Exercise stress test interpretation for cardiac diagnosis and functional evaluation.

The physiatrist, with the assistance of the physical therapist, can be the appropriate individual to prescribe and supervise exercise training programs for cardiac patients, although exercise testing is probably best left to cardiologists. Exercise test data, as supplied by the cardiologist from a diagnostic test, are often not sufficient for exercise programming - since diagnostic and fitness type testing may be carried out on different modalities, with monitoring of different parameters, using different test patterns to different endpoints, and with the patient on medication rather than off. This article describes special test modifications which provide information useful in preparing exercise guidelines for individual patients. These include walk-through, second-effort testing, testing on medication and non-standard monitoring. Based upon results from the fitness type of test, it is possible to predict which exercise candidates will benefit most from exercise programming and which should be referred elsewhere for more intensive medical management or consideration of surgery.