Recommendations for Clinical Exercise Laboratories

Abstract

The present statement provides a guide to initiating and maintaining a high-quality clinical exercise testing laboratory for administering graded exercise tests to adults. Pediatric testing has been addressed separately.1 It is a revision of the 1995 American Heart Association (AHA) “Guidelines for Clinical Exercise Testing Laboratories”2 and is designed to complement several other AHA documents related to exercise testing, including the AHA/American College of Cardiology (ACC) guidelines for exercise testing,3 the AHA’s “Exercise Standards for Testing and Training,”4 the AHA’s “Clinical Competence Statement on Stress Testing,”5 and the AHA’s “Assessment of Functional Capacity in Clinical and Research Settings.”6 Exercise testing is a noninvasive procedure that provides diagnostic and prognostic information and evaluates an individual’s capacity for dynamic exercise. Exercise testing facilities range from the sophisticated research setting to more conventional equipment in the family practitioner’s or internist’s office. Regardless of the range of testing procedures performed in any given laboratory, basic equipment, personnel, and protocol criteria are necessary to ensure the comfort and safety of the patient and to conduct a meaningful test. Environment Exercise testing equipment varies in size. The testing room should be large enough to accommodate all the equipment necessary, including emergency equipment and a defibrillator, while maintaining walking areas and allowing adequate access to the patient in emergency situations. It is also important that the laboratory comply with local fire standards and with procedures for other types of emergencies (eg, earthquake, hurricane). The laboratory should be well lighted, clean, and well ventilated, with temperature and humidity control. A wall-mounted clock with a sweep second hand or a digital counter is useful. The examining table should have space for towels, tape, and other items needed for patient preparation and testing. A curtain for privacy during patient preparation is useful. Minimization of interruptions …