How to Interpret a CRF Assessment – Key Measures that Provide the Best Picture of Health, Disease Status and Prognosis

Journal article

Ozemek, C., Hardwick, J., Bonikowske, A., Christle, J., German, C., Reddy, S., Arena, R. and Faghy, M. 2024. How to Interpret a CRF Assessment – Key Measures that Provide the Best Picture of Health, Disease Status and Prognosis. Progress in Cardiovascular Diseases. 83, pp. 23-28. https://doi.org/https://doi.org/10.1016/j.pcad.2024.02.014
AuthorsOzemek, C., Hardwick, J., Bonikowske, A., Christle, J., German, C., Reddy, S., Arena, R. and Faghy, M.
Abstract

Graded exercise testing is a widely accepted tool for revealing cardiac ischemia and/or arrhythmias in clinical settings. Cardiopulmonary exercise testing (CPET) measures expired gases during a graded exercise test making it a versatile tool that helps reveal underlying physiologic abnormalities that are in many cases only present with exertion. It also characterizes one's health status and clinical trajectory, informs the therapeutic plan, evaluates the efficacy of therapy, and provides submaximal and maximal information that can be used to tailor an exercise intervention. Practitioners can also modify the mode and protocol to allow individuals of all ages, fitness levels, and most disease states to perform a CPET. When used to its full potential, CPET can be a key tool used to optimize care in primary and secondary prevention settings.

KeywordsExercise testing; Cardiorespiratory fitness; Cardiopulmonary
Year2024
JournalProgress in Cardiovascular Diseases
Journal citation83, pp. 23-28
PublisherElsevier
ISSN1873-1740
Digital Object Identifier (DOI)https://doi.org/https://doi.org/10.1016/j.pcad.2024.02.014
Web address (URL)https://www.sciencedirect.com/science/article/pii/S0033062024000331?casa_token=B1eT3CV30bgAAAAA:_tcPqDPas7vE6MHvHdFBBFh0KwRasDJ-xOpDa1SJ4UCAcN_wmhdM_0GwiaanA8f5x2BmUk9p9g
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Online28 Feb 2024
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Accepted2024
Deposited12 Aug 2024
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Yessica Abigail Tronco Hernández, Fabio Parente, Mark A Faghy, Clare M P Roscoe, Frances A Maratos and Faghy, M. 2021. Influence of the COVID-19 Lockdown on the Physical and Psychosocial Well-being and Work Productivity of Remote Workers: Cross-sectional Correlational Study (Preprint). JMIR. https://doi.org/10.2196/preprints.30708
The need for exercise sciences and an integrated response to COVID-19: A position statement from the international HL-PIVOT network
Arena, Ross, Stoner, Lee, Haraf, Rebecca H., Josephson, Richard, Hills, Andrew P., Dixit, Snehil, Popovic, Dejana, Smith, Andy, Myers, Jonathan, Bacon, Simon L., Niebauer, Josef, Dourado, Victor Z., Babu, Abraham S., Maden-Wilkinson, Thomas M., Copeland, Robert J., Gough, Lewis A., Bond, Sam, Stuart, Kaz, Bewick, Thomas, Ashton, Ruth E.M. and Faghy, Mark 2021. The need for exercise sciences and an integrated response to COVID-19: A position statement from the international HL-PIVOT network. Progress in Cardiovascular Diseases. 67, pp. 2-10. https://doi.org/10.1016/j.pcad.2021.01.004
The Effects of a Nutrition Education Intervention on Sports Nutrition Knowledge during a Competitive Season in Highly Trained Adolescent Swimmers.
Foo, Wee Lun, Faghy, Mark A, Sparks, Andy, Newbury, Josh W and Gough, Lewis A 2021. The Effects of a Nutrition Education Intervention on Sports Nutrition Knowledge during a Competitive Season in Highly Trained Adolescent Swimmers. Nutrients. 13 (8). https://doi.org/10.3390/nu13082713
Cardiorespiratory and skeletal muscle damage due to COVID-19: making the urgent case for rehabilitation
Silva, Rebeca Nunes, Goulart, Cássia da Luz, Oliveira, Murilo Rezende, Tacao, Guilherme Yassuyuki, Back, Guilherme Dionir, Severin, Richard, Faghy, Mark, Arena, Ross and Borghi-Silva, Audrey 2021. Cardiorespiratory and skeletal muscle damage due to COVID-19: making the urgent case for rehabilitation. Expert Review of Respiratory Medicine. 15 (9), pp. 1107-1120. https://doi.org/10.1080/17476348.2021.1893169
Educators Perspectives on the Value of Physical Education, Physical Activity and Fundamental Movement Skills for Early Years Foundation Stage Children in England.
