CARDI

ORESPI
RATORYFI
TNESS

INDEX
CARDIORESPIRATORYFI TNESS
MaximalOxygenUptake
ASSESMENTOFCARDI ORESPI RATORYFI
TNESS
LABORATORYTECHNI QUE
1.Dir
ectmethod
2.Submaximalexerci
setesti
ng
3.RPE

FI
ELDMETHOD
1.Di
stance-basedwalkandruntest
sn
2.Ti
me-basedwal korruntest
s
3.YMCAst ept est

DEFI
NITION:
Cardi
orespi
rat
oryfi
tnessisrelat
edtotheabil
i
tyt
operformlar
gemuscl
e,
dynamic,
moderate-
to-hi
ghintensi
tyexer
cisef
orpr
olongedperi
ods.

 Per
formanceofsuchexerci
sedependsont
hefunct
ional
stat
eoft
her
espi
rat
ory
,
car
diovascul
ar,
andskel
etalmuscl
esyst
ems.

NEEDFORASSESMENT:
Car
diorespir
ator
yfit
nessisconsi
deredheal
th-
rel
atedbecause-
-
(a)Lowlevel
sofCRf it
nesshavebeenassociat
edwithamarkedlyi
ncr
easedri
sk
ofprematuredeat
hf r
om al
lcausesandspecifi
cal
l
yfrom car
diov
ascul
ardi
sease

(b)Incr
easesi
nCRf
it
nessar
eassoci
atedwi
thar
educt
ioni
ndeat
hfr
om al
l
causes.

(c)Highlev
elsofCRfi
tnessar
eassoci
atedwi
thhi
gherl
evel
sofhabi
tual
physi
calact
ivi
ty,
whi
chinturnar
eassoci
atedwi
thmanyheal
thbenef
it
s.

(d)TheassessmentofCRf
it
nessi
sani
mpor
tantpar
tofapr
imar
yorsecondar
y
prevent
ionprogr
am.

TheConceptofMaxi
malOxy
genUpt
ake
  Maxi
mal oxy
genupt
ake(
VO2max)i
saccept
edast
hecr
it
eri
onmeasur
eofCR
f
it
ness.

 Maximal oxy genuptakeistheproductofthemaxi mal car

diacoutput(L
bl
ood·min-1)andar t
eri
al-
venousoxygendifference(mLO2perLbl ood).
Si
gnif
icantv ariati
oninVO2maxacr osspopul ati
onsandf i
tnesslevel
sresul
ts
pr
imaril
yf rom differ
encesinmaximal car
diacout put
;ther
efore,
VO2maxi s
cl
oselyrelatedt othefunct
ional
capacityofthehear t
.

ASSESMENTOFCARDI
ORESPI
RATORYFI
TNESS

 LABORATORYTECHNI
QUE
 FI
ELDMETHOD

LABORATORYTECHNI QUE
4.Directmet
hod
5.Submaximalexerci
set
est
ing
6.RPE

1.Directmet hod
Open- ci
rcui
tspirometryisusedtomeasureVO2max.I nt
hisprocedure,t
he
subjectbreathesthr
oughal ow-r
esi
stanceval
vewithhis/
hernoseoccl uded
(orthroughanonl at
exf oam mask)whil
epulmonaryventi
lat
ionandexpi r
ed
fract
ionsofoxy gen(O2)andcarbondioxi
de(CO2)aremeasur ed.Moder n
automat edsystemspr ovi
deeaseofuseandadet ai
ledpri
ntoutoftestresul
ts
thatsavet i
meandef fort
.

Adv
ant ages
-provi
desabet t
erest i
mateofVO2max .
-Thecostsassoci atedwi t
htheequi pment,space,andper sonnel
needed
tocar r
youtt heset ests,di
rectmeasur ementofVO2maxgener al
l
yis
reservedforr esearchorcl i
nicalsett
ings.
-maximal exer ci
set esti
ngoffersincreasedsensit
ivi
tyinthediagnosi
sof
coronaryarter ydiseaseinasy mptomat ici
ndivi
duals
-Theuseofopenci rcui
tspir
omet ryduringmaximal exer
ci set
esti
ng
all
owsf ortheaccur ateassessmentofanaer obicthresholdandthe
measur ementofVO2max.

