EXERCISE MEDICINE STANDARD OPERATING PROCEDURES · Press ‘laser’ button on bed and using the ‘table’ and ‘arm’ button on bed position the cross hair of the laser 2cm below

Version 1.0 - Updated: 22/06/2018

EXERCISE MEDICINE STANDARD OPERATING

PROCEDURES

Version: 1.0 Dated: 22-06-2018


TABLE OF CONTENTS

Height and Weight 2

Anthropometry 2

Dual Energy X-Ray absorptiometry (DEXA) 3

Resting blood pressure 10

STRATEC XCT-3000 (pQCT) 11

Electrocardiogram 22

Cardiopulmonary Exercise Test (CPET) 24

Lung Function Test 29

Constant Load test 30

Sensory Organisation Test (SOT) 31

One Repetition Maximum Test (1RM) 34

Repeated Chair Rise 40

Timed up and Go 41

6 Metre Walking Tests 42

400 Metre Walk Test 43

6 Minute Walk test 44

Stair Climb 45

Actigraph

Author(s)

46

50


TESTING PROCEDURES

IDENTIFICATION (ID) SETTINGS All testing procedures must be identified according to their respective studies with the first two

initials of the patient’s first and last name (eg. SpMetsP_JaDo).

HEIGHT (&) WEIGHT

EQUIPMENT LOCATION & SET-UP Stadiometer located in treatment & assessment room (21.211) on the

left hand side next to the SOT.

COLLECTION If client is tall, stand on stool provided.

Pull up stadiometer height measurement.

Instruct client to step onto scale facing the wall, looking straight ahead

with arms relaxed by their side.

Ask client to tilt their head so it corresponds to the Frankfort plane.

Record height (nearest 0.1 cm).

Record weight using weight scale (nearest 0.1 kg).

NOTE: Height settings must not change once it has been entered into SOT, DEXA and

PQCT.

ANTHROPOMETRY

EQUIPMENT Constant tension tape measure

TESTING INSTRUCTIONS Waist: Subject stands with arms at their sides and abdomen relaxed, a horizontal measure is taken at the narrowest part of the torso or between the iliac crest and 12th rib

Hip: With the subject standing, heels touching, a horizontal measure is taken at the maximal circumference of the hip.

Record each trial. Two trials must be within 2mm.


DUAL ENERGY X-RAY ABSORPTIOMETRY (DEXA)

EQUIPMENT LOCATION & SET-UP Located in treatment & assessment room (21.211).

Sample Spine located in the middle cupboard labelled ‘CALIBRATION EQUIPMENT’ on the right side of room.

CALIBRATION Check Air conditioner is on, located immediately on the wall and to the left as you enter the

treatment room.

Ensure you are wearing a dose meter badge.

Turn on computer.

Click on QDR account.

A pop-up will show asking to back up computer, for the moment click “no”.

Make sure NHANES-BCA is enabled:

Click “Utilities”.

Click “System Configuration”.

Click “Analysis”.

At the bottom of the screen, make sure the box is ticked.

Click and open up “Daily QC”.

Collect sample spine from calibration equipment cupboard

Place the spine on DEXA bed with silver strip end closest to the computer and adjust position ensuring the red laser crossover is aligned with the cross marked on the silver strip (as pictured).

Click the continue box.

If the spine has been correctly positioned and scanned then the message ‘daily QC passed’ should appear and click OK and return spine to cupboard.


BODY COMPOSITION CALIBRATION To be completed twice per week

On the computer desktop click on QC at the top of screen and scroll down to open Body composition QC, and with the sample spine still in position, click continue.

A pop-up will indicate successful completion, click OK.

Remove sample spine from bed and replace in cupboard.

Click on continue to perform a whole body uniformity scan to finalise the procedure.

Complete DEXA calibration log, located next to the computer, enter both high and low air values and indicate ‘pass’ or ‘fail’. If calibration fails, inform Kyle immediately.

TESTING INSTRUCTIONS Whole Body Scan


Ask patient if there is any chance of pregnancy. DO NOT scan if pregnant.

Ask the patient to remove any metallic items they have on/with them eg. glasses, loose change, zips, metal buttons, reflective logos etc. Provide a towel/robe if necessary i.e if they had to remove their jeans.

Ask the patient if they have any internal objects that could interfere with the scan such as: Pacemaker leads Radioactive seeds Metal implants Surgical staples Radio-opaque catheters or tubes Wedding rings that cannot be removed

Make a note on testing sheet if any of the above has been identified.

Measure and record the patient’s height and weight.

Make sure ‘NHANES-BCA’ is enabled prior to scanning each client.

Click on ‘perform exam’ and then ‘new patient’.

Enter the patient details including height, weight, gender, DOB, ID and press ‘ok’.

Instruct the client to lie supine with their feet closest to the computer.

Position the individual so that they are central and within the scanning field as marked by the black lines with their head positioned 2cm from the end of the bed.

Palms are faced down on the bed. If patient does not fit within scanning field, ask them to place their hands vertical.

Feet are positioned wide and angled towards each other and held together by strapping tape. Explain to client that this position is used to scan both bones of the lower limbs.

For hygienic reasons, new strapping tape is to be used for each patient.

Explain to the patient what the scan is looking at, i.e body composition and BMD and that the scanning process will last for 3-4 minutes.


Instruct the patient to lie motionless on the table as movement can affect the scan quality.

Select perform ‘whole body’ scan and click on ‘scan now’ when the patient is correctly aligned on the table.

DEXA table must be cleaned with alcohol wipe after use.

Hip Scan The left hip is always scanned, if there is a hip replacement, then scan the right.

Remove tape from patient’s feet.

Place the plastic foot positioner under the patients legs, with the centre of the positioner aligned with the patient’s midline.

Rotate the patients’ left leg inwards with the medial side of their foot against the angled side.

Adjust the velcro strap to hold foot in correct position.

Press ‘laser’ button on bed and using the ‘table’ and ‘arm’ button on bed position the cross hair of the laser 7cm below the greater trochanter and in line with shaft of femur.

Click ‘new scan’, select ‘left hip’ and click ‘ok’.

Click ‘start scan’ once patient is in position.

If the hip is positioned correctly allow the scan to complete.

If the hip is not positioned correctly click the ‘reposition scan’ button before the scan is complete and reposition the scan by moving the image on the computer.

When the scan/hip is correctly positioned click ‘restart scan’ and then ‘start scan’ button to complete the scan.

Once the scan is complete, remove plastic foot positioner.


Lumbar Spine

Instruct patient to move down on the bed so that their head is positioned where their shoulders were previously on bed.

Place pillow under patients head in line with black marker on side of table.

Place the knee positioner (square cushion) under patient’s lower legs with knees bent at 90 ̊.

Press ‘laser’ button on bed and using the ‘table’ and ‘arm’ button on bed position the cross hair of the laser 2cm below iliac crest and centred in the mid-line of the patient.

