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Juerg Feldmann

Fortiori Design LLC
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Posts: 1,530
 #1 
This is  another  very advanced  group in  training  and physiological testing.
 http://www.balancepointracing.com  Here  an incredible great case, where they  studied  on a female  great athlete the  interesting situation of a minimal  desaturation ability in her legs  during  biking but as well during   isometric  loads  and   than  assessed   on her the reaction on an upper body muscle , in this case a biceps   activity.
 Here   to show you some of the discussion options  and I like to  show that here  to   learn together  how incredible a MOXY  printout  demonstrates  a unique insight  view in  what is going on  in connection with energy supply  and demand.

3  biceps  workouts.jpg 

you see the explanation on the top on what they did  and below the MOXY graph. I circle some interesting sections  for you to  try to yourself to explain  what may  actually have happened  there ???

isom  all thb smo2.jpg   Now  above is the actual   all study  so you can see, where the biceps  section is. Than followed by a leg section.
 Here the closer look at the leg  section  with   questions  and   explanations what they did.

leg  quadriceps.jpg

Andrew

Study Participant
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Posts: 45
 #2 
I would like to take a crack at explaining this, as I was the one torturing my poor subject in an attempt to explain the paradoxical readings I am gathering with Moxy on her. She is a well-trained endurance athlete with good strength to weight ratio on the bike, but a seemingly absent ability to desaturate using Moxy. In her recent 5-1-5, she completed 240 watts (she only weighs 51kg), but never showed SmO2 numbers lower than 70 for the entire test. The results Juger posted here were my attempt to shed some light on her "issues".

So, here is my attempt t describe the "biceps trial".
Red Circle = at the end of the isometric contraction (where there may have been an initial venous occlusion - clearly showing an excellent ability to desaturate with rapid rise in tHb), the trend in SmO2 then begins to rise slightly, and there is a plateau, and then small "hump" in tHb before a rapid drop back to baseline. I believe the slow rise in SmO2 is due to "fatigue" and loss of muscle contraction strength, allowing a balance of blood flow "in and out". It can't be an arterial occlusion, because this would show a "flat" tHb, but a dropping SmO2. As soon as the venous occlusion is released, there is an immediate drop in tHb.

Blue Circle - similar trend to isometric at first, with possible indication of venous occlusion, but then, halfway through interval, there is a drop in tHb and a rise in SmO2, again indicating muscle "fatigue" and inability to sustain contraction force.

Green Circles - as we started occlusion test (we used a tensor bandage on upper arm to restrict blood flow to bicep muscle) we initially caused compression enough to reduce tHb, but I am surprised to see this trend reverse and then plateau. Presumably we caused an arterial occlusion which would explain the profound drop in SmO2. The "dip" in tHb as we released the tourniquet could be explained by the "squeeze" on the limb enough to move blood "out" of the muscle, but not enough to cause a venous occlusion, which would yield a rising tHb trend.

I will try to interpret the other two graphs after I have some feedback form the group on these ideas, and make sure I have my head properly in tune with every one else before going forward.


Juerg Feldmann

Fortiori Design LLC
Registered:
Posts: 1,530
 #3 
What  can I add  other than .
This is the goal  of  our  Forum. We like to discuss  with Chef's  and not  with franchisee. We like to have  coaches  and center owners  out there, who    can do exactly that  looking  at a  simple tool  to get  an  incredible nice  feedback, once  we   open our  minds   to think outside the BOX  and  are ready to challenge  some  " classical" ideas to help to improve   individual  training programs  but still work in groups.
  Here the short  feedback 
 Red Circle = at the end of the isometric contraction (where there may have been an initial venous occlusion - clearly showing an excellent ability to desaturate with rapid rise in tHb), the trend in SmO2 then begins to rise slightly, and there is a plateau, and then small "hump" in tHb before a rapid drop back to baseline. I believe the slow rise in SmO2 is due to "fatigue" and loss of muscle contraction strength, allowing a balance of blood flow "in and out". It can't be an arterial occlusion, because this would show a "flat" tHb, but a dropping SmO2. As soon as the venous occlusion is released, there is an immediate drop in tHb

Brilliant  and   certainly the part:
 It can't be an arterial occlusion, because this would show a "flat" tHb, but a dropping SmO2

 
Here a  review  of a Biceps    workout    by John Williams  , top  MOXY coach   , strength  and triathlon  coach    down   on the  south  east  coast of the USA

biceps  J W.jpg  See  first  and second  contraction great  force  good   venous  an  art  occlusion and drop in SmO2  during the art. occlusion. Than  in set 3  but for  sure  4  hesitation  and loss of the ability  to actually create  still a  quality  contraction   with a force creating an art .occlusion.

