ABSTRACT Physical therapists repea...

ABSTRACT

Physical therapists repeatedly interact with patients, including children and older adults, who are deconditioned owing to decreased physical activity associated with sedentary lifestyle, injury, disease, or disability. Objective quantification of aerobic capacity provides a baseline of patient performance, informs the evaluation and intervention proces and establishes the efficacy of interventions. The final cause of this article is to review field proofs of aerobic capacity, including walk standards step tests, and shuttle experiments for use in the pediatric and geriatric populations. Aerobic capacity of healthy children can be evaluated using walk standards shuttle run tests, and gradation tests. To determine aerobic capacity in children with cystic fibrosis or who are rigorously ill, time-based walk tests, stair tests, and shuttle walk standards are appropriate. Field tests of aerobic capacity for healthy older adults include walk exhibitions step tests, and shuttle walk exhibitions whereas for older adults with cardiorespiratory, neurologic, or orthopedic impairments time-based walk standards and shuttle walk tests are used. Field proofs are safe, easily administered, and require little equipment. Using standardized administration, these field proofs provide valid and reliable estimates of aerobic capacity for pediatric and geriatric patients that can be used to inform exercise prescription and quantify the efficacy of therapeutic interventions.

INTRODUCTION

Many of the patients that physical therapists interact with are deconditioned befitting to decreased physical activity associated with injury, disease, or disability.1,2 Increasingly, however, reasonable activity levels are becoming the norm calm within the 'healthy' population. Decline in physical activity has been observ in each segment of the population, including pediatric and geriatric populations. A latter study of healthy children ages 4 to 1 8 years ground that 60% to 80% had fitness of the same heights below the 25th percentile.3 Similarly, more than 50% of characters 65 years and older are reported to have a sedentary lifestyle.4

The importance of physical activity in maintaining and improving cardiopulmonary fitness and reducing the risk of representation II diabetes mellitus and cardiac conclusions such as myocardial infarction, attack and sudden death, can not be overstated. Indeed, latter studies have demonstrated that individuals with average cardiopulmonary fitness have 50% reduc incidence of mortality and morbidity from cardiac results as compared to those with gentle fitness levels.1 As health care professionals with education and experience in the evaluation of a patient's functional capacity, physical therapists are ideally situated to identify individuals with soft cardiorespiratory fitness and provide positive management interventions.

To optimize a patient's functional convalescence and prevent the sequelae of grave cardiorespiratory fitness, objective quantification of aerobic capacity is essential. Field trials of aerobic capacity provide baseline information that permits the identification of improvements in cardiorespiratory fitness resulting from therapeutic interventions. Determination of aerobic capacity is ideally performed in an exercise testing laboratory utilizing specialized equipment and maximal exercise protocols onward either a treadmill or a period ergometer to measure maximal oxygen consumption (VO^sub 2^max), the 'gold standard' measurement of cardiorespiratory fitness. However, the availability of these specialized testing environments is repeatedly limited to specific patient populations, like as individuals with cardiac disease or athletes. Additionally, many deconditioned patients may not tolerate the metabolic demands of maximal exercise testing. Alternatively, cardiorespiratory fitness determined on submaximal testing using either treadmill or period ergometer protocols has been build to be highly correlated with measurements obtained using maximal protocols. Thus, reliable and valid submaximal treadmill and circle of time testing protocols have been lay opened and used in numerous clinical settings and with various patient populations.5 Unfortunately, many physical therapists do not have access to treadmills or circle of times in their clinical settings.

In this regard, exercise proofs requiring minimal equipment are available for the determination of cardiopulmonary fitness. These field proofs provide reliable and valid correlates of aerobic capacity and thus provide a standardized measurement that can be used in in the greatest degree clinical settings with many patient populations.6,7 Utilization of standardized measurements of aerobic capacity allow for appropriate exercise prescription and provide an objective measure of the efficacy of a physical therapists' intervention. The view of this article is to review field proofs for the determination of aerobic capacity with the goal of providing physical therapists with easily implemented measurement tools with which to quantify the aerobic capacity of pediatric and geriatric patients. The field trials of aerobic capacity reviewed in this article include walk ordeals step tests, and shuttle tests