Di
sadvant
ages
-Requi
ri
ngpar
ti
cipant
stoexer
ciset
othepoi
ntofv
oli
ti
onal
fat
igueand
 mightrequi
remedicalsuper
visi
onandemergencyequi
pment.
-
Thecost sassoci
atedwitht
heequipment
,space,andper
sonnel
needed
t
ocar r
youtthetests

2.Submaxi
malexer ci
set ests
 Thebasi cai m ofsubmaxi mal exer ciset est i
ngist odet erminethe
HRr esponset ooneormor esubmaxi mal wor kratesandusest he
resultstopr edictVO2max
 Al thought hepr imar ypur poseoft het esthast raditi
onal l
ybeent o
predictVO2maxf rom t heHR- wor kloadr elationship,i
tisi mpor t
ant
toobt ainaddi tional indicesoft hecl i
ent '
sr esponset oexer cise.
 Thepr act i
tionershoul duset hev ar i
oussubmaxi mal measur esof
HR, BP, wor kload, ratingofper ceivedexer ti
on( RPE) ,andot her
subject i
vei ndicesasv aluableinfor mat ion
 Submaxi mal f
ieldt estsar ebasedont her elati
onshipbet ween
exercisei ntensi t
yandt hebody ’
sr esponset ophy sicalexer t
ion( e.
g.,
exercisehear trate) .
 Submaxi mal t
est sar ebasedonhear tr ater esponsest ost eady-
stateaer obi cexer ciset hatismoni toredbyaski ngt heat hleteor
cli
entt omai ntainacer tainintensi ty(e.g.,awal kingorr unning
pace) .

Adv
ant
ages
 Cardior
espirat
oryfi
tnessprovidesagenerali
ndicati
onofheal
thand
theabil
it
yoft heheart,
lungs,andmusclestouseoxy gen
 Assesani ndivi
dual
’saerobicenduranceper
formanceandthe
abil
it
ytorecov eraf
teraboutofhi gh-
int
ensi
tyexerci
se.

FI
ELDTESTS

 Thesel
ectionofaspeci ficcardiorespir
atoryfi
tnesstestisbasedon
1.t hety peofactivi
tytheathleteorcli
entwilldointhesubsequentt
rai
ning
program
2.t helengt hofthetest(withlongerdurati
onsordi st
ancesgiv
ingabett
er
i
ndicat orofaerobicendurance
3.whet herthetestiscontinuousorintermitt
ent
4.t hetrainingstat
usoft heper sonbeingtested.

Theassessment
scoveredi
nasf ol
lows-:
1.20-
metermulti
-st
ageshuttl
erun(orPACERorbeept
est
)(31,
55,
59)
2.Yo-
Yointermi
tt
entrecover
ytest(
6,59)
 3.Distance-
basedwal kandruntests
4.Ti
me- basedwal korr untest
s(12- mi
nutetest
)
5.Submaxi malstept estorYMCAst eptest
6.Submaxi malrowinger gometertest
7.45-secondsquatt est(orRuff
ier-
Dicksontest
)
DISTA

DI
STANCE-
BASEDWALKANDRUNTESTSNCE-
BASEDWALKAND
RUNTESTS

Purpose
Dist
ance-basedwalkandruntest
sprovi
demeasur
esofcar
dior
espi
rat
oryf
it
nessusi
ng
conti
nuousf i
xed-
dist
ancepr
otocols.

Outcomes
Time,i
nseconds,
neededt
ocov
ert
hei
ntendeddi
stance;
est
imat
edmaxi
mal
aer
obi
c
capaci
ty

EquipmentNeeded
Trackormeasuredcour
se;
conesormar
ker
s;measur
ingt
ape;
stopwat
chort
imi
ng
device

Procedur e
Placethemar kersthesel ecteddistanceapart(1.5miles[2.
4km]wi l
lbeusedf orthis
explanation),cl
ear l
ydesignat i
ngameasur edcourseandast art
ingli
ne.I fa400- meter
(437.5y d)trackisusedi nsteadofa440- y
ardtrack,r
emembert oaccountf orthe2.3-
met er(2.5y d)di
fferencef oreachlapt obecompl et
ed.Forexampl e,t
he1. 5-mile
run/walkr equir
est heathleteorclienttocomplete6f ulll
apsona440y dtr
ack, or6ful
l
l
apsandanaddi tional13.8met ers( 2.
3met er
s×6l aps)ona400- met er(437.5y d)t
rack.
Ast andardizedwar m- upfollowedbyt hreetofi
vemi nutesofrestandr ecoveryshould
beconduct edpriortobegi nningt
heassessment .

