Dɛn ne Metabolic Exercise Stress Test? Momma yɛnka ho asɛm!

So woate ‘Metabolic Exercise Stress Test’ ho asɛm pɛn? Ebia na ehu aka wo kakra anaasɛ na wopɛ sɛ wuhu bere a wo duruyɛfo ka kyerɛɛ wo sɛ yɛ eyi no. Anaasɛ ebia na w’ani gye ho ara kwa sɛ wubehu ho asɛm. Enti, ɛnnɛ yɛbɛka sɔhwɛ yi ho asɛm tiawa, wɔ ɔkwan a wobɛtumi ate aseɛ so.

Nsonsonoe bɛn na ɛwɔ nea wɔfrɛ no nipadua mu apɔw-mu-teɛteɛ adwennwen sɔhwɛ yi ne adwennwen sɔhwɛ a wɔyɛ no daa no ntam?

Sɛ yɛbɛka no tiawa a, eyi yɛ sɔhwɛ a ɛhwɛ w’akwahosan mu bere a woreteɛteɛ w’apɔw mu no. Wɔyɛ no bere a wote sakre so anaasɛ wonam afiri a wɔde tu mmirika so no. Oduruyɛfo anaa mfiridwuma ho nimdefo a wɔatete no hwɛ wo so yiye. Eyi mu ade titiriw ne sɛ ɛhwɛ sɛnea wo koma ne w’ahurututu nyinaa yɛ adwuma yiye, ne sɛnea wo ntini nya oxygen yiye bere a woteɛteɛ w’apɔw mu (`Cardiorespiratory Fitness` - CRF). Ɛtɔ da bi a nnuruyɛfo nso frɛ eyi ``Koma ne ahurututu mu apɔw-mu-teɛteɛ sɔhwɛ`` (`CPET`). Efisɛ ``cardio'' kyerɛ koma, na ``ahurututu'' kyerɛ ahurututu. Enti wɔhwɛ eyinom abien no nyinaa dwumadi bere koro mu.

Afei ebia woresusuw ho sɛ, ‘Enti nsonsonoe bɛn na ɛda adwennwen ho sɔhwɛ a wɔyɛ no daa ne eyi ntam?’ Ɛno yɛ asɛmmisa pa! Adwennwen ho sɔhwɛ a wɔyɛ no daa titiriw no hwɛ wo koma ara kwa. Woteɛteɛ w’apɔw mu na wunya data fi nneɛma te sɛ EKG mu. Nanso wɔ nipadua mu adwennwen sɔhwɛ yi mu no, wofa anim akataso anaa ano aduru titiriw bi so home. Saa afiri yi susuw oxygen ne carbon dioxide dodow a ɛwɔ wo home a wohome no mu. Ɛsan nso susuw mframa dodow a w’ahurututu betumi agye mu Nokwarem no, ɛyɛ adwennwen sɔhwɛ a wɔyɛ no daa no fã a ɛkɔ akyiri a dɔn ne abɛn nyinaa ka ho. Enti, nsɛm dodow a wonya fi eyi mu nso dɔɔso, na wobetumi ate sɛnea koma ne ahurututu yɛ wɔn ade wɔ apɔw-mu-teɛteɛ mu no ase pɛpɛɛpɛ.

Dɛn na yebetumi asua afi sɔhwɛ yi mu?

Enti, dɛn ankasa na sɔhwɛ yi betumi ahu? Fa no sɛ wote nka sɛ woabrɛ bere a wobɔ mmɔden kakra mpo, anaasɛ wote nka sɛ woabrɛ bere nyinaa. Saa sɔhwɛ yi betumi aboa wo ma woahu nea ɛde eyi ba. Ebetumi akyerɛ wo pɛpɛɛpɛ sɛ ebia komayare, ahurututu mu yare, anaa n’abien nyinaa a wɔaka abom na ɛde wo apɔw-mu-teɛteɛ a wuntumi nnyina ano no.

