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QFieldBoden

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 #1 
I wonder if someone could give me a clear, short and easy to understand explanation of how to do this "clever analysis". It is my understanding, indeed it has been stated, as included below, that "with some clever analysis the data from the Moxy Monitor can indicate which of an athlete's physiological systems are limiting performance." What I want to know is how exactly one interprets the data to identify which physiological systems are limiting performance.

I can find no clear and straightforward explanation of how to do this, what to look for, or what to measure in the data generated by the unit. In the text below, taken from the Nordic Semiconductor Website it is also suggested that Moxy data can identify that cardiac stroke volume might be a performance limiter.

"Schmitz explains that the key to the muscle oxygen monitor’s success is down to the fact that––with some clever analysis––the results can indicate which physiological system is limiting performance. For example, the results may indicate that the athlete’s hemoglobin is “sticky” and hence not easily giving up its oxygen load to the muscles. Changes to the athlete’s breathing pattern could alter the acidity of the blood and hence encourage hemoglobin to release oxygen more easily. In a second example, if the Moxy device identifies that stroke volume (the amount of blood pumped during each heartbeat) is limiting performance, the athlete can undergo a program of interval training to boost that aspect of heart performance."

I think it was Albert Einstein who said:"If you can't explain it simply, you don't understand it well enough." - I need it explaining simply!
Juerg Feldmann

Fortiori Design LLC
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 #2 
you can't explain it simply, you don't understand it well enough."
 in our seminar  I often start with a picture  from this  genius  and than  get the challenge out, that after the seminar people  have to be able to run the assessment  and  talk loud  during our  assessment what  happens  , than the seminar was a relative success now  one of the challenges  is  to make it simple , that there has to be a basic language  of understanding  from the physiological field  and than  it is  very very simple.

 SmO2    reactions  first
  1. You start a test  and will have an immediate  drop in SmO2  before it goes  up. Reason the  classical idea of  ATP  CrP  and glucose   usage before  O2  is used  may  not apply but is  used  from many people.
 This drop gives you some indication of utilization due to release of O2  from myoglobin (  O2  dissociation curve )
2. After this initial drop we   have an increase in SmO2  due  too higher   delivery than utilization. ( This only  will be seen  if you do  not  warm up   and if you  have a long enough step  ( Hard to see in a classical VO2  test with three minutes steps.
 3. SmO2  will   reach an individual max level and stay there  as a sign of  either fully loaded  Hb  and MB  and still more  delivery than utilization  or it may be flat as we reach  a balance in  delivery  and utilization. Than we will see a  drop in SmO2  due to higher utilization than delivery. That's; it. To be sure  in what   situation we really are we will have to  get rid of  muscle activity for  a while to see how delivery  still delivers  or can't  deliver    when there is no usage  off O2  from working muscles.

 tHb reaction.
1. first drop due to  muscle compression,
2. Increase if CO overrules  with blood pressure the muscular compression.
 3. reaches a balance  when  CO  and muscle compression are balanced, will drop if  compression local  or systematic vasoconstriction will increase  due to  respiratory metaboreflex for example. It  can on the other side increase due to  venous occlusion . But we easy  can differentiate  between  increase due to  occlusion or due to vasodilatation. Easy as you sad. Vasodilatation will increase tHb in the rest   above base line tHb  and  if it was an occlusion  tHb will initially drop  before going up/  occlusion outflow.
 If it is a  respiratory limitation due to muscle weakness you have a  right shift of  O2  disscurve  and therefore a  drop in SmO2  and less reload in the rest but you have  a higher than baseline tHb  due to  CO2  reaction. If it is  a metaboreflex than you have a     add on to  muscle compression  and a  trend towards a venous occlusion  and  at rest you will have a  venous occlusion outflow first  but a normal SmO2  or often normal.
 If you have a muscular limitation you have    venous occlusion   together with a  " hidden" vasodilatation due to CO2  levels  and when you let go  no occlusion out flow but tHb overshoot and low SmO2.
 When you have  cardiac limitation you can see that on  tHb reactions often combined  with venous occlusion ( less preload )  so you have a  drop in SV or when in top athletes you have the    " sleeping Giant  you have the reaction by " stecher"  and a  drop in tHb at rest  due to BP  correction but with a lag time due to systemic  reaction of  15-30 seconds.
 Now  as you can see no cook book like VO2 max  and  calculator but  combination of physiology  and  different system interaction  it is  easy  and it can easy be followed it is just not mathematics  like FTP  and %  or 220 - age and it needs  a  little bit time commitment to  actually get the full benefit out of a great tool.
 It  can't be explained   simpler than just following the physiological reactions  step by step.  Cheers  and thanks for the great question.
 I bet the theory  from Einstein was not  to simple as his teacher in Aarau Switzerland ) failed him in math.
Juerg Feldmann

