Functional tests in the assessment of external respiration. Functional tests for assessing the state of the respiratory system Functional tests used for the study of external respiration

Research and functional assessment systems and organs is carried out by using functional tests... They can be one-time, two-moment, or combined.

The tests are carried out in order to assess the body's response to the load due to the fact that the data obtained at rest do not always reflect the reserve capabilities of the functional system.

The functional state of the body systems is assessed according to the following indicators:

• the quality of physical activity;
• the percentage of increased heart rate, respiratory rate;
• time to return to initial state;
• maximum and minimum blood pressure;
• time to return blood pressure to the original data;
• type of reaction (normotonic, hypertensive, hypotonic, asthenic, dystonic) by the nature of the pulse curves, respiratory rate and blood pressure.

When determining the functional capabilities of the body, it is necessary to take into account all the data in the complex, and not separate indicators (for example, respiration, pulse). Functional tests with physical activity should be selected and applied depending on the individual state of health and physical fitness.

The use of functional tests allows you to fairly accurately assess the functional state of the body, fitness and the possibility of using optimal physical loads.

The indicators of the functional state of the central nervous system are very important in determining the reserve capacities of the trainees. Since the technique for studying the higher nervous system using electroencephalography is complex, laborious, requiring appropriate equipment, the search for new methodological techniques is quite justified. For this purpose, proven motor tests can be used, for example.

Tapping test

The functional state of the neuromuscular system can be determined using a simple technique - identifying the maximum frequency of hand movements (tapping test). To do this, a sheet of paper is divided into 4 squares of 6x10 cm in size. Sitting at the table for 10 s, with a maximum frequency, place a point in one square with a pencil. After a pause of 20 s, the hand is transferred to the next square, continuing to perform movements with maximum frequency. After filling in all the squares, the work stops. When counting points, in order not to make a mistake, the pencil is led from point to point, without lifting it from the paper. The normal maximum frequency of hand movements in trained young people is approximately 70 points in 10 s, which indicates functional lability (mobility) of the nervous system, a good functional state of the motor centers of the central nervous system. A gradually decreasing frequency of hand movements indicates insufficient functional stability of the neuromuscular apparatus.

Romberg test

An indicator of the functional state of the neuromuscular system can be static stability, which is determined using the Romberg test. It consists in the fact that the person stands in the basic stance: the feet are shifted, the eyes are closed, the arms are extended forward, the fingers are spread (a complicated version - the feet are on the same line). The maximum stability time and the presence of hand tremor are determined. The time of stability increases as the functional state of the neuromuscular system improves.

In the course of training, changes occur in the nature of breathing. Respiratory rate is an objective indicator of the functional state of the respiratory system. Respiratory rate is determined by the number of breaths in 60 s. To determine it, you need to put your hand on the chest and count the number of breaths in 10 s, and then recalculate for the number of breaths in 60 s. At rest, the respiratory rate in an untrained young man is 10-18 breaths / min. In a trained athlete, this indicator decreases to 6-10 breaths / min.

During muscular activity, both the frequency and the depth of breathing increase. The reserve capabilities of the respiratory system are evidenced by the fact that if at rest the amount of air passing through the lungs per minute is 5-6 liters, then when performing such sports loads as running, skiing, swimming, it rises to 120-140 liters.

Below is a test to assess the functional performance of the respiratory system: Shtange and Gench tests. It should be borne in mind that when performing these tests, the will factor plays an important role. Material from the site

Stange test

A simple way to assess the performance of the respiratory system is the Stange test - holding the breath while breathing. Well-trained athletes hold their breath for 60-120 seconds. Breath holding is sharply reduced with inadequate loads, overtraining, overwork.

Gench test

For the same purposes, you can use the breath holding on the exhale - the Gench test. With training, the breath holding time increases. Holding the breath on exhalation for 60-90 s is an indicator of good fitness of the body. When overworked, this indicator decreases sharply.

Functional tests to assess the state of the cardiovascular system.