Nneɛma atitiriw a wɔhwɛ kwan fi sɔhwɛ yi mu ne:

• Hwehwɛ nea enti a wote nka sɛ wo home yɛ wo yaw na wobrɛ kɛse bere a woteɛteɛ w’apɔw mu no.
• Hwɛ apɔw-mu-teɛteɛ dodow a wo koma ne w’ahurututu betumi adi ho dwuma .
• Kyerɛ koma ne ahurututu mu nyarewa.
• Hwɛ sɛnea wo tebea no mu yɛ den na nya nea ɛbɛba daakye ho adwene (nkɔmhyɛ).
• Hwɛ asiane a ɛwɔ nsɛnnennen mu ansa na woayɛ oprehyɛn kɛse.
• Siesie w'ayaresa nhyehyɛe .
• Hwɛ sɛnea wo nipadua reyɛ n'ade wɔ mprempren ayaresa ahorow no ho .
• Hwɛ nkɔso a aba wɔ apɔw-mu-teɛteɛ nhyehyɛe ahorow te sɛ komayare a wɔde sa yare mu.
• Boa wo ma woyɛ nhyehyɛe bi a ɛbɛma woatumi ateɛteɛ w'apɔw mu dwoodwoo na etu mpɔn .

Woahu, sɔhwɛ yi ho hia dɛn? Titiriw sɛ wowɔ tebea bi te sɛ ``Heart Failure`` a, saa ``CPET`` sɔhwɛ yi betumi akyerɛ sɛnea wo tebea no mu yɛ den pɛpɛɛpɛ ne ayaresa ko a wuhia.

Nea ɛho hia yiye: Sɛ wowɔ afiri a ɛma wo koma yɛ den anaasɛ wode fibrillator a, akyinnye biara nni ho sɛ ɛsɛ sɛ woma oduruyɛfo hwɛ mu ansa na wɔayɛ nhwehwɛmu yi . Enti, wo ne wo duruyɛfo nka eyi ho asɛm ansa na woayɛ nhwehwɛmu no ho nhyehyɛe.

Hena na ohia saa nipadua mu adwennwen ho sɔhwɛ yi?

Enti, henanom na ɛsɛ sɛ wɔyɛ wɔn nipadua mu adwennwen ho sɔhwɛ yi? Nokwarem no, wo duruyɛfo no besi gyinae sɛ wuhia anaasɛ wunhia. Mpɛn pii no, mmofra a wɔadi boro mfe 10 ne mpanyimfo a wɔadi mfe biara betumi ayɛ sɔhwɛ yi. Nnuruyɛfo kamfo nhwehwɛmu yi kyerɛ, titiriw sɛnea ɛbɛyɛ a wobehu tebea horow a edidi so yi na wɔadi ho dwuma:

• `Akisikuru`
• Ahurututu mu Yare a Ɛmma Nnipa Ntumi Siw Nneɛma Mu (COPD) .
• Cystic Fibrosis a Ɛyɛ Fɛ
• `Koma a Ɛyɛ Adwuma`
• Ahurututu mu Yare a Ɛwɔ Ntam
• Ahurututu mu Kokoram
• `Ciliary Dyskinesia a Ɛho Hia`
• Ahurututu mu Ntini Mu Ntini Mu Ntini Mu Ntini Mu Ntini Mu Ntini Mu Ntini Mu Ntini Mu (PAH) .
• Sarcoidosis a ɛma obi nya ɔyare

Afei nso, wɔyɛ sɔhwɛ yi ansa na wɔayɛ oprehyɛn akɛse bi. Nhwɛsoɔ:

• Ahurututu a Wɔde Twitwa Oprehyɛn
• Ahurututu a Wɔde Si Ahurututu Mu ne Koma ne Ahurututu a Wɔde Si Ahurututu Mu Oprehyɛn
• Oprehyɛn a Wɔtew Ahurututu Mu Nneyɛ So (LVRS) .
• Oprehyɛn atitiriw afoforo a wɔyɛ wɔ ahurututu mu

So nnipa bi wɔ hɔ a ɛnsɛ sɛ wɔyɛ sɔhwɛ yi?

