Do we underestimate maximal oxygen uptake in cancer survivors? Findings from a supramaximal verification test

2020 ◽  
Vol 45 (5) ◽  
pp. 486-492 ◽  
Author(s):  
Justine Schneider ◽  
Kathrin Schlüter ◽  
Joachim Wiskemann ◽  
Friederike Rosenberger
Keyword(s):  
Oxygen Uptake ◽  
Cancer Survivors ◽  
Maximal Oxygen Uptake ◽  
Cardiopulmonary Exercise Test ◽  
Cycle Ergometer ◽  
Peak Power Output ◽  
Primary Therapy ◽  
Individual Level ◽  
The Individual

Cancer survivors demonstrate a reduced maximal oxygen uptake, which is clinically relevant in terms of overall survival. However, it remains uncertain whether they attain their “true maximal oxygen uptake” in a cardiopulmonary exercise test (CPET). In the present study, a supramaximal verification bout (Verif) was applied in cancer survivors to confirm attainment of maximal oxygen uptake. Seventy-five participants (age, 61 ± 12 years; n = 43 females with breast cancer and n = 32 males with prostate cancer, 6–52 weeks after primary therapy) performed a CPET on a cycle ergometer and a Verif at 110% peak power output. As verification criterion, maximal oxygen uptake in Verif should not exceed maximal oxygen uptake in CPET by >3%. On average, maximal oxygen uptake was significantly lower in Verif compared with CPET (1.60 ± 0.38 L·min–1 vs. 1.65 ± 0.36 L·min–1, p = .023). On the individual level, n = 51 (68%) satisfied the verification criterion, whereas n = 24 (32%) demonstrated a higher maximal oxygen uptake in Verif. n = 69 (92%) fulfilled ≥2 secondary criteria for maximal exhaustion in the CPET. While maximal oxygen uptake was not underestimated in the CPET on average, one-third of cancer survivors did not attain their true maximal oxygen uptake. Verif appears feasible and beneficial to confirm true maximal oxygen uptake in this population. Furthermore, it might be more reliable than secondary criteria for maximal exhaustion. Novelty In about one-third of cancer survivors, maximal oxygen uptake is underestimated by a CPET. This underestimation of maximal oxygen uptake is not necessarily indicated by secondary criteria for maximal exhaustion. A supramaximal verification bout appears feasible and helpful for the determination of maximal oxygen uptake in cancer survivors.

Similar maximal oxygen uptake assessment from a step cycling incremental test and verification tests on the same or different day

2020 ◽  
Vol 45 (4) ◽  
pp. 357-361 ◽  
Author(s):  
Leonardo Trevisol Possamai ◽  
Fernando de Souza Campos ◽  
Paulo Cesar do Nascimento Salvador ◽  
Rafael Alves de Aguiar ◽  
Luiz Guilherme Antonacci Guglielmo ◽  
...  
Keyword(s):  
Oxygen Uptake ◽  
Power Output ◽  
Maximal Oxygen Uptake ◽  
Peak Power ◽  
Individual Variability ◽  
Peak Power Output ◽  
Time To Exhaustion ◽  
Incremental Test ◽  
Incremental Protocol

The present study aimed to compare maximal oxygen uptake of a step incremental test with time to exhaustion verification tests (TLIM) performed on the same or different day. Nineteen recreationally trained cyclists (age: 23 ± 2.7 years; maximal oxygen uptake: 48.0 ± 5.8 mL·kg−1·min−1) performed 3 maximal tests as follows: (i) same day: an incremental test with 3-min stages followed by a TLIM at 100% of peak power output of the incremental test (TLIM-SAME) interspaced by 15 min; and (ii) different day: a TLIM at 100% of peak power output of the incremental test (TLIM-DIFF). The maximal oxygen uptake was determined for the 3 tests. The maximal oxygen uptake was not different among the tests (incremental: 3.83 ± 0.41; TLIM-SAME: 3.72 ± 0.42; TLIM-DIFF: 3.75 ± 0.41 L·min−1; P = 0.951). Seven subjects presented a variability greater than ±3% in both verification tests compared with the incremental test. The same-day verification test decreased the exercise tolerance (240 ± 38 vs. 310 ± 36 s) compared with TLIM-DIFF (P < 0.05). In conclusion, the incremental protocol is capable of measuring maximal oxygen uptake because similar values were observed in comparison with verification tests. Although the need for the verification phase is questionable, the additional tests are useful to evaluate individual variability. Novelty Step incremental test is capable of measuring maximal oxygen uptake with similar values during TLIM on the same or different day. Although the necessity of the verification phase is questionable, it can allow the determination of variability in maximal oxygen uptake.

scholarly journals Cardiopulmonary exercise testing for the measurement of maximal oxygen uptake in people with cancer-related fatigue: a retrospective analysis

