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TMT (Treadmill Test) Tips

TMT Test - Why It Is Done In Diabetes?

Dr. Hanish Gupta 92% (1913 ratings)
MBBS, DNB (General Medicine)
General Physician, Delhi
TMT Test - Why It Is Done In Diabetes?

A Stress test is done by making you do exercises like walking on a treadmill or riding a stationary bike during an Electro Cardiogram or ECG. Sometimes, medication to stimulate your heart is used instead of exercise.

The stress test compares the circulation of blood in the heart when you are resting and when you are under optimum physical pressure. There are various types of stress tests, but the most common of them is the Treadmill Stress Test or TMT

Why it’s done?

  1. A stress test is a common test for identifying a heart problem like Coronary Artery Disease or CAD in which the major blood vessels that supply your heart with blood, oxygen and nutrients, also called coronary arteries, get blocked, damaged or diseased. 
  2. It’s also used for determining the condition of your heart after a heart attack.
  3. TMT utilizes exercise so it helps to show up extreme shortness in breathing, chest discomfort, dizziness and sudden weakness- all of these indicating an underlying heart condition.
  4. TMT is also used to check the efficiency of the heart medications for diseases like angina and ischemia and to monitor heart function in patients who’ve had an angioplasty or a heart attack earlier.
  5. It is also to identify an abnormal heart rhythm due to exercise.

CAD and Diabetes
People with diabetes are at high risk of coronary artery disease, as it tends to present late, Diabetics also suffer more silent heart muscle problems like Ischemia. This is why TMT is a lifesaver for diabetics as early detection and intervention can save lives.

Preparation

  1. You need to prepare yourself before you take a stress test.
  2. You must not eat or drink anything but water for four hours before the exercise stress test which includes TMT.
  3. You should not drink any beverage with caffeine for twelve hours before the test too.
  4. You must stop all medications for the heart on the day the test is scheduled, unless specifically instructed by your doctor.
  5. If you are a diabetic, you should ask your doctor how much insulin can you inject on the day of the test, and if you are on pills, be aware that the medication is only to be taken after the completion of the stress test.
  6. You should wear comfortable clothes and soft walking shoes or sneakers for the TMT.

How is a TMT done?
A nurse or technician will place electrodes on your chest. These are then attached to wires that carry the electrical activity of your heart to the monitor and recorder of the ECG/EKG machine. These leads record different parts of your heart.

  1. Before you start the test, the EKG will record your heart activity on paper. This is called the Resting EKG.
  2. Initially, the treadmill is switched on at a rather slow ‘warm-up’ speed and gradually both the incline of the treadmill and the speed is increased every three minutes called stages.
  3. During TMT your blood pressure is recorded at the second minute in every stage.
  4. A stress test generally takes up to 90 minutes from beginning to end, but the exercise part of the test takes only 20 minutes.
  5. If you develop any uneasiness, TMT is stopped before the target heart rate is achieved.

How TMT Works
During the TMT, the healthy arteries in the heart dilate more than the blocked ones. This uneven dilation means that more blood is provided to the heart by the healthy arteries as compared to the blocked ones to their designated areas. This lowered blood flow makes the muscles in those areas thirsty for more blood during the TMT, creating symptoms like chest pain, and/or shortness of breath. If you wish to discuss about any specific problem, you can consult an Endocrinologist.

3185 people found this helpful

Have Leg Artery Blockages? Walk on a Treadmill

Dr. Sajeev Kumar 89% (28275 ratings)
C.S.C, D.C.H, M.B.B.S
General Physician, Alappuzha
Have Leg Artery Blockages? Walk on a Treadmill
A planned program of walking is good for people with blockage of leg blood vessels called peripheral arterial disease (pad). Normally when there is pain in the calf muscles in the leg on walking, the usual tendency is to rest and not walk. A study of 156 people with pad published in jama showed that regular six-minute walks on a treadmill improved their endurance and quality of life. The study examined patients with symptoms and without symptoms. Over the six months of the study, the participants who did their regular six-minute treadmill walks increased their walking distance by about 69 feet, while those who did not walk regularly saw a decrease of 49 feet.

There is the potential for greater oxygen extraction from the blood under maximum exercise conditions. The muscles can make better use of blood flow and the oxygen release that comes from it.