Nanso, ɛnyɛ obiara na obetumi anya sɔhwɛ yi. Nneɛma bi wɔ hɔ a enti ebia ɛnyɛ nea asiane biara nni ho sɛ wubenya bi. Nnuruyɛfo frɛ eyinom ‘nneɛma a ɛko tia’. Ebia sɔhwɛ yi renfata wo sɛ wowɔ tebea horow a edidi so yi mu biara a:

• Nyarewa a emu yɛ den (te sɛ atiridii anaa atiridiinini) .
• Acute Myocarditis anaa Pericarditis (koma ntini anaa ntini a atwa koma no ho ahyia a ɛyɛ hyew) .
• ``Koma mu yare`` a esii wɔ ɔsram biako mu
• Deep Vein Thrombosis (DVT) a ɛwɔ nan no mu
• Endocarditis (yare mmoawa a ɛwɔ koma no mu) .
• Hypertrophic Cardiomyopathy (koma ntini a ɛyɛ den a ɛnyɛ ne kwan so) .
• `Asaabo a Ɛnyɛ Yie`
• `Koma Valve Stenosis` a ɛkɔ fam anaasɛ emu yɛ den
• Nyinsɛn a nsɛnnennen wɔ mu anaasɛ ɛrenkyɛ awo
• Hypertension a Ɛyɛ Den
• Ahurututu mu Ntini a Ɛyɛ Den (PAH) .
• Arrhythmias a Wontumi Nhyɛ So
• Koma a Wontumi Nhyɛ So
• Angina a entumi nnyina (koma mu yaw) .

Ɔkwan bɛn so na wobetumi asiesie wɔn ho ama sɔhwɛ no?

Okay, afei momma yɛnhwɛ sɛnea yɛbɛsiesie yɛn ho ama sɔhwɛ yi. Ɛsɛ sɛ wudi akwankyerɛ a wo duruyɛfo de ama wo no akyi pɛpɛɛpɛ. Akwankyerɛ ahorow bi a ɛfa nneɛma nyinaa ho ni:

• Nnom biribiara a caffeine wom nnɔnhwerew 24 ansa na woayɛ nhwehwɛmu. Caffeine betumi aka nea efi nhwehwɛmu no mu ba no. Caffeine wɔ kɔfe, tii, anonne a ɛyɛ dɛ bi, ne chocolate mu. Strawberry ne nneɛma a wɔakyerɛw so sɛ ``decaffeinated`` anaa ``caffeine-free`` nso betumi ayɛ kakraa bi, enti eye sɛ wobɛkwati nso.
• Nnidi anaa nnom biribiara gye nsu nnɔnhwerew anan ansa na wɔayɛ sɔhwɛ no.
• Gyae sigaretnom anaa vaping nnɔnhwerew awotwe ansa na wɔayɛ sɔhwɛ no (sɛ ɛbɛyɛ yiye a, nnɔnhwerew 24 ye sen biara). Nicotine nso betumi aka nea efi mu ba no.

Dɛn na meyɛ wɔ nnuru a metaa nom no ho?

Ɛsɛ sɛ wubisa wo duruyɛfo no eyi ho asɛm. Ebia ɛho behia sɛ wɔnom nnuru bi wɔ ɔkwan soronko so da a wɔbɛyɛ nhwehwɛmu no. Mpɛn pii no, wɔmfa nnuru a wɔde kum ɛyaw a caffeine wom (te sɛ nnuru bi a wɔde kum aduan, te sɛ NoDoz®, Excedrin®, ne Anacin®) nkyerɛ nnɔnhwerew 24 ansa na wɔayɛ nhwehwɛmu.

Afotu titiriw a wɔde ma nnipa a wɔwɔ asikreyare:

Sɛ wofa insulin de hwɛ wo mogya mu asikre so a, bisa wo duruyɛfo dodow a ɛsɛ sɛ wonom da a wobɛyɛ nhwehwɛmu no. Nnipa dodow no ara bɛka akyerɛ wo sɛ fa dodow a wotaa de di dwuma no fã anɔpa na di aduan a emu nyɛ duru nnɔnhwerew anan ansa na wɔayɛ nhwehwɛmu no.

Sɛ worenom aduru bi a wode bɛhwɛ asikre a ɛwɔ wo mogya mu so a, ebia wɔbɛka akyerɛ wo sɛ nnom kosi sɛ wobɛyɛ nhwehwɛmu no awie.

Dɛn na ɛsɛ sɛ wɔhyɛ wɔ sɔhwɛ da no?

