The safety of exercise testing performed independently by physical therapists

The purpose of this study was to evaluate the safety of exercise testing performed independently by physical therapists (PTs) who possess advanced cardiopulmonary competencies which were assessed through the use of a structural evaluation instrument. From January 1980 to June 1985, a total of 10,577 exercise tests (ETs) were performed independently by PTs at our facilities. Five thousand three hunderd fifty-sx (51%) were diagnostic tests performed to rule out coronary artery disease, 4,393 (41%) were performed on individuals with known coronary artery disease, and the remaining 828 tests (8%) were performed on individuals classified as 'other'. All ETs were physician-referred. One death occurred after an ET, but was the result of a cerebrovascular accident, yielding a mortality rate of .9 per 10,000 tests. Three patients developed sustained ventricular tachycardia during ETs and were hospitalized. One patient developed hypotension and complex ventricular dysrhythmias postexercise, and was hospitalized. These four incidents yield a morbidity rate of 3.8 per 10,000 tests. The morbidity and mortality rates in this study compare favorably to those reported by Stuart and Ellestad, Rochmis and Blackburn, and Atterhog and associates. These statistics indicate that safe and independent exercise testing can be performed by PTs who possess an advanced level of competency in cardiopulmonary patient evaluation.