Green Circles - as we started occlusion test (we used a tensor bandage on upper arm to restrict blood flow to bicep muscle) we initially caused compression enough to reduce tHb, but I am surprised to see this trend reverse and then plateau. Presumably we caused an arterial occlusion which would explain the profound drop in SmO2. The "dip" in tHb as we released the tourniquet could be explained by the "squeeze" on the limb enough to move blood "out" of the muscle, but not enough to cause a venous occlusion, which would yield a rising tHb trend.


Here  how  I was reading this:
  Occlusion  test.
Not easy to do  and  to ave  a perfect arterial  occlusion picture  we needed  a fast inflating  cuff  with enough pressure  and fast enough to avoid   compression  time  and    adjustment time .
 Here what i mean  and think is happening . 2  green  circles.
 . a ) the  MOXY  was  as it seems on the biceps.
. When  we  do upper arm  occlusion test  we have the MOXY on the fore arm.
 Reason.
 The   compression  with what  w ever  band you use  will create  as well a  compression n the muscle  pushing arterial    blood   in 2  directions  and venous  blood out. To make  a simple picture . Where ever  I push  I push  venous  blood towards the heart  and some of the  arterial blood to the  venues  system , but as well I push some art  blood back   proximal to the occlusion band.
 So  fist  we  will   or could see a  drop in tHB  if the compression was  fats  but not fast enough.
  . Than  as we  create a little bit of a pooling proximal  from the band  and we try to  actually create  enough  pressure  for a arterial occlusion we  move   for  a short time through a venous occlusion pressure  and at that moment we  have  a short  inflow to the  MOXY area  from the pooled  an higher pressure  arterial section and tHb  will go up. The increase will depend on how long or slow   we have to create  art. occlusion pressure.. green Circle one.  Once we reach that pressure tHb will stay  flat , no  in and outflow  , but SmO2  will drop steady. ) once we release the band  we  see an occlusion outflow as we see in this third  green   set  we discuss. See below  an occlusion idea, but look carefully it is not a perfect one   either.   If the MOXY is on the forearm  and the occlusion   on the proximal   humerus  area  we  do not  have the risk of a  compression outflow  down there.
 What can you see.

PortaMon%20Tracing%20Occlusion.jpg 


Andrew

Study Participant
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Posts: 45
 #4 
Here it goes again...hopefully I can understand this one as well...

The occlusion appears to begin at approximately 100s mark. With a rapid rise in blood volume seen initially, I would assume this is while the cuff is being inflated, and the arm goes through a short period of venous occlusion, allowing blood into the forearm, but not out. Them very soon after a plateau in tHb is reached (arterial occlusion). But after approximately 190 seconds, that plateau changes to a very slow rise in tHb, which indicates some factor allowing "leakage" of blood past the cuff and INTO the forearm, but still complete venous occlusion (subtotal arterial occlusion).

Meanwhile, during the occlusion there is a steady and slow drop in oxyHb, presumably as the resting muscle uses oxygen. If the athlete were exercising, or under load, I would expect this drop to be much more significant.

With release of the cuff, there is an immediate flooding of the area with arterial blood, causing a short initial bump in tHb, and a massive overshoot in oxyHb, and a similar steep drop in deoxyHb as the "stored" blood leaves the forearm. Then a slower return towards baseline values before the data is cut off in the picture. Interesting that the deoxyHb drops and then stays flat. Presumably, the muscle is still at rest, and therefore not creating as much deoxyHb as seen in the pre-cuff exercise portion.

As noted earlier, I think the TSI is a representation of what Moxy calls SmO2, so the trend is similar to the oxyHb, with the only difference being that oxyHb is an absolute number, while SmO2 represents a % of tHb that remains oxygenated. So the TSI would be very similar to the trend noted with regards to oxyHb.
Juerg Feldmann

Fortiori Design LLC
Registered:
Posts: 1,530
 #5 
Here some  thoughts  to  go through. What Andrew  explains  perfect is the reaction  we  have   as we do an actual occlusion test.
 Here  are three examples . 2  from to  famous  universisties  and one  done  by Andri Faeldmann as a part of his  masters thesis  at the university of  Bern Switzerland  on NIRS.
 look   the picture  and see how a  proper  applied   Occlsuion  will look.
3 occl.jpg


 Second point. There is a fundamental  difference  whether we  create  an artificial occlusion  for example on the proximal part of your biceps  and we have the NIRS  fixed on the forearm.
 versus  we have  the   NIRS  fixed on the forearm  and than  we  create a natural occlusion     at the  muscle  under  the NIRS  with a muscle compression.
 So  in a  artificial occlusion we will miss a  initial reaction we have during  sport  and  we   miss for have a different reaction  when we let go the " occlusion.. What or  how  will that show up in a  NIRS / MOXY graph versus  what we  always read    and see when  we talk occlusion.
 

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