Accuracy of six minute walk test, stair test and spirometry using maximal oxygen uptake as gold standard

OBJETIVO: Determinar a acurácia das variáveis: tempo de escada (tTE), potência de escada (PTE), teste de caminhada (TC6) e volume expiratório forçado (VEF1) utilizando o consumo máximo de oxigênio (VO2máx) como padrão-ouro. MÉTODOS: Os testes foram realizados em 51 pacientes. O VEF1 foi obtido através da espirometria. O TC6 foi realizado em corredor plano de 120m. O TE foi realizado em escada de 6 lances obtendo-se tTE e PTE. O VO2máx foi obtido por ergoespirometria, utilizando o protocolo de Balke. Foram calculados a correlação linear de Pearson (r) e os valores de p, entre VO2máx e variáveis. Para o cálculo da acurácia, foram obtidos os pontos de corte, através da curva característica operacional (ROC). A estatística Kappa (k) foi utilizada para cálculo da concordância. RESULTADOS: Obteve-se as acurácias: tTE - 86%, TC6 - 80%, PTE - 71%, VEF1(L) - 67%, VEF1% - 63%. Para o tTE e TC6 combinados em paralelo, obteve-se sensibilidade de 93,5% e em série, especificidade de 96,4%. CONCLUSÃO: O tTE foi a variável que apresentou a melhor acurácia. Quando combinados o tTE e TC6 podem ter especificidade e sensibilidade próxima de 100%. Estes testes deveriam ser mais usados rotineiramente, especialmente quando a ergoespirometria para a medida de VO2máx não é disponível.

The highest intensity and the shortest duration permitting attainment of maximal oxygen uptake during cycling: effects of different methods and aerobic fitness level

The aims of this study were: (1) to verify the validity of previous proposed models to estimate the lowest exercise duration (T (LOW)) and the highest intensity (I (HIGH)) at which VO(2)max is reached (2) to test the hypothesis that parameters involved in these models, and hence the validity of these models are affected by aerobic training status. Thirteen cyclists (EC), eleven runners (ER) and ten untrained (U) subjects performed several cycle-ergometer exercise tests to fatigue in order to determine and estimate T (LOW) (ET (LOW)) and I (HIGH) (EI (HIGH)). The relationship between the time to achieved VO(2)max and time to exhaustion (T (lim)) was used to estimate ET (LOW). EI (HIGH) was estimated using the critical power model. I (HIGH) was assumed as the highest intensity at which VO2 was equal or higher than the average of VO(2)max values minus one typical error. T (LOW) was considered T (lim) associated with I (HIGH). No differences were found in T (LOW) between ER (170 +/- 31 s) and U (209 +/- 29 s), however, both showed higher values than EC (117 +/- 29 s). I (HIGH) was similar between U (269 +/- 73 W) and ER (319 +/- 50 W), and both were lower than EC (451 +/- 33 W). EI (HIGH) was similar and significantly correlated with I-HIGH only in U (r = 0.87) and ER (r = 0.62). ET (LOW) and T (LOW) were different only for U and not significantly correlated in all groups. These data suggest that the aerobic training status affects the validity of the proposed models for estimating I (HIGH).

Maximal Oxygen uptake cannot be determined in the incremental phase of the lactate minimum test on a cycle ergometer

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effects of aerobic endurance training status and specificity on oxygen uptake kinetics during maximal exercise

The main purpose of this study was to analyze the effects of exercise mode, training status and specificity on the oxygen uptake ((V)over dot O-2) kinetics during maximal exercise performed in treadmill running and cycle ergometry. Seven runners (R), nine cyclists (C), nine triathletes (T) and eleven untrained subjects (U), performed the following tests on different days on a motorized treadmill and on a cycle ergometer: (1) incremental tests in order to determine the maximal oxygen uptake ((V)over dot O-2max) and the intensity associated with the achievement of (V)over dot O-2max (I(V)over dot O-2max); and (2) constant work-rate running and cycling exercises to exhaustion at I(V)over dot O-2max to determine the effective time constant of the (V)over dot O-2 response (tau(V)over dot O-2). Values for (V)over dotO(2max) obtained on the treadmill and cycle ergometer [R=68.8 (6.3) and 62.0 (5.0); C=60.5 (8.0) and 67.6 (7.6); T=64.5 (4.8) and 61.0 (4.1); U=43.5 (7.0) and 36.7 (5.6); respectively] were higher for the group with specific training in the modality. The U group showed the lowest values for VO2max, regardless of exercise mode. Differences in tau(V)over dot O-2 (seconds) were found only for the U group in relation to the trained groups [R=31.6 (10.5) and 40.9 (13.6); C=28.5 (5.8) and 32.7 (5.7); T=32.5 (5.6) and 40.7 (7.5); U=52.7 (8.5) and 62.2 (15.3); for the treadmill and cycle ergometer, respectively]; no effects of exercise mode were found in any of the groups. It is concluded that tauVO(2) during the exercise performed at I(V)over dot O-2max is dependent on the training status, but not dependent on the exercise mode and specificity of training. Moreover, the transfer of the training effects on tau(V)over dotO(2) between both exercise modes may be higher compared with (V)over dot O-2max.