Pr otocol
1.Begi ntheprocedurebysay ingtot heathl
eteorcli
ent
:“Wear egoingtomeasur ehow
quicklyyoucanr unorwal k1.5mi les(2.4km).Areyoureadytobegin?Ifso,pl
ease
standbehi ndthestart
ingl ine.”
2.Next ,expl
ain:“
WhenIsay‘ Go,’r
un( orwalkorjogasneeded)asf astaspossibl
eto
compl etethetest.
”
3.Ver ball
ysignalt
heat hleteorcl i
ent“3,2,1,go,
”andrecordhowmucht i
mei srequi
red,
tothenear estsecond,tocov ertheintendeddist
ance.Atall
ysystem orcounti
ngdevice
shouldbeusedt oaccur atelycountthenumberofl apscompl et
ed.
AfterYouFi nish
Thet i
mer equiredtocov ertheselecteddi stanceisthefinalresult
.Todet er
minetimein
minut esfrom seconds, divi
det henumberofsecondsby60.Thef oll
owingdistance-
specificformul ascanbeusedt oest imatemaxi malaerobiccapacity(
VO2max; i
n
ml/kg/ min):
One- mile(1.6km)r un/ walkformul as;dev elopedusing18-to25- year-
olds(14):
Mal es
VO2max=( -9.06×t i
mei nmi n)+( 0.38×( timei nmin)2)+98. 49
Femal es
VO2max=( -6.04×t i
mei nmi n)+( 0.22×( timei nmin)2)+82. 2
Asanexampl e, awomanwhot akes9mi nut es(540secondsdi vi
dedby60)t ocov er1
mile(1.6km)hasanest i
mat edmaxi mal aer obi
ccapacityof:
VO2max=( -6.04×9mi n)+( 0.
22×( 9mi n)2)+82. 2
VO2max=- 54.36+( 0.22×81)+82. 2
VO2max=- 54.36+17. 82+82. 2=45. 7ml / kg/min

TIME-
BASEDWALKORRUNTESTS
TI
ME-
BASEDWALKORRUNTESTS

Purpose
Time-basedwal
korrunt
estsprov
idemeasur
esofcar
dior
espi
rat
oryf
it
nessusi
nga
conti
nuousfi
xed-
ti
meprotocol
.

Outcomes
Dist
ancecover
ed,
inmil
es(oryar
ds)orki
l
omet
ers(
ormet
ers)
,wi
thi
nthesel
ect
edt
ime
fr
ame; est
imat
edmaxi
malaerobi
ccapaci
ty

EquipmentNeeded
Trackormeasuredcour
se;
conesormar
ker
s;measur
ingt
ape;
stopwat
chort
imi
ng
device

Procedur e
Determinet heselectedtimef rame,whichwilll
ikelybeinfl
uencedbyt hespaceavai
lable
andt hetraini
ngstatusoft heat hl
eteorcli
ent,withlongerdi
stancesbeingbetter
tol
eratedbyt rai
nedi ndi
vidualsthanlesstrai
nedi ndivi
dual
s.
Clearlydesignateameasur edcourseanduseconesormar kerstoidentif
yevenl
y
spacedi nterval
distances.
Ast andardizedwarm- upfollowedbyt hreetofi
v emi nut
esofrestandr ecover
yshould
beconduct edpri
ort obeginningtheassessment .

Prot
ocol
1.Begintheprocedur
ebysay
ingtotheathl
eteorcl
ient
:“Wear
egoi
ngt omeasur
ehow
faryoucanrunorwalkin12minut
es.Areyoureadytobegi
n?I
fso,
pleasest
andbehi
nd
thestar
ti
ngline.
”
2.Next,expl
ain:“
WhenIsay‘ Go,’
run(orwalkorjogasneeded)asfaraspossi blefor12
minutestocompl etethetest
.”
3.Verball
ysignaltheathl
eteorcl
ient“3,
2,1,go,
”andrecordthedi
stancecov ered,
to
thenearest50met ers(55yd)wit
hinthesel
ectedti
mef r
ame.At al
l
ysy stem orcounting
devi
ceshoul dbeusedt oaccurat
elycountt
henumberofl apscompleted.

Af terYouFinish
Thet otaldi
stancecoveredwi
thintheselect
edti
mef r
amei sthefi
nalr
esul
t.Toconver
t
thedi st
ancecov er
edfrom meterstokil
ometer
s,di
vi
det henumberofmetersby1,
000,
ortoconv ertthedist
ancecoveredfrom yar
dstomil
es,divi
dethenumberofyar
dsby
1,760.

