Discussion Board Questions
QUESTION 1
Part I
One example of a test protocol is Bruce Test Protocol. It is used as a diagnostic test in the assessment of cardiac function, and can be used to test cardiovascular fitness.
In the article Exercise testing of pre-school children using the Bruce treadmill protocol: new reference values, the protocol is most commonly used on children and adults. The article compares half Bruce protocol with Bruce treadmill protocol (H, Monique et al, 2010). The half Bruce protocol is used for children due to the huge increments in workload in the Bruce treadmill protocol.
The study acquired that the original Bruce Protocol, which was applied to children between the ages of 4 and 5 years, were noted to have reduced maximal exercise capacity. The study was undertaken in Netherlands and evidence supported this claim. The endurance period for the original and half-Bruce protocol cannot be exchanged. Hence research recommends the use of the initial Bruce protocol in little children and accord them the chance to acquire guardrail for effective maximal performance to be acquired.
A learning impact acquired was through extended endurance period when children undertook another test. Researchers acquired that high test-retest reproducibility was in the Bruce protocol in school children around 10 years old (H, Monique et al, 2010). The article suggests that children aged 4 and 5 are more receptive to habitual walk on a treadmill. The tests were not acquired from new reference values with no prior Bruce treadmill protocol experience.
In the research, gas exchange was not assessed. In a clinical setup, there are no metabolic cart. Additionally, the use of tools like masks and mouth piece may scare children. Researchers reported a strong connection between maximal endurance and oxygen intake.
Importance
The testing protocol offers details on exercise capacity and enables evaluation of attributes, effectiveness of medication and threats that arise due to possible disease (H, Monique et al, 2010). Considering that children quite under-developed in knee area, treadmill testing is significant over others.
Other Cardiovascular Testing Protocol
Balke Test treadmill is another clinical test that can be used to acquire optimum VO2 in cardiac patients. This comprise of patients walking on treadmill at a set time and speed.
Part II
Time taken 9 minutes for sedentary men.
VO2 max = 14.8 – (1.379 × T) + (0.451 × T²) – (0.012 × T³) = 30.17 mls/kg/min
Program
The patient will be assessed at the start and end of the program for six weeks training. The Bruce protocol is applied for assessing the cardiovascular endurance (Brianmac, 2014). The sit-up test is applied to assess the dynamic endurance of the abdomen muscles, standing long jump is applied to test his power, sit and touch, trunk lateral flexion, hypertension, rotation and bending tests are used to test the patient’s flexibility. There is another 20m shuttle run test and 10- step stair climbing tests applied to tests his power and quickness. This is in addition to cycle breathing and aerobic training on the treadmill.
QUESTION 2
Part 1
An example of muscular fitness testing protocol is the abdominal straight test – straight leg lift. The main objective of this test is to project the extent of abdominal strength (Suzuki, et al, 1999). Poor muscle strength in the abdominal area can lead to poor posture that result to lower back pain.
The article Assessment of Abdominal Muscle Contractility, Strength, and Fatigue focusses on the abdominal muscle contractibility through assessing the twitch gastric pressure that proceeds the supramaximal electrical stimulation of the abdominal wall prior and after sit-ups (Brianmac, 2014). The paper acquires that the twitch gastric pressure is a vital sign of abdominal muscle contractibility and fatigue, when one undertakes maximal voluntary expulsive maneuvers the muscles are not completely activated, and the sit-ups bring about major low-frequency fatigue but limited high frequency fatigue of the muscles that has reduced impact on maximal breathing capacity.
The abdominal muscles are the main expiratory muscles. While at rest they are play a role in ventilation when required like exercising as well as inspiratory and expiratory loading. It is noted that patients that have extensive obstructive pulmonary diseases have contracting abdominal muscles in expiration. This goes on even while resting (Elbasan, et al., 2012). Fatigue comes in when the muscles are loaded leading to a decline to the ability to cause a decline in performance. This problem has been managed through an override volition through stimulating the abdomen using electrodes. This form of stimulation was noted to be quite effective. The paper assessed the abdominal muscle strength through twitch gastric pressure using supramaximal stimulation.
Importance
The twitch gastric pressure as a way to assess the abdominal muscles strength, was noted to be of great use in measuring the contractibility of the abdomen. From this, it appeared to be a good way to know the strength of the abdomen.
Other Muscular Fitness Testing Protocol
The Isometric Back Strength Test is another method that can be used to test muscular strength. The test assesses the back strength which is vital in core firmness and for safe guarding lower back pain.
Part II
A 25 year old man going for 20 successive push-ups is in the average range.
Program
• The man will have to warm up for 10 minutes
• The man lies down on the floor, place his hands on his shoulder and makes his arms to be straight. This will be how he starts.
• He then lowers his body until his elbows get to a 90 degrees position and then extends his arms to go back to his starting position.
• He will do this progressively daily for six weeks.
QUESTION 3
Part 1
A Body composition testing protocol is body mass index. It is a measure of body composition and is computed by computing the weight of an individual and dividing it by his or her height squared. If the figure is bigger, then the person is termed to be over-weight.
