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Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
I got  some great test results from  our friends in eastern Europe.
 So the following discussion ( depending  how far it may go ) is not a critic on what we   or anybody is doing , but one of many attempts to discuss  more critically the current ideas of testing, and ion specific  how we  design test protocols and what  this protocols may or may not  show us.
The first question I got with this test  was :
 Can we see from this result, what  the limiter or the compensator is.
 Answer NO.
Explanation :
 I strongly believe  and I like  to make my case, is:
 The  current protocols  will produce a physiological reaction based on the protocol. The physiological systems never ever have a time to react based on H. Selyes G.A.S  idea.
 Alarm Phase, adaptation ( homeostasis ) phase and Destruction or interruption phase.
 In the PP you can see the protocol  fast and easy It is a step test and based on the timing from the VO2 equipment we have a :
 1. 2 min 10 sec step length on 74 watt.
 Followed by a 3 .50 sec step length of 148 watt, followed by a 5min 50 second long  steady increase of  load every 10 seconds of 10 - 11 Watt from about 80 watt up to failure.
 Look at the PP and make  some thoughts on that.
 Remember tat any change in load  with a push of a button has an immediate  Alarm phase reaction of a certain duration.  To answer the alarm phase  the  physiological systems need some time.. If you add to the fact that any  change in load will always create a immediate ATP  demand, which has to be delivered from some where, than the question arises, whether  in a  classical Wingate or  VO2 test like here, the physiological reactions ever can take place or whether all is just a question for survival.
 Last question. How would the result look , if we had a load increase of 10 watt every 20 seconds or every 60 seconds or every  3 min or every 5 min  a.s.o.
 To find a limiter or a compensator we  have to have  sufficient time available so the different physiological system can actually try to react on the alarms phase and as such can either  compensate if needed or may show a limitation if this is reached.
 Hope this makes sense to start out with.

Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Okay here a short answer to a question I git a few hours back.
  In simple words as a summary.
 : " I can see the steady drop due to the type of test protocol. Do you have an example  from a step test with sufficient  time length and is it really so different.? "  Thanks and yes great point. I like to sent you a  base SMo2 MOXY test. The future owner of MOXY devices will have in their  package a simple explanation for a base test. It can be done by using just your HR monitor  or you can use speed or wattage and nothing more in combination with MOXY.
 Here is a printout from a base test done last week in running with a 5 min step length.

We have some base assessment ideas and for the  new developing test centers  who will use Physio flow for the cardiac information, NIRS  for the muscle oxygenation  ( a-v O2 )difference information  and  VO2 for respiratory information  we have some  different protocols, as well for on  or in the sport specific  assessments like Ice hockey or other sport disciplines. What we hope , that the many  new users of MOXY will help us and you to get as many new ideas and assessment protocols in so that we really can  support sport specific ideas and go back to practical applications.

Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Okay , after we made the same " mistake" as we all do, trying to squeeze the NIRS MOXY information into existing ideas and theories ( AT , LT, VT and so on ) I like to  show you a very different approach.
 Is it the right  one ?  Future users of MOXY will tell us and help us to  get the most out of it.
 Here a full  MOXY data-collection  from a very  great group   in eastern Europe. .

 What you see is a SmO2  trace from the moment the MOXY was started to the moment, where they took it off.
In this pilot equipment we had no way of making markers and start or stop  buttons in many cases.
 So  I take the risk here to be completely off from what they did. I have no exact information what and how they collected the information.
 What we know is location  and a sport.
 The location was the tibialis anterior.
 Is that a good spot. Many people take the  vastus lateralis of the quadriceps.
 . So the discussion here is , what is the right spot.
 Answer. : we do not know, as every muscle has some individual properties in a sport but as well even on the same athlete  depending on technique.
 I am actually very happy to have this test here. What we know is :
 No matter, where you fix the  MOXY, the trend in deoxygenation in the big picture for intensity  levels is everywhere the same.
 What is different is the amplitude of the traces. So as bigger the amplitude as easier it will be see the clear trends in SmO2.
 We did tests, where we  applied  NIRS on vastus medialis . lateralis, hamstrings , rectus femoris and now here on the tibialis anterior.
 Trends are the same.
 So thanks o much for this group.
 Practical question.
 Mounting the  moxy where you have the smallest risk of  extreme forces and impacts is the way to go.
 The quadriceps has the advantage that you can use the bike shorts.
 In  or on the tib . anterior you could use some pressure socks.
 We for the moment use specific tape but we are well n the  phase of actually having specific cloth to  use it so it is fast and easy.

