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Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Here a great case study sent to us  from Mary Ann Kelly  from the seminar center in California.
 I like to use  her  case study to give an answer to  many  similar questions.
  1. What is the best place  to mount the MOXY.

A:  The best place is most often   to have it on one of the main  muscle groups involved in you r activity. So cycling  leg muscles    an there  on the quadriceps.
 The beauty here is, that e have a build in pouch on the cycling shorts  so you simply  move the MOXY in an d  up you go.
 The trend   is   in most cases  the same no matter  , whether you have it on  laterals  / medialis  and so n.
 ( exception is , when you reach the HII  zoning. There  we  may see different reactions.
 BUT  As  Mary Ann's  case study shows  it may  be not that important on where you like to  fix  MOXY.
 She did  to answer this question a study  by mounting 4 MOXY's on a  client.   One moxy on  the left leg one on the right leg  one on  left and one on right arm.
  Than she did a TIP ( 5/1/5)  Than she used our "classical'  model  by Hans Selye  G.A.S  to  look for the  different zoning's.
 Here  for new  readers  in short a summary

Based on the many times  discussed reactions    she than  compared the different zoning's  in the different extremities. Are the 4 different zoning's for each extremity  a different one  or are they overlapping. Are there different reactions at the end of the assessment between  arms and legs.

all 4  in one.jpg 
Your thoughts ?????

Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Here another great case study sent to us   from Mary Ann Kelly JT  California.
  It was a study  done on a Versa Climber.
  She did  2  5 min step test  with 1 min rest in between each  5 min step.
  Than the test where done  in a row  2  first  5 min step test  followed by a second  one immediately after the first  ended . So same placement of MOXY to see   and compare.
 You try to  figure out  what is different and what may have  caused the change between  first and second. test result.
  Here first  for fun the O2Hb  HHB reaction  over the full length of both tests. It is easy to see, whether the first test stopped  and the second test started. 2 test in a rown  overlap versa O2hb hhb.jpg

Now based on this  info  you can already imagine the SmO2  reactions when overlapped.

versa  overalp   firts and seond  smo2.jpg 

 Now the question is  of limitation or difference  reaction  at thatt  stage.    so we look at the delivery  and what may have caused  the delivery difference.
  so here it is.

versa  2 test thb.jpg

Thanks  Mary Ann  and for all west coast  MOXY interested people / coaches  and  Centers. Look at the  upcoming Seminar schedule  Mary Ann put together  for the second half  of 2014.
  This is what you will  learn and play with  . A  fundamental different approach to physiological testing not based on physical performance but on physiological feedback.

Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Now here  from this Versa climber study  some interesting details.
 Look at the SmO2  /tHb   reactions  at the 1 min rest ?????
 Why  and what does this mean ?
versa thb smo2 opp.jpg

Courtesy  Mary Ann Kelly  California Seminar center


Development Team Member
Posts: 1,501
Here in comparison to a Versa Climber assessment  a view into the " real "  information during a  indoor rock climb.
 This  how it looks  as  an overview again courtesy of  Mary Ann Kelly   JT  California.

summary Aay.jpg 

This is a nice  example  for all new  , old  and future MOXY users.
  MOXY is a live info  and  live physiological bio marker feedback. This means , that we may in fact have to rethink the idea, of lab testing    for training planning  and we may simply go   and assess the physiological reactions  as we do the sport  . So in Motocross as suggested in another thread  go  and learn  what the demand of  an athlete is  and where he  may limit his performance. Utilization / delivery. Than assess how we  can mimic this demands  out side the sport  to enhance limiter  and  recover   compensator.
 The " test " protocol may suddenly be  much more sport specific  instead of  VO2 max testing  for Motocross rider or Icehcokey players on a bike or treadmill.. Again I  always wonder, what a  Pro cyclist would  say , if we suggest a VO2 max test on a rowing boat  ( erg )  or for a Runner a VO2 max test on an upper body cycle?
 So  why do we test Basket ball players  on a bike   for VO2 max   or  Ice hockey players  on a bike  and so on ?

Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Here    another great comparison  from a climbing assessment.
 This are  two climber.  One is a  climber  with many years of experience  and to p class climber. The other one is a very very young girl  who  loves to climb.
\ You can see the trends   .  and you make up your own conclusions.  one is SmO2  comparison trend  ( do not look values look trends )  and the other  is tHb  ( blood flow  reactions during a climb )

comparison  climbers.jpg

conmpariosn tHb.jpg

And here  from the  older  experience climber  a closer look  on tHb  and SmO2
sara  climb  thb  smo2.jpg

Jiri Dostal

Development Team Member
Posts: 51
Reply to 2 5-1-5 test - the difference between 1 and 2 is the blood outflow in the first case. I assume vasocontriction - low perfusion - higher O2 demand - higher extraction - steep decline in SmO2 - exercise stop. 
Why the vasoconstricon happened? I can only speculate as I have no other physiology info. Options:
  1. cardiac limitation - decline in SV (ischemia, hypetrophic CMP...) and CO followed by hypotension and reactive vasocontrion to maintain coronary perfusion
  2. metabo reflex and respiratory limitation
  3. ????

Why it did not happen in the second case? This can be explained by reaction already shown by V. Billat few years  ago - see attached file.  

Do we have a data from CPT system? This would help a lot.


Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Jiri  Thanks here a  long awaited  feedback.  For  more in depth interested readers see the picture in the att word  document.  and come back with   critics  and questions.


