Vo2 Max - Public or private?

Caroline_ie

Hi -

I am booked in for a series of Vo2 Max test on the bike for futher investigation of my Sports induced athma. Obviously when the doc said they were going to book me for a series of excercise tests, I replied: 'Vo2 Max?' ... they were quite surprised I knew what it was...

Is there a diference between the tests done in a Public Hospital or say Trinity College? Or is it all the same?

Cheers

tunney

Caroline_ie wrote: »

Hi -

I am booked in for a series of Vo2 Max test on the bike for futher investigation of my Sports induced athma. Obviously when the doc said they were going to book me for a series of excercise tests, I replied: 'Vo2 Max?' ... they were quite surprised I knew what it was...

Is there a diference between the tests done in a Public Hospital or say Trinity College? Or is it all the same?

Cheers

nah......... doubt it.

Vo2max interestingly enough has recently be shown in research NOT to be the maximum amount of oxygen that the CV system can supply to the muscles but rather the maximum amount of oxygen that the muscles can demand of the CV system.

RobFowl

Caroline_ie wrote: »

Hi -

I am booked in for a series of Vo2 Max test on the bike for futher investigation of my Sports induced athma. Obviously when the doc said they were going to book me for a series of excercise tests, I replied: 'Vo2 Max?' ... they were quite surprised I knew what it was...

Is there a diference between the tests done in a Public Hospital or say Trinity College? Or is it all the same?

Cheers

The ones in hospital test abroader range of lung function tests.
VO2 max is as Tunney says really quite a limited test and IMO is quite over-rated in the cycling community.
Tallaght hospital has a highly rated Pulmonary function lab as does the Mater.

StudentC

I'd say the main difference would be that the hospital will only be looking at your breathing response to an exercise challenge - i.e. they might do a 'pre' lung function test, get you to do the max test and then do a 'post' lung function test to look for exercise induced asthma. This is useful for you from a medical point of view obviously, but potentially not that useful for fitness testing / training planning etc.

In a private exercise physiology lab (e.g. Trinty as you mention, but also I'll take this opportunity to shamelessly plug our lab in the Institute of Sport and Health in UCD ) the emphasis would be on doing the test in order to plan your training. So while VO2max is measured, it often isn't the main variable of interest. It's nice to know your aerobic fitness, but you can't actually do anything with the number! So more interesting can be HR responses obviously, but also lactate would be measured and then training zones prescribed from there.

So in summary - hospital test: just looking at the asthma, private test: useful for your training.

RobFowl

StudentC wrote: »

So in summary - hospital test: just looking at the asthma, private test: useful for your training.

+1

austinbyrne21

Can anyone send me in the direction of a good link to this VO2 Max jazz? Something that will explain it to me like I'm a six year old... I'm starting to get serious about doing some training for triat.. (hmm, sportives) and I want to know a bit more about this kind of thing to see if it would be beneficial.

So, any websites worth a gander?

Lumen

austinbyrne21 wrote: »

So, any websites worth a gander?

Cycling Performance Tips - Exercise Physiology - The Cardiovascular System & Conditioning

austinbyrne21

Cheers Lumen, that'll make some light reading for later on this evening after work. Sorry for "hi-jacking" the thread as you's cool kids call it.

billy.fish

*looks around physiology lab*

Yep, Vo2 means nowt....it has its place. Very much so. For performance most definitly. As Tunney was saying it is a measure of muscular O2 demand, but during cycling as we only use a certain % of our max muscle we need to take the figres and adjust a little.

Deffo say the test is worth doing if you get the chance, but remember the protocol is what actually decides if the test is valid for your situation. Any protocol can max a subject, but most of the info is to be gleamed from the actual bits before max: v-vo2, Vt, and so on. Or in Tunney's case looking at CHO an fat utilisation.

mmm insulin

Any questions feel free to Pm me if you have questions, i get bored in my torture room...sorry lab. I usualy reply, unless Tunney wants lab results...