Fortiori Design LLC
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Posts: 1,530
 #3 
Here short an ad on :
 For example, the results may indicate that the athlete’s hemoglobin is “sticky” and .
This is super simple language   so  it  is  as explained sticky .
We  can make it closer to what it is  but than it is  complicated. O2 Dissociation curve  shift due to  for example CO2   levels.  Affinity  changes  due to this.
Juerg Feldmann

Fortiori Design LLC
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Posts: 1,530
 #4 
einstein.jpg 
 you are right , that is  as  I told many times  already the problem when you get older, you know everything  you just can't  remember it anymore.  Here is  his simple  explanation form the early day  when we went to school.

3f50fd206f2fe543a6a8a3e687cf74c3.png 



QFieldBoden

Development Team Member
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Posts: 46
 #5 
Going right back to the beginning of your reply and back to basics you said "You start a test" but I'm not clear which test is being started or what the test protocol is so I'm off to a bad start! [confused]

If it is this test (image below), from the Moxy documentation and on the assumption that in this example the athlete did not warm up as per the instructions why am I not seeing the initial drop to which you refer or are you referring to some other test protocol?

I'm sorry to appear thick but without clarity on the basics I'm always going to struggle thereafter!

Are any of the Moxy seminars available as video tutorials/podcasts?

CO? Carbon Monoxide? Cardiac Output? Commanding Officer? [wink]

MoxyRamp01.jpg 



Juerg Feldmann

Fortiori Design LLC
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Posts: 1,530
 #6 
Great comeback  and great   you insist.
 That's what we need  to see, where we have to  be more clear  and straight forward  and  as you mentioned make it simple.When you breath and eat this   ideas the whole day    you often forget that we have a different " language" and you combine this with my "Swenglish " swiss and  english  so it is no wonder  when people  get lost . Sorry  for many confusing  wording.
 So   I like to try  and please come back as many have this questions but never ask.  Ha ha  you are off   to a bad  start   I'm off to a bad start!
 because of us.
. Th example you show is a super bad  example and has to be changed.
  so I like to show you here  nice assessment ( not test ) so you can see how a " dream"  graph would look like.
This is  a full 5/1/5  (will tell  later what that means. so first just a full picture.
 It is a assessment done by Mary Ann Kelly  the MOXY expert on the USA est coast.
 See  l right  ( dark green  and left  light green    SmO2   graph only.

  Col smo2 r.jpg   

col smo2 l.jpg

So here  how you start.  You  do nothing for  1 min to have a resting baseline of SmO2  and tHb. If  you run  , stand n the side of a treadmill. if you do it in the field  simply stand  still.
 If you do it   n  a bike trainer  sit n bike position you choose to do the test  mainly. have the same pedal position  as you will have in the one  minute rest period. So for  example  right leg  at 12.00  clock so left  at 6.o0 clock, or what ever you choose, just repeat it the same.
 If you do it  on cross country skies  stand  the same as  you do the one minute load. if you do it in speed skating   stand as well the same even leg.
 If you do it in rowing  or kayaking same  use a resting position you may choose  on the start line  and use the same in the 1 min rest.
 This is  cut off in the above assessment.
 So that is the start. next    one  how you decide  load  to start out .

Juerg Feldmann

Fortiori Design LLC
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Posts: 1,530
 #7 
Okay here a  question. For what  sport  do you like to get   your information ?
Than here second  question. Do you mind , once you run the assessment to sen me the csv  file ( download  from MOXY  , so no power no HR just MOXY data  and we  show on here, where we  have to improve our feed backs. and where we need  additional information  form HR  or  any other markers you may have collected  or not.

I am running  one explanation behind.
 CO  stands  for  cardiac output.
Cardiac output is the  result  of   HR ( heart rate   x  SV  ( stroke volume. ) and is  usual given in L/ Min.
 so  for example a resting CO ( cardiac output   could be  4. 8 l /Min    So if that person has a resting heart rate  of 60  than  we have a stroke volume ( in ml )  of 80 ml. here  in a picture form one of  our  Physio flow seminars.
CO hr  and SV.jpg

QFieldBoden

Development Team Member
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Posts: 46
 #8 
Thanks for the update, I see where you are coming from with the initial fall. Been reading up about the 5-1-5 test so now understand what that is all about. I shall look forward to hearing about deciding the starting load.