Such exercise leads to improvement in" collateral circulation" i. E. Growth in the number of blood vessels supplying the legs. Clinicians should urge all pad patients, whether or not they have symptoms, to engage in a regular, supervised exercise program.

Walking is a standard recommendation for people with pad. A recommended regimen is a 40-minute walk three times a week for at least six months. Persistent leg pain is an indication that help is needed. In the absence of that symptom, physicians can test for pad by measuring the difference in blood pressure between an ankle and an arm.

6 Treadmill Workout

MD - Consultant Physician
General Physician, Bhopal
6 Treadmill Workout
6 Treadmill Workout

Stuck inside for your run? These routines are anything but run-of-the-mill

If you dread the tread, check out these six routines that will help you outrun boredom and get better results than ever. 

Turn Up Your Tempo 
Set the incline to 1 percent and warm up with 10 minutes of easy running. Then set the pace 2 minutes faster than your easy running pace—say 8 minutes per mile if you usually run 10-minute miles for a long, easy run. Go at that tempo for 3 to 4 minutes, and then walk for 3 to 4 minutes. That’s one round; do 3 to 5 total rounds. 

“This is a maximum aerobic effort that helps you push your easy pace”

Progression Run
Warm up with 5 to 10 minutes of easy running. Then set the incline at 1 percent and start running at a 5 miles-per-hour pace. Increase the speed 0.2 mph every minute until you completely fatigue.

“This workout will systematically and incrementally increase an athlete's lactate threshold,”
“It will also develop mental patience and boost VO2 Max.” 

Half-Mile Intervals 
Warm up with 15 to 20 minutes of easy running. Then run a half-mile at 75 percent of your hardest effort. When you hit the half-mile mark, slow to a jog for 200 meters. That’s one round; do 6 to 8 total rounds. 

“By not fully recovering between repeats you still improve your ability to run fast, but also ensure you have the aerobic strength and support to maintain goal pace on race day”

The Horrible Hill Workout
Warm up with 10 minutes of easy running. Begin your workout by setting the incline to 8 percent and sprint as fast as you can for 30 seconds. Then lower the incline to 5 percent and walk for 30 seconds. After walking, sprint for 90 seconds at your 10K pace, then walk for 2 minutes. That’s one round; do 6 to 9 total rounds.



“This workout challenges your anaerobic and neuromuscular system while also helping build strength with the long hill repeat”

Warm up with 10 minutes of easy running. Every time a commercial comes on during a show or game you’re watching, run 1 ½ to 2 minutes per mile faster than your warm-up pace until the regular program returns. Do this until completely fatigued.

“It’s a killer toward the end of a close Cricket game"

Progressive Intervals
Warm up with 10 minutes of easy running. Start the treadmill at 7 miles per hour on a 1 percent incline and run 60 seconds at that pace. Then lower the speed to an easy pace and take a 60 second break. Bump up the speed to 7.5 mph and repeat this 60 seconds of running with a 60-second break while increasing the speed by 0.5 mph after each break. Once you can’t hold that faster speed for the full 60 seconds, drop the interval down to 30 seconds of running with 60 seconds of rest until you can’t go anymore.

“As the workout progresses, you carry more and more fatigue into the next interval"

“It’s a great workout that gives you bang for your buck on the aerobic and anaerobic side of the coin.”

121 people found this helpful

Treadmill Or Outside Running - Which One Is Better?

Dr. Ranjana Arora 87% (217 ratings)
B.P.T, M.P.T(ORTHO), Certification In Gym Instructor & Prenatal & Post Natal
Physiotherapist, Gurgaon
Treadmill Or Outside Running - Which One Is Better?

Although both seem similar, treadmill and jogging are very different from each other. The same muscles are used in both the exercises and exactly same body movement is involved while performing these workouts. Both are done for cardiovascular fitness, to decrease the amount of fat in your body, and to tone your legs. However, here are a few pointers which show you the difference between treadmill and jogging:

  1. Treadmill is easy: Running on a treadmill is easier than going out for a jog. This is because a treadmill has a plain running surface with a constant environment. But when you go out for a jog, the surface may not be plain; the environment might not be constant as it can be windy or extremely sunny. The treadmill can also be adjusted according to your requirements, like the inclination or the speed of the belt can be increased or decreased. Also, it has less effects on your joints because you are able to have a flat surface to place your foot every time, unlike the rough surface of the roads and lanes when you jog.
  2. Convenience: Running a mile at home on a treadmill is much more convenient than going out for a jog. You can hop onto a treadmill for a run anytime, but going out for jog whenever you feel like, is difficult and can cause inconvenience. The weather might not be appropriate to go for a jog, or you might have certain things to do which you can while you are on the treadmill.
  3. Motivation: Treadmills allow you to see how much you have run, which will motivate you to work harder and surpass your previous limit. This is difficult when you go out for a jog as you cannot calculate how much you ran.
  4. Burning calories: Jogging outside is much more challenging than jogging on a treadmill. This is because of the various factors which you have to face like weather and terrain while you are jogging outside. This causes you to burn more calories than what you would on a treadmill. However, you can change the inclination and the speed of the treadmill which will also enable you to burn more calories.

Although jogging outside and on a treadmill might have these few differences, you will get the best results if you are able to combine both together. In case you have a concern or query you can always consult an expert & get answers to your questions!

5667 people found this helpful

Treadmill vs. Outdoor Running

MPT - Manual Therapy, BPTh/BPT
Physiotherapist, Udhampur
Treadmill vs. Outdoor Running

Let’s clear the difference between doing workout on treadmill vs. outdoor running:

People have this misconception about the treadmill which they consider to be the same as the outdoor running. Both of them have the advantages and disadvantages. The basic of both remains the same which is running and are good for the body.
If spending energy is your only motive then treadmill walking as compared with running is somewhat easier as it is performed on a pulled ground, where as when you run outside there are other resistance forces which acts on the body i.e. wind force, thus running outside requires more energy. But if you technically see treadmill gives you variety. You can opt for different pre-saved programs. You can change the inclination, resistance and can monitor the calorie burn. But at the same time if you are walking outside you are subjected to the nature and can also enjoy your workout, with the chances of distractions. And if you are running outside a good shoe is must.

Treadmill these days comes with variety such as padded belts to overcome the knee issues and you can also workout at the climate control conditions. Now if your motive is just to burn the calories, one have to set the treadmill to somewhat higher levels to match the workout been done in an open ground. It is seen that treadmill workout is 3-4% less than the outdoor running. Somewhere working on the treadmill can be boring.

Treadmill Vs Jogging - Which One Helps You Lose More Calories?

Dr. Kalyani Nambisan 90% (137 ratings)
Merrithew Stott Pilates, Bachelor of Physiotherapy
Physiotherapist, Bangalore
Treadmill Vs Jogging - Which One Helps You Lose More Calories?

Although both are similar, treadmill and jogging are very different from each other. The same muscles are used in both the exercises and the same forward body movement is involved in both the exercises. Both are done for cardiovascular fitness, to decrease the amount of fat in your body, and to tone your legs. However, here are a few pointers which show you the difference between treadmill and jogging:

1. Treadmill is easy: Running on a treadmill is easier than going out for a jog. This is because a treadmill has a plain running surface with a constant environment. But when you go out for a jog, the surface may not be plain; the environment might not be constant as it can be windy or extremely sunny. The treadmill can also be adjusted according to your requirements, like the inclination can be increased or decreased; the speed of the belt can be increased or decreased, etc. It also affects the joints less because you are able to have a flat surface to place your foot every time, unlike the rough surface of the roads and lanes when you jog.

2. Convenience: Running a mile at home on a tread mill is much more convenient than going out for a jog. You can hop onto a treadmill for a run anytime, but going out for jog whenever you feel like, is difficult and can cause inconvenience. The weather might not be appropriate to go for a jog, or you might have certain things to do which you can while you are on the treadmill.

3. Motivation: Treadmills allow you to see how much you have run, which will motivate you to work harder and surpass your previous limit. This is difficult when you go out for a jog as you cannot calculate how much you ran.

4. Burning calories: Jogging outside is much more challenging than jogging on a treadmill. This is because of the various factors which you have to face like weather and terrain while you are jogging outside. This causes you to burn more calories than what you would on a treadmill. However, you can change the inclination and the speed of the treadmill which will also enable you to burn more calories.

Although jogging outside and on a treadmill might have these few differences, you will get the best results, if you are able to combine both together.

6554 people found this helpful

When Should You Go For A Hearing Test?