2020 ◽  
Author(s):  
Rosemary Twomey ◽  
Colin Lavigne ◽  
Tristan Martin ◽  
S. Nicole Culos-Reed ◽  
Guillaume Y. Millet
Keyword(s):  
Oxygen Uptake ◽  
Maximal Oxygen Uptake ◽  
Perceived Exertion ◽  
Cardiopulmonary Exercise Testing ◽  
Cardiopulmonary Exercise Test ◽  
Cycle Ergometer ◽  
Gas Analysis ◽  
Rating Of Perceived Exertion ◽  
Recent Analysis ◽  
Cardiopulmonary Exercise

Purpose: The measurement of cardiorespiratory fitness (maximal oxygen uptake) using a cardiopulmonary exercise test (CPET) has several applications in oncology. A recent analysis reported that in people with cancer, the vast majority of CPETs are discontinued before the attainment of a plateau in oxygen uptake (V̇O2) or secondary criteria. The objective of this study was to describe the attainment of a V̇O2 plateau and secondary criteria from CPET in a sample of people with cancer-related fatigue.Methods: This was a retrospective and exploratory analysis of data from 51 participants who completed a CPET as part of baseline testing for a clinical trial. The CPETs were conducted in a single laboratory by the same lead experimenter, using a cycle ergometer, standard ramp protocol and breath-by-breath gas analysis. The incidence of a V̇O2 plateau was compared for ∆V̇O2 of ≤150 ml·min-1 and a more conservative ∆V̇O2 of ≤50 ml·min-1. Independent groups dichotomized using the latter criterion were compared, including for the attainment of common secondary criteria for heart rate, rating of perceived exertion and the respiratory exchange ratio.Results: A plateau in V̇O2 was observed in 100% of tests using a criterion of ∆V̇O2 ≤150 mL·min-1, and this was reduced to 57% using a more conservative criterion of ∆V̇O2 ≤50 mL·min-1. There were no differences in the attainment of secondary criteria (or any other variable) between groups dichotomized using observation of a V̇O2 plateau.Conclusion: The validity of classic plateau criteria (∆V̇O2 ≤150 mL·min-1) to verify V̇O2max in people diagnosed with cancer is questionable (100% attainment in the present study, 57% attainment with a more conservative definition of a V̇O2 plateau). Comparing our data with previous reports, we suggest that exercising maximally to elicit V̇O2max may be more tolerable in this population using a standard ramp protocol, recumbent cycle ergometer and facemask.

Central and peripheral adaptations of the gas transport system to one-leg training

1981 ◽  
Vol 59 (11) ◽  
pp. 1146-1154 ◽  
Author(s):  
S. G. Thomas ◽  
D. A. Cunningham ◽  
M. J. Plyley ◽  
D. R. Boughner ◽  
R. A. Cook
Keyword(s):  
Cardiac Output ◽  
Oxygen Uptake ◽  
Endurance Training ◽  
Maximal Oxygen Uptake ◽  
Enzyme Activities ◽  
Cardiovascular Responses ◽  
Cycle Ergometer ◽  
Left Ventricular ◽  
Enzyme Analysis ◽  
Ergometer Exercise

The role of central and peripheral adaptations in the response to endurance training was examined. Changes in cardiac structure and function, oxygen extraction, and muscle enzyme activities following one-leg training were studied.Eleven subjects (eight females, three males) trained on a cycle ergometer 4 weeks with one leg (leg 1), then 4 weeks with the second leg (leg 2). Cardiovascular responses to exercise with both legs and each leg separately were evaluated at entry (T1), after 4 weeks of training (T2), and after a second 4 weeks of training (T3). Peak oxygen uptake ([Formula: see text] peak) during exercise with leg 1 (T1 to T2 increased 19.8% (P < 0.05) and during exercise with leg 2 (T2 to T3 increased 16.9% (P < 0.05). Maximal oxygen uptake with both legs increased 7.9% from T1 to T2 and 9.4% from T2 to T3 (P < 0.05). During exercise at 60% of [Formula: see text] peak, cardiac output [Formula: see text] was increased significantly only when the trained leg was exercised. [Formula: see text] increased 12.2% for leg 1 between T1 and T2 and 13.0% for leg 2 between T2 and T3 (P < 0.05). M-mode echocardiographic assessment of left ventricular internal diameter at diastole and peak velocity of circumferential fibre shortening at rest or during supine cycle ergometer exercise at T1 and T3 revealed no training induced changes in cardiac dimensions or function. Enzyme analysis of muscle biopsy samples from the vastus lateralis (At T1, T2, T3) revealed no consistent pattern of change in aerobic (malate dehydrogenase and 3-hydroxyacyl-CoA dehydrogenase) or anaerobic (phosphofructokinase, lactate dehydroginase, and creatine kinase) enzyme activities. Increases in cardiac output and maximal oxygen uptake which result from short duration endurance training can be achieved, therefore, without measurable central cardiac adaptation. The absence of echocardio-graphically determined changes in cardiac dimensions and contractility and the absence of an increase in cardiac output during exercise with the nontrained leg following training of the contralateral limb support this conclusion.