 So now here the first picture of a SmO2 trace from the tib anterior during a cycling data collection.
 Keep this in mind  ( location ) as it may or may not have an impact on the trend in some NIRS traces.
 Pictures shows a 28 min data-collection.
. Now look at open minded at the trend.
 Here what we look  for .
 SmO2 increasing is an indication of an increase in O2 Hb ( oxygenated hemoglobin.)
 A flat SmO2  is a sign of a stable Oxygenation, where the intake of O2 and outflow ( use of O2 is in a stable situation. Now this can be on different levels, meaning you can be stable at 70 % SmO2   and  later at 60 % SmO2 which means not that by 60 % you run  into trouble. You may  just had a section,  between 70 and 60 , where you used more O2 than you could  deliver and you drop to 60 %. But now you are again in a balance of input and  outflow and you are perfectly  fine. So to believe the highest SmO2 is where you are  O2 balanced could be misleading. The point where we see SmO2 dropping  is not automatically the point where we may start to use O2 independent  energy sources, so therefore it is not where we  for sure can say  lactate will show up. The amount of O2 independent energy  needs  may create lactate but the produced lactate  is immediately used as energy source again   and may never show up in your finger or earlobe.
 The " classical' idea of anaerobic a-lacticid may be one of the unreal seen or unseen real.  We may produce lactate or for sure will produce lactate in this type of intervals, the time between load and rest is just so short , that the lactate never can show up in the test area.
 ( Lag time of lactate dynamic ).
 So here for you to rake a first peak at the overall picture of the data collection.  First job . each 30 number or line is a data collection of 2 data's per sec so 30 means one minute duration. Check the length of the data collection . Now try to estimate and figure out, how long  the possible real test length was.
 Try to  think , where they may have started the real test and where they may have stopped the real test. ?

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Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Here a first great  answer or  thoughts on the SmO2 values we see.
  Be patient as we will go through that step by step to show how SmO2 values can be used and what they may  show as information and than when we add respiratory info and cardiac info and SEMG we actually can get a lot of very interesting hints   from a test here we go
I been pocking around your info and the more I learn the less I know.
I grabbed this from your forum let me know if I am thinking correctly about this:
1) this first arrow is stable Oxygenation demand in equals demand out.
2) 2nd arrow the demand for O2 increases we start to produce lactate possible for energy. "threshold"
3) 3rd arrow is very little oxygenation
So, let me put power into this equation:
100,150,200,250 watts line is straight (equal O2)
300,350,400 line starts to dive (less O2)
450,500,550 line bottoms out (no or very little O2)
Wrong or right or almost?  There is no wrong or right but just thank you so much for helping us out here. Interpretation like this help us to design answers and seminars and workshops and additional on line help , as we see how and what thoughts SmO2 trends may be associated with.  So Answer here you are great to give it a try and you are  close and apart but you will see soon where and why.
Once you have this down than you add in Physio Flow to track cardiac function to see if this is the limiter?
Does a O2 sensor provide any meaningful data?  One of my task in this thread here is to show  how much or how little we can read out of SmO2 once we wrap  our ideas and information around this device. So you will be the critical feedback plus any other reader on here.

 The below pic is  the explanation on the SmO2 readings .

