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fitbyfred

Development Team Member
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Posts: 168
 #1 
Hi, here's a jogger we've been working with over 3 assessments since 2014. This newest assessment is an 8 min step. First 8 min step is a 'single'. It was just too slow for the jogger. The next 3 double steps are same load: 

Step 1: 3.3 mph, SpO2: 98%, pulse pressure:50
Step 2-3: 4.3 mph, SpO2: 97%, pulse pressure:48 & 54
Step 4-5: 5.1 mph, SpO2: 97%, pulse pressure:51 & 51
Step 6-7: 6.1 mph, SpO2: 96%, pulse pressure:50 & 45  

Here's the simple analysis with HR & SmO2
1st 8 min Step Endurance Screen.jpg   

Here's the image of the Peripedal post screen
IMG_2075.JPG 

Peripedal csv file attached.

My initial interpretation of the performance: 
Information from the functional treadmill assessment such as increasing HR, decreasing muscle blood flow supply along with a progressive decrease of O2 in the muscle (% SmO2) suggest a muscle blood inflow restriction is potentially the main limitation to greater exercise tolerance and improved jogging performance.   
 All thoughts and ideas are very welcome.csv 1st 8 min Step Screen.csv     


Andri

Fortiori Design LLC
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Posts: 65
 #2 
I just want to clarify am few points: These are 7 x 8 minute steps with a 1 minute break in between?

And secondly, I want to raise the discussion, which I have had with many different people, when we identify high intensity what is high intensity. If someone can maintain a performance level for 8 minutes is this high intensity? This is where a very large degree of subjectivity comes into play, and whatever the high intensity zone is defined as needs to be clearly stated for the athlete, client, trainer, etc. 

Example: Running for 8 minutes at a steady pace, and the collapsing because of absolute fatigue would mean the performance was maximum for the duration dictated, but of course this person could have performed at a much higher intensity had the duration been set to 4 minutes; or even more extreme asking a power lifter to squat at a maximum level will get you a high intensity performance for only a few seconds. 

Does this make sense? 

Again, important is setting the definition. The way I set HII zone in a 5-1-5 assessment is the inability to complete the 5 minute steps. If someone completes a five minute step and then the assessment ends, I set HII as above the final assessment intensity. This is not right or wrong, just a definition of HII that is then consistent with every assessment, something I have adjusted, and may adjust again. 
fitbyfred

Development Team Member
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Posts: 168
 #3 
Andri, hi, thanks for your points.

For clarity: the 7 steps were roughly 8 min per and most likely 1.5-2 min between. We were measuring BP between steps and with this assessment it wasn't easy to collect quickly.

Since we did not complete a recovery or interval profile I interpreted the assessment over 4 zones. If the subject and I get back to do this, we will work up the high intensity zone from the RIP info.

I agree with you, the final intensity is the strongest functional state the jogger could maintain over 8 min (but not maximal running effort). The final RPE: 7. They did not want to try another 8 min step. See adjusted chart

FBF 8 min Profile.jpg 

Indicators of nearing 8 min performance limitation: the subjective fatigue is 7 of CR-10. The heart rate is 181, the known max is 187 bpm.

Two additional thoughts:

- The Smo2 level at end stages gives us indications of the functional intensity and the subject is compensating to maintain the performance ?

- For some clients the 8 min steps may reveal more ideal ARI, STE & FE 'zoning' ?

From the csv data, we can see nicely the tHb reactions over 5 min of each stage and then min 6, 7 & 8 show some info at tHb & SmO2.

8 min MOXY info.jpg 

I'll definitely practice the longer assessment for suitable clients.

DanieleM

Development Team Member
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Posts: 264
 #4 
Hello Fred,

I definetely agree with your zoning.
One thing that is quite strange is the very high numbers on SmO2 even at the last stage.
My initial thoughts are about a muscular utlization limitation.
fitbyfred

Development Team Member
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Posts: 168
 #5 
That's the most fun part of all of the assessments and interpretations. 

On previous assessments this same client would de-load (SmO2) to very low level (10-20%) at the final step(s). During strength workouts and interval workouts the client can de-load the SmO2 to below 10%, so it appears that part is working. 

We interpreted the limitation to be a supply/delivery challenge, came up with corrective strategies (strength work, delivery endurance workouts plus bodyweight control) and now the supply/delivery restriction seems much less limiting.

Result is the de-load of SmO2 is less and the client can maintain a jog/run at SE & FE states for better and much longer. I should look for earlier assessments to post comparison.
Juerg Feldmann

Fortiori Design LLC
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Posts: 1,530
 #6 
Great discussion  and I will show  some examples  of  " calibration " workouts    combined  with longer  steps  for the workouts. As well some  ideas  at the start  reaction and end reactions of SmO2.
 Here a  first hint.
 At the start we often see a drop in SmO2  which can be lower than  actually at the end.
 What is the difference in the situation  at the start where we  have an initial drop in SmO2  and at the end of an assessment ?
 Now  if you  have the answer there  you as well will see, why  the client Fred  talks about  can desaturate    nice in a strength workout  compared  to an endurance assessment..
 Second. If we  talk about a delivery limitation than we have  to think on 2 levels.
 1. Deliver  as a part of a systemic  delivery . Cardiac  pump effect  and respiratory   system. . versus delivery as a  local  capillarisation reaction or density.
 So we may have  a perfect    systemic delivery but we may  not have a sufficient  local delivery ( blood vessels density.
 . The systemic  delivery feedback is  best seen  in the 1 min rest time  . Why and how ?.
 The local delivery is  harder to see  but if we have a perfect delivery  by a systemic  reaction  in an endurance load  so  enough O2  has to be delivered, but  we  do not see a  drop in SmO2  at the end all out the question  is   here  on why.
 So  if we deliver  enough  and we  see a  utilization but not very far down   than we have  possible a   vascularisation limitation. Now we know  from some great  research ( will try to  find the original again ) that prior  to increase in actual mitochondria density ( not to be confused  with mitochondrial enzymatic  reactions  [wink] we need  first an  increase in vascularisation before we  see an increase In  density of the mitochondria.  So  we may deliver enough  and we  have an " over delivery" of  O2  compared  to what  we  may be  able  to utilize  with the structures  we have.
 In a  strength workout  or  at the start, as mentioned as a  question above, we  do NOT have  yet  a  great delivery so  limited O2  is delivered  and  for the amount we deliver  we have enough mitochondria  to utilize this .In fact we may  not even deliver enough yet  so no other options than to utilize  as much as we  can  from what we have, including an initial draw  of O2   from the myoglobin , which does not take place  at the end  anymore  ) O2  diss curve  for Mb  and HB  !!! ) SmO2  drops  very far. Remember  that in an occlusion ( no delivery )  anybody will drop SmO2  down to   zero  or at least very low.
 Summary . SmO2  is as  well a  information of  a balanced  utilization and delivery . If the delivery far outpaces the utilization we will still be high in SmO2.  In athletes  who may  do an eccentric  workout  they will see the next day  a  very or much higher SmO2  than usual, as the utilization system is  overloaded still but the delivery system  not.
 Hope it makes  sense. 
Will be back later  with some very practical pictures  of  live  workouts  to show  how we  during a  workot  can see, when  and how we  may start to limit  a system  and who may try if  possible to  compensate.
Andri

Fortiori Design LLC
Registered:
Posts: 65
 #7 
It is important to consider scale in SmO2. I generally always leave a 0-100 scale to make sure I have a standard image. Of course there are technology limitations, for example adipose tissue thickness makes a signal less pronounced. Just to add to Daniele comments.
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