Dr. (Major) Vipin Kakar Retd. 88% (84 ratings)
MBBS (M.A.M.C), M.S. ENT
ENT Specialist, Delhi
When Should You Go For A Hearing Test?

Here are 6 signs to watch out for that could indicate 'You need to get your Ears tested':

1. Your TV is blaring: Do you often find people around you shouting above the TV sound complaining that it's too loud? When you find it hard to hear the TV at the average volume and find yourself turning up the sound, this could signify a hearing loss. Doctors are seeing a growing number of patients visiting them after prolonged exposure to loud music and sounds.

2. You find it hard to hear phone conversations: Do you find yourself asking the person on the other end of the phone line to 'repeat' themselves, or find yourself pressing the phone instrument right into your ear? If you are trying so hard to hear, you might find yourself missing out on bits of the conversation as focussing to clearly hear the conversation is exhausting work. Getting a hearing test might be a good option if this sounds like you.

3. You have trouble hearing in noisy environments: When you are out dining with friends or family at a busy restaurant or accompanying a friend shopping in a busy street, all that background noise makes it difficult to hear what the people are saying. People with hearing loss often have problems masking out background noise.

4. Family members telling 'you're going deaf': Trust the views of the people closest to you, they never lie about your health. Family members often are the first to sense signs of hearing loss as they find themselves repeating things to you or calling out louder to get your 'attention'.

5. Leaning closer: You find yourself leaning closer to people to follow the conversation or staring at their lips trying to lip-read what's being said.

6. Avoiding social interactions: You find yourself staying away from social occasions, family gatherings or avoid being the first to start conversations. If you wish to discuss about any specific problem, you can consult an ENT specialist.

3921 people found this helpful

Why and When Should I Go for HPV Test?

Panchkula & Delhi
Mother and Child Care, Panchkula
Why and When Should I Go for HPV Test?

Persistent infection of the uterine cervix with high risk human papilloma virus (HPV) leads to development of cervical cancer. Infection with HPV is common especially in sexually active young women, most infections are transient and spontaneously clear within 1 to 2 years without causing cancer. These transient infections may cause temporary changes in cervical cells. If a cervical infection with high risk HPV type persists the cellular changes can eventually develop into more severe precancerous lesions. If pre cancerous lesions are not treated, they can progress to cancer. Thus, an HPV DNA test is recommended to identify the high risk types of HPV.

Why is Pap Smear done?

An HPV test is done to:

Check for high-risk types of human papillomavirus (HPV) in women who had a Pap test that showed abnormal cervical cells called atypical squamous cells (ASCUS). An HPV test can help look for one or more high-risk types of HPV.
Check for HPV in women older than age 30 as part of screening for abnormal cervical cells.
Help check for abnormal cervical cells after treatment of a high-risk HPV infection.

When should one get screened for cervical cancer?

American Cancer Society does not recommend using HPV DNA test to screen for cervical cancer in females under 30. This is because females in their twenties who are sexually active are much more likely (than older females) to have a HPV infection that goes away on its own. For these young females, results of this test are not as significant and may be confusing.

For females age 30 and older, Pap & HPV co testing is less likely to miss an abnormality (i.e. lower false negative rate than pap testing alone. It also lengthens the screening interval to 5 years and still allows abnormalities to be detected in time to treat them.

Women of age >65 yrs who have had adequate screening history or those who have had total hysterectomy do not need any further screening.

HPV TEST

Is HPV test as safe and effective as Pap Smear?

The advantage of the HPV test is that the Pap test misses a fair number of carcinomas as it has a lower sensitivity. Studies have also shown that a negative HPV test is better at predicting that a woman will be free of lesions for the next three years than a negative Pap test.

And while the experience for the patient is the same for both tests, the HPV test requires less material from the cervix to detect an infection so there's less concern that a sample will be inadequate.

How is the HPV test performed?
Before an HPV test, do not douche, use tampons, or use vaginal medicines for at least 48 hours.
In the HPV test, a doctor takes a swab of cells from the cervix, just as for the Pap test. The cells are then analyzed in a laboratory. The genetic material (DNA) of the HPV virus is studied. This test can identify 13 or 14 of the high-risk HPV types associated with cervical cancer. HPV test results are generally available in 1 to 2 weeks.

You may have a small amount of vaginal bleeding or gray-green discharge after this test.