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Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Here a short first  idea.
 1. When ever we start  ( slow ) enough ) and no "warm " up prior to an assessment. we have the physiological reaction of an "Alarm phase" no matter how intense  the  start is, The question is, whether the physiological systems have time to react before we add the next Alarm phase( step to it ).
 Walter Cannon's fight and flight will show you easy, what we have to expect and many studies show, that the oxygenation reaction does  not depend on the  intensity at the start of a load, the trend reaction is always the same. What is  important is the  time lag of some reactions and the chance for the body to reply  with this physiological system to the  alarm phase.
 Walter Cannon .
 1. Increase in VE  ( VO2 equipment can tell the trend )
 2. Increase of CO  ( Physio flow can tell the trend)
 Change in vascular reaction  ( MOXY can tell the trend.
 So in simple words. If we start  low wattage  we will have an initial  tHb ( blood volume ) and SmO2  drop with a subsequent  decompression phase and an increase in SmO2. Picture one will show Cannons  info Pic 2 shows Selyes  idea and picture three shows an immediate reaction of SmO2 and a  time lag reaction of lactate  as a reflexion to show how they correlate.  So if we look the original SmO2 we can ask the following question.
 a) do we see an initial drop of SmO2 followed by a decompression phase.b) is it relative stable, indicating either  a balanced situation of a non active situation withe some movements around on the bike.
 If we already have the   SmO2 as a part of a test we would see either an increase if it is   very  small load or an increase f0llowed with a plateau or a decrease due to  deoxygenation.
 If we have or would have a test form like a Wingate or a 1  or  even 2 min step test we would see from the beginning a drop SmO2 as the Alarm phase  is followed by the next Alarm phase ( when changing to the next step) and there is simply not enough time  to  try to adjust the new ATP demand properly from all the team members like cardiac , respiratory and muscular reactions.
 The consequence is a  not optimal  blood flow , therefor  an not optimal blood return ,  smaller than expected SV  ( preload  lower ) a higher than expected RF ( if the respiratory system is not trained. and a higher than expect indirect gas exchange info like an RER above 1.0 despite low  wattage load.  Let's see whether this makes sense for the regular reader but come back with feedback and positive challenges.

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Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Okay let's show an example.
 First pic is a 3 min " classical test.
 Yellow on the old  test is tHb and purple is SmO2 or Hb Diff  with Hb Diff as a trend and SmO2 as an absolute number in %.
 You can see the nice  trend in the intensity, where O2 increases than  flattens out and than decreases.
 The problem is exactly the same as in a lactate test. Where is in the decreasing phase the critical intensity reached , where SmO2  can't be sustained and you run lower and lover on available O2 ( bio available  O2 ) and you have to start count on the input of energy from the  O2 independent energy sources . ( With all the reactions we will see later like increase in CO2  due to glycolysis and due to H +  increase. )
 The second picture is the same athlete but using our own protocol with the goal to give the physiological system  enough time  to try to reach ( if still possible ) a homeostasis , than interrupt and try to see, what happens if I repeat. Even as a " beginner" you can easy pick up, where you reach an optimal  tHb and whether it drops ( out of specific ) reasons or whiter it is stable and sometimes it may even increase. Wait later  on the test   we got and discuss here.
 Same holds true for the purple SmO2  (  Hb diff) trend . Yous see where it can hold or improve and where it starts to  drop continuously with no " rebound."
 Remember the protocol was 5/1/5  so every load is repeated a second time after 1 min rest . We named it IPAHD for individual physiological assessment of homeostasis disruption.

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Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
So here a speculation based on the MOXY info.
 The test started possibly about 16 min into the start of the moxy.
 See pic where you have this sudden increase in SmO2  and than  drop.
 You have this drop as well at the start of the moxy data collection. This can indicate, that the athlete did something relaxed . possibly a warm up and than  by 16 min stopped completely for a short moment and than started the test with 78 watt .
 To kind of back this up we can look at tHb reaction Blood flow. If you start you will make a muscle contraction and create a compression in the MOXY area and you will see a drop in tHb. The  " warm up " most often uncontrolled , is  low  enough in an intensity , that we are in a SmO2 balance but too  intense to see and increase in tHb and a increase in SmO2 . First 6 min of warm up was a steady pace followed with some changes in pace as you can see on  the tHb and SmO2 reaction. . We will discuss later , what a " warm " up has on an effect on a test result.
 ( Think , that we calibrate  ridiculously  the  wattage trainer. When do we calibrate the athlete? (, when you think that possibly 90 % of the variables in a physiological testing  come from the physiology and the small 10 % we spent money and time is  temperate, wattage , humidity  and more  small factors,) with  in the complete picture of  performance .) So I believe the test started by the third red line. And the test started after a complete stop of the athletes  See increase in tHb ( relaxation and therefor optimal SmO2 increase as well. Than at the 4 th line they change the system from longer step to  every 10 second  load increase. which again will not allow the system to even try to show a possibility of an  adaptation so we miss or never know physiologically , where the critical intensity is of a O2 balance.. Why do we not see by 78 watt an increase in SmO2  and tHb. ( reason is the warm up , which had its effect   for a warm up , opening the blood vessels and increase local blood flow.
 Problem: we do not know by what intensity this happens.  Speculation. The warm up  from this athlete was  more than the first step load of 2 min 50 second and 78 watts. He warmed up with a higher wattage.
 Hmmm push myself to the limit here but see what comes out. )

