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O2 during exercise in humans: the peak vs. maximum issue
1Department of Physiology, St. George's Hospital Medical School, London SW17 ORE, United Kingdom; 2Division of Physiology, Department of Medicine, University of California, San Diego, La Jolla 92092-0623; and 3Division of Respiratory and Critical Care Physiology and Medicine, Harbor-UCLA Medical Center, Torrance, California 90509
Submitted 10 January 2003 ; accepted in final form 8 July 2003
The quantification of maximum oxygen uptake (O2 max), a parameter characterizing the effective integration of the neural, cardiopulmonary, and metabolic systems, requires oxygen uptake (O2) to attain a plateau. We were interested in whether a O2 plateau was consistently manifest during maximal incremental ramp cycle ergometry and also in ascertaining the relationship between this peak O2 (O2 peak) and that determined from one, or several, maximal constant-load tests. Ventilatory and pulmonary gas-exchange variables were measured breath by breath with a turbine and mass spectrometer. On average, O2 peak [3.51 ± 0.8 (SD) l/min] for the ramp test did not differ from that extrapolated from the linear phase of the response in 71 subjects. In 12 of these subjects, the O2 peak was less than the extrapolated value by 0.1-0.4 l/min (i.e., a "plateau"), and in 19 subjects, O2 peak was higher by 0.05-0.4 l/min. In the remaining 40 subjects, we could not discriminate a difference. The O2 peak from the incremental test also did not differ from that of a single maximum constant-load test in 38 subjects or from the O2 max in 6 subjects who undertook a range of progressively greater discontinuous constant-load tests. A plateau in the actual O2 response is therefore not an obligatory consequence of incremental exercise. Because the peak value attained was not different from the plateau in the plot of O2 vs. work rate (for the constant-load tests), the O2 peak attained on a maximum-effort incremental test is likely to be a valid index of O2 max, despite no evidence of a plateau in the data themselves. However, without additional tests, one cannot be certain.
oxygen uptake; plateau; incremental ramp; cycle ergometry
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