2. use [blank_start]conductive[blank_end] electrode jelly 3. Secure with [blank_start]elastic[blank_end] bandage 4. Use low [blank_start]impedance[blank_end] / high stickiness electrodes

Oscilloscope Provides [blank_start]visual[blank_end] image of electrical activity of the heart Usually shows [blank_start]lead II[blank_end] Disinfect electrodes with [blank_start]alcohol[blank_end]

Electrodes [blank_start]V1[blank_end] – 4th intercostal space on right side of sternum. Looks at the right heart [blank_start]V2[blank_end] – 4th intercostal space on the left side of the sternum. Looks at [blank_start]right[blank_end] heart V3 – Between [blank_start]V2[blank_end] and V4 on left side. Looks at [blank_start]ventricular[blank_end] spetum V4 – [blank_start]5th[blank_end] intercostal space, left mid-clavicular line. Looks at [blank_start]ventricular[blank_end] septum V5 – Between [blank_start]V4[blank_end] and V6 on left side. Looks at [blank_start]left[blank_end] heart. V6 – intercostal space, left mid [blank_start]axillary[blank_end] line. Looks at [blank_start]left[blank_end] heart.

Leads [blank_start]AVF[blank_end]: [blank_start]Left[blank_end] Leg or foot +, everything else – [blank_start]AVL[blank_end]: Left arm +, everything else – [blank_start]AVR[blank_end]: Right arm +, everything else – Lead [blank_start]III[blank_end]: Left leg +, L arm – Lead [blank_start]II[blank_end]: Left leg +, R arm – Lead [blank_start]I[blank_end]: Left Arm +, Right arm –

Exercise Equipment Ergometers [blank_start]Arm[blank_end] Ergometer Use if pt cannot perform leg exercise Smaller Muscle mass in upper body stresses cardio and respiratory systems [blank_start]less[blank_end] Leg Ergometer (Bike) Good for patients with difficulty [blank_start]walking[blank_end] Increase workload by increasing pedaling [blank_start]frequency[blank_end] or increasing [blank_start]resistance[blank_end] Advantages: Less expensive, lighter, portable. Less fall risk, pt can stop exercising by choice, easier vitals, results are independent of bodyweight. Disadvantages: uncomfortable, exercise is limited more by [blank_start]muscle[blank_end] fatigue in legs Use [blank_start]metronome[blank_end] to keep pace Workload is independent of pt weight. Treadmill Vary the workload by [blank_start]speed[blank_end] and [blank_start]grade[blank_end] Speed = belt length x RPM Pt should take long strides. Don’t [blank_start]lean[blank_end] and don’t talk Douglass bag and Tissot spirometer used to measure ventilation and expired gas concentration. Have recording device that can plot volume, flow and time. Emergency equipment should be available – Cardiac monitor and defribrillator should be present esp with pt with heart disease. Advantage: Walking is natural, 75% of stress tests are done on treadmill Disadvantage: Fall Rish, patient cannot stop on their own, difficult to obtain vitals, body weight is a factor Calibrate by multiplying belt length by RPM Step Method Vary the workload by step height and ste0p rate Simple to do Difficult to determine [blank_start]specific[blank_end] workload