My sport is cycling, I am a UK based cycling coach. I'm currently doing most of my own training indoors using a RacerMate VELOtron so my power data is very accurate. The other thing is that this is an environment where things are very controlled so it is the ideal situation to collect data, power, Moxy, HR etc. and look at them together.

Since I started using a Moxy and generating data I have been writing up my experiences on a weblog I set up for the purpose, my thought was that over time, as the data content rises, this would be a useful resource.
Juerg Feldmann

Fortiori Design LLC
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Posts: 1,530
 #9 
Thanks  and  you are welcome.
  so here more questions. As you ave a lot  of power data  from your self  we  can   easy set up  an optimal assessment protocol. What i need is  FTP  from you as well as  Wattage  you   can sustain for 5 min going hard.
 2. You can  sent us  as well an FTP  test   where we  have your wattage   curve  from the test  as well HR  and  MOXY data. From the MOXY I need the  csv file  as you download it  with the 2 sec  data collections.
Than we  can make a fun   discussion. You take the wattage information with HR  or what ever you use  in a FTP  test to decide  where to train (  Zoning )  and I  simply  look at  MOXY info  from the FTP assessment. Than we  do  not  make a test but   simply a 5/1/5  assessment  and  we look at  wattage  feedback and what we  can do with that   and  we as well look what we  can read out of the MOXY info.
 Based on this two ( and we  keep it simple  so Einstein  will be happy with us )  we can show the fundamental  difference between a FTP   idea  and  zoning   theory  and a MOXY   information   and what we do with that.
 Are we ready for that fun  event   so it helps  us more.
Your data collection idea is great.
 We  do that now  since over  10 years  and  we  combine   cardiac hemodynamic ( Physio flow ) together  with VO23  equipment  ( cosmed)  and  NIRS  originally portamon  now  MOXY as well as blood values   like   the famous lactate but we  as well look other options  like ammonia  and so on.
 . The simple idea is  to  finally go back  to   an Einstein idea  and   show coaches  and athletes , that you can get pretty close ( never optimal ) to an incredible great physiological feedback  by  coming all the info we gathered  and  use MOXY    and   other   easy bio marker like HR  and RF ( respiratory ) frequency   to guide  an individual training idea  or rehabilitation  program.
 We have close to  10'000 test  soon  ( over 50'000 lactate test  form the last 30 years   and  once we have 1000  comparison  soon we  can  be  relative  but  not absolutely sure  that we  have a decent understanding  what we  can read  out  of  NIRS. So any group   doing the same is great for us to see, whether they come to similar  or  same conclusion.
 We just hope  to have  not  studies  out there  where they use  sample sizes  of  10 or  20 only  as this   often leads to    incorrect or even wrong conclusions.  Statistically we need sample sizes  of 1000  and up  to be  able to sustain discussion   on  current classical believes  and  newer  potential  controversial   results.
DanieleM

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Posts: 264
 #10 
Juerg,

based on your experience, do you expect to see limiter and compensator on every athlete or someone, perhaps elite athlete, can  have all the system parties well in balance?

Daniele
Juerg Feldmann

Fortiori Design LLC
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 #11 
Daniele
 That is a great  question  and here  some thoughts. 1. The " dream " is to have all systems  as  optimal as possible  so your "team" has no weak link.
 And it may be the best for your health.
, Reality  we see is that  the majority of   real high performance athletes  have a really weak link.  In  beginners  the weak link or limiter,  if they do NOT have a health reason  or disease,  is  most often the muscular system. Capillarisation  and therefore as well mitochondria density. This  is the reason, why despite training with a  " theory " they make progress.
  So no matter what you give them as  " zonings"  and or  any other idea  , when they start to move regular they will be better. This  is  just how nature  works. If they train too much  than they get into troubles.
 The advantage  of a muscular limitation  to be overloaded is, that it is not  too bad, compared  to an overload of a  more vital system.
 Nevertheless the examples  of  Rhabdomyelosis  cases   from Cross fit  show  some  clear  limitation there as well or  the trend of occlusion  strength workout  without control off the duration of the  occlusion (  SmO2    values )  can create some  unpleasant  health risks.


