Exercise tolerance test in pulmonology.
DOI:
https://doi.org/10.35954/SM2000.22.1.5Keywords:
Ergometric Functional Capacity; Power Developed; Aerobic Functional Capacity; Metabolic Equivalent; Exercise Limitation; Respiratory Reserve; Cardiac Reserve.Abstract
In our country, the exercise test was underused in the study of patients with respiratory disorders, in clear contrast to what occurs with cardiology patients. In fact, the concept prevailed that it is a highly complex, costly and long-lasting test. In order to demonstrate the erroneous nature of this position, a review is made of its fundamentals, instrumentation and usefulness of the test. A simple non-invasive test was selected, based on the determination of ergometric capacity in a similar way to the study of myocardial metabolism performed by cardiologists. The symptoms that make it necessary to stop exercise are evaluated and the physiological variations that accompany them are measured. This makes it possible to elaborate different functional patterns corresponding to the failure of the different systems that are integrated during exercise. In contrast to spirometric tests, exercise allows to discover early changes in lung function. Therefore the test should be indicated early. Its late use when the patient can only perform minor exertion adds little to the baseline study. An adequate choice of the load increment allows the test to be performed in an interval of 8 to 12 minutes of duration. At the end, some examples were selected to show the approach to different conditions or abnormal clinical situations. The procedure is generally safe, provided that the contraindications for its performance and the indications for its termination are complied with. The proposed method is a pathophysiological diagnostic model that is easy to apply in clinical practice. Its use increases diagnostic safety from a quantitative (exercise tolerance) and qualitative (identification of the cause limiting exercise) point of view.
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