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Case Study: Health Screening and Analysis and Interpretation of GXT Data

I have attached a file with a case study and questions to be answered I have answered several of them I need to know if the ones I answered are correct ( my answers are in red on the attachment) and there are 4 I didn't answer #'s 12, 13, 14 & 15 that I need answered. I also need to know if the VO2 and Mets calculations are correct in the GXT testing results.

Case Study: Health Screening and Analysis and Interpretation of GXT Data
Purpose: The purpose of this lab is to introduce the student to case study review of simple analysis of health histories and the interpretation of GXT testing results. Because many of the procedures introduced in this lab are utilized in the interactive on-line course, it is recommended the student complete this lab first before attempting the on line course.

Situation: John is a 38-year-old archeologist whose job requires some walking and hiking when he is collecting data in the field. However, much of his time is spent analyzing artifacts in the laboratory and writing research reports in his office. He is thinking about joining the employee fitness program at work, and therefore contacted you to evaluate his health risk and aerobic fitness level. His last medical examination was 3 months ago. You gave him a GXT using a Bodyguard cycle ergometer (wheel size = 3 m/rev) and collected the following data:

Brief Health History
Client: 38-year-old male Resting BP: 131/92 mmHg
Resting HR: 71 bpm Total cholesterol: 210 mg • dl-1
Height: 5 ft 10 in. (177.8 cm) HDL-cholesterol: 30 mg • dl-1
Body weight: 180.8 lb (82 kg) Smoking history: 1 pack per day
Waist Circumference: 42 inches
Activity interests: cycling Physical activity: job-related walking/hiking

GXT Testing Results
Stage Min Work rate (kgm/min) HR BP RPE VO2 Mets
1 1 180 110
2 180 115
3 180 119 168/92 7 Need to know Vo2 Need to know mets
2 4 360 130
5 360 136
6 360 138 180/90 13 Need to know Vo2 Need to know mets
3 7 540 151
8 540 158
9 540 163 215/88 16 Need to know Vo2 Need to know mets

Questions
1. On the basis of demographic data, evaluate this client's CHD risk profile. Given his CHD risk classification, did a physician need to be present during the GXT?
2. On the basis of the client's health history, identify the client's coronary heart disease risk factors.
3. Based on the client's health history is the client at risk for metabolic syndrome?
4. Based on the client's resting BP, determine his BP classification.
5. Determine the subject's age predicted maximum heart rate (MHR).
6. Determine the subject's heart rate reserve (HRR).
7. Review the recorded BP responses during testing. Determine if the SBP and DBP responses with increased exertion were normal.
8. Review the recorded HR responses during testing. Determine if the HR responses to increased exertion were normal.
9. Determine if steady state in HR was reached in each test stage.
10. Determine how hard the client perceived he was working based based on his reported RPE.
11. Determine if the subject reached termination criteria for a submax GXT using both HRR and %MHR criteria.
12. Calculate the energy cost of each workload (three stages) using the ACSM leg ergometry formula. Convert ml • kg-1 • min-1 to METs for each stage.
13. Determine the client's predicted VO2max using the multistage equation method?
14. Determine the client's predicted VO2max using the single stage formula?
15. What is this client's CR fitness classification?
16. Use the Karvonen (%HRR) method to identify the target HR zone. Use 50% to determine his minimum exercising HR and 85% to determine his maximum exercising HR).
17. What lifestyle changes do you recommend for this client?
18. Determine the client's BMI and classification of Disease Risk Based on BMI and Waist Circumference
19. Compute the client's TC/HDL Ratio and determine if it is normal.

Solution Preview

Questions
1. On the basis of demographic data, evaluate this client's CHD risk profile. Given his CHD risk classification, did a physician need to be present during the GXT?
• Yes

I am using the risk calculator for having heart disease based on the patient's demographic data, The relative risk for having CHD is high based on his smoking habits. Based on his blood pressure, he had a high relative risk of having CHD. Based on his total cholesterol and HDL cholesterol, he had a very high risk of having CHD.
2. On the basis of the client's health history, identify the client's coronary heart disease risk factors.
• Resting BP 131/92= Pre- Hypertension
• Total Cholesterol 210 mg *dl-1 = High
• Smoker
• Obese
• Does not get recommended exercise
• Low HDL
Smoker Relative Risk: high
Total cholesterol 210 mg/dl moderate
HDL cholesterol 30 mg/dl very high
Blood pressure 131/ 92 mmHg High

3. Based on the client's health history is the client at risk for metabolic syndrome?
• Yes
4. Based on the client's resting BP, determine his BP classification.
• Pre- Hypertension

Correct , according the classification chart of blood pressure:
Category Systolic ( mm Hg) Diastolic ( mm Hg)
Normal Lower than 120 Lower than 80
Prehypertension 120-139 80-89
Hypertension
Stage 1 140 - 159 90 -99
Stage 2 160 or higher 100 or higher

So both of his systolic and diastolic pressure ...

Solution Summary

The Cardiovascular respiratory fitness is the ability to perform dynamic exercise involving large muscle groups at moderate to high intensity for prolonged periods. It is determined by the VO2 max. Those are fit have higher V02 max values and can exercise more intensely than those who are not.

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