Oxygen uptake plateau: calculation artifact or physiological reality?

Submaximal Verification Test to Exhaustion Confirms Maximal Oxygen Uptake: Roles of Anaerobic Performance and Respiratory Muscle Strength

Background: The incremental exercise test is commonly used to measure maximal oxygen uptake (VO2max), but an additional verification test is often recommended as the "gold standard" to confirm the true VO2max. Therefore, the aim of this study was to compare the peak oxygen uptake (VO2peak) obtained in the ramp incremental exercise test and that in the verification test performed on different days at submaximal intensity. Additionally, we examined the roles of anaerobic performance and respiratory muscle strength. Methods: Sixteen physically active men participated in the study, with an average age of 22.7 ± 2.4 (years), height of 178.0 ± 7.4 (cm), and weight of 77.4 ± 7.3 (kg). They performed the three following tests on a cycle ergometer: the Wingate Anaerobic Test (WAnT), the ramp incremental exercise test (IETRAMP), and the verification test performed at an intensity of 85% (VER85) maximal power, which was obtained during the IETRAMP. Results: No significant difference was observed in the peak oxygen uptake between the IETRAMP and VER85 (p = 0.51). The coefficient of variation was 3.1% and the Bland-Altman analysis showed a high agreement. We found significant correlations between the total work performed in the IETRAMP, the anaerobic peak power (r = 0.52, p ≤ 0.05), and the total work obtained in the WAnT (r = 0.67, p ≤ 0.01). There were no significant differences in post-exercise changes in the strength of the inspiratory and expiratory muscles after the IETRAMP and the VER85. Conclusions: The submaximal intensity verification test performed on different days provided reliable values that confirmed the real VO2max, which was not limited by respiratory muscle fatigue. This verification test may be suggested for participants with a lower anaerobic mechanical performance.

Heavy-intensity priming exercise extends the V̇o2max plateau and increases peak-power output during ramp-incremental exercise

This study investigated whether a heavy-intensity priming exercise precisely prescribed within the heavy-intensity domain would lead to a greater peak-power output (POpeak) and a longer maximal oxygen uptake (V̇o2max) plateau. Twelve recreationally active adults participated in this study. Two visits were required: 1) a step-ramp-step test [ramp-incremental (RI) control], and 2) an RI test preceded by a priming exercise within the heavy-intensity domain (RI primed). A piecewise equation was used to quantify the V̇o2 plateau duration (V̇o2plateau-time). The mean response time (MRT) was computed during the RI control condition. The delta (Δ) V̇o2 slope (S; mL·min-1·W-1) and V̇o2-Y intercept (Y; mL·min-1) within the moderate-intensity domain between conditions (RI primed minus RI control) were also assessed using a novel graphical analysis. V̇o2plateau-time (P = 0.001; d = 1.27) and POpeak (P = 0.003; d = 1.08) were all greater in the RI primed. MRT (P < 0.001; d = 2.45) was shorter in the RI primed compared with the RI control. A larger ΔV̇o2plateau-time was correlated with a larger ΔMRT between conditions (r = -0.79; P = 0.002). This study demonstrated that heavy-intensity priming exercise lengthened the V̇o2plateau-time and increased POpeak. The overall faster RI-V̇o2 responses seem to be responsible for the longer V̇o2plateau-time. Specifically, a shorter MRT, but not changes in RI-V̇o2-slopes, was associated with a longer V̇o2plateau-time following priming exercise.NEW & NOTEWORTHY It remains unclear whether priming exercise extends the maximal oxygen uptake (V̇o2max) plateau and increases peak-power output (POpeak) during ramp-incremental (RI) tests. This study demonstrates that a priming exercise, precisely prescribed within the heavy-intensity domain, extends the plateau at V̇o2max and leads to a greater POpeak. Specifically, the extended V̇o2max plateau was associated with accelerated RI-V̇o2 responses.

A verification phase adds little value to the determination of maximum oxygen uptake in well-trained adults

PURPOSE

The objective was to investigate if performing a sub-peak or supra-peak verification phase following a ramp test provides additional value for determining 'true' maximum oxygen uptake ( V ˙ O2).

