Exercise testing is used to help diagnose pulmonary fibrosis (PF). It consists of cardiovascular exercise on a treadmill or stationary bike that measures how well the lungs and heart respond to physical activity, and to evaluate oxygen levels in the blood. As the body works harder during the test, it requires more energy, so the heart needs to pump more blood.

How is exercise testing done?

Exercise testing is a well-established procedure that has been in widespread clinical use for a long time. It is a safe test, sometimes referred to as a stress test, and re-creates the exercise of walking fast or jogging uphill. Medical professionals are present during the test and are trained to intervene in case anything unusual happens. The test may be interrupted at any time, if necessary.

Prior to the test, your doctor may ask about medicines you are taking, including over-the-counter herbal supplements, medicines and vitamins. No medicines should be stopped the day of the test unless instructed by your doctor.

Comfortable, loose-fitting clothes, such as shorts or sweatpants, and walking shoes with rubber soles should be worn. No food, drinks or smoking are allowed two to four hours before the exercise test.

As the patient walks or pedals on the exercise machine, an electrocardiogram (ECG) is used to check the heart rate, a blood pressure cuff is used to check blood pressure, and a pulse oximeter is used to check the amount of oxygen in the blood.

A catheter also may be placed in an artery in the arm to draw blood samples at different moments during the test. These blood samples will provide a more precise measure of the oxygen and carbon dioxide levels in the blood. These also can be measured by breathing into a tube at different moments during the test. After slowing down for a few minutes, the heart and blood pressure will be checked again while the patient is sitting or lying down.

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