Exercise testing
Recommendations for the exercise testing The evaluation of the cardiorespiratory function The physical training requires the interaction of physiological mechanisms that allow the cardiovascular and respiratory systems to supply the increasing demand of energy due to the contraction of the muscles. During the training the systems are both engaged, an adequate answer to the effort is the measure of theirs health state.
It’s very important acquire information on the patient’s clinical past before performing the test. Keep attention in particular way to the use of drugs, tobacco, to the physical fitness and symptoms produced with the exercise. Patient assent The patient is informed that he will be submitted to a maximum effort, which could be stopped at any moment, and of the risks of the test execution.
Real time test Before starting exercise test type a new patient information or choose one from the list of patient in the file. As soon as a patient has been entered the software is ready to start a test. The name of the active patient is shown on the status bar of the program window. Start a test Start the test as described in the chapter Operating modes. If you use the device in Holter mode, please skip this until Data management.
Manual protocol If you are using the K4 b2 with a treadmill without serial interface, it is possible to enter manually from the PC the event, the phase and the marker. sss Tip: pressing the Shift key while choosing the marker option will allow you to enter the label for that marker. Enter Load and Phase 1. 2. During the test select Load from the Events menu. Select the phase and/or type the value of the load and press OK to confirm. Set the markers Select Marker from the Events menu.
Data management As soon as the test has been completed or downloaded, all data stored can be retrieved for a complete management. Viewing data Data can be viewed in the following formats: Table form numeric values of the various parameters (columns) corresponding to each step (rows). Graphic form graphical presentation on Y1, Y2, X charts. Summary results of the test and statistical analysis of the blocks. Predicted predicted values, maximum value measured. View data in table form 1. 2.
sss Note: Double-click in the graph window to open the edit test Right-clicking, the graph can be exported in bmp file format. Customise the graphs 1. 2. With a graph on the screen, choose Customise graph from the View menu. On the Customise graph dialog box, select options to obtain the wished graph. Option Function Grid on X, Y axes show the grid lines in correspondence with x or y axes that make the graph easier for you to analyse data.
Viewing predicted values For some parameter it is possible to compare the maximum value measured during the test with its predicted value and the LT value both in percentage and absolute. View predicted values Choose Predicted from the View menu. Anaerobic (Lactate) Threshold detection The software allows to detect the Lactate Threshold (Anaerobic Threshold) according to the "Modified V-slope method" reference. The LT can be detected both manually and automatically.
Fittings The purpose of the fitting function is to find the function that fits as better as possible the measured data. The software allows to fit data according to 3 different functions: Model Function Algorithm Available for Linear Y=A*X+B Least squares Any Y vs any X graph Mono-Exp Y=A+B*exp[(t-t0)/tau] Levemberg Marquardt Any Y vs Time Graph Mean value This function is available only if the active window is a single Y graph (i.e. VO2 vs time or VO2 vs Load). Fit a graph with a linear regression 1.
Calculate the "Mean Value" 1. 2. 3. 4. 5. 6. Make active the graph window (any Y vs any X graph). Right-click and select Fitting. Choose Mean value in the type combo box Select the first point (X1) moving the mouse on the desired place in the graph pressing the Left key or using the + and – keys. Select the second point (X2) moving the mouse on the desired place in the graph pressing the Right key or using the + and – keys. Press OK to confirm.
Information about the Test The Test Information dialog box shows all the information concerning environmental data, patient data and some data about the test View the Information Choose Information from the View menu. Modify the information 1. Press the Modify button on the Information dialog box. 2. Change the values you want to modify and press OK to confirm. The software allows to assess the energy expenditure and metabolism substratum.
Print the current window 1. 2. 3. Be sure that the current active window is the graph or the report you desire to print. Select Print current window from File menu. Press OK to print, or Setup to customise the print. Print the report 1. 2. 3. Select the report to be printed from File menu. Press OK to print, or Setup to customise the print. To only view the report, without printing it, press Shift during the selection. View the report This function allows to show a preview of a selected report. 1.
Data Editing The software allows the user to edit the data acquired during the test in the following ways: sss Nota: In Data view, doubleclick in the window to enter in “Data Editing”. • deleting one or more steps • editing row data • input new parameters • data filtering (averaging or smoothing) • advanced data elaboration After data elaboration it is always possible to restore the original data file by pressing the Restore button .
