Validation of the portable VmaxST system for oxygen-uptake measurement

The aim of this study was to validate the accuracy of a new type of portable gas-analysis system (Sensormedics VmaxST) for the measurement of oxygen-uptake at expenditure levels that are reached during walking in patients with movement disorders. The criterion method was the Douglas Bag (DB) method, which is considered to be the gold standard. Accuracy evaluations were made in two trials, randomly using the VmaxST (ST) and the Douglas Bag method. Ten healthy adult subjects participated in the trials (age: 28.8 (4.3) years; body mass: 75 (13.3)kg; height: 179.3 (8.9)cm). Each trial consisted of two time periods: 5 min of resting in a comfortable chair and 5 min of cycling at an 80 W workload. During the fifth minute of each block, mean minute ventilation (VE), oxygen-uptake (VO2), and carbon dioxide production (VCO2) were measured or calculated for both systems. Energy expenditure (EE) values were calculated and net values calculated by subtracting resting measurements from gross measurements. The results show that no significant differences were found between the VmaxST and the Douglas Bag method for the primary parameters: EEnet and VO2net. Significantly higher values were found for rest and exercise values. However, these differences were very small. Therefore, the validity of the VmaxST is sufficient for use in gait studies to determine the energy cost of walking, especially when net values are calculated.

Automated metabolic gas analysis systems: a review

The use of automated metabolic gas analysis systems or metabolic measurement carts (MMC) in exercise studies is common throughout the industrialised world. They have become essential tools for diagnosing many hospital patients, especially those with cardiorespiratory disease. Moreover, the measurement of maximal oxygen uptake (VO2max) is routine for many athletes in fitness laboratories and has become a defacto standard in spite of its limitations. The development of metabolic carts has also facilitated the noninvasive determination of the lactate threshold and cardiac output, respiratory gas exchange kinetics, as well as studies of outdoor activities via small portable systems that often use telemetry. Although the fundamental principles behind the measurement of oxygen uptake (VO2) and carbon dioxide production (VCO2) have not changed, the techniques used have, and indeed, some have almost turned through a full circle. Early scientists often employed a manual Douglas bag method together with separate chemical analyses, but the need for faster and more efficient techniques fuelled the development of semi- and full-automated systems by private and commercial institutions. Yet, recently some scientists are returning back to the traditional Douglas bag or Tissot-spirometer methods, or are using less complex automated systems to not only save capital costs, but also to have greater control over the measurement process. Over the last 40 years, a considerable number of automated systems have been developed, with over a dozen commercial manufacturers producing in excess of 20 different automated systems. The validity and reliability of all these different systems is not well known, with relatively few independent studies having been published in this area. For comparative studies to be possible and to facilitate greater consistency of measurements in test-retest or longitudinal studies of individuals, further knowledge about the performance characteristics of these systems is needed. Such information, along with the costs and the common features associated with these systems, may aid physicians and scientists to select a system that is best suited to their requirements and may also improve the quality of these frequently-reported physiological measures.