3103 people found this helpful

Mantoux Test or Tuberculin Skin Test

Dr. Kaushal Maheshwari 88% (35 ratings)
MD - Pathology
Pathologist, Noida
Mantoux Test or Tuberculin Skin Test

Diagnosis of tuberculosis is based on a combination of clinical features, smear examination of sputum where available, tuberculin skin testing or Mantoux test, chest X-ray and Histopathologic / cytologic examination as appropriate. Common clinical features are weight loss, persistent fever and /or cough of more than 2 weeks duration and history of close contact with another Tuberculosis patient.

Mantoux test also known as Tuberculin skin test is used for the detection of infection by Mycobacterium Tuberculosis bacteria. The test consists of slowly injecting a liquid intradermally (superficially within the layers of the skin) on the forearm, leading to formation of a raised vesicle which should be easily visible to the naked eye. This liquid, used in India, is Tuberculin PPD RT 23 strain. Tuberculin is a glycerol extract of the Tuberculosis bacteria. This is one of the two WHO accepted standard tuberculins, apart from PPD-S. In India, where the prevalence of tuberculosis is high, the recommended dose of this liquid is 0.1 ml of 1 TU (TU stands for tuberculin units) .1 TU is the strength of the liquid mentioned on the vial. This liquid is usually administered by a very tiny syringe, usually of 26 gauge. (Needle diameter).

Please click on the link to watch a video  demonstrating  how this procedure is performed.

Test principle : The individual who has been infected with Tubercle bacilli responds with a hypersensitivity reaction at the test site in the form of induration. Induration is the palpable raised hardening of the skin, while erythema refers to redness of skin. Only induration is clinically significant and measured after 48 to 72hours following injection. Diameter of the Induration is measured by a scale in millimetres perpendicular to the long axis of the forearm.

Interpretation of the tuberculin test

  1. Size of induration 15 mm and above : - signifies infection with tubercle bacilli
  2. Size of induration 10-14 mm : - could be due to infection with tubercle bacilli, BCG induced sensitivity, or due to cross reaction with other environmental mycobacteria.

It is more likely to be attributable to infection with tubercle bacilli in case of history of contact with smear positive case of pulmonary TB, clinically confirmed TB OR X-ray consistent with active TB.

  1. Size of induration 5 -9 mm: usually non tuberculous in nature generally
  2. Size of induration <5 mm : indicates absence of any type of mycobacterial infection.

Precautions during this procedure :

  1. If a raised vesicle does not appear it means that the liquid has been injected too deeply, and the test should be repeated on the other arm. If the same arm is used the injection site should be should be separated at least 5 cm from the first injection site.
  2. Occasional patients may experience severe allergic reaction to the tuberculin PPD

Comments :

  1. Larger the size of the induration, higher the probability of presence of infection with tubercle bacilli.
  2. Almost all reactions with induration more than 15 mm maybe considered attributable to infection with tubercle bacilli.
  3. Formation of necrosis (ulcer) at the test site, indicates high degree of tuberculin sensitivity and suggests presence of infection with tubercle bacteria.
  4. Tuberculin reaction may be suppressed (falsely low) in presence of immunosuppressive states. Like HIV, malnutrition, patient on steroid therapy etc.
  5. Mantoux test is generally not recommended for infants less than 12 weeks old. If the test turns out to be positive, then it is significant, but if the test is negative, then the test needs to be repeated again.
  6. The tuberculin test detects only the presence or absence of tuberculosis infection. The presence of infection is not synonymous with disease. It simply means, that even if you have tuberculosis infection in your body, as detected by positive Mantoux test, it does not mean you have active Tuberculosis in your body and require anti tuberculosis drugs in all cases. The clinician will correlate your mantoux test result with other tests ( as mentioned at the top of the blog) to give you a final picture.  
  7. For more such interesting articles please visit my blogsite www.doctors4patients.com
5 people found this helpful

Urine Test For Pregnancy

Dr. Richa Sharma 92% (216 ratings)
MD - Obstetrtics & Gynaecology, MBBS, FNB Reproductive Medicine, MRCOG
IVF Specialist, Mumbai
Urine Test For Pregnancy

Try conducting the urine test for knowing about your pregnancy immediately after you wake up, as the presence level of hcg in the urine is the highest at that time.

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