Quigs Snr

Well I was planning on getting a full suite of tests done myself this winter to see what I am starting out with, V02, Power etc.... However, following a recent chest infection / asthma flare up though I am off for a "spiro" test first at the behest of my GP, whatever that is. Any of you lab folks / doctor types tell me what they are looking for ? FYI, I have been asthmatic for 20 years, real asthma, not the madey upey stuff that many cyclists seem to have. Most colds/flus go to the chest, other triggers include dust and pollen. Its not exercise induced thats for sure. So I am wondering with all that being said, whats a spiro test going to show me ?

billy.fish

Probably going to mostly focus on:
Peak flow, inspired volume, expired volume, residual volume, and so on. Simple enough test actually. May also look at ventilatory threshold if they do a stress test on you.

Clinical not my area so sorry if i cant help more!

leftism

Caroline_ie wrote: »

Hi -

I am booked in for a series of Vo2 Max test on the bike for futher investigation of my Sports induced athma. Obviously when the doc said they were going to book me for a series of excercise tests, I replied: 'Vo2 Max?' ... they were quite surprised I knew what it was...

Is there a diference between the tests done in a Public Hospital or say Trinity College? Or is it all the same?

Cheers

If you've got (or think you've got) exercise induced asthma i would recommend you call Bernard Donne in TCD on 8962012 and book yourself in for an EVH test along with a VO2max test if you're looking to get that done too...

I'm working in Bernard's lab as a physiology PhD. student and i'm also training a lot, and i also also have exercise induced asthma so i've a good idea what you're looking for.

If you are likely to be doping tested then an EVH test (Eucapnic Voluntary Hyperapnea test) is the gold standard for diagnosing asthma. I've a file about half an inch thick of all the tests i've done in Bernard's lab. You definitely need an EVH test done to prove you're an asthmatic so you can get a theraputic use exemption form!

In terms of diagnosing asthma, EVH tests are way better than VO2max tests.

P.S: +1 to Tunney et al. on how much of a performance indicator VO2max is. In terms of performance predictors, load (W) or velocity (km.hr-1) at the anaerobic threshold is a way better marker. Velocity at threshold has been shown to be a more accurate performance predictor in marathon runners. It is also a better marker of adaptations to aerobic training. VO2max will often not change even with large increases in aerobic capacity, where load at threshold should increase in response to training adaptations.

Just to give you an example, we had a guy test 2 years ago with a VO2max of 71 mL.kg-1.min-1 (very high for his sport), and a load at threshold of 190W. This year he came back and tested again. His VO2max had dropped to 66 mL.kg-1.min-1 but his load at threshold was now 200W. He knocked 8 secs off his 1k TT this year, so why was his VO2max down??? Because he had done serious weights in the gym and put on nearly 4kg of muscle in the winter season. This 4kg of muscle altered his oxygen delivery capacity somewhat, but he was a much stronger athlete with the same (if not slightly improved) aerobic capacity... So his overall performance was up.

StudentC

Quigs Snr wrote: »

Well I was planning on getting a full suite of tests done myself this winter to see what I am starting out with, V02, Power etc.... However, following a recent chest infection / asthma flare up though I am off for a "spiro" test first at the behest of my GP, whatever that is. Any of you lab folks / doctor types tell me what they are looking for ? FYI, I have been asthmatic for 20 years, real asthma, not the madey upey stuff that many cyclists seem to have. Most colds/flus go to the chest, other triggers include dust and pollen. Its not exercise induced thats for sure. So I am wondering with all that being said, whats a spiro test going to show me ?

As billy.fish says, probably forced vital capacity and forced expiratory volume (how big your lungs are and how fast you can blow out) with a peak flow as well (simpler measure of how fast you can blow out). Then maybe get you to take some ventolin (if that's what you use as a reliever) and repeat the tests, to see how you respond to the drug.

maybe a diffusing capacity test (hold your breath for about 10 seconds after breathing a particular gas mix), to see how well the transfer of oxygen from lung to blood happens, although that often isn't affected in asthma.

