SPORT AND EXERCISE PHYSIOLOGY TESTING GUIDELINES Sport and Exercise Physiology Testing Guidelinesis a comprehensive, practical sourcebook of principles and procedures for physiological testing in sport and exercise. Volume I: specific guidelines for physiological testing in over 30 sports disciplines. Volume II: guidelines for exercise testing in key clinical populations. Each volume also represents a full reference for informed, good practice in physiological assessment, covering: General Principles of Physiological Testing including health and safety, and blood sampling. Methodological Issuesincluding reliability, scaling and circadian rhythms. General Testing Procedures for lung and respiratory muscle function, anthropometry, flexibility, pulmonary gas exchange, lactate testing, RPE, strength testing and upper-body exercise. Special Populationsincluding children, older people and female participants. Written and compiled by subject specialists, this authoritative laboratory research resource is for students, academics and those providing scientific support service in sport science and the exercise and health sciences. Edward M. Winteris Professor of the Physiology of Exercise at Sheffield Hallam University. Andrew M. Jonesis Professor of Applied Physiology at the University of Exeter. R.C. Richard Davisonis Principal Lecturer in Exercise Physiology at the University of Portsmouth. Paul D. Bromleyis Principal Lecturer in Exercise Physiology at Thames Valley University and Consultant Clinical Scientist in the Department of Cardiology at Ealing Hospital, London. Thomas H. Mercer is Professor of Clinical Exercise Physiology and Rehabilitation, Department of Physiotherapy, School of Health Sciences, Queen Margaret University College, Edinburgh. SPORT AND EXERCISE PHYSIOLOGY TESTING GUIDELINES The British Association of Sport and Exercise Sciences Guide Volume II: Exercise and Clinical Testing Edited by Edward M. Winter, Andrew M. Jones, R.C. Richard Davison, Paul D. Bromley and Thomas H. Mercer First published 2007 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN Simultaneously published in the USA and Canada by Routledge 270 Madison Ave, New York, NY 10016 Routledge is an imprint of the Taylor & Francis Group, an informa business This edition published in the Taylor & Francis e-Library, 2006. “To purchase your own copy of this or any of Taylor & Francis or Routledge’s collection of thousands of eBooks please go to www.eBookstore.tandf.co.uk.” ©2007 Edward M. Winter, Andrew M. Jones, R.C. Richard Davison, Paul D. Bromley and Thomas H. Mercer for editorial material and selection. Individual chapters © the contributors. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging in Publication Data Sport and exercise physiology testing : guidelines : the British Association of Sport and Exercise Sciences guide / edited by Edward M. Winter ... [et al.]. — 1st ed. p. cm. Includes bibliographical references and index. 1. Physical fitness—Testing. 2. Exercise—Physiological aspects. I. Winter, Edward M. II. British Association of Sport and Exercise Sciences. GV436.S665 2006 613.7(cid:1)1—dc22 2006011234 ISBN 0-203-96683-X(cid:13)(cid:10) Master e-book ISBN ISBN10: 0–415–37965–2 (hbk) ISBN10: 0–415–37966–0 (pbk) ISBN10: 0–203–96683–X (ebk) ISBN13: 978–0–415–37965–6 (hbk) ISBN13: 978–0–415–37966–3 (pbk) ISBN13: 978–0–203–96683–9 (ebk) CONTENTS List of tables and figures ix Notes on contributors xiv Acknowledgements xvii Foreword by Sue Campbell xix Foreword by Clyde Williams xx Introduction 1 EDWARD M. WINTER, PAUL D. BROMLEY, R.C. RICHARD DAVISON, ANDREW M. JONES AND THOMAS H. MERCER PART 1 General principles 5 Rationale 7 EDWARD M. WINTER, PAUL D. BROMLEY, R.C. RICHARD DAVISON, ANDREW M. JONES AND THOMAS H. MERCER 1 Health and safety 11 GRAHAM JARMAN 2 Psychological issues in exercise testing 18 CRAIG A. MAHONEY 3 Blood sampling 25 RON MAUGHAN, SUSAN M. SHIRREFFS AND JOHN B. LEIPER 4 Ethics and physiological testing 30 STEVE OLIVIER VI CONTENTS PART 2 Methodological issues 39 5 Method agreement and measurement error in the physiology of exercise 41 GREG ATKINSON AND ALAN M. NEVILL 6 Scaling: adjusting physiological and performance measures for differences in body size 49 EDWARD M. WINTER 7 Circadian rhythms 54 THOMAS REILLY PART 3 General procedures 61 8 Lung and respiratory muscle function 63 ALISON MCCONNELL 9 Surface anthropometry 76 ARTHUR D. STEWART AND ROGER ESTON 10 Measuring flexibility 84 NICOLA PHILLIPS 11 Pulmonary gas exchange 101 DAVID V.B. JAMES, LEIGH