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MTF Clint

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 #1 
Here's an interesting test we did with compression gear, comparing the data from TSI% and SmO2. This is the first test that we've noticed not just a difference in numerical values, but a completely different trend altogether. Attached are two separate screen shots from the same test we did this week. The bottom graphs on the TSI data correspond to the right leg, and placement of the MOXY was just distal to the location of that NIRS device on the lateral vastus.




The test was cycling on a Tacx stationary trainer at 200 watts, which remained constant from interval A-J. It began with compression gear (from EC3D) on, and a 10min warm up (interval A-B). Interval C-D was without compression, E-F was with compression, G-H again without compression gear on, and finally I-J was with the compression. The final interval J-K was a cool down at 100 watts with compression.

What stood out to me was the difference in patterns between TSI% and SmO2. TSI% dropped with compression gear on, but SmO2 went up. TSI% went up without compression, but SmO2 dropped. My question to Roger and Juerg; Why two NIRS devices on the same leg and same muscle, but different patterns?

Attached Images
Click image for larger version - Name: PM_Compression_HbDiff.PNG, Views: 271, Size: 105.70 KB  Click image for larger version - Name: MOXY_Compression_Intervals.PNG, Views: 266, Size: 39.68 KB 

Juerg Feldmann

Fortiori Design LLC
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 #2 
Clint great work and I am not surprised on the difference. at all.
 TS % and SmO2  % are not the same they are based on very different ideas and assumptions.
 Now here a question to you :
 Can you sent me  the  OXY3 file from the  Portamon  data collection as well as the SmO2 excel sheet from MOXY as I like to  show something on here.
 Remember:
 A theory is only as good as we can steady learn from new challenges and questions. If we can explain everything in theory but nothing works in the practical field   something is  very wrong.
Juerg Feldmann

Fortiori Design LLC
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Posts: 1,530
 #3 
Clint question :
 : What stood out to me was the difference in patterns between TSI% and SmO2. TSI% dropped with compression gear on, but SmO2 went up. TSI% went up without compression, but SmO2 dropped. My question to Roger and Juerg; Why two NIRS devices on the same leg and same muscle, but different patterns?
  So this is actually great as it may gives us some very interesting answers on the information a dropping  or increasing TSI or SmO2  w may give us.
  What we need is same situation.
 where we see this opposing information.
 Than we  can test  the lactate trend and VO2 trend at the same situation to see, whether metabolically  we have  an answer  a few minuets later.
 Here what goes as a question.
 If TSI % drops, do we extract more O2 really or visa versa.
 So what i need from this  is as mentioned the Oxy 3 files and we look at T1 T3  as well as O2 Hb and  HHb.
Changes in O2 in the tissue as a dropping sign means we use O2 from the tissue but we may have a delivery problem  and visa versa.
  Some studies  with NIRS  tell us:
 If SmO2 or " TSI % drop fast or drop , than there is a  delivery problem but a good oxygen use.
 If   SmO2  or TSI %  do not drop than there is no delivery problem but a problem of oxygen extraction,.

Will  show some sinmilar interesting tests and we can than  later show  what and why this  may have happened
Juerg Feldmann

Fortiori Design LLC
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 #4 
Clint, looking closer to the files you have on here, than they look very nice  when comparing SmO2 and TSI % , can you show the files you saw the opposite reactions as well, where we see TSI drop but SmO2  going up.
 That's what we look for   so Oxy 3 from this including the SmO2 excel files from MOXY. Show it here or sent the raw data's to me and I can show it on here.
 In the above  can you tell the readers what is yellow m what is green on the left side of the  pictures from Portamon.

Green on the  right side is the T1T2T3 so it is TSI % . I assume  green on the right is tHb so  to explain, that it is not too confusing. Yellow may be TSI % on the left ???
Roger

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 #5 
Hi Clint,

One of the differences between Moxy and Portamon is that Moxy is designed to read only in the Muscle while the Portamon seems to reads all of the tissue under the sensor including the skin and fat.

Is it possible that the compression clothing affects the skin differently than the muscle?  If the compression clothing pushed blood out of the skin (mostly highly oxygenated blood) that might tend to cause the Portamon to read lower.  Could the extra blood that's pushed out of the skin improve muscle circulation and cause the muscle oxygenation (SmO2) to be higher?

The physiology is just speculation on my part.  Maybe Juerg could comment further.
MTF Clint

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 #6 
Roger... my thoughts exactly

Here you go Juerg. The oxy3 file should be attached to this post.