And then maybe, depending on the lab where they send you, a residual volume test (breathing on a helium mixture on the machine for a few minutes) to see how much of your lungs you actually use (again, not usually an asthma thing).

tunney

leftism wrote: »

If you are likely to be doping tested then an EVH test (Eucapnic Voluntary Hyperapnea test) is the gold standard for diagnosing asthma. I've a file about half an inch thick of all the tests i've done in Bernard's lab. You definitely need an EVH test done to prove you're an asthmatic so you can get a theraputic use exemption form!

Not at all, not even close to true. Asthma requires only an abbreviated TUE, can be done by any GP with definitely no need for an EVH (my TUE has been lodged for four years with the ISC based on peak flow.

leftism wrote: »

Just to give you an example, we had a guy test 2 years ago with a VO2max of 71 mL.kg-1.min-1 (very high for his sport), and a load at threshold of 190W. This year he came back and tested again. His VO2max had dropped to 66 mL.kg-1.min-1 but his load at threshold was now 200W.

Or another option - your power measuring mechanism needs recalibration and his threshold power hadn't increased?

StudentC

leftism wrote: »

You definitely need an EVH test done to prove you're an asthmatic so you can get a theraputic use exemption form!

leftism wrote: »

Just to give you an example, we had a guy test 2 years ago with a VO2max of 71 mL.kg-1.min-1 (very high for his sport), and a load at threshold of 190W. This year he came back and tested again. His VO2max had dropped to 66 mL.kg-1.min-1 but his load at threshold was now 200W. He knocked 8 secs off his 1k TT this year, so why was his VO2max down??? Because he had done serious weights in the gym and put on nearly 4kg of muscle in the winter season. This 4kg of muscle altered his oxygen delivery capacity somewhat, but he was a much stronger athlete with the same (if not slightly improved) aerobic capacity... So his overall performance was up.

Edit: I see Tunney got there first!

I thought you only needed an FEV1 for a TUE? Very few labs are able to do EVH so would be a nightmare to ask every athlete to get it done. Open to correction on that though, as I haven't looked at the TUE form in a while.

Re the guy's VO2 dropping but his power rising - of course if he puts on 4kg his relative VO2 is going to fall, but did his absolute change much? And a 10W difference isn't massive, unless you're really really confident of the calibration of your power metre. And the guy's 1km TT time probably isn't really related to his VO2 anyway.

Not trying to be argumentative, I agree with your point but just think that that guy maybe isn't the best case example!

RobFowl

leftism wrote: »

If you've got (or think you've got) exercise induced asthma i would recommend you call Bernard Donne in TCD on 8962012 and book yourself in for an EVH test along with a VO2max test if you're looking to get that done too...

If you are likely to be doping tested then an EVH test (Eucapnic Voluntary Hyperapnea test) is the gold standard for diagnosing asthma. I've a file about half an inch thick of all the tests i've done in Bernard's lab. You definitely need an EVH test done to prove you're an asthmatic so you can get a theraputic use exemption form!

tunney wrote: »

Not at all, not even close to true. Asthma requires only an abbreviated TUE, can be done by any GP with definitely no need for an EVH (my TUE has been lodged for four years with the ISC based on peak flow.

Sorry to be pedantic but both these statements are wrong.
Leftism If some one thinks they have asthma then their first port of calll should be their GP.
Also EVH testing is only one of the accepted methods.
Tunney what you say is correct ish. If you had an aTUE active as of 31st Dec 2008 then it is valid until 31st Dec 2009. (I'm presuming this is for ventolin or one of the other beta 2 agonists)
The wada regs introduced on 1st Jan 2009 actually abolished the aTUE and a full tue is now needed. Simple PEFR reading are no longer sufficiant on teir own. Basically you need to have it on file that you have an FEV1 which decreases by 16% on exertion or 12% with ventolin.
It also list a number of provocation tests which are accepted.
Also glucocorticoid inhalers no longer need TUE's simply a notification form.

As an aside unless you are an international class athlete then you can apply for a retroactive TUE after being tested as long as all the relevant information is in your medical file/record.

Not sure re tri but in cycling terms world/international class means you recive ISC funding (i.e. are a carded athlete).