METHODS

17 and 14 well-trained males and females, respectively, performed two ramp tests each followed by a verification phase. While the ramp tests were identical, the verification phase differed in power output, wherein the power output was either 95% or 105% of the peak power output from the ramp test. The recovery phase before the verification phase lasted until capillary blood lactate concentration was ≤ 4 mmol·L-1. If a V ˙ O2 plateau occurred during ramp test, the following verification phase was considered to provide no added value. If no V ˙ O2 plateau occurred and the highest V ˙ O2 ( V ˙ O2peak) during verification phase was < 97%, between 97 and 103%, or > 103% of V ˙ O2peak achieved during the ramp test, no value, potential value, and certain value were attributed to the verification phase, respectively.

RESULTS

Mean (standard deviation) V ˙ O2peak during both ramp tests was 64.5 (6.0) mL·kg-1·min-1 for males and 54.8 (6.2) mL·kg-1·min-1 for females. For the 95% verification phase, 20 tests showed either a V ˙ O2 plateau during ramp test or a verification V ˙ O2peak < 97%, indicating no value, 11 showed potential value, and 0 certain value. For the 105% verification phase, the values were 26, 5, and 0 tests, respectively.

CONCLUSION

In well-trained adults, a sub-peak verification phase might add little value in determining 'true' maximum V ˙ O2, while a supra-peak verification phase adds no value.

Can We Accurately Predict Critical Power and W' from a Single Ramp Incremental Exercise Test?

PURPOSE

The purpose of this study was to examine the suitability of a single ramp incremental test to predict critical power (CP) and W' . We hypothesized that CP would correspond to the corrected power output (PO) at the respiratory compensation point (RCP) and W' would be calculable from the work done above RCP.

METHODS

One hundred fifty-three healthy young people (26 ± 4 yr, 51.4 ± 7.6 mL·min -1 ·kg -1 ) performed a maximal ramp test (20, 25, or 30 W·min -1 ), followed by three to five constant load trials to determine CP and W' . CP and W' were estimated using a "best individual fit" approach, selecting the mathematical model with the smallest total error. The RCP was identified by means of gas exchange analysis and then translated into its appropriate PO by applying a correction strategy in order to account for the gap in the V̇O 2 /PO relationship between ramp and constant load exercise. We evaluated the agreement between CP and the PO at RCP, and between W' and the total work done above CP ( W'RAMP > CP ) and above RCP ( W'RAMP > RCP ) during the ramp test.

RESULTS

The CP was significantly higher than the PO at RCP (Δ = 8 ± 16 W, P < 0.001). W'RAMP > CP was significantly lower than W' (Δ = 1.9 ± 3.3 kJ, P < 0.001), whereas W'RAMP > RCP and W' did not differ from each other (Δ = -0.6 ± 5.8 kJ, P = 0.21).

CONCLUSIONS

Despite the fact that CP and RCP occurred in close proximity, the estimation of W' from ramp exercise may be problematic given the likelihood of underestimation and considering the large variability. Therefore, we do not recommend the interchangeable use of CP and W' values derived from constant load versus ramp exercise, in particular, when the goal is to obtain accurate estimates or to predict performance capacity.

Effects of Alternating Unilateral vs. Bilateral Resistance Training on Sprint and Endurance Cycling Performance in Trained Endurance Athletes: A 3-Armed, Randomized, Controlled, Pilot Trial

