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Int J Sports Med 2014; 35(02): 118-124
DOI: 10.1055/s-0033-1345135
Training & Testing
© Georg Thieme Verlag KG Stuttgart · New York

The Incidence of V˙O 2 plateau at V˙O 2max in a Cardiac-Diseased Population

P. B. Nolan
1   Department of Sport and Exercise Science, The University of Auckland, New Zealand
,
R. Maddison
2   National Institute for Health Innovation, The University of Auckland, New Zealand
,
L. Dalleck
1   Department of Sport and Exercise Science, The University of Auckland, New Zealand
› Author Affiliations
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Publication History



accepted after revision 11 March 2013

Publication Date:
14 August 2013 (online)

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Abstract

We sought to determine the incidence of V˙O 2 plateau at V˙O 2max in a cardiovascular-diseased (CVD) population using 4 different sampling intervals (15-breath moving average, 15 s, 30 s, and 60 s) and 3 different V˙O 2 plateau criteria (≤50 mL · min−1, ≤80 mL · min−1, and ≤150 mL · min−1). A total of 69 people (62±10 yrs.) with recently diagnosed CVD performed a maximal exercise test (10:07±2:24 min) on a treadmill. The test was classified as maximal (n=57, 2 430±605 mL · min−1) if self-terminated due to fatigue or classified as symptom-limited (n=12, 1 683±438 mL · min−1) if symptoms presented. Chi-square analysis revealed a significant (p<0.05) effect of sampling interval on incidence of V˙O 2 plateau at V˙O 2max across all 3 V˙O 2 plateau criteria. The sampling interval had an increasingly stronger influence on the incidence of V˙O 2 plateau at V˙O 2max with smaller criterion thresholds as evidenced by the Cramer’s V statistics: [≤50 mL · min−1 (Cramer’s V=0.548, p<0.05], ≤80 mL · min−1 [Cramer’s V=0.489, p<0.05], ≤150 mL · min−1 [Cramer’s V=0.214, p<0.05]. Incidence of V˙O2 plateau at V˙O 2max in CVD individuals is significantly influenced by the sampling interval applied. Based on our findings we recommend a15 breath moving average and V˙O 2 plateau criterion of ≤50 mL · min−1.