Hyɛ ntade a wubetumi adi akɔneaba wɔ mu na woateɛteɛ w’apɔw mu . Esiane sɛ ebia wo ho fifiri bɛtɔ wo kakra nti, ɛbɛyɛ papa sɛ wobɛpaw ntade a wɔde ntama a ɛte sɛ kotoku a ɛma ahome (te sɛ T-shirt a nsa nnim) ayɛ. Wubetumi ahyɛ saa ntade yi wɔ fie, anaasɛ wubetumi asesa wɔ hɔ. Afei nso, fa mpaboa a ɛyɛ fɛ (te sɛ mpaboa a wɔde ntama ayɛ anaa sneakers) bra . Wɔbɛyɛ locker bi wɔ hɔ a wode wo nneɛma besie. Nanso, ɛbɛyɛ papa sɛ wubegyaw nneɛma a ɛsom bo wɔ fie.

Ɔkwan bɛn so na wɔyɛ saa nipadua mu apɔw-mu-teɛteɛ sɔhwɛ yi?

Okay, afei ɔfã a ɛho hia no ba. Ɔkwan bɛn so na wɔyɛ sɔhwɛ yi? Wɔyɛ no wɔ `stress lab`, dan titiriw bi a wɔyɛ adwennwen sɔhwɛ ahorow wom. Mfiridwuma ho nimdefo a wɔatete no na ɔyɛ sɔhwɛ no, wɔ oduruyɛfo bi hwɛ ase. Wubetumi `sakre wɔ sakre a egyina hɔ so` anaasɛ `nantew wɔ treadmill so`. Sakraman a wɔde tu mmirika ne nea abu so sen biara. Wo duruyɛfo begyina mfe a woadi, w’akwahosan, ne sɛnea wo ho yɛ den so besi ɔkwan a eye ma wo ho gyinae.

Bere a woreteɛteɛ w’apɔw mu no, wɔde wo bɛka afiri bi a ɛsusuw wo home ne wo home ho. Wobetumi de ``facemask`` anaa ``ano aduru`` ayɛ eyi. Ebia wubetumi apaw nea ɛbɛma wo ho atɔ wo sen biara.

Sɛnea sɔhwɛ anammɔn ahorow no yɛ adwuma ni:

• `EKG` a wɔde bɛka abom: Mfiridwumayɛfo no de `electrodes` nketewa a ɛte sɛ sticker a ɛyɛ tratraa bɛhyɛ wo moma so mmeae ahorow. Wɔde eyinom bata monitor bi a ɛbɛhwɛ wo koma no anyinam ahoɔden dwumadi wɔ sɔhwɛ no nyinaa mu ho.
• Ahomegye fã: Eyi taa gye bɛyɛ simma abiɛsa. Mfiridwumayɛfo no bɛboa wo ma woasua anim akataso anaa ano aduru no na waka akyerɛ wo sɛ fi ase mfa mu home. Wɔbɛsusuw wo mogya mmoroso ne mogya mu oxygen dodow (baseline vital signs). Wɔde ECG monitor nso bedi dwuma de ahwɛ sɛnea wo koma bɔ. Sɛnea ɛbɛyɛ na wahwɛ oxygen ne carbon dioxide dodow a ɛwɔ wo mogya mu (ntini mu mogya mu mframa a wɔsusuw) no, mfiridwumayɛfo no de afiri ketewaa bi (arterial catheter) bɛhyɛ ntini bi a ɛwɔ wo nsa mu (radial artery) mu. Eyi bɛma wɔagye mogya bere ne bere mu bere a wɔreyɛ nhwehwɛmu no.
• Unloaded phase (warmup): Eyi gye simma abien kosi abiɛsa. ‘Unloaded’ kyerɛ sɛ worekɔ sakre so anaasɛ worenantew a wo mu duru foforo biara nka ho. Saa berɛ yi mu no, mfiridwumayɛfoɔ no boaboa ‘active baseline information’ ano. Eyi ne sɛnea wo koma ne w’ahurututu yɛ wɔn ade wɔ apɔw-mu-teɛteɛ a ɛba fam koraa ho.
• Apɔw-mu-teɛteɛ fã a ɛkɔ soro: Eyi ne sɔhwɛ no fã a ɛho hia sen biara. Egye simma 8 kosi 12. Wotra sakre no so anaasɛ wo nantew bere nyinaa. Mfiridwumayɛfo no de nkakrankakra ma afiri no ahoɔden a ɛko tia no yɛ kɛse. Wobɛfi ase ate nka nkakrankakra sɛ woabrɛ. Saa bere yi mu no, mfiridwuma ho nimdefo no bebisa wo sɛnea wote nka. Ade a ɛho hia sen biara ne sɛ wobɛteɛteɛ w’apɔw mu bere tenten biara a wubetumi.
• Ɔfã a ɛma obi ho tɔ no (cooldown): Eyi gye bɛyɛ simma abiɛsa kosi anum. Wobɛkɔ so atra pɔnkɔ so anaasɛ wobɛnantew sɛnea wotaa yɛ no, a worenkɔ so nyɛ wo duru biara. Mfiridwumayɛfo no bɛhwɛ wo sɛnkyerɛnne a ɛho hia no na wasusuw sɛnea wo koma bɔ no ho. Sɛ wo koma bɔ ne wo mogya mmoroso san ba sɛnea na ɛte kan no a, woasiesie wo ho sɛ wobɛkɔ.