Using the User fields The software is provided with three free fields in which the user may enter values coming from others devices such as lactate, blood pressure etc. To define the user fields: 1. Choose User Fields from the Options menu 2. Type the desired text in the input fields and press OK. To enter values in the user fields: 1. Choose Edit test from the Test menu. 2. Scroll horizontally until the fields USER 1, 2 and 3. 3. Enter the desired values and press OK to confirm.
Apply to Specifications Parameter >, >=, =, <, <=, <> specifies the reference parameter higher than, higher or equal, equal to, lower than, lower or equal, different specifies the value (mathematical expression) compared with the value of the specified parameter. do not use any selection criteria. Value/Formula… All steps Restore the original test To cancel all the editing, in the "Edit Test" dialog box press the Restore button, confirm your choice by pressing yes.
Customise the parameters The software allows the user to create customised parameters and predicted values, derived from the standard parameters (the ones that are calculated by default) through any mathematical formula. All the customised parameters can be used freely for viewing and printing purposes. Create a new parameter 1. 2. 3. 4. Choose Customise parameters from the Options menu.
Exporting data With this function you can export the tests data and parameters in different file formats: • *.xpo (Cosmed proprietary file format) • *.txt (ASCII) • *.xls (Microsoft Excel) • *.wk1 (Lotus 123) Export a test 1. 2. 3. 4. Choose Export Tests from the Test menu. Select the test to export from the list box and press OK to confirm. Select the file output format from the list box, click on *.xpo, *.txt, *.xls or *. wk1.
Creating Test Protocols The software allows to create different exercise protocols to use during the test. The load of the ergometer is automatically controlled by the software that change it according to the defined protocol. Create a new protocol 1. 2. 3. 4. 5. 6. 7. 8. 9. 2 88 - K4 b User Manual Choose Real Time > Ergom. Tests Protocols from the Options menu. Press New and enter a name for the protocol.
Software configuration The software can be customised as you wish. Most of the feature are easily editable to be tailored according to different purposes. Data viewing The software allows to calculate a huge number of parameters; it is advisable, in order to simplify the analysis of the results, view in the data window the only desired parameters. Select the parameters to view 1. 2. 3. Choose Parameters to view/Test visualisation… from the Options menu. Select the parameters you require to view.
Printout reports The software allows the user to printout data and graphics according to 4 customisable reports. Further it allows the user to customise a printout header that will be printed in each page. Set up the printout 1. 2. 3. Choose Reports from the Options menu. Define the desired features of the report and confirm. Enabling the option "Graphs in one page" all the graphs selected in the report will be printed in one page. Type the name you want apply to the report and press OK to save changes.
Electronic reports (*.pdf) If an Adobe PDF writer “Printer Driver” is installed and set as the default printer, it is possible to store the printout report automatically in any location of the HD or eventually LAN paths according to a customizable filename format. It is possible to define the created filename format selecting Options/Printout header..., and then Name format… Print the current window The print current window function is enabled when the active window is a graph or a data report. 1.
Events management during exercise testing By using K4 b2 in serial mode, beside standard measurements, the software allows also to save some extra "events". They are so called "events" since they are not continuously stored during the test but they can be saved upon user selection. Flow Volume loops This test is useful during exercise to detect abnormalities in the mechanics of ventilation in patients with pulmonary/ventilatory limitations to exercise.
O2 Saturation (optional) The O2 Saturation event is useful to check the quality of SpO2 signal acquired by the onboard Oxymeter (if available) during the test. O2 Saturation during the test 1. 2. 3. Start with normal Exercise test and begin the memorisation of breath values (F2). Select O2 Saturation from Test/Event... As soon as 5 or 6 complete pulses have been acquired press F3 to stop the acquisition. Spirogram The spirogram event allows to display and store the volume/time plot.
Save Raw data 1. 2. 3. 4. 2 94 - K4 b User Manual During the test choose Event from Events menu. Select Raw Data from the list. On the save data box give a name to the file and select the destination folder. To stop saving Raw data press the stop icon or press F3 on the keyboard.