ABSTRACT

Ji, S, Donath, L, and Wahl, P. Effects of alternating unilateral vs. bilateral resistance training on sprint and endurance cycling performance in trained endurance athletes: A 3-armed, randomized, controlled, pilot trial. J Strength Cond Res 36(12): 3280-3289, 2022-Traditional preparatory resistance training for cyclists mainly relies on simultaneous bilateral movement patterns. This lack of movement specificity may impede transfer effects to specific aerobic and anaerobic requirements on the bike. Hence, this study investigated the effects of resistance training in alternating unilateral vs. simultaneous bilateral movement pattern on strength and anaerobic as well as aerobic cycling performance indices. Twenty-four trained triathletes and cyclists (age: 31.1 ± 8.1 years; V̇ o2 max: 57.6 ± 7.1 ml·min -1 ·kg -1 ) were randomly assigned to either an alternating unilateral (AUL), a simultaneous bilateral (BIL) training group or a control group (CON). Ten weeks of resistance training (4 × 4-10 repetition maximum) were completed by both training groups, although CON maintained their usual training regimen without resistance training. Maximal strength was tested during isometric leg extension, leg curl, and leg press in both unilateral and bilateral conditions. To compare the transfer effects of the training groups, determinants of cycling performance and time to exhaustion at 105% of the estimated anaerobic threshold were examined. Maximal leg strength notably increased in both training groups (BIL: ∼28%; AUL: ∼27%; p < 0.01) but not in CON (∼6%; p > 0.54). A significant improvement in cycling time trial performance was also observed in both training groups (AUL: 67%; BIL: 43%; p < 0.05) but not for CON (37%; p = 0.43). Bilateral group exhibited an improved cycling economy at submaximal intensities (∼8%; p < 0.05) but no changes occurred in AUL and CON (∼3%; p > 0.24). While sprint cycling performance decreased in CON (peak power: -6%; acceleration index: -15%; p < 0.05), improvement in favor of AUL was observed for acceleration abilities during maximal sprinting (20%; d = 0.5). Our pilot data underpin the importance of resistance training independent of its specific movement pattern both for improving the endurance cycling performance and maximal leg strength. Further research should corroborate our preliminary findings on whether sprint cycling benefits favorably from AUL resistance training.

Is the maximal lactate steady state concept really relevant to predict endurance performance?

PURPOSE

There is no convincing evidence for the idea that a high power output at the maximal lactate steady state (PO_{_MLSS}) and a high fraction of [Formula: see text]O_2max at MLSS (%[Formula: see text]O_{2_MLSS}) are decisive for endurance performance. We tested the hypotheses that (1) %[Formula: see text]O_{2_MLSS} is positively correlated with the ability to sustain a high fraction of [Formula: see text]O_2max for a given competition duration (%[Formula: see text]O_{2_TT}); (2) %[Formula: see text]O_{2_MLSS} improves the prediction of the average power output of a time trial (PO_{_TT}) in addition to [Formula: see text]O_2max and gross efficiency (GE); (3) PO_{_MLSS} improves the prediction of PO_{_TT} in addition to [Formula: see text]O_2max and GE.

METHODS

Twenty-one recreationally active participants performed stepwise incremental tests on the first and final testing day to measure GE and check for potential test-related training effects in terms of changes in the minimal lactate equivalent power output (∆PO_LEmin), 30-min constant load tests to determine MLSS, a ramp test and verification bout for [Formula: see text]O_2max, and 20-min time trials for %[Formula: see text]O_{2_TT} and PO_{_TT}. Hypothesis 1 was tested via bivariate and partial correlations between %[Formula: see text]O_{2_MLSS} and %[Formula: see text]O_{2_TT}. Multiple regression models with [Formula: see text]O_2max, GE, ∆PO_LEmin, and %[Formula: see text]O_{2_MLSS} (Hypothesis 2) or PO_{_MLSS} instead of %[Formula: see text]O_{2_MLSS} (Hypothesis 3), respectively, as predictors, and PO_{_TT} as the dependent variable were used to test the hypotheses.

RESULTS

%[Formula: see text]O_{2_MLSS} was not correlated with %[Formula: see text]O_{2_TT} (r = 0.17, p = 0.583). Neither %[Formula: see text]O_{2_MLSS} (p = 0.424) nor PO_{_MLSS} (p = 0.208) did improve the prediction of PO_{_TT} in addition to [Formula: see text]O_2max and GE.

CONCLUSION

These results challenge the assumption that PO_{_MLSS} or %[Formula: see text]O_{2_MLSS} are independent predictors of supra-MLSS PO_{_TT} and %[Formula: see text]O_{2_TT}.