Thanks so much for your great thoughts.
I like to start with the end.
I love the study out of different reasons.


“This protocol, using VO2max rather than power as the controlling variable, demonstrates that the maintenance of exercise at VO2max can exceed 15 min independent of the VO2max value, suggesting that the ability to sustain exercise at VO2max has different limiting factors than those related to the VO2max value”


It is  soooooooo nice  to see, that   we  slowly get accepted publications accepting the fact, that VO2  whether we  talk about VO2  max or VO2  peak  or VVO2 is    really the summary of a  whole “ team” of physiological systems”  who all need  and work  with O2  to  keep  alive.  The fact , that we slowly  move  from the dark  black idea  of VO2  as  something absolute  to the bright side on inside view in  who contributes  to the  overall performance  and how is the O2  distributed    to   get to this performance.

This protocol,   

using VO2max rather than power as the controlling variable.

 When we started 30 years back to argue, that we should use a physiological bio marker to control intensity rather than power or speed we got some interesting faces looking at us.
We argued during a sport conference, that there is no such thing like a heart rate drift. It is only something like a performance drift.
Meaning , that when we use a stable value of a bio marker like HR or like RF to take a few simple examples, or in Billat's case VO2 max, or a fixed VO2 value, than we will have a performance drift.
So when using a fixed HR we will see a drop in performance over time instead of a drift in HR. Same when using RF.
Same as Billat points out we have a drop in performance , when trying to keep VO2 stable.

 In contrary if  performance stays  stable  and if we  are in a STEI intensity we  can afford  to drift HR  and SmO2    as we  have some compensatory mechanism but we drift into another training intensity and as such  have a different stimuli than possibly planned.

 See  South Africa  study by Mark



She than points out :
ability to sustain exercise at VO2max has different limiting factors than those related to the VO2max value .
Different limiting factors.
I would argue that there are different compensatory factors together with limiting factors.
The increase in time on VO2 max wills challenge more blood distribution into the working muscles, but as well a needed control of body temperature and so on.
The change in blood distribution for temperature condole for example takes blood out of the circulatory system and as such will decrease the cardiac preload due to less return of blood. Depending on the limiter at the VO2 max we may have a vasoconstriction (  easy to see with MOXY) or a vasodilatation ( easy to see with MOXY.). In both cases we either increase the right or the left ventricular workload and as such a higher demand of O2 for the cardiac system. The reduction in preload will be compensated with an increase (If possible ) of HR  . The increase in HR will stimulate an increase in RF and as such depending on the respiratory limitation a decrease in TV if limiting or and increase in VE if compensation.
In both cases it will demand more O2 for the respiratory system as well. The additional O2 use from cardiac and respiratory ( delivery systems ) will reduce the O2 delivery or supply to the working muscles ( easy to see  with MOXY) and as such we will see a drop in performance, but a maintained of the VO2 max as it was just a shift from who may need O2 now.

This VO2 is, as so often mentioned, the sum for the total need of O2 from the “ full team”. It does not tell us at all, who uses how much at all or whether we shift theO2 use from one system to an other system due to change in limitation and delivery.

 See  idea  of    our    team approach versus VO2  approach



 What we will see next in studies is the fact, that in some cases the suggestion in Billat’s study is not true or not working.

 a) if the muscular system is the limitation, than we see   the shift of  O2  use  from  a  max reached in the muscle  and a  drop in performance  due to  muscle limitation    so lower O2  use  from the muscle   but  higher O2 use  from  compensatory systems like heart and   respiration. So we  can maintain VO2  despite a  drop in performance.

   2. If  a vital system is the limitation than  we    will see not   a  maintaining  of VO2  levels  but a  drop in Performance including a drop in VO2.

  The  main reason why we  do not see that  so often is, that  we  have  vital systems limitations  more often in super  good trained athletes   as they  create an incredible muscular system  with an incredible high ability  to convert  and  try to `steel ``O2     and suddenly the delivery systems like cardiac  and respiration  are limiters.

Again the drift is due to shift of O2 demand to compensate for limitations. The increase in Body temperature for example will increase HR due to a drop in preload and as such a higher demand of O2 for the cardiac system so when working on a limit in performance the less O2 for actual muscle performance will drop and as such performance will drop .

 A  change in  energy substrate  availability  like a lower glucose  situation will shift   performance (  drop  and   increase the O2  needed  to keep  delivery systems happy.

 See  picture  form a  study on heat from Australia  and a study  form our own lab on glucose  levels.  See PP





Now  one last  interesting part of this study.

 They somehow seem to be able to   get the Cardiac out put  out  of more than the classical idea :

 CO = HR x SV

 See in their study. The results.



Look at S 1   HR 161 x SV 94 =   CO  15.1  True ??

Now look at  S 3   193 X 179 =  34. 6 True ???

 Now look at  S 6  195 X 126 =  24. 5   but  result  really is 28.3 ???

Why ??

 Or the mean value is  HR 184  x  SV  137 = 25.2  but  they have 15.1 L CO ??

Or  S  8  191 X 189 our  result 36.099 The studies result  30.1 L CO ??? No  I do not argue they are    wrong  they are just different from what  we used  to  think about CO  = HR x  SV ?

 As this study is accepted  by peer group review  we  have to  learn  how  we   now   look and  calculate  CO. So   any suggestion why the CO differs  is  welcome.

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