Rheumatic diseases increase the risk of additional diseases, especially cardiovascular diseases. Therefore, rehabilitation is individually adapted. Physiotherapists at Diakonhjemmet hospital use advanced tools, such as the Cardiopulmonary Exercise Test (CPET) to develop optimal rehabilitation plans.
- This test tool provides a deep understanding of the patient's physical capacity and is used to tailor effective and safe rehabilitation programmes, explains physiotherapist Susanne Brøndbo, acting unit manager at the National Treatment Service for Rheumatology 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 people and patients with varying degrees of lung and heart disease.
The test measures how the heart, lungs and muscles work under physical stress. The test has become an important part of investigation and treatment at Diakonhjemmet hospital. It is used in particular at the Activity Medicine Centre, at the rheumatology outpatient clinic and at the NBRR.
CPET, with stress on a treadmill, measures oxygen uptake, carbon dioxide excretion and ventilation, in addition to gas exchange, blood pressure and work ECG. CPET has a higher sensitivity than measurements taken at rest and can reveal 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 adapt the treatment exactly to each individual patient's needs, which is crucial to achieving the best possible health benefit.
Susanne Brøndbo adds that when this test forms the basis of rehabilitation, the training can be planned 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 integral part of the rehabilitation process for all patients who are able to complete the test.
- The patients with NBRR have complex challenges and high symptom pressure, and there is often a need to make changes in several areas of life at the same time in order to improve their overall state of health, explains Brøndbo.
She explains that the CPET for the physiotherapists at NBRR is one of several important mapping tools.
- This thorough mapping can help us understand why a patient is exhausted, has difficulty staying 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 has not been reduced, and then the patient can be advised to prioritize working with other change processes, she says.
The patients are satisfied with the mapping
Despite the fact that the CPET is a test to maximum stress, the experience at NBRR is that the patients handle the test well.
- None of the patients I have tested have regretted it afterwards or expressed that it was too demanding to carry out, says Brøndbo. She emphasizes that the vast majority are very satisfied that they were able to complete the test, and that many gain a positive experience that the body can withstand pushing itself to the maximum.
In summary
Physiotherapists have an important role in the rehabilitation of patients with rheumatic diseases, and CPET is a central tool in this work. By offering 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 Rheumatology Rehabilitation (NBRR)
NBRR offers tailored interdisciplinary 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 survey 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.
Areas of use for CPET in the clinic
- Measuring physical fitness as an important health variable
- Investigation of causes of shortness of breath
- Evaluation and prognosis assessment of patients with potential or established heart or lung disease
- Pre-operative assessment before major surgical interventions
- Assess work function against participation in working life and disability assessment
- A starting point for being able to guide the individual patient in individually adapted activities such as medicine
- Evaluate the effect of various training measures
More details about CPET
Measurement of physical fitness in patients with rheumatic disease
