Rheumatic diseases increase the risk of additional diseases, especially cardiovascular diseases. Therefore, rehabilitation is individually tailored. Physiotherapists at Diakonhjemmet Hospital use advanced tools, such as the Cardiopulmonary Exercise Test (CPET), to develop optimal rehabilitation programs.
“This test tool provides a deep understanding of the patient's physical capacity and is used to tailor effective and safe rehabilitation programs,” explains physiotherapist Susanne Brøndbo, acting unit manager at the National Treatment Service for Rheumatological Rehabilitation (NBRR) at Diakonhjemmet Hospital.
What is CPET?
CardioPulmonary Exercise Test (CPET), also known as ergospirometry or cardiopulmonary stress test, is considered the gold standard for assessing physical fitness and any limiting factors in both healthy individuals and patients with varying degrees of lung and heart disease.
The test measures how the heart, lungs and muscles function under physical stress. The test has become an important part of assessment and treatment at Diakonhjemmet Hospital. It is used in particular at the Activity Medicine Centre, at the Rheumatology Outpatient Clinic and at NBRR.
CPET, with treadmill exercise, measures oxygen uptake, carbon dioxide excretion and ventilation, in addition to gas exchange, blood pressure and exercise ECG. CPET has higher sensitivity than measurements taken at rest and can detect heart and lung disease at an early stage in the course.
Kristine Røren Nordén Kristine Røren Nordén, super user in CPET at Diakonhjemmet Hospital, emphasizes the value of the tool.
“CPET is the very best tool for measuring physiological work capacity and possible limiting factors in healthy people and patients with varying degrees of heart and lung disease,” says Nordén. She explains that the test makes it possible to tailor treatment precisely to each patient’s needs, which is crucial for achieving the best possible health benefits.
Susanne Brøndbo adds that when this test forms the basis for rehabilitation, the training can be designed so that the patient gets the best possible effect from the training, while avoiding training too hard.
CPET in clinical practice
At NBRR, CPET is used as an integrated part of the rehabilitation process for all patients who are able to complete the test.
– Patients at NBRR have complex challenges and high symptom burden, and there is often a need to make changes in several areas of their lives at the same time to improve their overall health, explains Brøndbo.
She explains that CPET for the physiotherapists at NBRR is one of several important mapping tools.
“This thorough assessment can help us understand why a patient is exhausted, has difficulty standing at work, or finds it challenging to participate in daily activities with their family. Sometimes the test result will show that the patient's physical capacity is not reduced, and then the patient can be advised to prioritize working on other change processes,” she says.
Patients are satisfied with the mapping
Despite the fact that CPET is a test of maximal load, the experience at NBRR is that patients handle the test well.
“None of the patients I have tested have regretted it afterwards or expressed that it was too demanding to complete,” says Brøndbo. She emphasizes that the vast majority are very satisfied that they were able to complete the test, and that many have a positive experience that their bodies can withstand pushing themselves to the max.
In summary
Physiotherapists play an important role in the rehabilitation of patients with rheumatic diseases, and CPET is a key tool in this work. By providing an accurate assessment of the patient's physical capacity, CPET enables physiotherapists to tailor rehabilitation in a way that is both safe and effective, which can improve the quality of life for the individual patient.
About the National Treatment Service for Rheumatological Rehabilitation (NBRR)
NBRR offers tailored multidisciplinary rehabilitation for patients over 18 years of age with chronic inflammatory rheumatic disease, both inflammatory joint diseases and connective tissue diseases. A stay involves a comprehensive assessment and coordinated measures from all six professional groups: rheumatologist, nurse, psychologist, social worker, occupational therapist and physiotherapist. A referral from a rheumatologist is required to receive a rehabilitation stay at NBRR.
Applications of CPET in the clinic
- Measuring physical fitness as an important health variable
- Investigation of causes of wheezing
- Evaluation and prognosis assessment of patients with potential or established heart or lung disease
- Pre-operative assessment before major surgical procedures
- Assess work function against work participation and disability assessment
- A starting point for guiding the individual patient in individually adapted activity such as medicine
- Evaluate the effect of various training measures
More details about CPET
Measuring physical fitness in patients with rheumatic disease