Comparison of physiological responses of running on a nonmotorized and conventional motor-propelled treadmill at similar intensities

This study aimed to test the agreement of the incremental test's physiological responses between tethered running on a nonmotorized treadmill (NMT) to matched relative intensities while running on a conventional motorized treadmill (MT). Using a within-subject crossover design, nine male recreational runners (age = 22 ± 5 years; height = 175 ± 6 cm; weight = 68.0 ± 16.6 kg) underwent two test sessions: one was an incremental intensity protocol on an MT; the other was on an instrumented NMT. Intensity thresholds at \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\dot{\text V}}$$\end{document}V˙O_2max, respiratory compensation point (iRCP), and lactate threshold (iLT) were registered for analysis, together with \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\dot{\text V}}$$\end{document}V˙˙O₂, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\dot{\text V}}$$\end{document}V˙˙E, ƒ_R, and blood lactate concentration ([Lac]). Comparisons were based on hypothesis testing (Student's T-test), effect sizes (Cohen's d), ICC, and Bland Altman analysis. Statistical significance was accepted at p < 0.05. Attained \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\dot{\text V}}$$\end{document}V˙O_2max (MT = 52.2 ± 7.3 mL·kg^-1·min^-1 vs NMT = 50.1 ± 8.1 mL·kg^-1·min^-1) and \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\dot{\text V}}$$\end{document}V˙˙O₂ at iRCP (MT = 46.3 ± 7.2 mL·kg^-1·min^-1 vs NMT = 42.8 ± 9.3 mL·kg^-1·min^-1) were not different between ergometers (p = 0.15 and 0.13, respectively), with significant ICCs (0.84 and 0.70, respectively) and Pearson’s correlations (r = 0.87 and 0.76, respectively). The [Lac] at iLT presented poor agreement between conditions. Significant correlations were found (r between 0.72 and 0.83) for relative power values of i\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${\dot{\text V}}$$\end{document}V˙O_2max (6.56 ± 1.28 W·kg⁻¹), iRCP (4.38 ± 1.50 W·kg⁻¹), and iLT (4.15 ± 1.29 W·kg⁻¹) related to their counterpart obtained on MT. Results show that running on an NMT offers a higher glycolytic demand under the same relative internal load as running on an MT but with a similar aerobic response and correlated intensity determination.

The Oxygen Uptake Plateau-A Critical Review of the Frequently Misunderstood Phenomenon

A flattening of the oxygen uptake–work rate relationship at severe exercise indicates the achievement of maximum oxygen uptake \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\left({\text{VO}}_{2\max } \right)$$\end{document}VO2max. Unfortunately, a distinct plateau \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\left( {{{\text{VO}}}_{2} {\text{pl}}} \right)$$\end{document}VO2pl at \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2\max }$$\end{document}VO2maxis not found in all participants. The aim of this investigation was to critically review the influence of research methods and physiological factors on the \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2} {\text{pl}}$$\end{document}VO2pl incidence. It is shown that many studies used inappropriate definitions or methodical approaches to check for the occurrence of a \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2} {\text{pl}}$$\end{document}VO2pl. In contrast to the widespread assumptions it is unclear whether there is higher \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2} {\text{pl}}$$\end{document}VO2pl incidence in (uphill) running compared to cycling exercise or in discontinuous compared to continuous incremental exercise tests. Furthermore, most studies that evaluated the validity of supramaximal verification phases, reported verification bout durations, which are too short to ensure that \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2\max }$$\end{document}VO2max have been achieved by all participants. As a result, there is little evidence for a higher \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2} {\text{pl}}$$\end{document}VO2pl incidence and a corresponding advantage for the diagnoses of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2\max }$$\end{document}VO2max when incremental tests are supplemented by supramaximal verification bouts. Preliminary evidence suggests that the occurrence of a \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2} {\text{pl}}$$\end{document}VO2pl in continuous incremental tests is determined by physiological factors like anaerobic capacity, \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2}$$\end{document}VO2-kinetics and accumulation of metabolites in the submaximal intensity domain. Subsequent studies should take more attention to the use of valid \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2} {\text{pl}}$$\end{document}VO2pl definitions, which require a cut-off at ~ 50% of the submaximal \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2}$$\end{document}VO2 increase and rather large sampling intervals. Furthermore, if verification bouts are used to verify the achievement of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{{2{\text{peak}}}}$$\end{document}VO2peak/\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$${{\text{VO}}}_{2\max }$$\end{document}VO2max, it should be ensured that they can be sustained for sufficient durations.

Verification Testing to Confirm V˙O2max in a Hot Environment

PURPOSE

This study aimed to evaluate the validity and reliability of a verification test to confirm GXT V˙O2max in a hot environment.