Key words

exercise testing - cardiovascular disease - oxygen plateau
 

  • References

  • 1 Ades PA, Savage PD, Brawner CA, Lyon CE, Ehrman JK, Bunn JY, Keteyian SJ. Aerobic capacity in patients entering cardiac rehabilitation. Circulation 2006; 113: 2706-2712
    CrossrefPubMedGoogle Scholar
  • 2 Astorino TA, Robergs RA, Ghiasvand F, Marks D, Burns S. Incidence of the oxygen plateau at VO2max during exercise testing to volitional fatigue. J Exerc Physiol Online 2000; 3: 1-12
    PubMedGoogle Scholar
  • 3 Astorino TA, Willey J, Kinnahan J, Larsson SM, Welch H, Dalleck LC. Elucidating determinants of the plateau in oxygen consumption at VO2max. Br J Sports Med 2005; 39: 655-660 discussion 660
    CrossrefPubMedGoogle Scholar
  • 4 Astorino TA. Alterations in VO2max and the VO2 plateau with manipulation of sampling interval. Clin Physiol Funct Imaging 2009; 29: 60-67
    CrossrefPubMedGoogle Scholar
  • 5 Astrand I. Aerobic work capacity in men and women with special reference to age. Acta Physiol Scand 1960; Supplementum. 49: 1-92
    CrossrefPubMedGoogle Scholar
  • 6 Bassett DR, Howley ET. Maximal oxygen uptake: “classical” versus “contemporary” viewpoints. Med Sci Sports Exerc 1997; 29: 591-603
    CrossrefPubMedGoogle Scholar
  • 7 Blair SN, Kampert JB, Kohl 3rd HW, Barlow CE, Macera CA, Paffenbarger Jr RS, Gibbons LW. Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women. JAMA 1996; 276: 205-210
    CrossrefPubMedGoogle Scholar
  • 8 Blair SN, Kohl 3rd HW, Paffenbarger Jr RS, Clark DG, Cooper KH, Gibbons LW. Physical fitness and all-cause mortality. A prospective study of healthy men and women. JAMA 1989; 262: 2395-2401
    CrossrefPubMedGoogle Scholar
  • 9 Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982; 14: 377-381
    PubMedGoogle Scholar
  • 10 Cumming GR, Borysyk LM. Criteria for maximum oxygen uptake in men over 40 in a population survey. Med Sci Sports 1972; 4: 18-22
    PubMedGoogle Scholar
  • 11 Cunha FA, Midgley AW, Monteiro WD, Farinatti PT. Influence of cardiopulmonary exercise testing protocol and resting VO2 assessments on %HRmax, %HRR, %VO2max and %VO2 relationships. Int J Sports Med 2010; 31: 319-326
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Dalleck LC, Astorino TA, Erickson RM, McCarthy CM, Beadell AA, Botten BH. Suitability of verification testing to confirm attainment of VO2max in middle-aged and older adults. Res Sports Med 2012; 20: 118-128
    PubMedGoogle Scholar
  • 13 Day JR, Rossiter HB, Coats EM, Skasick A, Whipp BJ. The maximally attainable VO2 during exercise in humans: the peak vs. maximum issue. J Appl Physiol 2003; 95: 1901-1907
    CrossrefPubMedGoogle Scholar
  • 14 Doherty M, Nobbs L, Noakes TD. Low frequency of the “plateau phenomenon” during maximal exercise in elite British athletes. Eur J Appl Physiol 2003; 89: 619-623
    CrossrefPubMedGoogle Scholar
  • 15 Fletcher GJ, Balady GJ, Amsterdam EA, Chaitman B, Eckel R, Froelicher VF, Leon AS, Piña IL, Rodney R, Simons-Morton DA, Williams MA, Bazzarre T. Exercise standards for testing and training: a statement for healthcare professionals from the American Heart Association. Circulation 2001; 104: 1694-1740
    CrossrefPubMedGoogle Scholar
  • 16 Froelicher VF, Brammell H, Davis G, Noguera I, Stewart A, Lancaster MC. A comparison of the reproducibility and physiologic response to three maximal treadmill exercise protocols. Chest 1974; 65: 512-517
    CrossrefPubMedGoogle Scholar
  • 17 Gordon D, Hopkins S, King C, Keiller D, Barnes RJ. Incidence of the plateau at VO2max is dependent on the anaerobic capacity. Int J Sports Med 2011; 32: 1-61
    Article in Thieme ConnectPubMedGoogle Scholar
  • 18 Gulati M, Pandey DK, Arnsdorf MF, Lauderdale DS, Thisted RA, Wicklund RH, Al-Hani AJ, Black HR. Exercise capacity and the risk of death in women: the St James Women Take Heart Project. Circulation 2003; 108: 1554-1559
    CrossrefPubMedGoogle Scholar
  • 19 Hambrecht RP, Schuler GC, Muth T, Grunze MF, Marburger CT, Niebauer J, Methfessel SM, Kubler W. Greater diagnostic sensitivity of treadmill versus cycle exercise testing of asymptomatic men with coronary artery disease. Am J Cardiol 1992; 70: 141-146
    CrossrefPubMedGoogle Scholar
  • 20 Harriss DJ, Atkinson G. Update – Ethical standards in sport and exercise science research. Int J Sports Med 2011; 32: 819-821