Blood circulation is one of the most important physiological processes that maintain homeostasis, ensuring continuous delivery of nutrients and oxygen necessary for life to all organs and cells of the body, removal of carbon dioxide and other metabolic products, processes of immunological protection and humoral (fluid) regulation of physiological functions. It is possible to assess the level of the functional state of the cardiovascular system using various functional tests.

One-time trial. Before performing a one-step test, rest while standing, without movement for 3 minutes. Then the heart rate is measured in one minute. Next, 20 deep squats are performed in 30 seconds from the starting position of the legs shoulder-width apart, arms along the body. When squatting, the arms are brought forward, and when straightened, they are returned to their original position. After doing the squats, the heart rate is calculated for one minute. The assessment determines the rate of increase in heart rate after exercise in percent. A value of up to 20% means an excellent response of the cardiovascular system to stress, from 21 to 40% - a good one; from 41 to 65% - satisfactory; from 66 to 75% - bad; from 76 and more - very bad.

Ruffier index. To assess the activity of the cardiovascular system, you can use the Ruffier test. After a 5-minute resting state in a sitting position, count the heart rate in 10 seconds (P1), then perform 30 squats within 45 seconds. Immediately after squatting, calculate the pulse for the first 10 s (P2) and one minute (РЗ) after the load. The results are assessed by the index, which is determined by the formula:

Ruffier index = 6x (Р1 + Р2 + РЗ) -200

Heart performance assessment: Ruffier index

0.1-5 - "excellent" (very good heart)

5.1 - 10 - "good" (good heart)

10.1 - 15 - "satisfactory" (heart failure)

15.1 - 20 - "bad" (severe heart failure)

Breathing is the process that ensures the consumption of oxygen and the release of carbon dioxide by the tissues of a living organism.

Distinguish between external (pulmonary) and intracellular (tissue) respiration. External respiration is called the exchange of air between the environment and the lungs, intracellular - the exchange of oxygen and carbon dioxide between the blood and the cells of the body. To determine the state of the respiratory system and the ability of the internal environment of the body to be saturated with oxygen, the following tests are used.

Stange test (holding the breath while inhaling). After 5 minutes of rest while sitting, take 2-3 deep breaths and exhales, and then, after taking a full breath, hold the breath, the time is noted from the moment of holding the breath until it stops.

The average indicator is the ability to hold the breath while inhaling for untrained people for 40-55 seconds, for trained people - for 60-90 seconds or more. With an increase in fitness, the time for holding the breath increases; in case of illness or overwork, this time decreases to 30-35 seconds.

Genchi test (holding the breath while exhaling). It is performed in the same way as the Shtange test, only the breath is held after a complete exhalation. Here, the average indicator is the ability to hold the breath while exhaling for untrained people for 25-30 seconds, for trained people for 40-60 seconds and

Serkin's test. After a 5-minute rest while sitting, the time for holding the breath on inspiration in a sitting position is determined (first phase). In the second phase, 20 squats are performed in 30 seconds. and holding the breath while inhaling while standing is repeated. In the third phase, after resting while standing for one minute, the time for holding the breath while sitting is determined (the first phase is repeated)

The functional state of the cardiovascular and respiratory systems determines the ability of the human body to adapt to the changing conditions of the external environment. The impact of environmental factors, heredity, sports stress, as well as acute and chronic diseases affect the structure of organs and the course of physiological processes. The absence of pronounced clinical symptoms does not mean complete health, therefore, functional tests of the respiratory system are used to assess the reserves of the human body, readiness for increased loads and for the purpose of early diagnosis of disorders.

Samples for assessing the functional state of the respiratory system

Pathologies of the bronchopulmonary system most often develop against the background of infectious processes (pneumonia, bronchitis) and are accompanied by characteristic clinical signs:

• Cough with sputum (purulent or serous in nature).
• Shortness of breath (depending on the phase of breathing, difficulty breathing in or out).
• Chest pain.