 In top athletes , let's take here endurance athletes,   we see limiters of the vital organs  much more often than in beginners.
 This  group   trains  so many hours  and often  great and good quality workouts  for the muscles. that the  capillarisation  and the mitochondria density is  so  good developed , that the delivery systems simply can't offer all the O2  the muscles  could use.

 So   the  step in this group  is  and was clear. They did not made anymore progress,because  current training intensities  do not  make a difference between   training of different systems , it is always   push limiter  and than use compensator, as  we do not  assess what intensity is  possible to  only stress the limiter. without compensation. 
 How  do you overcome this ?
a)  find the limiter and train these system .
How  do you find them  ?
For sure not  with VO2 max testing , lactate testing  and or FTP , there  you find a   one number test result  you call it  threshold or  100 %  and you  take the famous calculator  and you go.
 Or you can use some  substances  to improve   delivery.
a) Plasma expanders
  or 
b)O2   transport improvement like EPO , as one of  the   well known,  but as well different
gases  you can inhale.
  Or 
you can try to improve the physiological knowledge on how we  could find limiter  and than  improve the ideas of  trainings  by  using  physiological ideas rather than %  of a  maximal performance.

 Hope this is not too harsh but this great question  pushed  me to this   uncomfortable  answer.
Juerg Feldmann

Fortiori Design LLC
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Posts: 1,530
 #12 
So  as  we  wait  for  some feedback I like to go one step further here.
1. NO warm up.
 Why ?
  Because  we    do not make a TEST, we make an assessment.
We are interested  to see, how your body reacts.
 a) locally 
b) systemic  
 By avoiding a  " warm up " we start even if it is a very low  performance  with the  most likely highest stress on the local   area in the  whole assessment.
 We  start out  and have a  very limited  ( low ) support of the delivery systems  like  Cardiac system  ( CO = HR  x SV )  the respiratory system   VE is the total  air you move  in l / Min  which   is  RF ( respiratory frequency  x  TV  ( Tidal volume.)
 So it is similar  to the CO = HR  x SV
  as CO   is the volume of the blood and VE is the volume of the air  both going through a  kind of a  pump system,.
 HR  is  similar  like RF  as it is the beat  per minute  and the respiratory frequency  per minute.
  SV  is similar  to TV  as it is the amount  per heart beat  versus the amount in air  per breath.
. So  when we suddenly start  with  ( in this discussion)  with a biker  we  may start a low  wattage  let's  say 80 watts  but it is  a huge load  considering the metabolic situation, as we have start  out of rest so  no or small delivery of  O2  but the need of immediate energy  as we start  bang on.

 So the initial  step  and the repetition of this initial step  will give us  feedback already on  2 main areas  to keep it simple.
 1. Cardiac   ability. ( Reaction over  frequency  or  over volume  so we look at HR reaction  and  SV reaction.
At the start we  have non of them activated  but as we repeat the same load  we have   after the first 5 min an initial activation done  and the tHb reaction will tell us  more on this.
 The second information we  will have is  immediately the capillarisation situation of this  client and  we will get a feedback in the first  2  - 3   low intensity  steps.
 So   we look at  muscular compression reaction versus  cardiac output, vasodilatation    and last but not least   capillarisation reaction.
 In the first  2  - 3  steps we already  get a picture  on this   important    information, as it will help us than to plan the direction  we like to go with this athlete  and or it will help us to identify  the Limiter  easier.
 This is just the tHb information.
 The SmO2 information is  as well very interesting as we   use immediately O2  ( Which asks  the  question of the classical   theory, that you will use  first  ATP  and CrP.   and once this is depleted  we than look for  further options.
 This idea  most likely is  outdated  and  has to be reviewed as we  showed on many   discussions on this forum.
 So the   initial start and the repeat of the same  load  and the SmO2  reaction ( trend ) will tell us  already  some information on utilization  ability  of this athlete.
 Here   I  try to show you the  idea in a picture  from our  seminar  script. for MOXY experts

warm up thb  start.jpg 




Now  next picture  is  teh reaction of SmO2  but I will  get rid of that part as it does not follow really Einsteins  simplicity  so just  for  fun .
warm up smo2  start.jpg


So next up is the  next  part of the assessment if  we do it practical   with our friend in the UK.



