Tests of functional diagnostic

In base of functional diagnostic in sports medicine there are different physical load tests. These tests are carried out by sports doctor for person’s physical work capacity and the estimation and assessment of fitness level and giving recommendations.
Sports achievements depend on 3 major body systems which limit possibility to do or to continue physical load. These 3 systems have to work together simultaneously and effectively:
1. the cardiovascular system – provides blood supply and oxygen transport
2. the breathing system – provides oxygen uptaking and carbon dioxide elimination out of the body
3. the body muscles which are involved in physical work with muscle weakness, pain, energy reserve and the activity of ferments systems
The physical work capacity and the functional abilities of the body mostly limit the functional possibilities of the cardiovascular system and the breathing system.

Functional diagnostic can be done for reasons:
■ Evaluate heart and lung function
■ Identify unexplained shortness of breath
■ Detect and evaluate heart diseases or failure
■ Aid in developing an exercise program (the reasons of testing please look below)

The most popular diagnistics tests in SPORTS LABORATORY are:
Complex cardiopulmonary exercise test- physical load stress test »»»
Calorimetry- metabolism intensity assessment test »»»


COMPLEX CARDIOPULMONARY EXERCISE TESTING

Image description Complex cardiopulmonary exercise testing (Veloergometry or treadmill test with breathing gases analysis and pulse oximetry) is now the 'gold standard' for evaluation of the function of cardiovascular and breathing systems, the physical work capacity of the body. The physical work capacity and the functional abilities of the body mostly limit the functional possibilities of these two systems.
Complex cardiopulmonary exercise testing is a modern and objective method of evaluating the functions of cardiovascular and breathing systems during the rest and the increase physical load, the recovery time and it is totally non-invasive method.
This method allows estimating person’s real health condition, fitness level; providing individually optimal physical load; giving full information for activity or sports training regime recommendations and assessing potential possibilities of the body in the future.
The electrocardiography shows the electrical activity in your heart. During the exercise, the sports doctor will carefully watch the ECG for any evidence of heart problems such as: a heart rate that is too fast or too slow, irregular heartbeats (arrhythmia) or changes in the shape of the ECG complex. Image descriptionThese changes may mean the areas of your heart are not getting enough blood flow during the exercise due to narrowed or diseased arteries in your heart (changes in the coronary blood flow, the heart valve functions, etc.).
During the testing the analyses of breathing gases is used as compact and quick method. The oxygen will be transported from the lungs via the pulmonary circulation and the systemic circulation, but the carbon dioxide will be transported to the lungs via the systemic circulation and the pulmonary circulation. At the same time the increase in requirement will be met by the same pathway. Different metabolic pathways have different features on gas exchange. It is possible to identify aerobic metabolism, anaerobic metabolism and indeed the intracellular response to exercise during the Complex cardiopulmonary exercise testing study. Cellular respiration is connected to external respiration via the cardiovascular and pulmonary systems. The limiting factors of oxygen and carbon dioxide transporting are the cardiac function (cardiac output adequacy), the effectiveness of ventilation (volumes), the state of the vascular system (if there is widespread vascular disease), the pulmonary vascular and finally the actual intracellular metabolic pathways (if the oxygen and substrate are being utilized). All these questions can be answered by Complex cardiopulmonary exercise testing.
During the testing there are measured maximal aerobic capacity and as well as the point where aerobic metabolism is changed to anaerobic metabolism as a source of energy. Anaerobic threshold is very accurately measured via gas exchange data.
The test is done in a controlled and safe situation. This method is also used for the evaluation of disability. Many people, who suffer from exercise intolerance, may notice less decrement in their normal daily activities. During the rest condition tests may not be indicated for the severity of the loss in their abilities. There is a strong relationship between functions of the body and symptoms of exercise intolerance.

What are the advantages?

The advantages of Complex cardiopulmonary exercise testing over conventional veloergometry or stress tests are that Complex testing measures the all functional parameters of the body during the exercise including: the qualitative and quantitative parameters of cardiovascular and breathing systems and assess exercise intolerance.
Conventional stress tests only look at a patient's electrocardiogram during the exercise.

Who can be tested?