Anaerobic contribution during maximal anaerobic running test: correlation with maximal accumulated oxygen deficit

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Effect of aerobic training status on both maximal lactate steady state and critical power

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The validity of critical speed determined from track cycling for identification of the maximal lactate steady state

The objective of this study was to determine the critical speed (CS) for track cycling and to assess whether a lactate steady state occurs at this speed. Fourteen competitive cyclists performed the following tests on an official cycling track (333.3 m): 1) incremental test for determination of the intensity corresponding to 4 mM of blood lactate (onset of blood lactate accumulation, OBLA) and maximal oxygen uptake (VO(2)max); 2) CS: 3 maximal bouts for distances of 2, 4 and 6 km executed in random order and with a period of recovery of 40 to 50 min between bouts. CS was determined for each subject from the linear regression between the distance and the time taking to cycle it; 3) Endurance test in which subjects were instructed to pedal at 100% of their individually determined CS for 30 min. At the 10(th) and 30(th) min (or upon exhaustion), 25 mul of blood were collected from ear lobe for later analysis of blood lactate [Lac]b. An increase less than or equal to1 mM between 10 and 30 min of exercise was considered as the criterion for the occurrence of the lactate steady state. CS (49.6 +/- 8.6 ml.kg(-1).min(-1); 36.9 +/- 2.7 km.h(-1)) was significantly higher than OBLA (43.7 8.0 ml.kg(-1).min(-1); 35.24 +/- 2.6 km.h(-1)) although the two parameters were highly correlated (r=0.97). During the endurance test, only 8 of the 14 subjects completed the 30 min period at CS. of these 8 subjects, only 2 presented a lactate steady state. Time to exhaustion at CS was 20.3 +/- 1.6 min for the remaining 6 subjects. The 12 subjects who did not reach a lactate steady state presented mean [Lac]b values of 7.4 +/- 1.3 mM at 10 min and of 9.4 +/- 1.9 mM at the end of the test (exhaustion), characterizing an exercise intensity of high lactacidemia. on the basis of the present results, we can conclude that CS determined by a track cycling test seems to overestimate the intensity of the maximal lactate steady state for most subjects.

Effect of the chronological age and sexual maturation on the time to exhaustion at maximal aerobic speed

The purposes of this study were: a) to verify the effect of chronological age and sexual maturation on the time to exhaustion at VO(2)max (t(lim)) and; b) to examine the reproducibility of t(lim) in boys aged 10-15 years. Forty boys, divided into 4 groups, in accordance to the chronological age (G10-12 and G13-15) and sexual maturation (P1-P3 and P4-P5 levels for pubic hair), performed the following tests: 1) incremental test for determination of VO(2)max and; 2) all-out exercise bout performed at VO(2)max to determine the t(lim). There was no difference of t(lim) (sec) between G10-12 and G13-15 (181.5 +/- 96.3 vs. 199 105.5). While the two measures of t(lim) were moderately related (r = 0.78), t(lim) from the second test (226.6 +/- 96.1 s) was higher than that of the first (191.3 +/- 79.2 s). We can conclude that the t(lim) is not influenced by chronological age and sexual maturation. Besides, t(lim) presents a lower reproducibility in children and adolescents.

Exercise mode affects the time to achieve VO2max without influencing maximal exercise time at the intensity associated with VO2max in triathletes

The objective of this study was to analyze, in triathletes, the possible influence of the exercise mode (running x cycling) on time to exhaustion (TTE) and oxygen uptake (VO2) response during exercise performed at the intensity associated with the achievement of maximal oxygen uptake (IVO2max). Eleven male triathletes (21.8 +/- 3.8 yr) performed the following tests on different days on a motorized treadmill and on a cycle ergometer: 1) incremental tests in order to determine VO2max and IVO2max and, 2) constant work rate tests to exhaustion at IVO2max to determine TTE and to describe VO2 response (time to achieve VO2max-TAVO(2max) and time maintained at VO2max-TMVO2max). No differences were found in VO2max, TTE and TMVO2max obtained on the treadmill tests (63.7 +/- 4.7 ml.kg(-1).min(-1); 324.6 +/- 109.1 s; 178.9 +/- 93.6 s) and cycle ergometer tests (61.4 +/- 4.5 ml.kg(-1).min(-1); 390.4 +/- 114.4 s; 213.5 +/- 102.4 s). However, TAVO(2max) was influenced by exercise mode (145.7 +/- 25.3 vs. 176.8 +/- 20.1 s; in treadmill and cycle ergometer, respectively; p = 0.006). It is concluded that exercise modality affects the TAVO(2max) without influencing TTE and TMVO2max during exercise at IVO2max in triathletes.