Dobell, Alexandra, Pringle, Andy, Faghy, Mark and Roscoe, Clare M P 2021. Educators Perspectives on the Value of Physical Education, Physical Activity and Fundamental Movement Skills for Early Years Foundation Stage Children in England. Children. 8 (5), p. 338. https://doi.org/10.3390/children8050338
Cardiopulmonary exercise testing as a vital sign in patients recovering from COVID-19.
Arena, Ross and Faghy, Mark A 2021. Cardiopulmonary exercise testing as a vital sign in patients recovering from COVID-19. Expert review of cardiovascular therapy. 19 (10), pp. 877-880. https://doi.org/10.1080/14779072.2021.1985466
Current and Future Implications of COVID-19 among Youth Wheelchair Users: 24-Hour Activity Behavior.
Conners, Ryan T, Bates, Lauren C, Lassalle, Patricia Pagan, Zieff, Gabriel, Whitehead, Paul N, Stevens, Sandra, Killen, Lauren, Cochrum, Robert, Rodebaugh, Kathryn L, Stoner, Lee and Faghy, Mark A 2021. Current and Future Implications of COVID-19 among Youth Wheelchair Users: 24-Hour Activity Behavior. Children. 8 (8). https://doi.org/10.3390/children8080690
COVID-19 infection and cardiometabolic complications: short- and long-term treatment and management considerations
Stoner, Lee, Faghy, Mark and Conners, Ryan 2021. COVID-19 infection and cardiometabolic complications: short- and long-term treatment and management considerations. Reviews in cardiovascular medicine. 22 (2), pp. 263-265. https://doi.org/10.31083/j.rcm2202031
Physical activity and sedentary behavior in people with spinal cord injury: Mitigation strategies during COVID-19 on behalf of ACSM-EIM and HL-PIVOT
Bates, Lauren, Conners, Ryan, Zieff, Gabriel, Adams, Nathan, T., Edgar, Kyle, M., Stevens, Sandra, Faghy, Mark, Arena, Ross, Vermeesch, Amber, Rodney, Joseph, P., Keith, Nicole and Stoner, Lee 2021. Physical activity and sedentary behavior in people with spinal cord injury: Mitigation strategies during COVID-19 on behalf of ACSM-EIM and HL-PIVOT. Disability and Health Journal. 15 (1). https://doi.org/10.1016/j.dhjo.2021.101177
Current activities centered on healthy living and recommendations for the future: a position statement from the HL-PIVOT network
Arena, Ross, Kaminsky, Leonard A., Williams, Mark, Sabbahi, Ahmad, Popovic, Dejana, Axtell, Robert, Faghy, Mark, Hills, Andrew P., Olivares Olivares, Silvia Lizett, Lopez, Mildred, Pronk, Nicolaas P., Laddu, Deepika, Samuel Babu, Abraham, Josephson, Richard, Whitsel, Laurie P., Severin, Rich, Christle, Jeffrey W., Zuniga Dourado, Victor, Niebauer, Joseph, Savage, Patrick, Austford, Leslie D. and Lavie, Carl J 2021. Current activities centered on healthy living and recommendations for the future: a position statement from the HL-PIVOT network. Current Problems in Cardiology. 46 (6). https://doi.org/10.1016/j.cpcardiol.2021.100823
A flow resistive inspiratory muscle training mask worn during high-intensity interval training does not improve 5 km running time-trial performance
Brown, Peter I., Faghy, Mark, Davis, Nichola, Mayes, JP and Maden-Wilkinson, Tom 2020. A flow resistive inspiratory muscle training mask worn during high-intensity interval training does not improve 5 km running time-trial performance. European Journal of Applied Physiology. 121, p. 183–191. https://doi.org/10.1007/s00421-020-04505-3
Using system mapping to help plan and implement city-wide action to promote physical activity
Cavill, Nick, Richardson, Debra, Faghy, Mark, Bussell, Chris and Rutter, Harry 2020. Using system mapping to help plan and implement city-wide action to promote physical activity. Journal of Public Health Research. 9 (3). https://doi.org/10.4081/jphr.2020.1759
Cardiopulmonary exercise testing in the COVID-19 endemic phase
Faghy, Mark, Hull, James, Cooper, Brendan and Sylvester, Karl 2020. Cardiopulmonary exercise testing in the COVID-19 endemic phase. British Journal of Anaesthesia. 125 (4), pp. 447-449. https://doi.org/10.1016/j.bja.2020.06.006
Cross validation of actigraph derived accelerometer cut‐points for assessment of sedentary behaviour and physical activity in children aged 8‐11 years
Duncan, Michael J., Eyre, Emma L.J., Cox, Val, Roscoe, C., Faghy, Mark, Tallis, Jason and Dobell, Alexandra 2020. Cross validation of actigraph derived accelerometer cut‐points for assessment of sedentary behaviour and physical activity in children aged 8‐11 years. Acta Paediatrica. 109 (9), pp. 1825-1830. https://doi.org/10.1111/apa.15189
