Exercise Testing

How does everyone assess increase in functional capacity? Currently we are looking at either an increase in 6MWT by 10% OR an increase in peak METs from 3rd session and discharge by 40%.

Does anyone actually look at symptom limited GXT pre and post? If so, what protocols do you use?

For those who look at increase in peak METs from 3rd session and discharge, how do you navigate all the "issues" that come up - such as, pt changing modality throughout the course of the program, etc?

Thank you!

We try to get pre and post functional GXT for everyone who is capable. We’re in the process of figuring out better practices to get metrics for everyone else. I want to follow this discussion to see what other folks do.

Megan,

We do both 6mwt increase of 10% and MET by 40% from the 3rd session. These are parameters the AACVPR recommends for certification for measuring functional capacity. Also, in response to your question regarding patients switching modalities throughout the program and assessing Met level. Whatever modality the patient originally had MET measured on, should be the same modality that is remeasured at the end of their program. This is also an AACVPR recommendation. We usually always measure on the treadmill. If the patient does not use the treadmill due to mobility issues, then we will use the NuStep.

Amy - I'd love to hear more about your process/protocol. Is this the first/second/third time the patient is getting on this modality? What RPE do you have them target? I want my team to be more intentional going forward so wanting to get an understanding of what everyone else is doing. Thanks!