Complex cardiopulmonary exercise testing offers a host of benefits for many people. It may be used in all age groups. Complex cardiopulmonary exercise testing may be used to indicate whether a health problem is psychological or physiological; evaluate the cardiovascular or pulmonary diseases. Cardiac and respiratory function may be evaluated dynamically by exercise Veloergometry, spirometry and blood pressure control simultaneously. This method detecting exercise induced asthma as well as restrictive and obstructive lung disease. If you do sport or decide to start it you definitely have to consult with sports doctor and make Complex cardiopulmonary exercise testing.
Complex cardiopulmonary exercise testing can be done for a variety of reasons:
■ Once a year for the full prophylactic health control
■ Several times per year for the estimation of dynamic of health condition, fitness level, the adequacy of training regime or the necessity of food supplements during the load or recovery (vitamins, mineral substances, micronutrients, sports nutrition and drinks)
■ If you are 30 or over and you haven’t done full prophylactic health check up
■ If you usually have a big physical (hard work, competitions) and emotional load (stress)
■ If you haven’t done any physical activity during the last 3 years and you would like to start to do sport
■ If you have some chronic disease (s), complains about your health in everyday life or during and after the physical activity, for example:
--- Complains about self-feeling:
> Daily bad self-feeling and / or fatigue
> Big stress at work and in social life
> Real tiredness or complains after some physical activities
> Overload (physical, emotional, stress)
> White triangle around your mouth during the physical load

--- Complains about cardiovascular system:
> Heart disease (s) or it had been for some of your closest relatives
> High blood pressure
> Intermission, arrhythmic or fast heart beating
> Any pain in chest, “region of heart” (e.g. burning, stabbing, constriction of the chest, myocardial ischemia, etc.)
> Dizziness or the losing consciousness during the rest or physical load
> If you haven’t had ECG record with doctor consultation during the last 3 years
> High cholesterol level in the blood

--- Complains about breathing system:
> Lung and / or breathing system disease (s)
> Bronchial asthma
> Shortness of breath, difficult breathing, dyspnoea
> Determining health condition and guide pulmonary and cardiac rehabilitation
> One of the best ways of evaluating health condition and fitness of athletes.

Sports / fitness testing

Complex cardiopulmonary exercise testing is well suited for evaluating athletes (health condition, physical work capacity) and assessing methods of improvement. Athletes can also gain information about their real level of fitness.
For athletes, Complex cardiopulmonary exercise testing can determine the peak performance and guide training programs. This type of testing is utilized by many professionals and Olympic athletic teams in different kinds of sport.
Each group of athletes has different types of training and physical requirements, and evaluations should be made frequently at each stage of their progression. In some Olympic sports selection of team members may be based on these cardiopulmonary exercise test results.

Remember!

The best result can reach only in cooperation between sports doctor, sports coach and sportsman. Sports doctor estimates health condition and the possibilities of the body, but sports coach makes optimal training regime and sportsman accomplishes and realizes.

How do you prepare?

Take with you your medical paper with doctor written diagnosis or results of blood analyses. If you don’t have we will take analyses after the testing.
Bring the complete list of all medications that you are.
Wear comfortable sportswear and boots and take with you a towel for a shower.
DO NOT perform any heavy exercise for 24 hours before the test.
NO alcohol for 24 hours before the test.
DO NOT eat for 2 hours before the test.
NO coffee, tea, caffeinated beverages for 6 hours before the test.
NO cigarettes or other tobacco products for 6 hours before the test.
If you use a fast-acting inhaler, BRING IT WITH YOU. You may need to use it before or after your test.

How is the test done?

A cardiopulmonary exercise test is performed at SPORTS LABORATORY to set definite protocols.
The testing is done on the one of the modern cardiopulmonary test systems in doctor’s office with all necessary equipment and medicine for emergency help and first aid.
The person is exercised preferably on a bicycle ergometer; is connected to computerised 12 lead ECG, the blood pressure cuff and face mask with sensors for breathing gases analysis. The inspired and expired gases are continuously sampled and analysed for amount of oxygen consumption and carbon dioxide production. A blood pressure cuff is placed on one arm and pulse oximetry clip placed on a finger. A blood pressure will be taken before you start and about every 2 minutes until you have completed the test.