Here are the WADA guidelines re asthma
http://www.wada-ama.org/rtecontent/document/Asthma_en.pdf

tunney

RobFowl wrote: »

Sorry to be pedantic but both these statements are wrong.
Leftism If some one thinks they have asthma then their first port of calll should be their GP.
Also EVH testing is only one of the accepted methods.
Tunney what you say is correct ish. If you had an aTUE active as of 31st Dec 2008 then it is valid until 31st Dec 2009. (I'm presuming this is for ventolin or one of the other beta 2 agonists)
The wada regs introduced on 1st Jan 2009 actually abolished the aTUE and a full tue is now needed. Simple PEFR reading are no longer sufficiant on teir own. Basically you need to have it on file that you have an FEV1 which decreases by 16% on exertion or 12% with ventolin.
It also list a number of provocation tests which are accepted.
Also glucocorticoid inhalers no longer need TUE's simply a notification form.

As an aside unless you are an international class athlete then you can apply for a retroactive TUE after being tested as long as all the relevant information is in your medical file/record.

Not sure re tri but in cycling terms world/international class means you recive ISC funding (i.e. are a carded athlete).

Here are the WADA guidelines re asthma
http://www.wada-ama.org/rtecontent/document/Asthma_en.pdf

Cheers, good to know, if something this big had changed I would have expected to have heard something from the anti-doping officer. Will have to investigate.

"Also glucocorticoid inhalers no longer need TUE's simply a notification form." I *think* that this covers my case, but again I think further investigation is reuired.

blorg

I was looking into this earlier in the year myself as started racing and got my GP to fill out the abbreviated TUE; I then found out the far longer full TUE was required. Out of interest, what is the procedure/cost for getting this investigated?

On the plus side my exercise-induced asthma diagnosed last year seems to have gone away this year. I have not had constricted breathing from hard efforts despite having made harder efforts than ever before in my life (last year on a number of occasions I literally couldn't breathe after climbing a hill fast.)

My GP reckoned it was related to my bad hayfever so this could be a factor, could it also be from training more?

billy.fish

Its changed a since Bejing for asthma. main reason being most of the rowers and swimmers were 'ashmatic'. Dont even get me started on that. But yes, you need to now have a proper backup to say that you are actually clinically diagnosed with asthma or EIA.

As for the 10W difference, it depends on many many variables.

Was this on a bike erg, rowing erg, arm crank, paddle erg? Not just cyclists use W as measure of power, its used for other ergs. If he was on a bike erg and only did 190W.....hmmmmm at that vo2 i'd be hoping they wernt a cyclist.

But as StudentC pointed out a 1km TT is not an aerobic effort, unless you were walking or something silly like that. Rowing, cycling, running, skiiing etc its a predominately anaerobic event, and although aerobic capacity will have a part to play in delivering O2 to the muscle it will not be the pure determinant.

Would be interesting in the case of that athlete to see what his absolute measures were for V02, and the change in vo2 at separate points along the power curve. Nice way to look at economy, efficiency and substrate utilisation.

billy.fish

blorg wrote: »

My GP reckoned it was related to my bad hayfever so this could be a factor, could it also be from training more?

Doubtful on the training more unless you were over-reaching or overtrained at the time. Might be another haematological reason. You get a CBC done at any stage?

RobFowl

blorg wrote: »

I was looking into this earlier in the year myself as started racing and got my GP to fill out the abbreviated TUE; I then found out the far longer full TUE was required. Out of interest, what is the procedure/cost for getting this investigated?

Some GP's have the nessecary equipment. If it's unclear on provisional testing then the spiromety can be free on the public system (with a GP referral) or starts at 200+ and can be well in excess of 1000 if it's difficult to diagnose.

blorg

@billy- CBC = complete blood count? No. IIRC he may have done something with lung capacity and peak flow (complete exhalation as fast as possible?)

Part of the problem was this ONLY occurred after an intense bout of exercise so IIRC the tests he did came up pretty normal. He was happy to prescribe Ventolin all the same, and it did seem to help at the time at alleviating the symptoms. I am still on the first inhaler since early last summer so that would give you an indication how often I need to use it.