Is maximal lactate steady state during intermittent cycling different for active compared with passive recovery?

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Oxygen uptake kinetics and time to exhaustion in cycling and running: A comparison between trained and untrained subjects

The objective of the present study was to compare pulmonary gas exchange kinetics (VO 2 kinetics) and time to exhaustion (Tlim) between trained and untrained individuals during severe exercise performed on a cycle ergometer and treadmill. Eleven untrained males in running (UR) and cycling (UC), nine endurance cyclists (EC), and seven endurance runners (ER) were submitted to the following tests on separate days: (i) incremental test for determination of maximal oxygen uptake (VO 2max) and the intensity associated with the achievement of VO 2max (IVO 2max) on a mechanical braked cycle ergometer (EC and UC) and on a treadmill (ER and UR); (ii) all-out exercise bout performed at IVO 2max to determine the time to exhaustion at IVO 2max (Tlim) and the time constant of oxygen uptake kinetics (τ). The τ was significantly faster in trained group, both in cycling (EC = 28.2 ± 4.7 s; UC = 63.8 ± 25.0 s) and in running (ER = 28.5 ± 8.5 s; UR = 59.3 ± 12.0 s). Tlim of untrained was significantly lower in cycling (EC = 384.4 ± 66.6 s vs. UC; 311.1 ± 105.7 s) and higher in running (ER = 309.2 ± 176.6 s vs. UR = 439.8 ± 104.2 s). We conclude that the VO 2 kinetic response at the onset of severe exercise, carried out at the same relative intensity is sensitive to endurance training, irrespective of the exercise type. The endurance training seems to differently influence Tlim during exercise at IVO 2max in running and cycling. © 2003 Taylor & Francis Ltd.

Maximal power output during incremental cycling test is dependent on the curvature constant of the power-time relationship

The aim of this study was to investigate whether the maximal power output (Pmax) during an incremental test was dependent on the curvature constant (W') of the power-time relationship. Thirty healthy male subjects (maximal oxygen uptake = 3.58 ± 0.40 L·min(-1)) performed a ramp incremental cycling test to determine the maximal oxygen uptake and Pmax, and 4 constant work rate tests to exhaustion to estimate 2 parameters from the modeling of the power-time relationship (i.e., critical power (CP) and W'). Afterwards, the participants were ranked according to their magnitude of W'. The median third was excluded to form a high W' group (HIGH, n = 10), and a low W' group (LOW, n = 10). Maximal oxygen uptake (3.84 ± 0.50 vs. 3.49 ± 0.37 L·min(-1)) and CP (213 ± 22 vs. 200 ± 29 W) were not significantly different between HIGH and LOW, respectively. However, Pmax was significantly greater for the HIGH (337 ± 23 W) than for the LOW (299 ± 40 W). Thus, in physically active individuals with similar aerobic parameters, W' influences the Pmax during incremental testing.

Nutritional and metabolic risk factors for insulin resistance in adults

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Evidence of ecotypic differentiation between populations of the tree species Parapiptadenia rigida due to flooding

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Relação entre índices fisiológicos aeróbios e desempenho em provas de curta e média duração em ciclistas de elite

Poucos são os estudos que possibilitam verificar quais as respostas fisiológicas são associadas ao desempenho em uma amostra de ciclistas de elite nacional. Portanto, o objetivo do presente estudo foi determinar e relacionar diferentes índices fisiológicos aeróbios com o desempenho em testes contra relógio de 4 e 20km em ciclistas de alto nível. A amostra foi composta por 14 ciclistas profissionais de elite nacional do sexo masculino (28,5 ± 4,7 anos, 73,47 ± 8,29 kg, 176 ± 6,76 cm), que realizaram um teste progressivo em laboratório para a determinação do consumo máximo de oxigênio (VO2max: 62,23 ± 8,28 ml·kg·min-1), intensidade relativa ao VO2max (iVO2max: 500,83 ± 58,65 w), economia de movimento (EM: 0,1166 ± 0,0362 ml·kg·min·w-1) e 1º e 2º limiares ventilatórios (LV1: 348,21 ± 43,26 w; LV2: 417,86 ± 60,79 w, respectivamente). Também foram submetidos a duas provas de 4 e 20km contra relógio. Para correlação entre os índices fisiológicos e desempenho, foi utilizado o coeficiente de correlação de Pearson (p< 0,05). Não foi encontrada correlação entre os índices fisiológicos (VO2max absoluto e relativo, iVO2max, EM, LV1 e LV2) e o desempenho de 4km (r= 0.38; 0.16; -0.33; 0.20; -0.50; -0.20, respectivamente) e 20km (r= 0.24; 0.01; -0.13; -0.12; -0.48; -0.19, respectivamente) contra relógio em atletas de alto nível. Estes resultados sugerem que tais variáveis não apresentam capacidade de explicar o desempenho em provas de contra relógio nas respectivas distâncias, provavelmente, devido à homogeneidade entre os sujeitos.