QFieldBoden

Development Team Member
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Posts: 46
 #13 
Hi Juerg, I worked out a starting point for my Moxy RAMP and set up a control file for the VELOtron so that it covered the right range of wattages (5 minute steps up) and started at a suitably low level.

At the moment posting all my stuff on a public forum is not really what I want to be doing for a variety of reasons!

I ran my test and the results were interesting, quite different to the "sample" on the Moxy website. There was no initial change in my SmO2 from the resting level and after a lengthy period of stability at around 70-80% it started to slowly decline. The decline commenced at was actually quite a significant wattage. There was no sudden fall-off in SmO2 at all and I terminated the test when I felt I was working more than hard enough :-)

I've not been training for a few days because I have had a cold and I just wanted to try out the methodology and I did find the results interesting, though different from what might have been expected from the literature posted on the Moxy website. I think it will be interesting to return to this test in the future and make comparisons following a period of targeted training.
Juerg Feldmann

Fortiori Design LLC
Registered:
Posts: 1,530
 #14 
Send  me the csv  file as I like to see the tHb reaction. The  explanation of the SmO2  is super interesting   but it could be a problem  with the way the data  got collected. To see, whether it was really your reaction or not  can be easy   check  over the reaction of tHb  and the numbers   of tHb.  If you sent me the csv  file on factquestions@hotmail.com private  and  therefor I have your  email, than I can give you a    mail back. The 1 minute break  will show us   whether we  have a  problem here with signals  or  not. As well     nice  will be to see the start wattage. So here  for other readers  , what you can do  when   something like this   opens  questions.
 Leave the moxy  on the leg ,  stop it  an recover  for  20 - 30 minutes,  and than do some  strength load  like one leg squatting to failure  one set  or if you are too  tired  make a  occlusion  on the thigh  and  wait  and see  for    about  1 min duration..
 The occlusion ( with as usual )  some rare  exceptions  which unlikely  will be the case here  will show  or has to show a drop in SmO2.
 The 1 leg squatting  may   but  may not show a  extreme  drop in SmO2  but if you do a real hard  1 leg squat  we will see the quality for your   muscle contraction by having a  venous  and  if you push hard enough an arterial  occlusion  trend   including a   occlusion outflow. Here  once more short  2  picture. . a)  is a   4  sets of  biceps  all out contraction.

bi iso thb.jpg   


The below  one is a 1 leg  squatting to exhaustion  once in a  hypercapnic    option  and once in a normo capnic  option  courtesy  of Nick McLean.
r leg spiro.jpg


The following  are  pictures SM AF 1.jpg  of different  reactions inSmO2  and you can see how  difficult it is  to  find a  BP ( break point ) in some cases, which is  or would be needed, if we like to use it like a  threshold idea. This test   was sent to us  from  Sandy Musson a MOXY expert in Ontario Canada.

Here another one which   may look  similar  like yours  but still an increase . Red is O2Hb standing for  oxygenated  hemoglobin, blue is HHb  standing for deoxygenated  hemoglobin. Brown is the tHb  as an indication of blood flow   reactions. dani bias thb  o2hb.jpg 

 Now the  red  trace  pretty much shows the trend   of SmO2   see below.
Dani thb  smo  colour.jpg 
When looking just SmO2 we do not see a  great  fluctuation despite  stop and start.
 This indicates a problem with utilization of  O2  ( bio availability ) Interestingly enough , he is creating a vasodilatation towards the end  as a sign that the body somehow  tries  to  get O2  going but he is not able  to do it.  Same in your case  potentially  and  it   will give you a great indication  on how  and when  you can afford  to do  other  training units  and what you  should not do at the current situation.

Next one is  from a world class 100 mile runner in preparation for a  24 hour  world record  attempt.
smo2 both runs.jpg 
perhaps one more  here. it is an interesting case, where you see, that he actually  ( green ) desaturates  in the  1 min rest period.

Mun closer look inc thb.jpg 




liversedge

Development Team Member
Registered:
Posts: 15
 #15 
Hi Juerg,

One reflection:

In your answers here often you ask for files of tests etc to respond with. But the questions are more general. They are asking how to analyse moxy data -- not how to analyse *my* moxy data.

It reminds me of the saying "give a man a fish and you feed him for a day, teach a man to fish and you feed him for life".

What Quentin and I seem to be asking is; "How do you analyse, what are you looking for" 

Hope that makes some sense [smile]

Thank you for your persistence !!

Mark

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