Dɛn ne `RPE` nsenia no?

Ɔkwan bi wɔ hɔ a wɔfa so kyerɛkyerɛ sɛnea wote nka sɛ woabrɛ wɔ sɔhwɛ no mu. Wɔfrɛ no `Rating of Perceived Exertion` (RPE) nsenia. `RPE` nsenia ahorow pii wɔ hɔ. Nea wɔtaa de di dwuma ma `CPET` ne sɛ wode wo nsateaa bɛkyerɛ sɛnea ɛyɛ den sɛ wobɛhome ne sɛnea wo nan abrɛ wɔ nsenia a efi 0 kosi 10. Dodow a dodow no kɔ soro no, dodow no ara na wote ɔbrɛ nka.

Ɛwom mpo sɛ saa mfiri no nyinaa boaboa nea ɛrekɔ so wɔ wo nipadua mu ho nsɛm pii ano de, nanso wo nkutoo na wubetumi ahu sɛnea wote nka. Enti, sɛ wowɔ nsɛmmisa bi fa saa nsenia yi ho ansa na woafi sɔhwɛ no ase a, bisa mfiridwumayɛfo no.

Sɛ meyɛ sɔhwɛ no a, mɛte nka dɛn?

Sɔhwɛ no te nka dɛn? Sɛ wubenya nea efi mu ba ankasa, nokwarem na mfaso wɔ so a, ɛsɛ sɛ woteɛteɛ w’apɔw mu kosi sɛ wobɛbrɛ ankasa. Ɛyɛ ade a ɛfata sɛ wo koma bɔ, wo mogya mmoroso, ne wo home bɛkɔ soro. Wo fifiri bɛtɔ wo, na wo nan bɛte nka sɛ woabrɛ kakra. Ebia wobɛte nka nso sɛ w’ano ayɛ kusuu esiane sɛ wobɛhome afa ano aduru no mu nti.

Eyi yɛ sɔhwɛ, enti ɛte sɛ sɔhwɛ. Nanso, sɛ wuhu sɛnkyerɛnne biara a ɛyɛ soronko wɔ sɔhwɛ no mu a, ɛsɛ sɛ wugyae apɔw-mu-teɛteɛ ntɛm ara na woka kyerɛ mfiridwumayɛfo no. Nsɛnkyerɛnne a ɛtete saa no bi ne:

• Ɛyaw, ahometew, koko, abasa, anom a ɛyɛ den
• Ahome a ɛyɛ tiaa a emu yɛ den
• Adwene a ɛyɛ basaa, atenka a ɛma obi totɔ piti

Saa nsɛnkyerɛnne yi betumi ayɛ aduruyɛ mu tebea a egye ntɛmpɛ ho sɛnkyerɛnne, te sɛ ``komayare.'' Esiane sɛ mfiridwumayɛfo rehwɛ E.C.G. hwɛ so no, sɛ wohu nsakrae bi a asiane wom a, wobegyae sɔhwɛ no ntɛm ara.

Bere tenten ahe na sɔhwɛ yi gye?

Wo nhyehyɛe no nyinaa begye bɛyɛ simma 75, nanso nokwarem no, wobɛteɛteɛ w’apɔw mu bɛyɛ simma 20, a nea ɛka ho ne sɛ wobɛma wo ho ayɛ hyew na wo ho adwo wo.