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Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Here to close up the day with a small review   n  the  ideas we discussed already many times.
 Hans Selye's G.A.S. in a picture   done with NIRS.
 ( Portamon)
 Than we   worked over many many  testes to see, whether every time we have a picture   like that , we have the same information with MOXY.
 So we used both equipment and we simply overlapped the data's as you can see in pic 2. In many cases we had identical information. There are some very specific  situations, where it looked as they show different results, but when understanding the fundamental difference in the two equipment we actually  could make even more out of the results, when combining both results.
 We had an unplanned live demo in Switzerland with a Finnish world class athlete and the  results , when running both MOXY and NIRS at the same time live where incredible interesting and made for all the seminar  people absolute sense and they could predict the trends  from one by looking at the other one, once they understood the difference  and why  we can see  and what we can see on the screen.

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Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Wowww , I got a whole series of e mails all commenting on the same  2 points.
 Here the two points .
 1. Quality control and MOXY
2. Classical test protocol influences the physiological result. lET'S START AS USUAL THE OPPOSITE  WITH 2 FIRST.
The mails for the second questions are  from many great people and test centers all a kind of questioning my idea ( which is great ) that what we did in the past with a 3 min test may not be that optimal and for sure the lactate balance point test  has to be reviewed for sure.
 For all LBP users , you may remember  if you took a course , that  the  push was for the second  part of the test to  go for longer than three minute steps exactly due to the time lag of  the equipment first and the  physiological systems  second.. The main reason for sure is the equipment or better the way we test  the  different physiological values.
 One value, where we should not have to discuss anymore about the time lag is lactate.
 Other values seem to be harder to accept , that they lag behind and as such  produce very wrong conclusions.
  Example is RER , where we even sell to our customer a " cookbook " telling them how much fat and how much carbs we seem to burn at what intensity.
 The time lag is big 1 - 2 minute of RER reaction and with exception of at complete rest and under minimal  load the RER is never RQ and if we would like to get close we would have to make step length of 7 - 10 min and we would have to look , whether we breath with a mouth piece only  or  a face mask as any change in TV and RF will change RER.

  So here  again a statement we can discuss. The only  nearly direct information of changes in oxygenation is NIRS  or MOXY ( portamon ) or any NIRS equipment.
 That means, when we use SmO2 like in this discussion we have to keep this in mind, that we see a change in SmO2  far before we can see a change in the indirect methods like lactate and VO2  equipment.
 And  we still have the risk , that for example lactate may never show a change, as the time lag is so big between actual production place and time and testing site and time. So lactate can be used ( recycled) already far before  we can see or proof it on a finger or earlobe.
 Wit VO2 it is the same. The use or place , where O2 is used or not used and CO2 is produce and where it is moved to ( Mask / mouth piece  has a lag time and as such will give the result as so often explained.
 Unreal seen.
 Moxy gives the  unseen real  now seen. ( remember the Greek materialism ) Wowww did I =hated this in high school as I went through a humanistic  sport gymnasium in Switzerland.
 Outside was perfect Snow conditions   Real and seen. and we talked about unreal seen  and unseen real.
 when  reality was perfect powder snow. So no wonder  some readers here are getting confused . So here  in one picture the answer.
 Show me your  VO2 test and I show you the test here we discuss.
 look at the red square one minute and I highlighted  load in wattage, VO2  / kg in L and RER , but you can as well see the other values like HR, CO2 and so on. Now look at the question ?
 is 148 watt for example really always the same physiological load or  may  it be possible, that 1498 watt can have very very different  physiological reactions as a result of the way we approach 148 watt.
 Would we think that 84 watt  may  be more likely in the fat burning  intensity with a RER of closer below 0.85  and not above 1.0 ???
 Would we think, that an RER by 148  and over 260 watt  is the same a unreal seen.
 Here the pic an you make your own conclusion and look, if you agree, that there is a time lag on how much the time lag really may be.
 So when over the next days we look  even closer as how to use SmO2 for interpretation and for training idea than try to keep this in mind and try to argue with numbers rather than with believes. Here in the pic my numbers courtesy of a great group  form eastern Europe. Same test we discuss the Smo2 values.

 The first part : Quality control we will leave for tomorrow. As it is a great way to show you , how we can use MOXY and quality control is always the first graph we open in the EUK software before we even start to analyze, as a bad quality control index means. Repeat the test and take more care on = where an dhow you mount the MOXY.