Fundamental movement skills and accelerometer-measured physical activity levels during early childhood: a systematic review
Dobell, Alexandra, Pringle, Andy, Faghy, Mark and Roscoe, Clare M. P. 2020. Fundamental movement skills and accelerometer-measured physical activity levels during early childhood: a systematic review. MDPI AG. https://doi.org/10.3390/children7110224
A biopsychosocial framework for recovery from COVID-19
Stuart, K., Faghy, M.A., Bidmead, E., Browning, R., Roberts, C., Grimwood, S. and Winn-Reed, T. 2020. A biopsychosocial framework for recovery from COVID-19. International Journal of Sociology and Social Policy. 40 (9/10), pp. 1021-1039. https://doi.org/10.1108/ijssp-07-2020-0301
Integrated sports and respiratory medicine in the aftermath of COVID-19
Faghy, M., Ashton, R., Maden-Wilkinson, T., Copeland, R. J., Bewick, T. and Smith, A. 2020. Integrated sports and respiratory medicine in the aftermath of COVID-19. The Lancet Respiratory Medicine. 8 (9), p. p852. https://doi.org/10.1016/s2213-2600(20)30307-6
Calibration and cross-validation of accelerometery for estimating movement skills in children aged 8–12 years
Duncan, M., Dobell, A., Noon, M., Clark, C.T., Roscoe, C., Stodden, D., Sacko, R., Eyre, E. and Faghy, M. 2020. Calibration and cross-validation of accelerometery for estimating movement skills in children aged 8–12 years. Sensors. 20 (10), p. 2776. https://doi.org/10.3390/s20102776
Sodium bicarbonate ingestion improves time-to-exhaustion cycling performance and alters estimated energy system contribution: a dose-response investigation
Gurton, William H., Gough, Lewis A., Sparks, S. Andy, Faghy, Mark and Reed, Katharine E. 2020. Sodium bicarbonate ingestion improves time-to-exhaustion cycling performance and alters estimated energy system contribution: a dose-response investigation. Frontiers in Nutrition. 7. https://doi.org/10.3389/fnut.2020.00154
Inspiratory muscle training (IMT) for adults discharged from hospital with community acquired pneumonia (CAP) – a feasibility study
Pick, HJ, Faghy, Mark, Cresswell, G, Lim, WS and Bewick, T 2018. Inspiratory muscle training (IMT) for adults discharged from hospital with community acquired pneumonia (CAP) – a feasibility study. Thorax.
A review of inspiratory muscle training. When and why does it work?
Faghy, M. 2019. A review of inspiratory muscle training. When and why does it work? Japanese Journal of Physical Fitness and Sports Medicine. 68 (1), pp. 3-5. https://doi.org/10.7600/jspfsm.68.3
Functional training of the inspiratory muscles improves load carriage performance
Faghy, Mark and Brown, Peter I 2019. Functional training of the inspiratory muscles improves load carriage performance. Ergonomics. 62 (11), pp. 1439-1449. https://doi.org/10.1080/00140139.2019.1652352
Estimating physical activity in children aged 8–11 Years using Accelerometry: Contributions from fundamental movement skills and different Accelerometer placements
Duncan, Mike, Roscoe, Clare M. P., Faghy, Mark, Tallis, Jason and Eyre, Emma 2019. Estimating physical activity in children aged 8–11 Years using Accelerometry: Contributions from fundamental movement skills and different Accelerometer placements. Frontiers in Physiology. https://doi.org/10.3389/fphys.2019.00242
P25 Inspiratory muscle training (IMT) for adults discharged from hospital with community acquired pneumonia (CAP) – a feasibility study
HJ Pick, MA Faghy, G Cresswell, WS Lim, T Bewick and Faghy, M. 2018. P25 Inspiratory muscle training (IMT) for adults discharged from hospital with community acquired pneumonia (CAP) – a feasibility study. BMJ Journals. https://doi.org/10.1136/thorax-2018-212555.183
Active recovery strategy and lactate clearance in elite swimmers
Mark A. Faghy, Mitch Lomax and Peter I. Brown 2018. Active recovery strategy and lactate clearance in elite swimmers. The Journal of Sports Medicine and Physical Fitness. 59 (9), pp. 1487-1491. https://doi.org/10.23736/s0022-4707.18.09228-9
From startline to frontline: the application of respiratory exercise physiology to occupational performance
Faghy, Mark, Blacker, Sam D. and Brown, Peter I. 2017. From startline to frontline: the application of respiratory exercise physiology to occupational performance. Sport and Exercise Scientist.