Thefoll
owingformul
ascanbeusedtoest
imat
emaxi
mal
aer
obi
ccapaci
ty(
VO2max;
in
ml/kg/min):
12-
mi nut
er un/
walkf
ormulas
VO2max=( 22.
35×dist
ancei
nkm)-11.28
VO2max=( 35.
97×dist
ancei
nmi)-11.
28

SUBMAXI
MALSTEPTEST

YMCASTEPTEST

Purpose
Thesubmax i
malst
eptestorYMCAsteptestprov
idesameasur
eofcar
dior
espi
rat
ory
fi
tnessusi
ngaconti
nuousfi
xed-
cadenceprot
ocol.

Outcomes
Recover
yhear
trat
einbeat
spermi
nut
e;est
imat
edmaxi
mal
aer
obi
ccapaci
ty

Equi
pmentNeeded
Asturdybench,step,
orboxwit
hahei
ghtof16.
25i
nches(
41.
3cm)
;ti
mingdev
ice;
metronome;heartrat
emonit
or

Pr
ocedur
e
Setametronometoei
ther88beat
sperminut
e( apaceof22st
epsperminut
e)f
or
womenor96beatsperminut
e(apaceof24stepsperminut
e)formen.

Pr
otocol
1.Begi ntheprocedur ebysayingtotheathlet
eorclient:
“Wear egoingtomeasur
e
yourheartrateafteryoucompl et
eat hr
ee-minut
est eptest
.Arey oureadyt
o
begin?Ifso,pleasestandinfrontofthebench.”
2.Next ,explai
n:“WhenIsay‘ Go,’st
artbysteppi
ngupwi thonef ootfol
l
owedbythe
 otherfootandt hensteppingdowni nthereverseorder.Youmayst artwithei
ther
footast heleadf oot,andift hatlegbecomest i
red,f
eel f
reet ochanget othe
otherfootast heleadfoot.Doy ourbestt omakeeachst epint i
mewi ththe
audibl
esi gnal provi
dedbyt hemet r
onome.Pl easestayint hestandingpositi
on
withbothf eetont hegr oundwhi l
eImeasur eyourheartratebypl aci
ngmy
fi
ngersony ourneckorwr ist.”
3.Verball
ysi gnal t
heathleteorcl ient“3,
2, 1,go,
”andmoni torthattheathl
eteor
cli
entcansaf elykeepupwi ththemet ronomepace.I ftheat hlet
eorcl i
entcannot
maintainther equiredpacef ol
lowingencour agement,stopt hetestandconsi der
analternativeassessment .Appr oxi
mat el
y5secondsaf terthetestisfi
nished,
measur eandr ecordthe15- secondpul secount .
T
Aft
erYouFi ni
sh
The15-secondpul
secountmeasuredattheendofthetesti
sthef
inal
resul
t.Mul
ti
ply
thi
sval
uebyf ourt
ocalcul
atehear
trat
einbeatsperminute(
bpm),whi
chcanbeused
toest
imatemaximalaerobi
ccapaci
ty.

Seethefollowingf ormulasthatwer edevelopedi

nhealt
hy,youngadult
s:
Women; inml /kg/mi n
VO2max=65. 81-( 0.1847×hear tr ateinbpm)
Women; inml /kg/mi n
VO2max=111. 33-(0.42×hear trat einbpm)
Forexampl e,awomanwhocompl etesthesubmaximal st
eptestwit
hani mmedi
ate
postexer
cisehear trateof120beat spermi nute(
a15-secondpulsecountmul
ti
pli
edby
4)hasanest imatedmaxi malaerobi ccapacityof
:
VO2max=65. 81-( 0.1847×120bpm)
VO2max=65. 81-22. 16=43. 65ml /kg/minW

ENTY-

REFERENCES:
1. ACSM’
sgui
del
i
nesf
orexer
ciset
est
ingandpr
escr
ipt
i 8thedi
on, ti
on

2. Amer
icancol
l
egeofspor
tsmedi
ci
ne.ACSM gui
del
i
nes

3. Assesmentf
orspor
tsandat
hlet
icper
for
mance,
byDav
idH.Fakuda

4. Phy
sical
fit
nessandwel
l
ness,
byJer
rol
dS.GREENBERG.