(Circulation. 1995;91:580.)
© 1995 American Heart Association, Inc.
Articles |
Exercise Standards
A Statement for Healthcare Professionals From the American Heart Association
The purpose of this report is to provide revised standards and guidelines for the exercise testing and training of individuals free from clinical manifestations of cardiovascular disease as well as those with known cardiovascular disease. These guidelines are intended for physicians, nurses, exercise physiologists, specialists, technologists, and other healthcare professionals involved in the regular exercise testing and training of these populations. This report is in accord with the "Statement on Exercise" published by the American Heart Association in Circulation (1992;86:340-344).
These guidelines are a revision of the 1990 standards1 of the AHA that addressed the issues of exercise testing and training. An update of background, scientific rationale, and selected references are provided, and current issues of practical importance in the clinical use of these standards are considered.
Exercise Testing
The Cardiovascular Response to Exercise
Exercise, a common
physiological stress, can elicit cardiovascular
abnormalities not present at rest and can be used to determine the
adequacy of cardiac function. Because exercise is only one of many
stresses to which humans can be exposed, it is more appropriate to call
an exercise test exactly that and not a "stress test." This is
particularly relevant considering the increased use of nonexercise
stress tests.
Types of Exercise
Three types of muscular
contraction or exercise can be applied as
a stress to the cardiovascular system: isometric (static), isotonic
(dynamic or locomotory), and resistive (a combination of isometric and
isotonic).2 3 Isometric exercise, defined as a
muscular
contraction without movement (eg, handgrip), imposes greater pressure
than volume load on the left ventricle in relation to the body’s
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