Exercise Stress Test

Description

Several guidelines recommend an exercise stress test to further clarify results. This is because an asymptomatic arterial lesion in the lower limbs may become symptomatic after induced stress. Essentially, the procedure is used to differentiate between vascular disorders and their severity.

Exercise stress tests can be performed in different ways together with TOPP, PVR or ABI measurement protocols. Patients with reduced movement capacities can be assessed using a passive stress test.

Measurement Principle

Before performing the exercise, a regular TOPP, PVR or ABI test should be conducted on the patient to acquire reference values. After completion, the patient is asked to perform specific movements, such as toe tip stands (calf indication), knee bends (thigh and hip indication) or treadmill (for determination of the walking distance). The exercise must be performed under medical guidance and should provoke the physical complaint.

After the exercise, the patient should take a lying position with the measurement cuffs applied on the ankles. The cuffs will inflate to and maintain the highest ankle amplitude recorded before the stress test. On the measurement screen, a dotted line marks the amplitudes before exercise, which the patient should recover to. Once the initial pulse wave amplitudes are reached, the test can be completed, and the recovery time is documented.

The recovery time can be interpreted as follows:

Almost initial amplitudes after 20 to 30 seconds à no indication for PAD.
No amplitudes at the beginning but recovery within 1 minute à good compensation of a possible occlusion.
No amplitudes at the beginning and recovery within 2 to 3 minutes à bad but sufficient compensation of a possible occlusion.
Recovery time of more than 5 minutes à insufficient compensation of a possible occlusion.

For patients with limited motility, a passive stress test can be conducted by performing a suprasystolic compression on thighs in lying position for three minutes. Afterwards, recovery time can be recorded.

Main Parameters

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Table of Contents

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