Verification phase as a useful tool in the determination of the maximal oxygen uptake of distance runners

2006 ◽  
Vol 31 (5) ◽  
pp. 541-548 ◽  
Author(s):  
Adrian W. Midgley ◽  
Lars R. McNaughton ◽  
Sean Carroll
Keyword(s):  
Heart Rate ◽  
Oxygen Uptake ◽  
Maximal Oxygen Uptake ◽  
Peak Oxygen Uptake ◽  
Treadmill Running ◽  
Distance Runners ◽  
Peak Heart Rate ◽  
Incremental Test ◽  
Volitional Exhaustion

This study investigated the utility of a verification phase for increasing confidence that a “true” maximal oxygen uptake had been elicited in 16 male distance runners (mean age (±SD), 38.7  (± 7.5 y)) during an incremental treadmill running test continued to volitional exhaustion. After the incremental test subjects performed a 10 min recovery walk and a verification phase performed to volitional exhaustion at a running speed 0.5 km·h–1 higher than that attained during the last completed stage of the incremental phase. Verification criteria were a verification phase peak oxygen uptake ≤ 2% higher than the incremental phase value and peak heart rate values within 2 beats·min–1 of each other. Of the 32 tests, 26 satisfied the oxygen uptake verification criterion and 23 satisfied the heart rate verification criterion. Peak heart rate was lower (p = 0.001) during the verification phase than during the incremental phase, suggesting that the verification protocol was inadequate in eliciting maximal values in some runners. This was further supported by the fact that 7 tests exhibited peak oxygen uptake values over 100 mL·min–1 (≥ 3%) lower than the peak values attained in the incremental phase. Further research is required to improve the verification procedure before its utility can be confirmed.

Perceived Exertion during Physical Exercise among Individuals High and Low in Fitness

1996 ◽  
Vol 82 (2) ◽  
pp. 419-424 ◽  
Author(s):  
Antonios K. Travlos ◽  
Daniel Q. Marisi
Keyword(s):  
Heart Rate ◽  
Physical Exercise ◽  
Oxygen Uptake ◽  
Core Temperature ◽  
Maximal Oxygen Uptake ◽  
Perceived Exertion ◽  
Cycle Ergometer ◽  
Ratings Of Perceived Exertion ◽  
Workload Analysis ◽  
Fitness Level

This study was conducted to investigate the influence of fitness level and gradually increased amounts of exercise on individuals' ratings of perceived exertion (RPE). 20 men served as paid subjects. They were divided into groups of high (>56 ml/kg/min.) and low fitness (<46 ml/kg/min.) according to their maximal oxygen uptake (VO2 max). Participants were required to pedal on a cycle ergometer at a progressively increased workload (every 10 min.) corresponding to 40, 50, 60, 70, and 80% of individual VO2 max values. Heart rates, RPE, and core temperatures were recorded every 5th minute after the initiation of exercising at a specific workload. Analysis indicated that, when controlling for VO2 max values, elevations of heart rate and core temperature were not affected by fitness. However, highly fit individuals perceived themselves under less exertion than did the group low in fitness. Correlations showed that, taking into consideration fitness, there is a stronger relationship between RPE and heart rate and RPE and core temperature for the highly fit individuals than for the less fit.

Validity and Reliability of the Huet Questionnaire to Assess Maximal Oxygen Uptake

2004 ◽  
Vol 29 (5) ◽  
pp. 623-638 ◽  
Author(s):  
Damien Trivel ◽  
Paul Calmels ◽  
Luc Léger ◽  
Thierry Busso ◽  
Xavier Devillard ◽  
...  
Keyword(s):  
Oxygen Uptake ◽  
Maximal Oxygen Uptake ◽  
High Reliability ◽  
Stress Test ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Epidemiological Studies ◽  
Cycle Ergometer ◽  
Sample Population ◽  
Validity And Reliability

The usual fitness tests available to assess maximal oxygen uptake [Formula: see text] a key fitness component, are not particularly useful for epidemiological studies. Questionnaires to assess [Formula: see text] however, are simple, easy to use, and inexpensive. In 1986, Huet developed such a French general questionnaire, which now also has an English version. Its simplicity is interesting as it could be used to survey large populations. The purpose of this study was to assess the validity and reliability of this Huet questionnaire in a sample of healthy French volunteers. A total of 108 subjects were included in this study, 88 males and 20 females. The validity of the questionnaire was checked using correlation coefficients and a Bland-Altman plot between questionnaire estimations and measures of [Formula: see text] obtained with a stress test on a cycle ergometer. An intraclass correlation coefficient (ICC) was also calculated to determine the reliability of the questionnaire. Significant correlation was obtained with the Huet questionnaire and measured [Formula: see text] (r2 = 0.77, p = 0.0001, SEE = 5.97 ml•kg−1•min−1, n = 108). The ICC showed very high reliability (ICC = 0.988, n = 21). The Huet questionnaire is an easy, rapidly administered tool that correlated highly with [Formula: see text] in this sample population. Key words: physical activity, epidemiology, evaluation

