Commentaries on Viewpoint: V̇o2peak is an acceptable estimate of cardiorespiratory fitness but not V̇o2max

Exercise intervention does not reduce the likelihood of VO2max underestimation in older adults with hypertension

The present study aimed to investigate whether training status would influence the capacity of a verification phase (VER) to confirm maximal oxygen uptake (VO₂max) of a previous graded exercise test (GXT) in individuals with hypertension. Twelve older adults with hypertension (8 women) were recruited. Using a within-subject design, participants performed a treadmill GXT to exhaustion followed by a multistage VER both before and after a 12-wkcombined exercise training programme. Individual VO₂max, respiratory exchange ratio (RER), maximal heart rate (HR_max), and rating of perceived exertion (RPE) were measured during both GXT and VER tests. Absolute and relative VO₂max values were higher in VER than in GXT at baseline, but only absolute VO₂max differed between bouts post-intervention (all p < 0.05). Individual VO₂max comparisons revealed that 75% of the participants (9/12) achieved a VO_2max value that was ≥3% during VER both before (range: +4.9% to +21%) and after the intervention (range: +3.4% to +18.8%), whereas 91.7% (11/12) of the tests would have been validated as a maximal effort if the classic criteria were employed. A 12-wk combined training intervention could not improve the capacity of older adults with hypertension to achieve VO₂max during a GXT, as assessed by VER.

Estimation of maximal oxygen uptake using the heart rate ratio method in male recreational football players

Maximal oxygen uptake (VO_2max) is associated with cardiovascular and metabolic health in the general population. The heart rate (HR) ratio method (HR_ratio) is a valid, easy and accessible method for estimating VO_2max in well-trained subjects. This study examined the validity of using the HR_ratio to estimate VO_2max in recreational football players in the untrained and trained states. Sixty-six participants (age 39.3 ± 5.8 years) were tested pre-training and 28 after 12 weeks, for VO_2max assessment, running on a treadmill alternating speed (1 km h⁻¹) and inclination (1%) increments every 30 s until exhaustion. Maximal HR (HR_max) was assessed directly with a multiple approach and estimated with selected equations. Resting HR (HR_rest) was measured in supine position, after 15 min of rest. The HR_ratio method considers the product of HR_max/HR_rest ratio by a theoretical proportionality factor (15 ml kg⁻¹ min⁻¹, TPF) to estimate VO_2max. This population-specific proportionality factor (SPF) was 14.6 ± 2.6 ml kg⁻¹ min⁻¹. In the untrained state (n = 66), participants’ actual VO_2max (41.3 ± 6.2 ml kg⁻¹ min⁻¹) was moderately lower (~ 2 ml kg⁻¹ min⁻¹) than the estimated VO_2max using the TPF. A nonsignificant difference (0.7 ml kg⁻¹ min⁻¹) was found when the VO_2max was estimated using the SPF. When using HR_max equations and the TPF, a small nonsignificant difference (~ 1.5 ml kg⁻¹ min⁻¹) was reported between actual and estimated VO_2max. In the trained state (n = 28), the estimated VO_2max values were not significantly different from the actual VO_2max (44.2 ± 5.2 ml kg⁻¹ min⁻¹), with large effect sizes when considering TPF and estimated HR_max. The results of this study provide evidence of the applicability of HR_ratio in estimating VO_2max in male adult/middle-aged recreational football players.

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.

Is a verification phase needed to determine V ˙ O2max across fitness levels?

INTRODUCTION

Current methods (plateau/secondary criteria) to determine maximal oxygen consumption (V ˙ O2max) are inconsistently achieved leading some to suggest the use of a verification phase (VP) to confirmV ˙ O2max.

PURPOSE

To provide further evidence for the inclusion of a VP to confirmV ˙ O2max in different fitness levels.

METHODS

Forty-nine participants (22 females; 21.9 ± 2.6 years, 24.3 ± 2.8 kg m-2, 45.27 ± 7.68 mL kg-1 min-1) had theirV ˙ O2 and heart rate measured during three graded exercise tests (GXT) on separate days each followed by a VP of differing intensity (85%, 95%, 105% final workload). Participants were divided into groups using norms adapted from American College of Sports MedicineV ˙ O2max guidelines (30.47-61.47 mL kg-1 min-1).V ˙ O2max was confirmed if theV ˙ O2peak on the VP or an additional GXT was within ± 2 × typical error of theV ˙ O2peak attained on the first GXT. There was no effect of test number so the third GXT was not included in comparison with VP.

RESULTS

TheV ˙ O2peak from the first GXT was not different than either value attained following the VP at 95 or 105% workload or a second GXT (p > 0.999). The 85% VPV ˙ O2peak was lower than the first GXTV ˙ O2peak (p = 0.002). The VP confirmed the GXTV ˙ O2peak on 73% of VP (no differences among fitness levels). Submaximal VP (85 and 95%) was less effective as 65% and 51% of participants achieved a higherV ˙ O2peak on one of the GXT.