The article Body Mass Index and Body Composition Measures by Dual X-Ray Absorptiometry in Patients Aged 10 to 21 Years with Spinal Cord Injury talks about how to know the body composition of patients with spinal cord injury with the help of body mass index (BMI) (M. Craig et al, 2007).
The paper recognizes obesity as a predictor of morbidity and mortality as arising from the task it does due to chronic diseases like cardiovascular diseases. A good number of studies show that studies applied body mass index as a way to assess obesity. However, the method has not been applied in assessing the body composition of children with the same condition.
The basis of the study was that children with conditions that arise from SCI could have major contrasts in their body composition when evaluated using DXA in comparison to able-bodies tools. Precisely, children were noted to have extensive reduced lean tissue mass and major fat mass when compared to age and BMI-matched controls (M. Craig et al, 2007). These would make the BMI aspects like sensitivity to be bigger in able-bodied persons and people with SCI.
Importance
The body mass index is significant as it is a simple method that calls for the assessment of height and weight.
Other Body composition testing protocol Method
The skinfold thickness is a test that measures the body composition and fat percentage. This is done in certain parts of the body (M. Craig et al, 2007). It relies on formulas that show the percentage of fat for a person of a certain age and gender. It may vary with regard to the type of skinfold test protocol applied.
Part II
The accuracy in measuring the percentage body fat using the body pod is high. This makes the values acquired to be correct (M. Craig et al, 2007). The patient with 32% in body fat is an average measure.
Program
A vital program for fat reduction would be;
• A diet plan – this would call for management of macronutrients like protein, fats and carbohydrates
• A cardiovascular program – this connects with dietary aspects that burns fat
• A weight training program – this reduces the general mass based on adipose tissue. It should be no longer than 45 minutes.
QUESTION 4
Part 1
The sit and reach test is an example of the flexibility testing protocol and assesses the flexibility of the lower back and hamstring muscles (M. Kristin, 2010). This is test is vital as the tightness of the lower back is implicated to the lumbar lordosis, forward pelvic and lower back pain.
The article Modifications to the Standard Sit-and-Reach Flexibility Protocol talks about the varied modifications to the standard sit-and-reach protocol. A good number of exercises are meant to elevate the size of strength and aerobic size is bound to lower the flexibility of the spinae and hamstrings (E. Laurence, et al., 1999). Patients that do flexibility that are below the recommended may suffer from injury as they train or daily activities. The most common method to acquire flexibility has been the sit-and-reach that is based on a single measure. The flexibility can be measured using a multitest flexometer.
The sit and reach test and its modifications can be applied by athletic trainer as a way to measure some muscle groups. The passive changes can bring more details regarding the inert tissues and connect with the sit and reach test. Moreover, it can be used by a trainer to know if the manual therapy, and delicate tissue mobilization are relevant therapeutic needs to add mobility and if it is, the methods of benefit would be applied (E. Laurence, et al., 1999). Good examples being muscle energy, active exercise and massage.
Importance
The sit-and-reach test protocol gives the user an indirect assessment of the impact brought by the four major muscle groups that influence the sit-and-reach figures: hamstrings and spinae among others.
Other Flexibility Test Protocol
The Calf Muscle Flexibility Test is an indirect flexibility tests for the calf muscle that calls for limited facilities (E. Laurence, et al., 1999). It uses the tape measure or ruler to measure.
Part II
The female has weak core muscles that limits her lumbar range of motion.
Program
The patient has to stay active, avoid positions and actions that elevate the back pain. When the pain reduces one should undertake gentle strengthening exercises for the stomach, back and legs as well as stretching activities (M. Kristin, 2010). This would useful to recover faster, safeguard re-injury on the back and limit the threat of disability from back pain.
References
Brianmac (2014). Press Up Test. Retrieved on 1st January 2014 from: http://www.brianmac.co.uk/pressuptst.htm
E. Laurence, et al. (1999). Modifications to the Standard Sit-and-Reach Flexibility Protocol. Journal of Athletic Training 34(l):43-47.
Elbasan, B. et al. (2012). Effects of chest physiotherapy and aerobic exercise training on physical fitness in young children with cystic fibrosis. Ital J Pediatr. 38(2).
H, Monique et al (2010). Exercise testing of pre-school children using the Bruce treadmill protocol: new reference values. European Journal of Applied Physiology, 108 (2), pp 393-399.
M. Craig et al (2007). Body Mass Index and Body Composition Measures by Dual X-Ray Absorptiometry in Patients Aged 10 to 21 Years With Spinal Cord Injury. J Spinal Cord Med.30(Suppl 1): S97–S104.
M. Kristin (2010). Review for the generalist: evaluation of low back pain in children and adolescents. Pediatr Rheumatol Online J. 8(28).
Suzuki, J. et al (1999). “Assessment of Abdominal Muscle Contractility, Strength, and Fatigue”. American Journal of Respiratory and Critical Care Medicine, 159 (4), pp. 1052-1060.