As a cue, ask patient to locate their belly button.

Click ‘new scan’ and select ‘AP Lumbar Spine’.

Click ‘Start Scan’ once patient is in position.

If the lumbar spine is positioned correctly allow the scan to complete.

If the lumbar spine is not positioned correctly click the ‘reposition scan’ button and reposition

the scan by moving the image on the computer.

When the scan/lumbar spine is correctly positioned click ‘restart scan’ and then ‘start scan’ button to complete the scan.

IVA HD Imaging Click ‘New Scan’ and select ‘AP Lumbar Spine’.

Press ‘Enable Lateral’ button on DEXA bed.

Press ‘Continue’ on computer pop up.

Hold ‘Enable Lateral’ Button on DEXA bed until machine stops moving.

Instruct client to place hands under head as machine will do a scan of the side of their spine. Ask the client to hold their breath during the ten second scan time.

Click ‘Start Scan’ once patient is in position.

If the spine is positioned correctly allow the scan to complete.


DATA ANALYSIS INSTRUCTIONS

NOTE: Generally, the machine analyses each scan automatically, however, if the lines

or points are not in the correct position, follow the checklist below. If any scan falls below the green zone, all three scans must be forwarded to the patient’s GP.

Whole Body Scan

To analyse immediately after scan: Click ‘Analyse Scan’ in pop up. Click ‘Next’ on pop up.

To analyse previously completed scan: Click ‘Analyse Scan’ icon Enter clients surname and click to highlight scan needed then click ‘Next’ Click ‘Next’ on pop up.

A pop up will appear to compare to a previously analysed scan, only if a prior scan was performed. If a previous scan was undertaken, select it to compare to baseline.

Click the icon in the top left corner of the window if not already selected.

Click the ‘Line Mode’ icon if not already selected.

Checklist The top horizontal line of scan image should be situated just under the client’s jaw. Small horizontal line in the spine situated approximately level of T12/L1. Horizontal line above the pelvis should sit just above the iliac crest. Make sure, the vertical lines on either side of the spine are close to the spine but not

touching.

Click the ‘Point Mode’ icon. The point at both left and right shoulders should be positioned between the head of the

humerus and scapula at the glenoid fossa. The points along the spine should be close to the spine, matching the curvature if

possible.


The points on either side of the iliac crest should be situated out at the sides to include soft tissue of the chest and thighs.

The lower point of the triangle below the pelvis must cross both femoral necks.

Use the scroll bar to scroll the image to the bottom of the scan. The points near the feet need to include as much of the

soft tissue in the thighs as possible without including the hand and fingers.

Once scan has been appropriately analysed click ‘Results’ icon.

Click the ‘Close’ icon at the bottom left of the screen.

Click the ‘Report’ icon.

Click the ‘Print’ icon to print a copy of the scan and the results.

Click ‘Ok’ on pop up.

Click ‘Close’ once completed.

Hip Scan

To analyse immediately after scan: Click ‘Analyse Scan’ in pop up. Click ‘Next’ on pop up.

To analyse previously completed scan: Click ‘analyse scan’ icon Enter clients surname and click to highlight scan needed

then click ‘next’ Click ‘next’ on pop up.

Hip analysis is automatically performed

Click the ‘close’ icon at the bottom left of the screen.

Click the ‘report’ icon.

Click the ‘print’ icon to print a copy of the scan and the results.

Click ‘ok’ on pop up.

Click ‘close’ once completed.

Lumbar Spine

To analyse immediately after scan: Click ‘Analyse Scan’ in pop up. Click ‘next’ on pop up.

To analyse previously completed scan: Click ‘analyse scan’ icon Enter clients surname and click to highlight scan needed then click ‘next’ Click ‘next’ on pop up.

Lumbar spine analysis is automatically performed.


Click the ‘Exclude’ icon to exclude L1 on the scan (L1 will appear red and is not included in the results).

If auto analysis is incorrect on scan a manual analysis is needed

To perform a manual analysis: Click the ‘Global ROI’ icon Click ‘Line Mode’ icon (if not already selected) Click and drag the horizontal lines to position the top line

between the T12 and L1 intervertebral space and the bottom line between the L4 and L5 intervertebral space

Click the ‘Bone Map’ icon Click the ‘vertebral lines’ icon Click and drag on each yellow line to position between

vertebral spaces Click the ‘Results’ icon Click the ‘Exclude’ icon to exclude L1 on the scan (L1 will

appear red and is not included in the results).

Click the ‘close’ icon at the bottom left of the screen.

Click the ‘report’ icon.

Click the ‘print’ icon to print a copy of the scan and the results.

Click ‘ok’ on pop up.

Click ‘close’ once completed.

IVA HD Imaging

To analyse immediately after scan: Click ‘Analyse Scan’ in pop up. Click ‘next’ on pop up.

Click ‘Markers’ icon.

Right click on L4 and click ‘Add Marker’.



If marker incorrectly placed right click and select ‘Delete Marker’.

Double click on individual points and drag into correct position.

The six points on each vertebrae are positioned on the superior and inferior of the anterior, posterior and midpoints of L4, L3 and L2 vertebrae.

Click ‘Print Report’ icon.


RESTING BLOOD PRESSURE

EQUIPMENT LOCATION & SET-UP Blood pressure monitor located in Treatment & Assessment (21.211) or Consult Room 3

(21.214), ECU Joondalup.

Manual Sphygmomanometer located in the draw in Treatment & Assessment (21.211) and stethoscope located on the shelf in Research office (21.243)

TESTING INSTRUCTIONS Instruct client to lay supine on bed for at least five minutes prior to measuring

Check if there are any issues ie. Lymphedema

Place arm in cuff and tighten Velcro strap. Use large cuff if necessary and make a note on testing sheet.

Press ‘Start/Stop’ button to begin measurement

Three measures of blood pressure are taken with 30 seconds rest between each


STRATEC XCT-3000 (PQCT)

EQUIPMENT LOCATION & SET-UP Located in treatment & assessment room (21.211).

Black rod and cone (for calibration) located on bench on right side of treatment room next to pQCT machine and computer.

CALIBRATION


Turn computer on (button on right side of computer)

Double click to open ‘Start C-XCT’ icon on desktop

Log into program User= user Password= user

Twist red button on top of scanner to turn it on

Remove leg clamp from machine.

Insert black rod and cone into slot in front of scanning circle

Press ‘Ok’ on pop up for QA-Scan for standard phantom.