E. SANDALS, DAN M. WOOD AND ANDREW M. JONES 12 Lactate testing 112 NEIL SPURWAY AND ANDREW M. JONES 13 Ratings of perceived exertion 120 JOHN BUCKLEY AND ROGER ESTON 14 Strength testing 130 ANTHONY J. BLAZEVICH AND DALE CANNAVAN 15 Upper-body exercise 138 PAUL M. SMITH AND MIKE J. PRICE PART 4 Clinical exercise physiology 145 16 Exercise testing for people with diabetes 147 PELAGIA KOUFAKI CONTENTS VII 17 Cardiac disorders 156 KEITH GEORGE, PAUL D. BROMLEY AND GREGORY P. WHYTE 18 Peripheral circulatory disorders 169 JOHN M. SAXTON AND NIGEL T. CABLE 19 Cardiopulmonary exercise testing in patients with ventilatory disorders 179 LEE M. ROMER 20 Exercise assessment for people with end-stage renal failure 189 PELAGIA KOUFAKI AND THOMAS H. MERCER 21 Physiological testing for neuromuscular disorders 199 DAVID A. JONES AND JOAN M. ROUND PART 5 Special populations 209 22 Children and fitness testing 211 GARETH STRATTON AND CRAIG A. WILLIAMS 23 Testing older people 224 JOHN M. SAXTON 24 Testing the female athlete 237 MELONIE BURROWS 25 Testing an aesthetic athlete: contemporary dance and classical ballet dancers 249 MATTHEW WYON Index 263 TABLES AND FIGURES TABLES 1.1 An example of a 3(cid:2)3 risk rating system 14 7.1 Circadian variation in muscle strength and power from various sources 56 9.1 Skinfold measurements 80 9.2 Girth measurements 81 11.1 Effect of a 1% increase in F O and F CO on the error E 2 E 2 incurred in the calculation of SO andSCO at three levels 2 2 of exercise intensity 106 11.2 Effect of measurement precision on the determined SO 2 for heavy intensity exercise with 45 s expirate collections 107 11.3 Total precision in the calculation of SO andSCO at 2 2 three levels of exercise intensity and for four collection periods 108 13.1 Summary of the relationship between the percentages of maximal aerobic power, maximal heart rate reserve, maximal heart rate and Borg’s rating of perceived exertion 121 14.1 Correlation between sprint running and selected test performances 134 14.2 Examples of equations used to calculate 1-RM lifting performances from multiple maximal repetitions 135 15.1 Recommended starting and increments in exercise intensity for graded arm crank ergometry tests 141 15.2 Recommended ranges of resistive loads to be used in association with an optimisation procedure linked to corrected peak power output 144 16.1 Plasma glucose levels for the diagnosis of diabetes and in impaired glucose tolerance state 148 17.1 Common congenital cardiovascular defects 163 17.2 Common inherited cardiovascular diseases 164 TABLES AND FIGURES IX 18.1 Interpretation of ABPI results 171 19.1 Discriminating measurements during exercise in patients with obstructive and restrictive ventilatory disorders 185 20.1 Absolute and relative contraindications to exercise testing in patients with ESRF 191 20.2 Special considerations for exercise testing of patients with ESRF 192 20.3 Reasons to terminate the exercise test 193 21.1 Summary of the main disorders and diseases affecting skeletal muscle, arranged according to their main presenting symptom 200 21.2 Possible investigations of muscle function in relation to symptoms of weakness and fatigue 204 22.1 Cut off points for girls and boys between age 5 and 18 years defined to pass through UK BMI 25 and 30 at age 19.5 years 216 22.2 The EUROFIT fitness test battery 220 23.1 Common tests of balance and agility in the elderly 231 24.1 Definitions for menstrual terms in female athletes 242 25.1 Peak strength values for quadriceps and hamstrings in dancers 252 25.2 Indices of anaerobic power in dancers and comparative indices from other sports 253 25.3 Maximal aerobic uptake of dancers, other selected sports and untrained individuals 254 25.4 Reported ranges of movement in dancers 255 25.5 Anthropometric data for dancers 258 FIGURES 2.1 Models of the stages of behaviour 23 5.1 A nomogram to estimate the effects of measurement repeatability error on whether ‘analytical goals’ are attainable or not in exercise physiology research 44 5.2 Using a confidence interval and ‘region of equivalence’ for the mean difference between methods/tests 45 5.3 Various examples of relationships between systematic and random error and the size of the measured value as shown on a Bland-Altman plot 46 8.1 Static lung volumes 67 8.2 (a) Spirogram of volume against time, (b) Spirogram of volume against flow 68 9.1 A triceps skinfold measurement illustrating appropriate technique 79 9.2 Skinfold locations 81 10.1 Measuring shoulder flexion in supine 87