New Data-based Cutoffs for Maximal Exercise Criteria across the Lifespan

Abstract

Purpose To determine age-dependent cutoff values for secondary exhaustion criteria for a general population free of exercise limiting chronic conditions; to describe the percentage of participants reaching commonly used exhaustion criteria during a cardiopulmonary exercise test (CPET); and to analyze their oxygen uptake at the respective criteria to quantify the impact of a given criterion on the respective oxygen uptake (V˙O2) values. Methods Data from the COmPLETE-Health Study were analyzed involving participants from 20 to 91 yr of age. All underwent a CPET to maximal voluntary exertion using a cycle ergometer. To determine new exhaustion criteria, based on maximal respiratory exchange ratio (RERmax) and age-predicted maximal HR (APMHR), one-sided lower tolerance intervals for the tests confirming V˙O2 plateau status were calculated using a confidence level of 95% and a coverage of 90%. Results A total of 274 men and 252 women participated in the study. Participants were nearly equally distributed across age decades from 20 to >80 yr. A V˙O2 plateau was present in 32%. There were only minor differences in secondary exhaustion criteria between participants exhibiting a V˙O2 plateau and participants not showing a V˙O2 plateau. New exhaustion criteria according to the tolerance intervals for the age group of 20 to 39 yr were: RERmax ≥ 1.13, APMHR210 − age ≥ 96%, and APMHR208 × 0.7 age ≥ 93%; for the age group of 40 to 59 yr: RERmax ≥ 1.10, APMHR210 − age ≥ 99%, and APMHR208 × 0.7 age ≥ 92%; and, for the age group of 60 to 69 yr: RERmax ≥ 1.06, APMHR210 − age ≥ 99%, and APMHR208 × 0.7 age ≥ 89%. Conclusions The proposed cutoff values for secondary criteria reduce the risk of underestimating V˙O2max. Lower values would increase false-positive results, assuming participants are exhausted although, in fact, they are not.

Severe-intensity constant-work-rate cycling indicates that ramp incremental cycling underestimates ⩒o2max in a heterogeneous cohort of sedentary individuals

“…However, despite the fact that it was surpassed on average at~93% of the bout's ⩒o 2peak , the fact that the criterion value for HR identified 20 of the 23 individuals who did not achieve their ⩒o 2max on RAMP-INC suggests that at least for some individuals, it might have been valid for this purpose. Finally, contrary to our third hypothesis, use of newly-proposed age-dependent values for RER and HR [14] did not improve the ability to identify instances when CWR confirmed that RAMP-INC was characterized by a submaximal ⩒o 2peak . Specifically, use of more stringent RER values yielded the same conclusion (acceptance of ⩒o 2max for 33 of 35 RAMP-INC tests including 23 during which it was confirmed to have not been reached) while use of less stringent HR values resulted in seven additional confirmations of ⩒o 2max on RAMP-INC that included five tests during which the CWR bout refuted that conclusion.…”

“…The peak values for each variable were defined as the highest 20-s rolling-average value measured during each test. To evaluate secondary criteria that have traditionally been used for verifying ⩒o 2max during INC, we determined the number of participants who achieved/surpassed an RER of 1.10 and/or a HR of 95% of the age-predicted maximum (220 minus age) on RAMP-INC. To evaluate newly-proposed age-dependent criteria, we determined the number of participants who achieved/surpassed an RER of 1.13, a HR of 96% of the adjusted age-predicted maximum (210 minus age; APMHR 210 ) and/or 93% of the age-predicted maximum based on the formula recommended by Tanaka et al (208 minus 0.7 � age; APMHR 208 ) for aged 20-39 yr or achieved/surpassed an RER of 1.10, a HR of 99% of APMHR 210 and/or 92% of APMHR 208 for aged 40-59 yr [14]. In each case, for these participants, we also determined the ⩒o 2 values that were present at the point at which the RER and HR criterion values were achieved during the test and then expressed them as a percentage of the ⩒o 2peak during RAMP-INC and the higher ⩒o 2peak achieved across both tests.…”

“…Blood pressure (SunTech Tango M2, Morrisville, NC), HR and ECG were also monitored continuously during the tests. The WR peak and time to T lim on RAMP-INC were recorded and participants rated their whole-body sense of effort at T lim using the Borg RPE scale (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) immediately following the test. Time to T lim and RPE were also recorded for CWR.…”

“…The degree to which traditional secondary criteria are useful might, therefore, depend on the physical-activity and/or obesity status of the individual. Moreover, Wagner et al have recently proposed new age-dependent secondary criteria for RER and HR based on data collected during RAMP-INC cycling tests performed by a large cohort of healthy men and women aged 20-91 yr. [14]. Importantly, the values they derived, which were calculated using one-sided lower tolerance intervals (confidence level, 95%; coverage, 90%) for tests characterized by a ⩒o 2 plateau, were higher (RER) and lower (HR) than the aforementioned traditional ones and, therefore, less likely to result in false confirmation (type I error) or false rejection (type II error) of ⩒o 2max , respectively [14].…”

Can Gaming Get You Fit?

“…Criteria for the attainment ofVO 2max was adjusted for age. However, since not all participants fulfilled to criteria for attainment ofVO 2max, we report this asVO 2peak (Wagner et al, 2020). We reportVO 2peak as the mean of the three highest 10-s values during the test.…”