The Cycling Physiology of Miguel Indurain 14 Years After Retirement

2012 ◽  
Vol 7 (4) ◽  
pp. 397-400 ◽  
Author(s):  
Iñigo Mujika
Keyword(s):  
Oxygen Uptake ◽  
Blood Lactate ◽  
Body Mass ◽  
Power Output ◽  
Aerobic Power ◽  
Cycle Ergometer ◽  
Cycle Ergometer Test ◽  
Age Related ◽  
The Individual ◽  
Aerobic Power Output

Age-related fitness declines in athletes can be due to both aging and detraining. Very little is known about the physiological and performance decline of professional cyclists after retirement from competition. To gain some insight into the aging and detraining process of elite cyclists, 5-time Tour de France winner and Olympic Champion Miguel Indurain performed a progressive cycle-ergometer test to exhaustion 14 y after retirement from professional cycling (age 46 y, body mass 92.2 kg). His maximal values were oxygen uptake 5.29 L/min (57.4 mL · kg−1 · min−1), aerobic power output 450 W (4.88 W/kg), heart rate 191 beats/min, blood lactate 11.2 mM. Values at the individual lactate threshold (ILT): 4.28 L/min (46.4 mL · kg−1 · min−1), 329 W (3.57 W/kg), 159 beats/min, 2.4 mM. Values at the 4-mM onset of blood lactate accumulation (OBLA): 4.68 L/min (50.8 mL · kg−1 · min−1), 369 W (4.00 W/kg), 170 beats/min. Average cycling gross efficiency between 100 and 350 W was 20.1%, with a peak value of 22.3% at 350 W. Delta efficiency was 27.04%. Absolute maximal oxygen uptake and aerobic power output declined by 12.4% and 15.2% per decade, whereas power output at ILT and OBLA declined by 19.8% and 19.2%. Larger declines in maximal and submaximal values relative to body mass (19.4–26.1%) indicate that body composition changed more than aerobic characteristics. Nevertheless, Indurain’s absolute maximal and submaximal oxygen uptake and power output still compare favorably with those exhibited by active professional cyclists.

Training Prescription Guided by Heart-Rate Variability in Cycling

2019 ◽  
Vol 14 (1) ◽  
pp. 23-32 ◽  
Author(s):  
Alejandro Javaloyes ◽  
Jose Manuel Sarabia ◽  
Robert Patrick Lamberts ◽  
Manuel Moya-Ramon
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Oxygen Uptake ◽  
Power Output ◽  
Maximal Oxygen Uptake ◽  
Peak Power ◽  
Performance Enhancement ◽  
Time Trial ◽  
Peak Power Output ◽  
Road Cycling

Purpose: Road cycling is a sport with extreme physiological demands. Therefore, there is a need to find new strategies to improve performance. Heart-rate variability (HRV) has been suggested as an effective alternative for prescribing training load against predefined training programs. The purpose of this study was to examine the effect of training prescription based on HRV in road cycling performance. Methods: Seventeen well-trained cyclists participated in this study. After an initial evaluation week, cyclists performed 4 baseline weeks of standardized training to establish their resting HRV. Then, cyclists were divided into 2 groups, an HRV-guided group and a traditional periodization group, and they carried out 8 training weeks. Cyclists performed 2 evaluation weeks, after and before a training week. During the evaluation weeks, cyclists performed a graded exercise test to assess maximal oxygen uptake, peak power output, and ventilatory thresholds with their corresponding power output (VT1, VT2, WVT1, and WVT2, respectively) and a 40-min simulated time trial. Results: The HRV-guided group improved peak power output (5.1% [4.5%]; P = .024), WVT2 (13.9% [8.8%]; P = .004), and 40-min all-out time trial (7.3% [4.5%]; P = .005). Maximal oxygen uptake and WVT1 remained similar. The traditional periodization group did not improve significantly after the training week. There were no differences between groups. However, magnitude-based inference analysis showed likely beneficial and possibly beneficial effects for the HRV-guided group instead of the traditional periodization group in 40-min all-out time trial and peak power output, respectively. Conclusion: Daily training prescription based on HRV could result in a better performance enhancement than a traditional periodization in well-trained cyclists.

Sign in / Sign up

Export Citation Format

Share Document