Press ‘F4’ to save and proceed to perform standard phantom

Press ‘Yes’ to start repeated measurement

Pop up will appear saying QA successful, press ‘Ok’

Remove rod and cone from machine

Press ‘Ok’ to log result

Press ‘No’ to print

Replace leg clamp


TESTING INSTRUCTIONS - TIBIA Place leg positioner into slot and tighten with lever at the bottom

To enter new patient details Press ‘New Patient’ Enter clients last and first name Enter Id (eg. SpMetsP_JaDo) Date of Birth Gender – 1 = Female and 2 = Male Measure Mask (click F2 for list and select ‘Tibia 4 Slice 4, 14, 38, 66’ and press ‘enter’) Press F4 to proceed

Left leg is used for measurement unless pins or plates are inserted. If so, use the right leg. If changing sides, remember to indicate which side on the computer.

Measure the object length and enter into computer: Measure left leg on the medial side the distance between the distal malleolus and tibial

plateau (proximal end of tibia).

Enter clients height and weight

Press F4 to save and proceed

Confirm start measurement.

A pop up will appear saying ‘Attention Device will move’, press ‘Ok’


Press ‘Ok’ to start movement

To position machine hold ‘Move SV start position’ until Z position is reached. This will automatically stop once the position is reached

Position client into machine Client to sit in blue chair, place a towel in the knee support Stand to the side of the machine and push the device into position so that the leg clamp

is at a comfortable height. If necessary, adjust seat height. Client to place left leg through two circles. Laser is positioned on the distal side of medial malleolus Tighten support around knee Attach foot with Velcro into foot holder

Instruct client to sit as still as they can while scan is in process

Click ‘Start SV’

You can press F4 to shorten SV once image is correct otherwise wait for scan to complete

Reference Line (R Line) should be through the most part of bone and is usually positioned automatically. If not, move line.

For a repeat scan ensure R Line is in same section of bone as previous scan shown on screen

Press ‘Start CT’ to begin full scan

Scan will take approximately 10 minutes to complete

Remind client to keep their leg still

Explain to client that the machine takes four measures of bone density at four different sites between the ankle and knee. The green part of the machine will move to scan each section.

Remove client from machine


DATA ANALYSIS INSTRUCTIONS FOLLOWING MEASUREMENT:

Once measurement has finished, click ‘ok’ on the green screen.

Click ‘Ok’ (black square with white writing in bottom left corner)

Click ‘New’ in the bottom left

To find Region of Interest (ROI): To find the area of the tibia (larger bone), click the middle of the tibia and press ‘F’ to

have it highlighted. Make sure there are no gaps around the tibia. Ensure the fibula is excluded.

Once the area has been defined, click ‘Ok’ on the bottom left

A pop up will appear to confirm the ROI designation. If it displays ‘tibia’ click ‘OK’. If it displays a different area, amend to ‘tibia’ and click ‘OK’

Click ‘Ok’ to overwrite the tibia ROI name

The screen will show all 6 slices of the tibia with pictures, slice one should be the newly designated ROI. Slice two and three should show a square box drawn only around the tibia. If not amend as follows:

Click select and enter. Select slice to be amended Select analysis – enter; results – enter; new – enter Draw a box around the tibia only. Click ‘Ok’ Pop up box will appear to rename ROI designation ensure/amend to ‘Tibia’ Click ‘Ok’ to overwrite Click ‘OK’; click ‘OK’

The screen will show all 6 slices again. Slices 4, 5, 6 will need to be amended as follows: Click select and enter. Select slice 4 Select analysis – enter; results – enter; new – enter Draw a box around the whole image. Click ‘Ok’ Pop up box will appear to rename ROI designation. Type ‘MUSCLE+BONE_AR’ and click

‘Ok’ Click ‘Ok’ to overwrite Click ‘Ok’; click ‘Ok’ Repeat for slice 5 – rename ROI Designation to ‘BONE-AREA’ Repeat for slice 6 – rename ROI Designation to ‘TOTAL-AREA’


The screen should now show six slices as pictured

Click ‘Analysis’

Scroll across and click ‘Auto’

Click ‘Ok’ to overwrite results

Click ‘Ok’ to define ROI

Scroll across and click ‘Continue” – not ‘New’

Auto Analysis will occur

The screen will show slices 1-3 correctly, click ‘Continue’

Click ‘Ok’ on pop up to print

The screen will show slices 4 – 6 correctly, click ‘Continue’ and ‘Ok’ to print. Slice 4 should have dark grey area removed from the outside.

Once both pages have printed, click ‘Ok’ on the bottom right. Click ‘Ok’ again

The screen should now show six slices, all with the tibia highlighted. Click ‘report’

Ensure all six are ticked in the pop-up box, and click ‘Ok’

Press ‘print results’ then deselect ‘print slices’. Click ‘Ok’

Click the black ‘Print’ button to print off the results (two pages)

Click ‘End’ to finish and return to the main screen

To analyse at a later date: Scroll across to ‘Analyse’

From drop down box click ‘Select patient’ – enter

Click ‘name’ – enter

Enter name – ‘OK’

Select Patient from list – enter

Click F4

From the list of scans – click the one to be analysed and continue as above


TESTING INSTRUCTIONS – FEMUR Remove leg positioner from slot

To enter new patient details Press ‘New Patient’ Enter clients last and first name Enter Id (eg. SpMetsP_JaDo) Date of Birth Gender – 1 = Female and 2 = Male Measure Mask (click F2 for list and select ‘Femur distal 2 slices at 4% 3.3%’ and press

‘enter’)



Left leg is used for measurement unless pins or plates are inserted. If so, use the right leg. If changing sides, remember to indicate which side on the computer.

Measure the object length and enter into computer (in millimetres):

Measure left leg on the lateral side the distance between the greater trochanter and tibial plateau (proximal end of tibia).


Confirm start measurement.

A pop up will appear saying ‘Attention Device will move’, press ‘Ok’

Press ‘Ok’ to start movement

To position machine hold ‘Move SV start position’ until Z position is reached. This will automatically stop once the position is reached

Position client into machine Client to sit in blue chair, with a pillow behind their back. Stand to the side of the machine and push the device into position so that there will be

clearance around the whole thigh throughout the measurement. If necessary, adjust seat height.

Client to place left leg through green opening so that knee is positioned under the laser. Laser is positioned just distal to the lateral/medial joint spaces close to the tibial

tuberosity. Attach foot with Velcro into foot holder


Instruct client to sit as still as they can while scan is in process

Click ‘Start SV’

You can press F4 to shorten SV once image is correct otherwise wait for scan to complete

Reference Line (R Line) should be through the most part of bone of the femur and is usually positioned automatically. If not, move line.

For a repeat scan ensure R Line is in same section of bone as previous scan shown on screen


Press ‘Start CT’ to begin full scan

Scan will take approximately 10 minutes to complete

Remind client to keep their leg still

Explain to client that the machine takes two measures of bone density at two different sites along the thigh. The green part of the machine will move to scan each section.

Remove client from machine.


DATA ANALYSIS INSTRUCTIONS FOLLOWING MEASUREMENT:

Once measurement has finished, click ‘ok’ on the green screen.