METHODS

Twelve recreationally trained cyclists completed a two-test protocol that included a GXT progressing 20 W·min-1 followed by a biphasic supramaximal-load verification test (1 min at 60% increasing to 110% maximal GXT wattage until failure) in a hot environment (39°C, 32% relative humidity). Rest between tests occurred in a thermoneutral room and was anchored to the duration required for gastrointestinal temperature to return to baseline.

RESULTS

Mean verification test V˙O2max (51.3 ± 8.8 mL·kg-1·min-1) was lower than GXT (55.9 ± 7.6 mL·kg-1·min-1, P = 0.02). Verification tests confirmed GXT V˙O2max in 92% of participants using individual analysis thresholds. Bland-Altman analysis revealed a sizable mean bias (-4.6 ± 4.9 mL·kg-1·min-1) with wide 95% limits of agreement (-14.0 to 5.0 mL·kg-1·min-1) across a range of V˙O2max values. The high coefficient of variation (9.6%) and typical error (±3.48 mL·kg-1·min-1) indicate potential issues of test-retest reliability in the heat.

CONCLUSIONS

Verification testing in a hot condition confirmed GXT V˙O2max in virtually all participants, indicating robust utility. To enhance test-retest reliability in this environment, protocol recommendations for work rate and recovery between tests are provided.

Influence of grade of obesity on the achievement of VO2max using an incremental treadmill test in youths

The purpose of this study was to analyze the influence of grade of obesity on the probability of achieving a VO2 plateau and threshold secondary criteria for verifying VO2max during a treadmill walk test in youths with obesity. Therefore, 72 youths with obesity (aged 8-16) performed an incremental treadmill walk test to exhaustion during which oxygen uptake (VO2), minute ventilation (VE), heart rate (HR) and rating of perceived exertion were continuously measured. HR corresponding to a "hard" level of perceived exertion was reported and expressed as a percentage of the predicted HRmax. The rate of achievement of criteria for validation VO2max (VO2 plateau; HR>95% theoretical HRmax; RER>1.0; rating of perceived exertion ≥ "hard") was compared between participants with grade I and grade II obesity. 37% of the participants achieved a VO2 plateau and 23% achieved both an HR>95% and RER >1.0. Youths with grade II obesity had lower minute ventilation (p<0.01) tended to be more likely to reach an HR>95% (OR = 0.33; P=0.06) and a "hard" rating of perceived exertion than grade I (OR = 4.5; P=0.07). However, there was no influence of grade of obesity on the achievement of VO2 plateau, and RER>1.0.

Is a verification phase useful for confirming maximal oxygen uptake in apparently healthy adults? A systematic review and meta-analysis

BACKGROUND

The 'verification phase' has emerged as a supplementary procedure to traditional maximal oxygen uptake (VO2max) criteria to confirm that the highest possible VO2 has been attained during a cardiopulmonary exercise test (CPET).

OBJECTIVE

To compare the highest VO2 responses observed in different verification phase procedures with their preceding CPET for confirmation that VO2max was likely attained.

METHODS

MEDLINE (accessed through PubMed), Web of Science, SPORTDiscus, and Cochrane (accessed through Wiley) were searched for relevant studies that involved apparently healthy adults, VO2max determination by indirect calorimetry, and a CPET on a cycle ergometer or treadmill that incorporated an appended verification phase. RevMan 5.3 software was used to analyze the pooled effect of the CPET and verification phase on the highest mean VO2. Meta-analysis effect size calculations incorporated random-effects assumptions due to the diversity of experimental protocols employed. I2 was calculated to determine the heterogeneity of VO2 responses, and a funnel plot was used to check the risk of bias, within the mean VO2 responses from the primary studies. Subgroup analyses were used to test the moderator effects of sex, cardiorespiratory fitness, exercise modality, CPET protocol, and verification phase protocol.

RESULTS

Eighty studies were included in the systematic review (total sample of 1,680 participants; 473 women; age 19-68 yr.; VO2max 3.3 ± 1.4 L/min or 46.9 ± 12.1 mL·kg-1·min-1). The highest mean VO2 values attained in the CPET and verification phase were similar in the 54 studies that were meta-analyzed (mean difference = 0.03 [95% CI = -0.01 to 0.06] L/min, P = 0.15). Furthermore, the difference between the CPET and verification phase was not affected by any of the potential moderators such as verification phase intensity (P = 0.11), type of recovery utilized (P = 0.36), VO2max verification criterion adoption (P = 0.29), same or alternate day verification procedure (P = 0.21), verification-phase duration (P = 0.35), or even according to sex, cardiorespiratory fitness level, exercise modality, and CPET protocol (P = 0.18 to P = 0.71). The funnel plot indicated that there was no significant publication bias.