CONCLUSION

The use of a VP at 105% or a second GXT was able to confirm theV ˙ O2max value attained across a range of fitness levels.

Articles with impact: insights into 10 years of research with machine learning

Worldwide scientific output is growing faster and faster. Academics should not only publish much and fast, but also publish research with impact. The aim of this study is to use machine learning to investigate characteristics of articles that were published in the Journal of Applied Physiology between 2009 and 2018, and characterize high-impact articles. Article impact was assessed for 4,531 publications by three common impact metrics: the Altmetric Attention Scores, downloads, and citations. Additionally, a broad collection of (more than 200) characteristics was collected from the article's title, abstract, authors, keywords, publication, and article engagement. We constructed random forest (RF) regression models to predict article impact and articles with the highest impact (top-25% and top-10% for each impact metric), which were compared with a naive baseline method. RF models outperformed the baseline models when predicting the impact of unseen articles (P < 0.001 for each impact metric). Also, RF models predicted top-25% and top-10% high-impact articles with a high accuracy. Moreover, RF models revealed important article characteristics. Higher impact was observed for articles about exercise, training, performance and V̇o_2max, reviews, human studies, articles from large collaborations, longer articles with many references and high engagement by scientists, practitioners and public or via news outlets and videos. Lower impact was shown for articles about respiratory physiology or sleep apnea, editorials, animal studies, and titles with a question mark or a reference to places or individuals. In summary, research impact can be predicted and better understood using a combination of article characteristics and machine learning.NEW & NOTEWORTHY Common measures of article impact are the Altmetric Attention Scores, number of downloads, and number of citations. To our knowledge, this is the first study that applies machine learning on a comprehensive collection of article characteristics to predict article attention scores, downloads, and citations. Using 10 years of research articles, we obtained accurate predictions of high-impact articles and discovered important article characteristics related to article impact.

Is V̇O2peak a Valid Estimation of V̇O2max in Swimmers with Physical Impairments?

Purpose: Peak and maximal oxygen uptake ([Formula: see text] and [Formula: see text], respectively) are used in assessing aerobic power. For swimmers with physical impairments, it is unclear whether the physiological variables obtained in 200-m and Nx200-m tests are similar. The objective of this study is to assess the validity of [Formula: see text] as an estimator of [Formula: see text] and complementary physiological variables, in particular, carbon dioxide production ([Formula: see text]), respiratory exchange ratio (RER), minute-ventilation ([Formula: see text] and absolute (HR) and relative (%HRmax) heart rates-which were obtained in a time trial test (200-m) and an incremental intermittent test (Nx200-m) performed by swimmers with physical impairments. Methods: Eleven well-trained swimmers with physical impairments performed 200-m all-out and Nx200-m from low to all-out (controlled by a visual pacer), both with a respiratory valve system and a portable gas analyzer. Results: A paired Student's t-test showed no statistical difference (p > .05) for all comparisons. The intraclass correlation coefficient (ICC) was 0.97 and 0.98 for [Formula: see text] in l/min and ml/kg/min, respectively; ICC = 0.75 to 0.9 for [Formula: see text] (l/min and ml/kg/min),[Formula: see text] (in l/min) and HR (beats/min); ICC = 0.5 and 0.75 for %HRmax; and ICC < 0.5 for RER. Passing-Bablok regression showed that the dispersions were acceptable, considering the proportionality, except for HR and %HRmax. Bland-Altman method showed a high level of agreement for all variables. Conclusions: The [Formula: see text] and [Formula: see text], as well as the physiological variables [Formula: see text] and HR obtained, respectively, by 200-m and Nx200-m tests in swimmers with physical impairment were not different.

Measurement and Interpretation of Maximal Aerobic Power in Children

The assessment of maximal aerobic power ( V˙O2max ) in both children and adults is an invaluable tool for the evaluation of exercise performance capacity and general physical fitness in clinical, athletic, public health, and research applications. The complexity of means and considerations, as well as varying specific aims of V˙O2max testing, has prevented the formulation of a universally applicable, standard testing protocol, in general, and for children in particular. Numerous tester-controllable factors, such as exercise modality, metabolic measurement system, testing protocol, or data reduction strategies, can affect both the measurement and interpretation of V˙O2max data. Although the general guiding principles are similar, children differ from adults in several aspects. One notable difference is the frequent absence of a discernible V˙O2 plateau in children. Thus, the proper choice of equipment and procedures may be different for children than for adults. It is therefore the aim of this article to highlight the general and pediatric-specific considerations that may affect V˙O2max measurement and interpretation of results.