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Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Okay I ow you the answer n quality control  and MOXY.
 Under quality control I understand the option to verify, whether the  MOXY was properly connected to the muscle.
 There are different points we may have to think on.
. Muscle shape,, intensity of the motion of this body part. Tape or the way you mount the MOXY.
 The main "risk:" factor is that there is light moving  in between moxy and tested area.
 There are different ways you can reduce that last problem./ Black shorts or towel.
 Than move the moxy into a small plastic see through bag so you protect the optodes and receiver from sweat.
 Nevertheless, even if you do all perfect you always  will have same small  loss of optimal  quality for the light sources.
 We did many years back and I was repeating the same ideas  with MOXY, extreme situations to see how reliable the equipment is on the light source interruption.
. We where honestly surprised, that if you do a good job the  sensor emit very very  great results with little interference. The most changes come form :
 heat and cold. So we applied heat  and ice and you have changes but not just form the quality control but mainly a big difference between MOXY and  Portamon on one specific are.
. Than we  check  with and without gravity position , we check by heating the surrounding muscle like it ccould happend in ice hockey, and so on.
 The result was  that we have one measi=urement in the moxy I call QCI  but it is really the adipose tissue information.
 BUT. the fat layer should not change a lot  or nothing during a test. Pressure and muscle contraction change  very  slightly the measurement possibly due to change in density .
 So in our discussion test here from eastern Europe  I did as usual a QCI first. The reason is to see, whether it is worth while to  go through all speculations and observation and than at the end you see that the sensor was not stable mounted.
 So the pic show you a QCI and it is  incredible great very small changes and the changes  exactly where you would expect it. In fact the changes in QCI will even help to explain what may have happened and when you com=bine it with all other info's like  respiration and cardiac and SEMG you will have perfect picture which even makes sense.
 I like to show that over the next few days even into more details.
 So here to start the day. SmO2 and QCI . look where we had the  " biggest" changes and  think on reasons why, by going through some of my observations I explain above. You can see  2 markers. First line is , where I believe he  quite the " warm up "   and the second one is where he quite the  actual test.
 . Interesting is  as well that you can see, where he may have quite the warm up short break and than you can see where he really started the  first step of 70 + wattage.
 So if that holds true you now can put the times in 2 min 10 on first step, followed by 148 second step for 3. 50 seconds, so total 6 min relative=. controlled  followed by an increase of 10 - 11 watts every  10 seconds till failure.
 See  watt profile at the beginning.
 Now think l;lag times and missing of adaptation time and you can see, why I  would have problem to make any conclusion  from this results based on the VO2  information.
 The only physiological info we have is, that under this specific test conditions ( protocol ) this athletes reached on this day this wattage and used at that moment so much VO2.  If we would repeat the test  later we could have very different end numbers.
 What we can see is the live response of SmO2 and what happens there. We than add the live response of tHb and look what happens there and than we can show some clear lag times for example between RER and VE or RER and SmO2. See pic 2  RER and time lag when looking at VE VE is top by 6 min like  SmO2 is top by 6 min. RER you can see on the list the delay and therefor the wrong conclusion of  metabolic substrate use.
 Pic three is tHb as representation of blood volume and SmO2. We will get back to this as it is super interesting as it was done on the tib. anterior.

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Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
So let's look at the last pick and  move n some IP  ( interest points.
 Than  we can make some observations ( not conclusions)  as a conclusion would be build on speculation at this time of our journey through Moxy interpretation.  Here a PP you can than develop at home when you take it for yourself.

Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Here a short add on, why I believe,  that when people start using NIRS MOXY but they are stuck on the classical ideas of VO2 and % and lactate , they " abuse" a great tool by trying to force it into existing theories , instead of giving it a new try and chance.
 Here an example for a big NIRS study  and sorry but I simply can't see, how they can claim that oxygenation of VO2 or lactate  has anything close to say , that there is a threshold. You take that graph give it to 100 people  plus a  Monkey , who throws a dart and the chance that the Monkey hits a spot we decide to give it the name Lactate threshold is about the same as from any other " expert" trying to  find a lactate threshold. Take the scales away and you have three graphs  with no even close to any trends  other than increasing or declining . You can move as much mathematical around as you like but it is not usable at all. Here the pic from the study.

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