Click ‘Ok’ (black square with white writing in bottom left corner)

Click ‘New’ in the bottom left

To find Region of Interest (ROI): Draw a box around the profile of the femur Hold down the shift button while pressing ‘B’ multiple times. Dots will appear around the box Drag the dots in to the profile of the femur, ensure the patella is excluded

Once the area has been defined, click ‘Ok’ on the bottom left

A pop up will appear to confirm the ROI designation. If it displays ‘femur’ click ‘OK’. If it displays a different area, amend to ‘femur’ and click ‘OK’

Click ‘Ok’ to overwrite the femur ROI name

Click ‘OK’

Click ‘OK’

The screen will show all 6 slices of the femur with pictures, slice one should be the newly designated ROI. Slice two and three should show a square box drawn only around the bone. If not amend as follows:

Click select and enter. Select slice to be amended Select analysis – enter; results – enter; new – enter Draw a box around the tibia only. Click ‘Ok’ Pop up box will appear to rename ROI designation ensure/amend to ‘Femur’ Click ‘Ok’ to overwrite Click ‘OK’; click ‘OK’

The screen will show all 6 slices again. If slices 4, 5, 6 need to be amended proceed as follows: Click select and enter. Select slice 4 Select analysis – enter; results – enter; new – enter Draw a box around the whole image. Click ‘Ok’ Pop up box will appear to rename ROI designation. Type ‘MUSCLE+BONE_AR’ and click

‘Ok’ Click ‘Ok’ to overwrite Click ‘Ok’; click ‘Ok’


Repeat for slice 5 – rename ROI Designation to ‘BONE-AREA’ Repeat for slice 6 – rename ROI Designation to ‘TOTAL-AREA’

The screen should now show six slices as pictured

Click ‘Analysis’

Scroll across and click ‘Auto’

Click ‘Ok’ to overwrite results

Click ‘Ok’ to define ROI

Scroll across and click ‘Continue” – not ‘New’

Auto Analysis will occur

The screen will show slices 1-3 correctly, click ‘Continue’

Click ‘Ok’ on pop up to print

The screen will show slices 4 – 6 correctly, click ‘Continue’ and ‘Ok’ to print. Slice 4 should have dark grey area removed from the outside.

Once both pages have printed, click ‘Ok’ on the bottom right. Click ‘Ok’ again

The screen should now show six slices, all with the tibia highlighted. Click ‘report’

Ensure all six are ticked in the pop-up box, and click ‘Ok’

Press ‘print results’ then deselect ‘print slices’. Click ‘Ok’

Click the black ‘Print’ button to print off the results (two pages)

Click ‘End’ to finish and return to the main screen

To analyse at a later date: Scroll across to ‘Analyse’

From drop down box click ‘Select patient’ – enter

Click ‘name’ – enter

Enter name – ‘OK’

Select Patient from list – enter

Click F4

From the list of scans – click the scan to be analysed and continue as above


ELECTROCARDIOGRAM Equipment required

12 lead electrocardiograph (ECG) machine, calibrated and programmed to AHA specification: o Set low frequency filter to <0.05 Hz to avoid distortion for the ST segment o Set high frequency filter to >100 Hz to prevent loss of high frequency information

Pulse Oximeter (SP02).

ECG paper (Recording)

Disposable ECG electrodes

Towels – (Hygiene)

Razor - (Hair Removal)

Abrasive Tape – (Skin Preparation)

Cleaning (Alcohol) Wipes – (Skin Preparation)

Disposable Gloves – (Hygiene)

Adjustable bed - wide enough to ensure all of the participants limbs are supported.

Preparations

Explain the testing procedure to the participant, and emphasize that unrestricted access to the chest area will be required during testing.

The participant should rest in the supine position. If the participant is unable to maintain the supine position this should be documented.

Wearing gloves, the skin should be prepared to avoid any skin-electrode impedance. This may include:

Shaving hair at electrode sites. Sharps to be disposed of in sharps container.

Exfoliate if necessary with a light abrasion using a gauze swab or abrasive tape.

Cleaning the skin with alcohol wipes. Confirm any allergies with the participants.

Electrodes should be placed according to Figure 1. Any alterations to electrode placement should be recorded clearly.

11

Electrode Position

Limb (Resting) R (Right arm) Right forearm, proximal to the wrist

L (Left arm) Left forearm, proximal to the wrist

N (Right leg) Right lower leg, proximal to the ankle

F (Left leg) Left lower leg, proximal to the ankle

Limb (Exercise) R (Right arm) Above the right shoulder blade

L (Left arm) Above the left shoulder blade

N (Right leg) Above the waist on the right lower back

F (Left leg) Above the waist on the left lower back

Chest Leads V1 4th intercostal space at the right sternal edge

V2 4th intercostal space at the left sternal edge

V3 Midway between V2 and V4

V4 5th intercostal space in the mid-clavicular line

V5 Left anterior axillary line, lateral to V4

V6 Left mid-axillary line, lateral to V4 and V5


Once electrodes are all placed on the participant, connect the corresponding leads

On the computer you can click ‘patient’ and ‘new patient’ (below)

Complete all requested fields and click ‘ok’

To start a resting ECG, select the patients name and click ‘Start Resting ECG’ (below)


CARDIOPULMONARY EXERCISE TEST: Equipment, Location & Set-Up:

EMRI Treatment Room 21.211

Metabolic Cart

Facemask

Cycle Ergometer (programmable ergometer with RAMP protocol)

Echocardiogram (ECG), 12 leads

Tympanic Thermometer, Stadiometer and Weight Scale

Measuring Tape, Sphygmanometer and Blood Pressure Cuff

Handheld Spirometer – capable of measuring FVC, FEV, FEV/1.0%

RPE Chart (0 to 10) and Collection Sheet for recording

Requires at least three people (as well as the Doctor)

Doctor can monitor ECG and Heart Rate

Person #1 can oversee the session and record

Person #2 can monitor RPE and Metabolic Cart

Person #3 can monitor Blood Pressure and SPO2

Absolute Contraindications to Exercise Testing:

Recent significant changes in the resting ECG which suggest significant ischemia. Recent myocardial infarction (within 2 days) or any other acute cardiac events. Uncontrolled cardiac dysrhythmias causing symptoms or hemodynamic compromise. Tachydysrhythmia or bradydysrhythmia High degree atrioventricular block

Relative Contraindications to Exercise Testing:

Left main coronary stenosis and/or moderate stenotic heart disease. Electrolyte abnormalities (e.g. hypokalemia, hypomagnesemia). Severe arterial hypertension: (systolic: >200mm Hg and/or diastolic: >110mm Hg) at rest. Hypertrophy cardiomyopathy, or other forms of outflow tract obstruction. Uncontrolled metabolic disease (e.g. diabetes, thyrotoxicosis, myxedema). Chronic infection disease (e.g. mononucleosis, hepatitis, AIDS).