In medical practice, for the diagnosis of diseases, laboratory tests and instrumental methods are most often used, which assess morphological changes (radiography, computed tomography). The chronic course of diseases that reduce the patient's quality of life (bronchial asthma or obstructive pulmonary disease (COPD)) require monitoring of the process. Treatment tactics are determined by the severity of changes and the degree of decrease in function, which in mild stages is not determined using X-ray methods.

In sports medicine and functional diagnostics, methods of tests and samples are widely used, which assess the state of the respiratory system at different levels (calibers of the bronchi) and determine the "reserve" of capabilities of each person.

Functional test (test) is a method that examines the response of an organ or system to a dosed load using standardized indicators. In the practice of pulmonologists, most often spirometry, which determines:

• Lung vital capacity (VC).
• Inspiratory and expiratory speed.
• Forced expiratory volume.
• Air flow rate through bronchi of different caliber.

Another method, lung plethysmography, is used to assess changes in the volume of the respiratory organs during a respiratory act.

Additional use of provocative tests (starting a pathological reaction using pharmacological agents), studying the effectiveness of drugs are components of functional pulmonological diagnostics.

In sports medicine, tests are used to study endurance, reactivity and the dynamics of a person's fitness. For example, an improvement in the indicators of the Shtange and Genchi test indicates a positive trend in swimmers.

Indications and contraindications for functional breathing tests

The introduction of functional tests into clinical practice obliges to form a contingent of patients for whom it is advisable to conduct a study.

• Long-term smoking experience (more than 10 years) with a high risk of developing diseases.
• Bronchial asthma (for clinical diagnosis and treatment selection).
• COPD.
• Patients with chronic dyspnea (to determine the cause and location of the lesion).
• Differential diagnosis of pulmonary and heart failure (in combination with other methods).
• For athletes to assess the strength of the muscles of the chest, tidal volume.
• Monitoring the effectiveness of treatment for pulmonary diseases.
• Preliminary assessment of possible complications before surgery.
• Ability to work and military expertise.

Despite its wide clinical application, testing is accompanied by increased stress on the respiratory system and emotional stress.

Functional breathing tests are not performed when:

• Severe condition of the patient due to somatic disease (hepatic, renal failure, early postoperative period).
• Clinical variants of coronary heart disease (IHD): progressive exertional angina, myocardial infarction (within 1 month), acute cerebrovascular accident (HNMC, stroke).
• Essential hypertension with a very high risk of cardiovascular diseases, malignant hypertension, hypertensive crises.
• Gestosis (toxicosis) in pregnant women.
• Heart failure stages 2B and 3.
• Pulmonary insufficiency, which does not allow for respiratory manipulation.

Important! The result of the study is influenced by the weight, sex, age of a person and the presence of concomitant diseases, therefore, the analysis of spirometry data is carried out using special computer programs.

Do I need special preparation for the examination

Breathing function tests using a pneumotachometer or spirometer are performed in the morning. Patients are not advised to eat before the procedure, as a full stomach limits the movement of the diaphragm, which leads to distorted results.

Patients who regularly take bronchodilating agents (Salbutamol, Seretide and others) are advised not to use the drugs 12 hours before the study. The exception is patients with frequent exacerbations.

For the objectivity of the results, doctors advise not to smoke at least 2 hours before the study. Immediately before the study (20-30 minutes) - exclude all physical and emotional stress.

Types of functional breathing tests

The methodology for conducting various tests differs due to the multidirectional research. Most of the tests are used to diagnose the latent (latent) stage of bronchospasm or pulmonary insufficiency.

The widely used functional tests are presented in the table.

The use of functional diagnostics in the clinical practice of therapists is justified by early diagnosis and control of the effectiveness of treatment of diseases. Sports medicine uses tests to assess a person's condition before a competition, to monitor the adequacy of the selected regimen and the body's response to stress. Dynamic research methods are more informative for doctors, since dysfunction is not always accompanied by structural changes.