Whole body active warm up and inspiratory muscle warm up do not improve running performance when carrying thoracic loads
Faghy, Mark and Brown, Peter I. 2017. Whole body active warm up and inspiratory muscle warm up do not improve running performance when carrying thoracic loads. Applied physiology, nutrition, and metabolism. 42 (8). https://doi.org/10.1139/apnm-2016-0711
Impact of Weekly Swimming Training Distance on the Ergogenicity of Inspiratory Muscle Training in Well-Trained Youth Swimmers
Lomax M, Kapus J, Brown PI and Faghy M 2017. Impact of Weekly Swimming Training Distance on the Ergogenicity of Inspiratory Muscle Training in Well-Trained Youth Swimmers. Journal of Strength and Conditioning Research. 33 (8), pp. 2185-2193. https://doi.org/10.1519/jsc.0000000000002375
Functional inspiratory muscle training (IMT) improves load carriage performance greater than traditional IMT techniques: 1652 Board #305 June 2, 9: 00 AM - 10: 30 AM.
Faghy, Mark, Lindley, Martin R. and Brown, Peter I. 2016. Functional inspiratory muscle training (IMT) improves load carriage performance greater than traditional IMT techniques: 1652 Board #305 June 2, 9: 00 AM - 10: 30 AM. Wolters Kluwer. https://doi.org/10.1249/01.mss.0000486377.59880.50
Pilot study : can inspiratory muscle training relieve symptoms ff dyspnoea and improve quality of life for advanced cancer patients ?: 1872 Board #24 June 2, 3: 30 PM - 5: 00 PM.
Lindley, Martin R., Faghy, Mark, Sowter, Heidi M. and Mickleborough, Timothy D. 2016. Pilot study : can inspiratory muscle training relieve symptoms ff dyspnoea and improve quality of life for advanced cancer patients ?: 1872 Board #24 June 2, 3: 30 PM - 5: 00 PM. Wolters Kluwer. https://doi.org/10.1249/01.mss.0000486545.72377.ea
Effects of load mass carried in a backpack upon respiratory muscle fatigue
Faghy, Mark, Blacker, Sam D. and Brown, Peter I. 2016. Effects of load mass carried in a backpack upon respiratory muscle fatigue. European Journal of Sport Science. 16 (8), pp. 1032-1038. https://doi.org/10.1080/17461391.2016.1202326
Limitations and trainability of the respiratory system during exercise with thoracic loads
Faghy, Mark 2016. Limitations and trainability of the respiratory system during exercise with thoracic loads. PhD Thesis https://doi.org/10.48773/92y02
Training the inspiratory muscles improves running performance when carrying a 25 kg thoracic load in a backpack
Faghy, Mark and Brown, Peter I. 2015. Training the inspiratory muscles improves running performance when carrying a 25 kg thoracic load in a backpack. European Journal of Sport Science. 16 (5), pp. 585-594. https://doi.org/10.1080/17461391.2015.1071878
Preloaded Time Trial to Assess Load Carriage Performance
Mark A. Faghy and Peter I. Brown 2014. Preloaded Time Trial to Assess Load Carriage Performance. Journal of Strength and Conditioning Research. 28 (12), pp. 3354-3362. https://doi.org/10.1519/jsc.0000000000000555
Thoracic load carriage-induced respiratory muscle fatigue
Faghy, M. and Brown, P.I. 2014. Thoracic load carriage-induced respiratory muscle fatigue. European Journal of Applied Physiology. 114, p. 1085–1093. https://doi.org/10.1007/s00421-014-2839-4
Ventilatory muscle strength, diaphragm thickness and pulmonary function in world-class powerlifters
Brown, Peter I., Venables, Heather, Liu, Hymsuen, de Witt, Julie T., Brown, Michelle R. and Faghy, Mark 2013. Ventilatory muscle strength, diaphragm thickness and pulmonary function in world-class powerlifters. European Journal of Applied Physiology. 113, p. 2849–2855. https://doi.org/10.1007/s00421-013-2726-4