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10 March 2017

CORP: Measurement of the Maximum Oxygen Uptake (VO2max): VO2peak is no longer acceptable.

Posted in English, Clinical CPET, Scientific

indirect calorimetry

A new paper on the Journal of Applied Physiology examines the so-called secondary criteria used to validate VO2max iin particular with exercise naïve, unmotivated and/or clinical populations.

This article is part of the new Cores of Reproducibility in Physiology (CORP), an American Physiology Society(APS)-wide initiative responsive to a growing concern on the frequency with which published outcomes cannot be replicated by other investigators.

The development of rapid-response gas analyzers, enabling measurement of breath-by-breath pulmonary gas exchange, has led to replacement of the discontinuous progressive maximal exercise test (that produced an unambiguous VO2-work rate plateau definitive for VO2max) with the rapidly-incremented or ramp testing protocol. Whilst this expedient is more suitable for clinical and experimental investigations and enables measurement of the gas exchange threshold, exercise efficiency, and VO2 kinetics, a VO2-work rate plateau is not an obligatory outcome. This shortcoming has led to investigators resorting to so-called secondary criteria such as respiratory exchange ratio, maximal heart rate and/or maximal blood lactate concentration, the acceptable values of which may be selected arbitrarily and result in grossly inaccurate VO2max determination.

This article highlights some of the methodological issues that can thwart accurate assessment of VO2max and cautioned against the acceptance of VO2peak measured during ramp incremental exercise as a maximum value in all but those who are familiar with maximal exercise testing and are highly motivated.

The authors advocate the "inclusion of a short constant-work rate verification phase, completed at a higher work rate than that achieved during the ramp test, in the exercise test battery to enable verification of the VO2max".

The article details are the following:

- Title: "CORP: Measurement of the Maximum Oxygen Uptake (VO2max): VO2peak is no longer acceptable"
- Authors: Poole DC, Jones AM
- Published in
: J Appl Physiol (1985). 2017 Feb 2:jap.01063.2016

The study can be purchased at the following link: click here