The screenshot of the graphs shows right leg (top graph) left leg (bottom graph)
The right graph for both legs is TSI%
The left graphs are the middle optode- depth #2. Total hemoglobin (green line) oxyhemoglobin (red) deoxy (blue) and HbDiff (yellow) 


 
Attached Files
oxy3 serratia_compression_#3.oxy3 (1.29 MB, 22 views)

Juerg Feldmann

Fortiori Design LLC
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 #7 
Wowww guys great discussion.
 1. You can see: 2 NIRS ideas 2 different out comes  and possibly if not critically discussed one out come bad for pressure  clothing and one good.
 What we do not know yet which one would be good.
 The idea behind pressure clothing is, that it suppose to support performance. So Blood on the surface similar we would have in heat reduces performance. So pushing it in would be better ( See Roger).
  I like to show you here another TSI %  open question.
 We tried   simple pressure  and temp difference to see how TS % would react and it reacted not the way we would  have thought. when tHb goes up and O2 Hb foes up and HHb goes down we would expect an increase in TSI % ??? yes ??? See picture below  2 world class athletes  same   idea but in one you can see green TSI % increasing as  tHb yellow  and O2Hb red  are increasing
 The second one we have as well tHb up and O2Hb up but TSI % down ????

2. Colour to have similar ideas.  red is O2Hb , blue is HHb , green is TSI or SmO2 , yellow is tHb and purple is Hb diff . So we can always  have immediately info.
 Now look at the  TSI  right screen shot.
 The  in this case yellow as the Hb diff and SmO2  below ?????
 You give the comments.
 Now  Clint  check or sent us the pictures or screen shoots  where we have the " controversy between  TSI going down and  SmO2 going up and  than look at   Hb diff  from the portamon  and how that worked.
  Idea lets' see how O2 Hb and  Hb diff work  in that  2 examples from Clint and how TSI % and  SmO2  look and see, whether it makes sense and form what equipment. ?

Attached Images
Click image for larger version - Name: yama_gk_closer_look_comp_2_vasc.JPG, Views: 24, Size: 82.66 KB 

MTF Clint

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 #8 
Juerg I've changed the colors to match what you use..
What I was talking about when I said the patterns were opposite, is what we saw when we compared the two graphs below. Left graph with the blue line is SmO2 from the right leg (vastus lateralus) and the bottom right graph is the right leg same muscle (just superior to the MOXY). Purple is HbDiff and green is TSI%. Interval A-B was a 10 min warm-up, and the rest were 5min intervals with and without compression.

When you compare the trends in interval C-D to E-F you'll see in the TSI and HbDiff in C-D is a higher value when compared to E-F, but opposite reaction with SmO2. (C-D was without compression, and E-F was with) This is what I was referring too as the opposing patterns...



The graph below shows the information from the three different depths T1, T2, T3. (T3 being the deepest) Roger talks about the blood in the skin, and how portamon takes this into account when giving us data.. Do these graphs showing the difference between the depths illustrate that, or do they show us the compression is working and shunting blood towards the core?



My personal belief with the compression gear is the reduction in vibrations when wearing the gear is the real benefit. But at what cost... Does this shunting effect outweigh the reduction in cooling since the blood is being pushed away from the surface?

Remember the old Russian vibration plates that were supposed to make everything 10 times harder? Giving you twice the workout in half the time.. The vibrations really do affect the muscles, 20 push ups with vibrations is like 40 without. In opposite terms, it's similar to the way a carbon fiber bike reduces vibration when compared to aluminum. So we reduce the cooling capabilities of the skin by shunting blood towards the core. This in turn takes the highly concentrated blood (as Roger pointed out earlier) and gives it to the muscles who are doing the work. At the same time, we reduce the vibrations of that muscle and allow the blood to flow freely. Sounds good to me...

Not trying to debate about the compression gear here. Just sharing one of the ways we use the MOXY to test our athletes and the equipment they use. And maybe hoping Juerg and the rest of you guys will help me out with the interpretation of this data also.

Attached Images
Click image for larger version - Name: SmO2_vs_TSI+HbDiff.JPG, Views: 252, Size: 161.29 KB  Click image for larger version - Name: Compression_Depths_R1,_R2,_R3.JPG, Views: 254, Size: 280.92 KB 

Juerg Feldmann

Fortiori Design LLC
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 #9 
Clint, fascinating and incredible great work.
First a question back :
  what is the top graph on the right side ?
 I can use this  samples really well to show what we actually can see.
As you mentioned this is not the place to discuss  compression stockings but rather MOXY use.
 If you can sent me the MOXY excel  so we as well have the O2Hb and HHb and therefore the tHb we have an even better idea on what is going on between the 2 ideas of SmO2 and TSI %.
 Clint you solve for me a problem I was moving around my head for a long time since I compared SmO2 and TSI % and you  with this great  case study just solved it.
 What it really shows us is , that Rogers SmO2  use is much more relevant and usable in sport than the TSI % which is great in certain studies , where the tHb is stable and that's how TSI 5  really is calculated , respectively the assumption of it.
Woww great. So just   the answer on my question above will give the finally oh yessssssssssss  or  oh   s......

