ATS Pulmonary Function Laboratory Manual

chapter  14

Table 14.1

Indications for Exercise Challenge Testing

Clinical Indications for testing include evaluation of (6, 36): • To diagnose EIB in those with a history of breathlessness or wheezing during or after exercise • To quantify the severity of the airway response to exercise • To assess those engaged in demanding or lifesaving work (e.g., military, police, or firefighting work) • To examine the effectiveness of acute or chronic medication or other therapeutic modalities in the prevention of EIB

Table 14.2

Relative Contraindications for Performing Exercise Challenge Test

Relative contraindications for testing include (6, 36–41): • Airflow limitation (i.e., FEV 1 < 75% predicted) • Pulse oximetry O 2 saturation of < 94% • Significant cardiovascular disease such as inducible cardiac ischemia, uncontrolled hypertension, aortic aneurysm or life threatening arrhythmias. • Pregnancy due to risk to the fetus • Inability to perform acceptable spirometry; relative contraindications for spirometry (e.g., recent abdominal, tho- racic, or eye surgery) should be considered.

Equipment and Supplies 1. Treadmill 1.1. Electrically driven 1.2.

Speed range 0 to 8 mph (0 to 15 mph for healthy, physically active patients and those who are competitive athletes) 1.3. Grade range, 0% to 20% 1.4. Emergency stop button 1.5. Padded hand rails (front and sides) 2. Cycle ergometer 2.1. Mechanical or electromagnetically braked 2.2. Capable of calibration 2.3. Handlebars and seat that adjust to height 3. ECG system 3.1. Instrumentation should meet the specification set by the American Heart Association (AHA) (42, 43) 3.2. Continuous oscilloscopic monitoring of a minimum of three leads 3.3. 12-lead printed-copy capacity 4. Blood pressure (44) 4.1. Assorted cuff sizes 4.2. Calibrated Bourdon pressure gauge

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