Functional test- an integral part of the comprehensive methodology of medical control of persons involved in physical culture and sports. The use of such tests is necessary to fully characterize the functional state of the student's body and his fitness.

The results of functional tests are evaluated in comparison with other data of medical supervision. Often, adverse reactions to stress during a functional test are the earliest sign of deterioration in the functional state associated with illness, overwork, overtraining.

Here are the most common functional tests used in sports practice, as well as tests that can be used for independent physical education.

Functional tests provide information on the functional state of the respiratory system. For this purpose, spirometry, ultrasound examination, determination of minute and stroke volumes and other research methods are used. Spirometry is a measurement of the vital capacity of the lungs and other lung volumes using a spirometer. Spirometry allows you to assess the state of external respiration.

Rosenthal functional test allows you to judge the functional capabilities of the respiratory muscles. The test is carried out on a spirometer, where the examinee has it 4-5 times in a row with an interval of 10-15 seconds. define VC. Normally, the same indicators are obtained. A decrease in VC throughout the study indicates fatigue of the respiratory muscles.

The Votchal-Tiffno test is a functional test for assessing tracheobronchial patency by measuring the volume of air exhaled in the first second of forced expiration after maximum inspiration, and calculating its percentage to the actual vital capacity of the lungs (the norm is 70-80%). The test is carried out for obstructive diseases of the bronchi and lungs. The oxygen utilization factor is the percentage of oxygen used by the tissues to the total oxygen content in arterial blood. It is an important indicator characterizing diffusion processes through alveolar-capillary membranes (norm 40%). In addition, according to special indications, bronchospirography is performed (the study of ventilation of one lung isolated by intubation of the bronchus); a test with blockade of the pulmonary artery and measuring the pressure in it (an increase in pressure in the pulmonary artery above 40 mm Hg indicates the impossibility of pneumoectomy due to the development of hypertension in the pulmonary artery after surgery).

Functional tests for holding the breath - functional load with holding the breath after inhalation (Stange's test) or after exhalation (Genchi's test), the delay time is measured in seconds. Stange's test allows assessing the resistance of the human body to mixed hypercapnia and hypoxia, reflecting the general state of the body's oxygen supply systems when holding the breath against the background of a deep breath, and the Genchi test against the background of deep exhalation. They are used to judge the oxygen supply of the body and assess the general level of fitness of a person.

Equipment: stopwatch.

Stange test. After 2-3 deep breaths, the person is asked to hold his breath on a deep breath for the maximum time possible for him.

After the first test, you need to rest for 2-3 minutes.

Genchi test. After 2-3 deep breaths and exhalations, the person is asked to exhale deeply and hold his breath for the maximum possible time.

Evaluation of test results is carried out on the basis of tables (Table 1, Table 2). Good and excellent marks correspond to the high functional reserves of the human oxygen supply system.

Table 1. Indicative indicators of the Shtange and Genchi samples

Table 2. Evaluation of the general condition of the subject by the parameter of the Stange sample

Stange test. The examinee in a sitting position takes a deep breath and exhale, and then inhale and holds his breath. Normal test of Shtange - for non-athletes 40-60 seconds, for athletes 90-120.

Genchi test. The examinee in a sitting position takes a deep breath, then incomplete exhalation and holds his breath. Normally, the sample is -20-40 seconds (non-athletes), 40-60 seconds (athletes). Rosenthal's test. Fivefold measurement of VC at 15-sec intervals. In N, all VCs are the same.

Serkin's test. It is carried out in three stages. 1st phase: holding the breath while inhaling while sitting; 2nd phase: holding the breath while inhaling after 20 squats in 30 seconds, 3rd phase: repetition of 1st phase after a minute. This is a test of endurance. For a healthy trained person 1st phase = 45-60 sec; 2nd phase = more than 50% of 1st phase; 3rd phase = 100 or more% 1st phase. For a healthy untrained person: 1st phase = 35-45 sec; 2nd phase = 30-50% of 1st phase; 3rd phase = 70-100% of 1st phase. With latent circulatory failure: 1st phase = 20-30 sec, 2nd phase = less than 30% of 1st phase; 3rd phase = less than 70% of 1st phase.