Last question  . on the graphs where you have T1  to T3 you have 6 graphs.
 The left side is  which leg ?
Is it the left leg ?

Now  one more point .  We do not have a MOXY info on the left leg do we.
 Why , when we look carefully we can see that the difference is not  that extreme opposing. we have a different info between left and right.
 Look at SmO2 right leg and Hb Diff right leg at the  2 sections ????
 Than look at  TSI at the right leg at this section ???
One way to get more info out of T1  to T3 is to overlap them at the same graph here an example
This is a MyPAHD just looking , where the tHb  changes  . The skinny yellow line is T1  surface and the thick one is T3  deep layer.
 You can see, where this client starts to  change blood flow in the surface. 
 This  client had  a muscular limitation  followed by a respiratory limitation. The MyPAHD gave us the  hint  where we would  look closer for the UrPAHD
Clint I will make a summary on what you can see and how  you can use this information, as well why the MOXY gives a clear simple answer  and the Portamon some  additional  areas to discuss. When you look carefully and you take the actual trend on what happens with the  Hb Diff   than you can see how SmO2 and Hb Diff  have the same trend . The  real difference is  with MOXY we have an actual value we may be able to use and  with Hb Diff we   only have a trend.

Attached Images
Click image for larger version - Name: BN_closer_look_t1_t3_only_thb.JPG, Views: 30, Size: 52.33 KB 

Juerg Feldmann

Fortiori Design LLC
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Posts: 1,530
 #10 
Okay  here Clint, you made me thinking  about the whole issue on Compression stockings and MOXY, Portamon.
 There will be lot's more to come. Not That I think I know more but I have a lot more questions.
 Let's start. .1
 The pictures you sent with T1  T2 T3  are great but for most of us very difficult to read. So what I do normally is, that I  overlap the levels on one screen to see the relative changes during an assessment.
 Actually what I do is I take only  T1 and T3. For readers T1 is the lover depth T3 is the deeper depth. So we look at more on the skin oxygenation versus  muscle oxygenation.
 T3 is more likely closer to what we have  with MOXY. ( Moxy has a  slightly deeper penetration.
 What is more interesting is the claim that  T1  is more likely  on the surface and as such  more likely influenced by pressure  like in this case stockings, versus T3 or MOXY , which more likely   shows oxygenation changes in the muscle. I  show you here some interesting case studies, where I was looking for shift in blood volume  from the surface to the deeper muscle tissue or visa versa.
 Here a  UrPAHD  running assessment with a cardiac patient.
   We started very slow so  we walked first and than   at a speed where walking was uncomfortable he started to jog.
 Let's see whether you can explain and pick up where  he shifted from walking to running. The first picture is a UrPAHD over the full assessment and you can see the change from walk to run and how  we basically have 2 sports running and walking and how the full idea of UrPAHD with Alarm phase and homeostasis and  disruption works as well at the second part of the test with running.
 The second picture is a closer look at the change from walk to run.
 The thin line is T1 and the thicker line is T3. Si thin is more on the surface , thick is more  in the depth.

The  third picture is a RPM study , From marker F the wattage was fixed. We changed  different RPM from very slow 50 to very high  140 . The thick yellow line is T3 tHb and the thin  yellow line is T1 tHb. The red line is O2Hb  at T3 level and the pink  one is  O2Hb T1 level . Blue is HHb. You can see, when   overlapping  it at the same picture  the relative change on where we start to reduce blood volume on the surface relative to the depth as well when we see O2 Hb dropping  in comparison to surface and  depth.
 So In the evening I will  how some more questions, when  looking back to MOXY  Portamon study  from Clint in the 5 min compression and no compression interval workout.

Attached Images
Click image for larger version - Name: munsell_walk_run_3.jpg, Views: 28, Size: 48.76 KB  Click image for larger version - Name: munsell_2_closer_look_at_walk_to_run.jpg, Views: 27, Size: 59.73 KB  Click image for larger version - Name: rpm_level_2.jpg, Views: 26, Size: 49.59 KB 

Juerg Feldmann

Fortiori Design LLC
Registered:
Posts: 1,530
 #11 
Here  the ongo9ng discussion on the pressure stockings and case study done by Clint. Some very interesting open questions concerning the difference between MOXY  ( O2 test in muscles only ) and Portamon  (  Surface information but problem with Skin  blood volume change )
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