Discuss with Patient:

Explain the test clearly to the patient

Inform the patient that it is a cycle test, lasting ~10 minutes

Explain that the ‘resistance’ will progressively become harder

Explain the pedal rate required (70-80 RPM) and aim for exhaustion

Describe what ‘RPE’ is, and show the patient the RPE chart

Explain the test requirement to achieve near-exhaustion (RPE ≥ 9)

Explain the expected sensations:

Exhaustion is: complete inability to maintain effort required by test

Pathway to exhaustion will be uncomfortable, patient must be prepared

Exhaustion does not mean “I have a dry mouth” or “I feel thirsty”

Exhaustion does not mean “This is getting hard” or “My muscles are tired”

Pre Test Measurements

Calibrate Metabolic Cart as per protocol to be ready for use shortly before supervising doctor arrives

Record height, weight, waist circumference, hip circumference as per protocol


Resting ECG to be carried out with patient in supine position for 5 minutes. Record respiratory rate by counting patient breaths for 60 seconds at the 3rd minute. Following the end of the 5 minutes rest period, record Blood Pressure (both arms), Oxygen Saturation, Heart Rate and Temperature. Sit patient up and measure Seated Blood Pressure (both arms)

Lung Volume

Set up Mouth Piece

Bike set up

Turn on the cycle ergometer

The power switch is located directly beneath the seat

Once it has loaded, swipe the screen (in any direction) to be taken to the home page

Select ‘Protocol’

Select ‘ Start Protocol’

Select the desired workload

10W, 15W or 20W options

Press ‘Start’ when ready to commence the test

The time will still not commence until the participant begins to cycle

Once the participant is finished, press the ‘Recovery’ button

Following the 5 minute recovery period, press ‘Stop’

The screen will now show a session summary page.

‘Max Workload’ can be obtained from this page

Once completed, turn the bike off via the power switch below the seat


Running the CPET

Set up the patient on the cycle ergometer (record seat height for future tests with this patient)

The saddle of the ergometer should be adjusted so that the legs of the patient are almost completely stretched when the pedals are at their lowest point.

Make sure the feet are secured to the pedals.

Adjust handlebars to a height that is comfortable for the patient.

Place blood pressure cuff on arm with highest reading

Place the SPO2 on the opposite arm to blood pressure

Check all ECG leads to ensure they are in place and move lower limb leads to the patient’s posterior trunk

Once doctor gives the go-ahead to begin, position mouth piece and check no air is leaking

Enter patient details onto Met Cart o On the computer select ‘VO2/Metabolic Testing’ (below left) o Enter patient name, Med Rec #, Age, Sex, Height and Weight (below right) o Once you click ‘ok’, you will be prompted to start the test

Begin test (on cycle ergometer and metabolic cart)

Many measures to be collected instantaneously – be organised

Maintain a pedal rate: 70 to 80 RPM

Warm up for 4 minutes unloaded

Commence test at 20 watts per minute and RAMP at 10 or 15 watts per minute based on your assessment of patient (record selected RAMP for further testing sessions)

At voluntary exhaustion/completion, commence recovery on bike o Do your best to ensure patient has given their “best effort” if voluntary exhaustion o Recovery for 5 minutes at 20 watts and aim to maintain pedal rate of 50RPM o Make sure you help the patient through the recovery protocol o Monitor the patient constantly to ensure their safety o Patient may be at increased risk of fall for ~10 minutes after test o Remove face mask AFTER 5 minute recovery period o Offer the patient a chair and some water

Measurements taken at regular intervals:

HR at start; every minute; at exhaustion and during recovery

RPE (0-10) at start; every 3 minutes; and at exhaustion

BP at start; every 3 minutes; at exhaustion; and during recovery

ECG at start; every 3 minutes; at exhaustion and end of recovery

Rel. VO2max; Absolute VO2max; Max Workload; RQ/RER; Ventilatory Threshold to be

recorded at the very end


Recording and Patient Monitor

Blood Pressure

ECG and Heart Rate

RPE Chart and Metabolic Cart


CPET Success Criterion:

Must achieve volitional exhaustion. This means the patient can no longer maintain >50 RPM due to fatigue

If the patient has voluntarily stopped the test due to exhaustion then it stands to reason they must score the test as an RPE >9

As an objective guide only, patients should achieve an RER/RQ near 1.1

Patients must also be free of cardiac abnormalities as judged by the qualified and supervising medical professional. Cardiologist clearance to be sought if required.

CPET Stop Criterion:

In the absence of adverse event(s), the CPET should not be stopped until the patient reaches voluntary exhaustion.

The following criteria to stop the CPET may apply: Pedal frequency drops below 50RPM due to patient exhaustion only and not

due to patient inattention. As the assessor, it is your job to keep patient pedal rate up until they cannot sustain it, as the patient will be preoccupied with completing the test and not minor details

Extreme hypertension during exercise >115 diastolic or >250 systolic Abnormal ECG during exercise with complaints by patient Severe cardiac arrhythmias observed by monitoring doctor If patient feels unwell or indicates non-test specific pain Supervising doctor alerts to cease test.


LUNG FUNCTION TEST: Equipment

Vatalograph Micro

Disposable Mouthpiece

Performing a test

Fit the white disposable mouthpiece onto the flow head

Turn machine on

You will be prompted to enter in (using arrows) o Height in cm o Gender (0 for male, 1 for female) o Weight in kg o Age in years

Once the above information is entered you will be prompted to begin the test. o Participant to sit upright and hold the machine away from their mouth. o Inhale as deeply as possible and then insert the mouthpiece carefully into their mouth (not

like a trumpet) and clamp gently between their teeth. o Lips to seal around mouthpiece

Participant to exhale as fast and as long as possible for at least 6 seconds o Machine to beep twice to indicate that the test is complete. o Use the up and down arrows to scroll through the results – FVC, FEC1, FEV1 % and PEF.


CONSTANT LOAD TEST:

Equipment

Monark Bike

Stop Watch

Blood Pressure Equipment

Heart Rate Monitor

Pulse Oximeter

Thermometer

CPET Workload Pre-Test Procedure

Measure resting blood pressure, heart rate and oxygen saturation Test Procedure

The test runs a total of 10 minutes (warm-up ramp through to completion and recovery).

Workload is 70% of the maximum workload derived from the participant’s first CPET.

Participant performs a three minute warm-up (used as a ramp into the test). o Minute 1 = 0% of determined workload (e.g. 0 watts) o Minute 2 = 40% of determined workload (e.g. 60 watts) o Minute 3 = 80% of determined workload (e.g. 120 watts)

Test begins immediately at the 4th minute, at the determined workload (e.g. 200watts at CPET – 70% is 140 watts)

o Participant must cycle at 70 – 80 rpm through-out the 3 minute test. o Encouragement is able to be provided if needed.

