How well the exercise professional understands human behaviour and personal mood variables will play an important part in the testing experience of the par-ticipant. The importance of understanding basic human behaviour cannot be overstated in an exercise test setting. The British Association of Sport and Exercise Sciences accreditation scheme, established as a gold standard in applied sport and exercise science, has recently acknowledged the need for min-imum sport science knowledge from all key sciences prior to the approval of accreditation.
When testing different groups, exercise professionals will build up a strong knowledge of the individuals and the types of test most appropriate for these specialist populations. Paediatric populations are one such specialist group.
Because of the dearth of knowledge that such participants might have about laboratory- or field-based testing, it is essential that those working with young people ensure a caring, compassionate and sensitive approach to their work.
This is particularly relevant in understanding the goals and motivations that young people will have towards exercise testing, particularly if the procedures are invasive, intense and not fully understood by the participants (Whitehead and Corbin, 1991; Goudas et al., 1994). Notwithstanding the ethical issues that will have had to be approved prior to this, young children will often need more advanced habituation to some testing procedures. If blood samples are being taken, as will often occur in paediatric studies, then demonstration might help, as might anaesthetic creams to minimise pain. The use of mouth pieces is being superseded by face masks in peak oxygen uptake testing, however if mouth pieces are to be used it will often help habituate children and minimise anxiety if they can be given a mouth piece to take home for several days prior to the test.
MODEL OF BEHAVIOUR CHANGE
When prescribing exercise programmes after laboratory- or field-based exercise testing, it is essential that exercise professionals are cognisant of adherence issues, the stages of behaviour change a participant might be demonstrating and willingness on the part of the participant. This will vary between populations.
For example, professional and elite athletes would normally present themselves for testing with high intrinsic motivation to succeed and strong personal com-mitment to prescribed programmes if they possess confidence in the exercise professional and feel the programmes are beneficial to their personal (and usu-ally sporting) potential. This requires the exercise professional to be able to communicate with all exercise test participants on a practical level using lan-guage, which is sincere, simple, but not degrading. Most athletes want to be confident that the exercise professional is aware of contemporary issues and training protocols, but they might not want (or need) to know the intricate detail behind the theory.
To this end, establishing clear motives for exercise testing, having an unambiguous understanding of goals that will arise from this and an aware-ness of the stage, in the Stages of Behaviour Change (Prochaska and DiClemente, 1986), the participant is in will be important (Figure 2.1). These are less relevant concerns when working with elite athletes, since the Governing Body, coaching staff or the athletes have probably established these themselves. However, when assessing participants from the general population who might be part of a corporate testing programme or who have simply made themselves available for testing, or who are part of a research study involving non-elite participants, these covert motives become much more rele-vant. The concerns arising from this include; will the participant adhere to any exercise programme arising from analysis of the test results; how will adherence 22 CRAIG A. MAHONEY
be optimised (e.g. social support, priority level, re-assessment, time allocation, SMART goals, monitoring), what factors can help them achieve their goals (or the goals of the programme funder), when re-assessment occurs will this be a positive experience for the participant?
Clearly, the whole area of exercise testing is affected by factors, which exhibit both a cognitive and a behavioural basis. To help minimise their effect on test results, exercise professionals (and participants) should have an under-standing of these and be prepared to adapt testing regimens to minimise their impact wherever possible. The following is offered as guidance to participants and exercise professionals.
Guidance for participants
Prior to the day of testing, ensure good rest and sleep where possible. In the same way physical performance can be affected by under or over arousal, so too can exercise test performances. If feeling lethargic then use arousal strategies such as:
● Light exercise
● Warm up routines
● Loud music.
If participants are feeling anxious, then the following relaxation routines might help:
● Calming music
● Relaxation exercises or tape
● Imagery relaxation
● Calm movements, breathing control and tranquil thoughts
● Biofeedback (if previously developed)
● Thought awareness and positive thinking.
Action Making change
Contemplation Thinking about change
Maintenance Regular behaviour Commitment
Ready to change
Relapse Gives up new behaviour
Pre-contemplation Not thinking about change
Figure 2.1 Models of the stages of behaviour
Guidance for exercise professionals
● Give time for habituation.
● Allow participants to take home pieces of equipment that may cause anxiety, for example, mouth pieces for VO2maxtests, especially children.
● Ensure all participants are supported in an equitable and consistent manner.
● Be sensitive to participant concerns related to some tests, for example, Multi Stage Fitness Test where motivation is highly significant and the test often generates considerable concerns in the minds of performers.
Exercise testing is a complex and multifaceted activity that combines the academic knowledge, practical skills, experiential awareness and personal capacity of the testing team to ensure the participant(s) have the most positive experience achievable. Where possible, exercise professionals must endeavour to ensure that all participants have a positive mental state leading up to and upon engaging in the exercise testing programme. This will increase the potential both for optimal and maximum achievable results. However, regardless of the scien-tific competency of the exercise physiologist undertaking the testing, sometimes no matter how effective their communication, counselling or relaxation skills, a patient with heart failure that might be progressing to end stage (i.e. death or transplant) and is being evaluated, by, for example, cardiopulmonary exercise testing, for this reason is not going to approach the test with a positive mental state. In such circumstances all we can do is manage those things that are within our control in order to minimise the potential negative experiences of testing.
REFERENCES
American College of Sports Medicine (ACSM). (2005). ACSM’s Guidelines for Exercise Testing and Prescription, 7th edn. Philadelphia, PA: Lippincott Williams & Wilkins.
de Vries, H.A. and Housh, T.J. (1995). Physiology of Exercise: for Physical Education, Athletics and Exercise Science, 5th edn. Dubuque: WC Brown.
Heyward, V.H. (1998). Advanced Fitness Assessment and Exercise Prescription.
Champaign, IL: Human Kinetics.
Goudas, M., Biddle, S. and Fox, K. (1994). Achievement goal orientations and intrinsic motivation in physical fitness testing with children. Pediatric Exercise Science, 6: 159–167.
Prochaska, J.O. and DiClemente, C.C. (1986). Toward a comprehensive model of change. in W.R. Miller and N. Heather (eds) Addictive Behaviours: Processes of Change. pp. 3–27. New York: Plenum Press.
Rothman, A., Salovey, P., Turvey, C. and Fishkin, S. (1993). Attributions of responsibil-ity and persuasion: increasing mammography utilisation among women over 40 and with internally oriented message. Health Psychology, 12: 39–47.
Whitehead, J.R. and Corbin, C.B. (1991). Youth fitness testing: the effect of percentile – based evaluative feedback on intrinsic motivation. Research Quarterly for Exercise and Sport, 62(2): 225–231.
24 CRAIG A. MAHONEY
INTRODUCTION
The collection of blood samples from human subjects is required in many physiological, biochemical and nutritional investigations. The use to be made of the sample will determine the method of collection, the volume of blood required and the way in which the specimen is handled.