CONCLUSIONS

The verification phase seems a robust procedure to confirm that the highest possible VO2 has been attained during a ramp or continuous step-incremented CPET. However, given the high concordance between the highest mean VO2 achieved in the CPET and verification phase, findings from the current study would question its necessity in all testing circumstances.

PROSPERO REGISTRATION ID

CRD42019123540.

Verification-phase tests show low reliability and add little value in determining [Formula: see text]O2max in young trained adults

OBJECTIVE

This study compared the robustness of a [Formula: see text]-plateau definition and a verification-phase protocol to day-to-day and diurnal variations in determining the true [Formula: see text]. Further, the additional value of a verification-phase was investigated.

METHODS

Eighteen adults performed six cardiorespiratory fitness tests at six different times of the day (diurnal variation) as well as a seventh test at the same time the sixth test took place (day-to-day variation). A verification-phase was performed immediately after each test, with a stepwise increase in intensity to 50%, 70%, and 105% of the peak power output.

RESULTS

Participants mean [Formula: see text] was 56 ± 8 mL/kg/min. Gwet's AC1 values (95% confidence intervals) for the day-to-day and diurnal variations were 0.64 (0.22, 1.00) and 0.71 (0.42, 0.99) for [Formula: see text]-plateau and for the verification-phase 0.69 (0.31, 1.00) and 0.07 (-0.38, 0.52), respectively. In 66% of the tests, performing the verification-phase added no value, while, in 32% and 2%, it added uncertain value and certain value, respectively, in the determination of [Formula: see text].

CONCLUSION

Compared to [Formula: see text]-plateau the verification-phase shows lower reliability, increases costs and only adds certain value in 2% of cases.

Effect of intensive prior exercise on muscle fiber activation, oxygen uptake kinetics, and oxygen uptake plateau occurrence

Purpose

We tested the hypothesis that the described increase in oxygen uptake (\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{{2}}$$\end{document}V˙O2)-plateau incidence following a heavy-severe prior exercise is caused by a steeper increase in \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{{2}}$$\end{document}V˙O2 and muscle fiber activation in the submaximal intensity domain.

Methods

Twenty-one male participants performed a standard ramp test, a \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{{{\text{2max}}}}$$\end{document}V˙O2max verification bout, an unprimed ramp test with an individualized ramp slope and a primed ramp test with the same ramp slope, which was preceded by an intensive exercise at 50% of the difference between gas exchange threshold and maximum workload. Muscle fiber activation was recorded from vastus lateralis, vastus medialis, and gastrocnemius medialis using a surface electromyography (EMG) device in a subgroup of 11 participants. Linear regression analyses were used to calculate the \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{{2}}$$\end{document}V˙O2-(\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\Delta \dot{V}{\text{O}}_{{2}} /\Delta P$$\end{document}ΔV˙O2/ΔP) and EMG-(∆RMS/∆P) ramp test kinetics.

Results

Twenty out of the 21 participants confirmed their \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{{{\text{2max}}}}$$\end{document}V˙O2max in the verification bout. The \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{{2}}$$\end{document}V˙O2-plateau incidence in these participants did not differ between the unprimed (n = 8) and primed (n = 7) ramp test (p = 0.500). The \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\Delta \dot{V}{\text{O}}_{{2}} /\Delta P$$\end{document}ΔV˙O2/ΔP was lower in the primed compared to the unprimed ramp test (9.40 ± 0.66 vs. 10.31 ± 0.67 ml min⁻¹ W⁻¹, p < 0.001), whereas the ∆RMS/∆P did not differ between the ramp tests (0.62 ± 0.15 vs. 0.66 ± 0.14% W⁻¹; p = 0.744).

Conclusion

These findings do not support previous studies, which reported an increase in \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{{2}}$$\end{document}V˙O2-plateau incidence as well as steeper increases in \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{{2}}$$\end{document}V˙O2 and muscle fiber activation in the submaximal intensity domain following a heavy-severe prior exercise.