At completion, participant cycles at 50 watts for 4 minutes to recover

Record heart rate at start of warm-up, start of test (4th minute), end of test (7th

minute), every 30 seconds for first 2 minutes of recovery, and at the 3rd and 4th

minutes of recovery.

Record RPE (0-10 scale)


SENSORY ORGANISATION TEST (SOT)

EQUIPMENT LOCATION & SET-UP Neurocom located in back left corner of treatment room (21.211)

TESTING INSTRUCTIONS Instruct client to remove shoes and socks.

Record client’s height and weight. DO NOT edit height settings.

Explain to client that the machine will assess their balance under various conditions.

Explain procedure of test and explain each condition Six different conditions Three trials of each condition Each trial takes 20 seconds Client to stand relaxed with hands beside body Explain to client that in different conditions the walls or floor may tilt depending on how

much their body sways. In addition, clients’ may have their eyes closed/open depending on the condition.

Mention to the client that they should stand as still as they can. Instruct the client to wear their glasses if normally worn.

Click ‘new patient’ icon

Enter client details: First and last name Patient ID (Studytwo initials from first and last name) eg. SpMetsB-JaDo Height Date of Birth Operator Comments (enter test time line g. baseline, post or follow-up) Click ‘save patient file’ Click ‘ok’ on pop up Click ‘continue’ Click ‘assessment’ Click ‘Sensory Organisation Test’ Click ‘continue’ Check client is in correct position according to computer Click ‘continue’ Assist the client to put on the harness

Assist client to step onto platform and face screen.

Clip harness onto straps and adjust so that the clips sit horizontal to clients shoulder


Position clients’ feet onto force plate with the medial malleolus of each foot centred directly over the thick black horizontal line.

Position the lateral calcaneus according the following height chart: S = Short 76-140cm M = Medium 141-165cm T = Tall 166-203cm The instructions on screen will indicate which line to use for each client

Client may move forefoot (in or out) to position of comfort (do not move heels). NOTES:

Reposition client if they move or lose their balance.

Instructors must always have one hand on the mouse.

While the test is active, keep conversation to a minimum.

To begin test click ‘start’ and then say “Ready go” and click the mouse or any key to begin on go.

After each trial tell the client to relax before starting the next one.

Explain to client each condition before starting the three trials

Remind client each time to either close their eyes or keep them open First condition

Eyes open Nothing surrounding you will move Stand as still as you can

Second condition Eyes closed Nothing surrounding you will move Stand as still as you can Instructor to say “Eyes closed – Ready go” Inform client they can put their hands up if they fall, instructor will be

positioned behind. Third condition

Eyes open The walls may tilt back or forward Stand as still as you can

Forth condition

Eyes open The floor platform may tilt back or forward Stand as still as you can

Fifth condition Eyes closed The floor platform may tilt back or forward Stand as still as you can Instructor to say “Eyes closed – Ready go”

Sixth condition Eyes open The walls and floor may tilt/move back or forward Stand as still as you can Instruct client to turn around and step off slowly once the test is concluded

Once last trial of sixth condition is completed a popup will appear to close test click ‘yes’

Click ‘ok’


Click ‘analysis’

Click to highlight most recent test (in top left hand corner)

Click ‘create PDF file’

On pop up enter file name (Two initials of first and last name (study & time point) eg. AST_CoWh_Baseline

Click ‘save’

Click print icon and click ‘ok’

Close PDF by clicking cross and top right of page

Click ‘main menu’

Click ‘close file’

Clean platform after each use


ONE REPETITION MAXIMUM TEST

EQUIPMENT LOCATION & SET-UP Smith Chest Press Machine, 450 Incline Leg Press/Supine Leg Press, Seated Supported

Row and Leg Extension Machines located in left room of Vario Health Clinic, ECU Joondalup Campus.

TESTING INSTRUCTIONS Chest Press

Adjust bench position so bar is positioned in middle of clients sternum. Measure and record the distance between back of bench (leg frame) and inside of rear

frame of Smith Machine. Position stoppers on machine so elbows are at 900 to start. Bench angle/seat position set at 0 (on incline chair). Record if step is used (if used record height). Measure distance from index finger to index finger. Ensure distance is equal for both hands and record on data collection sheet (grip

distance). Make a note on testing sheet if clients use a pillow. Instruct client on correct lifting technique:

Lower back firmly against seat Client to take a deep breath and breathe out on the effort Raise bar to full arm extension and return to 900 to complete one full

movement Ensure full control of bar during both phases of the lift.

Begin a warm up consisting of: 6 repetitions at approximately 60% of 1RM with 2 minutes rest 3 repetitions at approximately 80% of 1RM with 2 minutes rest

Proceed to 1RM test trials. Maximum of 5 trials to determine 1RM. Rest period of 2 minutes between each trial To avoid unnecessary fatigue aim to determine 1RM in 3 trials. Appropriate level of motivation should be consistent between all clients and time

points. All attempts recorded. Cross through failed attempts. Record final successful 1RM

attempt.


Incline Leg Press

Preferred testing machine is incline leg press. If client has physical contraindications use supine leg press and make note of machine

used on data collection sheet. Take hooks off. Instruct client to sit in machine with lower back firmly supported against back rest. Their feet need to be positioned on metal plate with back of heels in line with bottom

grip. Adjust winch to lower plate so knees are positioned at 900. Measure and record the

distance from the bottom of the plate to the floor Feet are positioned shoulder width apart with knees behind toes. Instruct client on correct lifting technique:

Hands holding side grip Explain to client to brace core muscles, take a deep breath and breathe out on

the effort Lift plate until legs are extended (without locking knees) and return to 900

position Ensure full control of plate during both phases of the lift.


Proceed to 1RM test trials. Maximum of 5 trials to determine 1RM. Rest period of 2 minutes between each trial To avoid unnecessary fatigue aim to determine 1RM in 3 trials. Appropriate level of motivation should be consistent between all clients and time

points. All attempts recorded. Cross through failed attempts. Record final successful 1RM

attempt. Lock hooks back into position and remove the weights.


Seated Row

Adjust seat position so chest pad is positioned mid sternum and record seat height.

Adjust chest pad into a position where arms are fully extended and record.

Measure and record grip position (distance from bottom of grip upwards).

Record where their feet are positioned (either on floor or on foot rest).

Instruct client on correct lifting technique Client to take a deep breath and breathe out on the effort Pull bar towards body keeping elbows tight to body and chest firmly on chest pad. Tester to hold hand at clients mid-axillary line ensuring client pulls bar to 900 each

lift. Ensure full control of bar during both phases of the lift.


Proceed to 1RM test trials.

Maximum of 5 trials to determine 1RM.

Rest period of 2 minutes between each trial

To avoid unnecessary fatigue aim to determine 1RM in 3 trials.

Appropriate level of motivation should be consistent between all clients and time points.