Complex cardiopulmonary exercise test consists of 4 phases:
■ Rest phase – all measurements are noted and recorded during the rest
■ Reference phase - the person is asked to pedal the ergometer in constant speed
■ Load phase – the resistance of bicycle ergometer continuously increasing every minute by 10 watts. You will be asked to report any discomfort such as chest pain, chest pressure or shortness of breath.
■ Recovery phase – load decrease and after 2 minutes pedalling the person must stop and continue sit on a bicycle ergometer.

The test lasts usually around 20-45 minutes in total. The test may be stopped if the individual cannot longer continue to exercise or when the sports doctor has gathered medical indications (abnormal ECG changes, too high blood pressure, other significant symptoms) or enough information (reached peak heart rate).
At the end of the test, the bicycle will gradually slow down and you will be assisted to a chair or bed. Your ECG and blood pressure will continue to be monitored for additional 6-8 minutes or until you don’t have serious changes in the data and your ECG is normal.
No blood tests are performed during the testing routinely, but it is possible (lactate).
Then the test results are analysed by sports doctor during the consultation.

If you have any questions or would like some information / consultation, call +37167523042; +37126557425. We will be happy to answer to all your questions.


METABOLISM TESTING - CALORIMETRY

Image description Image descriptionMetabolism in the body pass in the oxidation process and each kind of nutrients (proteins, carbohydrates, fats) give fixed amount of energy.
Calorimetry is equally efficient and accurate metabolism analysis method which measures the energy expenditure during the rest and increase physical load.
The goal of this method is to assess necessary energy for the body function ensuring; during the daily activities and the different physical activities. It is based on precise gas volume and concentration measurements of the breathing system.
Sedentary lifestyle, overweight and obesity have become a big problem for large part of the world population. Mostly overweight and obese conditions are the consequence of wrong eating habits. The most important thing is to provide balance between the food intake and the energy expenditure which consists of Basal metabolism, Metabolism induced by lifestyle and Metabolism induced by physical activity.
Calorimetry and balanced Food plan allow to estimate of chosen diet adequacy.
The expenditure of daily energy depends on physical activity, involving amount of muscles and emotional stress.
Sedentary lifestyle and food with excessive energetic value enable the deposition of energy reserve as subcutaneous fat or internal fat around organs of the body. It gives negative effect on the weight of the body – overweight and if the lifestyle has not been changed also obesity.
Calorimetry also helps people with reduced weight because they usually eat food with too low energetic value and the body is short with nutrients, vitamins and mineral substances.
During the test there is estimated the rest energy expenditure and the physical load intensity in which the energy processes of the body involve mostly fat reserve. For the body weight correction Calorimetry allows to estimate of optimal physical load, training intensity and frequency according to the person’s health condition and metabolism intensity.

Who can be tested?

Calorimetry testing may be used in all age groups for both genders.
Metabolic testing can be done for a variety of reasons:
■ Sedentary lifestyle and person’s wish to change it
■ Overweight or obesity
■ Reduced weight
■ Detect and evaluate possibilities of regulation of the body weight and increase person’s involvement and knowledge about himself / herself
■ Complains and diseases which cause sedentary lifestyle and wrong eating habits
■ Work out balanced food plan
■ Estimation of necessary amount of daily energy
■ Estimation of optimal physical load for the reduction of fat reserve
■ Aid in related psychological problems

How the Calorimetry is done?

Calorimetry is performed at Sports laboratory to set definite protocol.
Metabolism measurements are noted and recorded during the all Calorimetry phases:
1. Rest lying phase
2. Rest sitting phase
3. Load phase – the person is asked to sit on the bicycle ergometer and to pedal the ergometer in constant speed. The resistance of bicycle is increased slowly but continuously. You will be asked to report about any complains or discomfort such as chest pain, chest pressure or shortness of breath.
4. Recovery phase – load decrease and after 2 minutes pedalling the person must stop and continue sit on the bicycle.

The person is connected to computerised 12 lead ECG, the blood pressure cuff and face mask with sensors for breathing gases analysis. The inspired and expired gases are continuously sampled and analysed for oxygen consumption and carbon dioxide production.
The test usually lasts around 30 minutes in total. The test may be stopped if the individual can no longer continue doing exercise or when the doctor has enough information (reached all metabolism measurements).
All the test results are then analysed by doctor at consultation.

If you have any questions or would like some information / consultation, call +37167523042; +37126557425. We will be happy to answer to all your questions.

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