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Howley ET, Bassett DR, Welch HG. Criteria for maximal oxygen uptake: review and commentary. Med Sci Sports Exerc 1995; 27: 1292-1301
    PubMedGoogle Scholar
  • 22 Howley ET. VO2max and the plateau – needed or not?. Med Sci Sports Exerc 2007; 39: 101-102
    CrossrefPubMedGoogle Scholar
  • 23 Huggett DL, Connelly DM, Overend TJ. Maximal aerobic capacity testing of older adults: a critical review. J Gerontol A Biol Sci Med Sci 2005; 60: 57-66
    CrossrefPubMedGoogle Scholar
  • 24 Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J, Corey P, Shephard RJ. Prediction of long-term prognosis in 12 169 men referred for cardiac rehabilitation. Circulation 2002; 106: 666-671
    CrossrefPubMedGoogle Scholar
  • 25 Kavanagh T, Mertens DJ, Hamm LF, Beyene J, Kennedy J, Corey P, Shephard RJ. Peak oxygen intake and cardiac mortality in women referred for cardiac rehabilitation. J Am Coll Cardiol 2003; 42: 2139-2143
    CrossrefPubMedGoogle Scholar
  • 26 Midgley AW, Bentley DJ, Luttikholt H, McNaughton LR, Millet GP. Challenging a dogma of exercise physiology: does an incremental exercise test for valid VO2 max determination really need to last between 8 and 12 min?. Sports Med 2008; 38: 441-4477
    CrossrefPubMedGoogle Scholar
  • 27 Midgley AW, McNaughton LR, Polman R, Marchant D. Criteria for determination of maximal oxygen uptake: a brief critique and recommendations for future research. Sports Med 2007; 37: 1019-1028
    CrossrefPubMedGoogle Scholar
  • 28 Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE. Exercise capacity and mortality among men referred for exercise testing. N Engl J Med 2002; 346: 793-801
    CrossrefPubMedGoogle Scholar
  • 29 Myers J, Walsh D, Sullivan M, Froelicher V. Effect of sampling on variability and plateau in oxygen uptake. J Appl Physiol 1990; 68: 404-410
    PubMedGoogle Scholar
  • 30 Noakes TD. 1996 J.B. Wolffe Memorial Lecture. Challenging beliefs: ex Africa semper aliquid novi. Med Sci Sports Exerc 1997; 29: 571-590
    CrossrefPubMedGoogle Scholar
  • 31 Noakes TD. How did A V Hill understand the VO2max and the “plateau phenomenon”? Still no clarity. Br J Sports Med 2008; 42: 574-580
    CrossrefPubMedGoogle Scholar
  • 32 Noakes TD. Maximal oxygen uptake: “classical” versus “contemporary” viewpoints: a rebuttal. Med Sci Sports Exerc 1998; 30: 1381-1398
    PubMedGoogle Scholar
  • 33 Noakes TD. Time to move beyond a brainless exercise physiology: the evidence for complex regulation of human exercise performance. Appl Physiol Nutr Metab 2011; 36: 23-35
    CrossrefPubMedGoogle Scholar
  • 34 Noakes TD. Implications of exercise testing for prediction of athletic performance: a contemporary perspective. Med Sci Sports Exerc 1988; 20: 319-330
    CrossrefPubMedGoogle Scholar
  • 35 Pollock ML, Bohannon RL, Cooper KH, Ayres JJ, Ward A, White SR, Lennerud AC. A comparative analysis of four protocols for maximal treadmill stress testing. Am Heart J 1976; 92: 39-46
    CrossrefPubMedGoogle Scholar
  • 36 Poole DC, Wilkerson DP, Jones AM. Validity of criteria for establishing maximal O2 uptake during ramp exercise tests. Eur J Appl Physiol 2008; 102: 403-410
    CrossrefPubMedGoogle Scholar
  • 37 Robergs RA, Dwyer D, Astorino T. Recommendations for improved data processing from expired gas analysis indirect calorimetry. Sports Med 2010; 40: 95-111
    CrossrefPubMedGoogle Scholar
  • 38 Robergs RA. An exercise physiologist’s “contemporary” interpretations of the “ugly and creaking edifices” of the VO2max concept. J Exerc Physiol Online 2001; 4: 1-44
    PubMedGoogle Scholar
  • 39 Sidney KH, Shephard RJ. Maximum and submaximum exercise tests in men and women in the seventh, eighth, and ninth decades of life. J Appl Physiol 1977; 43: 280-287
    PubMedGoogle Scholar
  • 40 Taylor HL, Buskirk E, Henschel A. Maximal oxygen intake as an objective measure of cardio-respiratory performance. J Appl Physiol 1955; 8: 73-80
    PubMedGoogle Scholar
  • 41 Vincent WJ, Weir JP 4th ed. Statistics in Kinesiology. Champaign: Human Kinetics; 2012
    Google Scholar
  • 42 Williams PT. Physical fitness and activity as separate heart disease risk factors: a meta-analysis. Med Sci Sports Exerc 2001; 33: 754-761
    PubMedGoogle Scholar