All attempts recorded. Cross through failed attempts. Record final successful 1RM attempt.


Supine Leg Press Adjust seat back position so the red arrow is pointing to 5

Feet are positioned on plate with toes at the top of plate

Hands lightly gripping hand grips

Adjust seat position so knees are positioned as close to 900 as possible. Record on the testing sheet.

Instruct client on correct lifting technique Push platform away from body by straightening legs (without locking knees)

and lower back to 900 position. Client to take a deep breath and breathe out on the effort Ensure full control of machine during both phases of the lift. Advise client that the plate moves, not the chair.







All attempts recorded. Cross through failed attempts. Record final successful 1RM attempt.


Leg Extension Position back rest so knees are in line with yellow axis of rotation of machine.

Ask client to flex their feet and adjust foot rest so it is positioned just above their ankles. Measure and record the distance from the fixed arm to the base of the adjustable pad (pictured)

Adjust lifting arm of machine to position knees at 900.

Instruct client on correct lifting technique Hands holding hand grips beside legs Client to take a deep breath and breathe out on the effort Client to raise legs to full extension and lower back to 900 position. Ensure full control of machine during both phases of the lift.







All attempts recorded. Cross through failed attempts. Circle final successful 1RM attempt.

If client unable to reach full extension on lift record knee angle achieved.


PROCEDURES FOR RETESTING Warm-up percentages must be based off the 1RM achieved during the last testing session

Exceptions to this will be made if the weights used during training exceed the baseline

1RM.

If this is the case, re-estimate the 1RM based off training weights (there is an excel

file on the v-drive titled “1RM Estimate” to assist with this estimation. Note that the

1RM estimate will be very conservative because the 1RM testing involves a smaller

range of motion than required during training sessions – clients should easily

exceed this estimate during testing).

The first 1RM trial should be the actual 1RM achieved in the previous testing session

Exceptions to this will be made if:

The client is struggling/easing through the warm up weights

The regular weights used during training exceed the previous 1RM (used re-

estimated 1RM based on instructions above)

The client is suffering from an injury/illness

The exact same set-up, instructions and motivation need to be strictly maintained for every re-test

conducted


REPEATED CHAIR RISE

EQUIPMENT LOCATION & SET-UP Chair located in left room of Vario Health Clinic, ECU Joondalup Campus.

TESTING INSTRUCTIONS Position chair up against wall.

Position client on chair with back against back rest and arms across chest.

Feet are shoulder width apart on floor with knees positioned at 900.

Instruct client to stand and sit five times as fast as possible.

Ensure client stands fully upright (knees straight) before returning to chair with upper back touching back rest on each stand/sit attempt.

Inform client to be wary of their head hitting the wall.

Instruct client with “3, 2, 1 Go” instructor is start stop watch and client is to begin on “go”

Instructor is to count out each stand and sit attempt

Instructor is to stop the stopwatch once the client returns their back to the backrest on the 5th attempt.

Complete three trials with appropriate rest according to testing sheet.


TIMED UP & GO TEST EQUIPMENT LOCATION & SET-UP

Chair and marked course (3m) located in left room of Vario Health Clinic, ECU Joondalup Campus.

TESTING INSTRUCTIONS Position armed chair on taped markers up against wall.

Position white marker at the end of the three metre line in between the two parallel tapes.

Client to begin seated in chair with back firmly against back of chair and arms across chest

Feet are shoulder width apart on floor with knees positioned at 900.

Instruct client to stand and walk up and around white marker (3m distance) as fast as possible and sit back in chair

The client needs to return into chair in a controlled manner with back against back rest

Instruct client with “3, 2, 1 Go” instructor is start watch and client is to begin on “go”

Instructor is to stop the stopwatch once the client returns their upper back to the backrest

Complete three trials with appropriate rest according to testing sheet.


6M WALKING TESTS

EQUIPMENT LOCATION & SET-UP Computer located on right side immediately as you enter store room of Vario Health Clinic.

Corridor where test is performed is located through door adjacent to store room.

TESTING INSTRUCTIONS Unplug computer from power source and take into corridor.

Attach portable table to wall and connect USB cable to middle port of computer.

Log into computer (password located to bottom left of keyboard).

Double click ‘Kinematic Measurement System’ icon on desktop.

On screen that appears click ‘XPV6’ and ensure ‘COM3’ is highlighted then click ‘ok’.

Click ‘ok’ on next pop up.

Click ‘tests’ on top of screen, scroll down to ‘running’ and scroll across to ‘multiple gate test’.

Explain and demonstrate protocol of test.

Have the client start with their feet shoulder width apart and in line with the horizontal line.

6 metre normal walk Have client walk at a normal/everyday pace past 6m mark.

6 metre fast walk Have client walk as fast as possible (without running) past 6m mark.

6 metre backward walk Position client with heels on start line. Instruct client to walk as fast as possible heel to toe past 6m distance. Make a note if technique is incorrect.

Complete 3 trials of each test

Record time at the end of each trial, click ‘reset’ on the computer prior to starting next trial.

Close the program, log off, remove USB cable, return and plug in computer


400M WALKING TEST

EQUIPMENT LOCATION & SET-UP Timer

Heart rate monitor

Cones and door stoppers located on right side immediately as you enter store room of Vario Health Clinic

20m course located in corridor to right of Vario Health Clinic

TESTING INSTRUCTIONS 20m distance is marked out on the floor, place a cone at the mark at each end, and prop glass

doors open with stoppers.

Connect heart rate monitor to client and check if it is working.

Instruct client to complete a walk from one cone to another (20m) in “as few strides as possible” (count number of strides taken and record).

Have client return slowly to start position and wait for heart rate to plateau.

Instructions of the test: This is a 400m walk test Client is to walk at their fastest pace up and around the markers, bear in mind they will

be completing a total of ten laps (up and back =1 lap). Client is to be careful when turning around markers if they have any knee/ankle

problems Client is to stand behind cone to start If client is unwell or any pain occurs they can stop the test at any time

Record the clients resting heart rate

When ready to start instruct client with “3, 2, 1, Go,” and they are to start on go.

On go press stop watch to start

Mark on data collection sheet each lap completed and after each lap let the client know what lap they are on.

At the end of the tenth lap stop the stopwatch as soon as client crosses the marker and record the time.

Participant performs a slow walk (active recovery) to recover from the test.

Record the participant’s heart rate: 1) Immediately post-test, 2) one minute post-test, and

3) two minutes post-test.


6 MINUTE WALK TEST

EQUIPMENT LOCATION & SET-UP Timer

Heart rate monitor

Measuring tape located on a shelf on the left hand side of room 21.243.

Cones and door stoppers located on right side immediately as you enter store room of Vario Health Clinic

30m course located in corridor to right of Vario Health Clinic

TESTING INSTRUCTIONS 20m distance is marked out on the floor, place a cone at the mark at each end, and prop glass

doors open with stoppers.