Mɛyɛ dɛn anya sɔhwɛ no mu aba?

Wo duruyɛfo bɛkyerɛ wo bere ne ɔkwan a wobɛfa so ahu nea ebefi mu aba no. Ɛda adi sɛ wubetumi ahu nea afi mu aba no wɔ wo kɔmputa so aduruyɛ ho kyerɛwtohɔ mu. Wobɛnya hokwan nso ne wo duruyɛfoɔ ahyia asusu yei ho.

Saa sɔhwɛ yi kyerɛw susudua mpempem pii, a wɔda no adi wɔ graph format a ɛyɛ den a wɔfrɛ no ``nine-panel plot.`` Eyinom yɛ graph ahorow a ɛyɛ den, mfiridwuma mu a ɛma mfonini a edi mũ a ɛkyerɛ sɛnea wo koma ne w’ahurututu reyɛ adwuma. Wo duruyɛfo no bɛhwehwɛ nea afi mu aba yi mu na wakyerɛkyerɛ mu akyerɛ wo wɔ ɔkwan a wubetumi ate ase so.

Ɛyɛ ade a ɛfata sɛ wobɛte ehu ne ehu nka kakra bere a wɔka kyerɛ wo sɛ wobɛyɛ metabolic exercise stress test no. Ɛno yɛ nea ntease wom. Nanso nsusuw ho ntra so.Eyi yɛ sɔhwɛ a wɔtaa yɛ a ebetumi ama wo ne wo duruyɛfo anya nea ɛrekɔ so wɔ wo koma ne w’ahurututu mu no ho nhumu kɛse.

Ampa, ebetumi ayɛ nwonwa kakra sɛ wobɛteɛteɛ w’apɔw mu bere a wohyɛ electrode ne mfiri afoforo. Nanso kae sɛ mfiri biara boaboa nsɛm a ɛho hia a ɛbɛboa ma woayɛ w’ayaresa no ho nhyehyɛe ano. Sɛ wowɔ nsɛmmisa bi fa sɛnea wubesiesie wo ho ama sɔhwɛ no anaa nea wobɛhwɛ kwan bere a woadu lab no ho a, nsuro sɛ wubebisa wo duruyɛfo.

Enti, nneɛma bɛn na ɛho hia paa a yɛpɛ sɛ yɛde fi asɛm yi mu kɔ fie?

Sɛ yɛbɛka no tiawa a, `Metabolic Exercise Stress Test` (`CPET`) yɛ sɔhwɛ titiriw a ɛkyerɛ sɛnea wo koma ne w’ahurututu yɛ wɔn ade wɔ apɔw-mu-teɛteɛ ho. Ebetumi aboa wo ma woahu nea ɛde wo home tiaa ne ɔbrɛ ba, ahu ayaresa tebea horow, ayɛ ayaresa ho nhyehyɛe, na woasusuw asiane a ɛwɔ hɔ ho ansa na wɔayɛ wo oprehyɛn.

Ɛho hia yiye sɛ wubedi oduruyɛfo no akwankyerɛ (a ɛfa caffeine, sigaretnom, aduan, ne nnuru ho) akyi pɛpɛɛpɛ ansa na wɔayɛ nhwehwɛmu yi.

Ɛyɛ ade a ɛfata sɛ wobɛte ɔbrɛ kakra nka bere a wɔreyɛ sɔhwɛ no. Nanso, sɛ wuhu sɛnkyerɛnne biara a ɛyɛ soronko a, ka kyerɛ mfiridwumayɛfo no ntɛm ara. Kae sɛ eyi yɛ sɔhwɛ a ɛbɛma woanya w’akwahosan ho nsɛm a ɛsom bo na aboa wo ma woanya ayaresa a eye sen biara. Enti, nsuro sɛ wo ne wo duruyɛfo bɛkasa na woasua eyi ho ade pii.

` Metabolic Exercise Stress Test, CPET, Koma mu Nhwehwɛmu, Ahurututu mu Nhwehwɛmu, Apɔw-mu-teɛteɛ mu Nhwehwɛmu, Nea ɛde Ɔbrɛ ba, Koma Akwahosan, Ɔhome mu Akwahosan