From our eastern europe MOXY users.

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Juerg Feldmann

Fortiori Design LLC
Registered:1355349061
Posts: 1,530

Posted 1375557917	#1

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
Registered:1355349061
Posts: 1,530

Posted 1375592059	#2

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
Registered:1355349061
Posts: 1,530

Posted 1375804168	#3

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. ? Attached Images

Juerg Feldmann

Fortiori Design LLC
Registered:1355349061
Posts: 1,530

Posted 1375807862	#4

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. Thanks The below pic is the explanation on the SmO2 readings . Attached Images

Juerg Feldmann

Fortiori Design LLC
Registered:1355349061
Posts: 1,530

Posted 1375817555	#5

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. Attached Images

Juerg Feldmann

Fortiori Design LLC
Registered:1355349061
Posts: 1,530

Posted 1375826435	#6

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. Attached Images

Juerg Feldmann

Fortiori Design LLC
Registered:1355349061
Posts: 1,530

Posted 1375830659	#7

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. ) Attached Images

Juerg Feldmann

Fortiori Design LLC
Registered:1355349061
Posts: 1,530

Posted 1375836044	#8

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. Attached Images

Juerg Feldmann

Fortiori Design LLC
Registered:1355349061
Posts: 1,530

Posted 1375850115	#9

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 ALL ARE GREAT AND THANKS SO MUCH ( EVEN BETTER IF YOU WOULD MAIL THIS TO THE FORUM. i CAN UNDERSTAND THAT MANY DO NOT LIKE TO GIVE THE NAME AND THE PLACE OR UNIVERSITY THEY WORK FOR SO SIMPLY MAKE A NAME UP AS THE QUESTIONS ARE GREAT AND WE MAY GET MUCH BETTER ANSWERS THAN MY ONE AS i AM BIAS TOWARDS MANY IDEAS. Hmm must be late as I hit the big letter button. well needs more concentration. 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. Attached Images

Juerg Feldmann

Fortiori Design LLC
Registered:1355349061
Posts: 1,530

Posted 1375888650	#10

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. Attached Images

Juerg Feldmann

Fortiori Design LLC
Registered:1355349061
Posts: 1,530

Posted 1375895112	#11

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
Registered:1355349061
Posts: 1,530

Posted 1375909252	#12

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. Attached Images

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