Connect heart rate monitor to client and check if it is working.

Have client sit in a chair and wait for heart rate to plateau.

Instructions of the test: This is a 6 minute walk test Client is to walk at their fastest pace up and around the markers, with the goal of

walking as far as possible in 6 minutes. Client is to be careful when turning around markers if they have any knee/ankle

problems – demonstrate the turn if necessary. If client is unwell or any pain occurs they can stop the test at any time Explain that to end the test the client will be instructed to stop, they must stand in place

until the stop position has been marked. Client is to stand behind cone to start

Record the clients resting heart rate


On go press stop watch to start

Mark on data collection sheet each lap completed.

After each minute let the client know how long they have left to go.

At the end of 6 minutes instruct the client to stop and place a marker on the floor where the client is standing

Instruct the client to return to the seat and passively recover for 2 minutes (longer if required).

Record the participant’s heart rate: 1) Immediately post-test, 2) one minute post-test, and

3) two minutes post-test.

Mark on the data sheet if a half lap was completed and measure the distance from


STAIR CLIMB

EQUIPMENT LOCATION & SET-UP Staircase located between student information office and physiology research lab (19.150)

Timer

TESTING INSTRUCTIONS

Explain and demonstrate protocol of test. Client to climb stairs to first landing as fast as possible one step at a time without using

handrail. Client is to start climb with dominant leg.


On go press stop watch to start.

Press stop as soon as client reaches first landing.

Once finished client is to return slowly to ground level on side of staircase.

Test is completed 3 times with 1 minute rest in between.


ACTIGRAPH INITIALISATION

Click on Actigraph icon to open the software

Select check box corresponding to the devices to be initialized and click “Initialize.” A drop down box will appear, click ‘Regular initialization’

Enter Start Date and Time and Stop Date and Time.

Start date should be set as the day they should start wearing the device. Enter start time as 6am.

Check the ‘Use stop time.’ This date should be 7 days after the start date and the time set as 6am as they should be removing the device that morning.

After data collection parameters have been set up for each model, select the ‘Enter Subject Info…’ button.

On the Subject Name screen enter the subject details, using Name, study ID and time-point for Subject name.

DOB, Height and weight can be entered when downloading if the information is not available when initializing.


When all information has been entered, select the ‘Initialize 1 device’ button, progress is displayed in the ‘Status’ column, once the initialization is complete, the device is ready to be removed.

DOWNLOAD

To download data from a GT3X+, select check box corresponding to the device to be downloaded and click ‘Download’. The download options screen will pop up.


Click ‘change location’ and select the corresponding study from the list of folders

Check <Subject name> <Start date>

Ensure all subject information is correct (amend if required)

Clicking “Download All Devices” will immediately download all of the data from the GT3X+ into selected folder.

RECHARGING AND LED DECODING

Recharging is automatic and is accomplished by connecting the device to a standard USB port. Charging time will depend on the battery life, but typically will not exceed four hours for a fully depleted battery. Once the battery is completely charged (max voltage of approximately 4.18V), the LED light will remain illuminated. If the battery voltage drops below 3.1 volts while in use, the Actigraphs will not have sufficient power to collect data and will warn the user through a series of coded flashes. The battery level, reported in volts, can be viewed at any time by starting ActiLife and plugging in the device.

Important: The ActiLife 5 software will not allow initialization if the voltage is below 3.82 volts.

ActiGraph GT3X+ Connected to PC

Red LED (Fault Indicator)

2 Flashes Li-Ion Battery is Faulty

3 Flashes A hardware failure occurred while recording data. Contact customer support at [email protected]

Green LED

1 Flash Battery Charging

Multiple Flashes Communicating with PC via USB

Steady On Battery Fully Charged

ActiGraph GT3X+ Not Connected to PC

Red LED (Fault Indicator)

No Flashing (LED Off) Normal operating condition or battery dead

2 Flashes Low Battery (use ActiLife Lifestyle software to check for remaining battery life). The unit needs to be recharged.

3 Flashes - Unexpected Battery Failure (Temporary battery power loss) or - Battery Level has fallen below 3.1V and the unit has entered Halt Mode

Green LED

No Flashing (LED Off) Actively collecting data (“Flash Mode” disabled) or battery dead

1 Flash - Delay before start mode (the LED always flashes prior to starting data collection) - Actively taking data ("Flash Mode" enabled – not recommended)

2 Flashes N/A

3 Flashes - End of memory reached (Device no longer collecting data) - Battery died while unit was in delay before start mode (no data collected on device)

Note: The Red LED will ALWAYS flash to indicate LOW BATTERY regardless of whether "Flash Mode" is enabled or disabled. If a “stop time” (optional) has been reached, the Green LED will stop flashing all together regardless of its previous state.


AUTHOR(S)

Standard Operating Procedures for a series of assessments performed at, and by, the Exercise

Medicine Research Institute (EMRI) exercise physiologists and exercise scientists who are all

accredited with Exercise and Sport Science Australia (ESSA).

1. Dr Nicolas Hart, PhD, AES, CSCS, ESSAM

Senior Research Fellow – Exercise Medicine Research Institute

Postdoctoral Research Fellow – Cancer Council of Western Australia

2. Professor Robert Newton, PhD, AEP, CSCS*D, FESSA, FNSCA

Associate Dean (Medicine and Exercise) – School of Medical and Health Sciences

Foundation Professor (Exercise Science) – Exercise Medicine Research Institute

3. Professor Daniel Galvão, PhD, AES, FACSM

Director – Exercise Medicine Research Institute

Professor (Exercise and Sport Science) – School of Medical and Health Sciences

4. Professor Dennis Taaffe, PhD, DSc, MPH, AEP, FACSM, ESSAM

Director – Survey Research Centre, Exercise Medicine Research Institute

Professor (Exercise Gerontology) – School of Medical and Health Sciences

5. Mr Kyle Smith, MSc, AEP, ESSAM

Clinical Rehabilitation Supervisor – Vario Health Clinic

Exercise Physiology Supervisor – Exercise Medicine Research Institute

6. Mrs Claire Mason, BSc, AEP, ESSAM

Senior Clinical Exercise Physiologist – Exercise Medicine Research Institute

7. Mrs Charlotte Cummins, BSc, AEP, ESSAM

Senior Clinical Exercise Physiologist – Exercise Medicine Research Institute

8. Mr Daniel Bomford, BSc, AEP, ESSAM

Clinical Exercise Physiologist – Exercise Medicine Research Institute

9. Miss Olivia Pisconeri, BSc, AEP, ESSAM

Clinical Exercise Physiologist – Exercise Medicine Research Institute

Documents

EXERCISE MEDICINE STANDARD OPERATING PROCEDURES · Press ‘laser’ button on bed and using the ‘table’ and ‘arm’ button on bed position the cross hair of the laser 2cm below