Functional tests for assessing the state of the cardiovascular system Martine-Kushelevsky test (with 20 squats)

After a 10-minute rest in a sitting position, the subject's pulse is counted every 10 s up to 3 times the same numbers. Next, BP and RR are measured. All found values ​​are original. Then the subject does 20 deep squats, with arms being thrown forward, in 30 seconds (under the metronome). After squatting, the subject sits down; the first 10 from the 1st minute of the recovery period, the pulse is counted, and in the remaining 50 seconds, the blood pressure is measured. First, the 2nd minute of the recovery period, the pulse is determined in 10-second intervals up to a 3-fold repetition of the initial values. In conclusion, the sample is measured by blood pressure. Sometimes in the recovery period there may be a decrease in heart rate below the initial data ("negative phase"). If the "negative phase" of the pulse is short (10-30 sec), then the reaction of the CVS to the load is normotonic.

Evaluation of the results of the test is carried out according to the data of the pulse, blood pressure and the duration of the recovery period. Normotonic reaction: increased heart rate up to 16-20 beats in 10 s (by 60-80% of the initial), SBP increases by 10-30 mm Hg (no more than 150% of the initial), DBP remains constant or decreases by 5 -10 mm Hg

Atypical reactions : hypotonic, hypertensive, dystonic, stepwise.

Atypical reactions. Hypertensive- significant increase in SBP (up to 200-220 mm Hg) and DBP, heart rate up to 170-180 beats / min. This type of reaction occurs in the elderly, in the initial stages of hypertension, with physical overstrain of the CVS.

Hypotonic- a slight increase in blood pressure with a very significant increase in heart rate up to 170-180 beats / min, the recovery period increases to 5 minutes after the first load. This type of reaction is observed with VSD, after suffering infectious diseases, with overwork.

Dystonic- a sharp decrease in DBP until the appearance of the phenomenon of "endless" tone (with a change in vascular tone). The appearance of this phenomenon in healthy athletes indicates a high contractility of the myocardium, but it may be. This type of reaction occurs with VSD, physical overstrain, in adolescents in puberty.

Stepped - SBP rises by 2-3 minutes of the recovery period. Such a CVS reaction occurs when the regulation of blood circulation is impaired and may be associated with an insufficiently rapid redistribution of blood from the vessels of internal organs to the periphery. Most often, this reaction is noted after a 15-second run with overtraining.

CombinedNSroba Letunova

The test includes 3 loads: 1) 20 squats in 30 seconds, 2) 15-second running, 3) running in place for 3 minutes at a pace of 180 steps per minute. The first load is a warm-up, the second reveals the ability to rapidly increase blood circulation, and the third reveals the body's ability to sustainably maintain increased blood circulation at a high level for a relatively long time. The types of response to exercise are similar to the 20 squat test.

Ruffier test - quantitative assessment of the pulse response to short-term exercise and the rate of recovery.

Methodology: after 5 minutes of rest in a sitting position, the pulse is counted in 10 s (recalculation per min - P0). Then the subject does 30 squats in 30 s, after which the pulse is determined in a sitting position in 10 s (P1). The third time the pulse is measured at the end of the first minute of the recovery period for 10 s (P2).

Ruffier index = (P0 + P1 + P2- 200) / 10

Evaluation of results: excellent - IR<0; хорошо – ИР 0-5, удовлетворительно – ИР 6-10, слабо – ИР 11-15;

unsatisfactory - IR> 15.

An indicator of the quality of the reaction of the cardiovascular system.

PKR = (RD2 - RD1): (P2 - P1) (Р1 - pulse at rest, РД1 - pulse pressure at rest, Р2 - pulse after exercise, РД2 - pulse pressure after exercise) . Good functional state of the cardiovascular system with RCC = 0.5 to 1.0.