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Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
I like to start in 2015  on this  section here a  collection of  graphs  sent to us  from all over the world.  As  we have  always a goal in our  workouts  , so  do we have a goal in our    presentation  on the forum.
 I like this  idea here, as i was motivated  form many emails  asking  just for that.
 Many regular  MOXY users in the world  are by now  at least as  good or even better than we are.
 So  I like to share  many of the mails  and test  , which are getting sent to us.
 Many of them sent a full explanation on what they see  and planed  from their assessments   and even more now  start to sent  many great ideas  in to us  on how they plan to use  it. I often have to sent  a  short  email back   with comments like:
 Nothing to add you are great  and we  all learn together.
 One of the nicest  feed backs  I  am getting is  the feedback of understanding :  most often they  sound about like this :
  " After using MOXY now  in my own  way  and comparing with some of your ides  I can fully understand, why you  do not like to make a cookbook  or why you may  try to refuse  to get a metric i  forced upon a bio marker."

Well it took me nearly 40 years to accept that bio markers are what they are bio markers  from your own individual  response  and as  such    the future  on how we  workout.
 The   intense  search and development   to  have bio sensors  is this direction many companies  try to aim for.

As  technology improves  and we can start looking live  on  physiological reactions, the idea  to force this reactions   back into a classical idea  of  statistical metrics   will start  to disappear.
 Nothing wrong  with  what we did   and  why we looked  for this  metrics.  Using VO2  equipment,   taking nonstop blood and understanding the time lag of this  bio marker as well as  using HR  as a surrogate  for  many    test results  was they bets way to go.
 As  performance HR  and VO2    move  often linear  , the   result had to be a  calculator  and %  of  what ever we  called  max or threshold.
 The development of  live    biosensores  like NIRS  / MOXY  start now  to    create  a situation, where  %    or nay calculation is obsolete  as we see  what is happening. as  such we  can use physical information like speed and wattage  and combine it with  real physiological reactions as we go along  and we  are a huge step forward in coaching  and rehabilitation.
  As  such we  are very happy to have   many groups  out there looking for   metrics   but we  simply have a problem to   go back in time  to    force that route.

 As such I like to start with a graph here we  discuss since a while.
 Ruud  from The Netherlands  sent it to us  and he did  an incredible job  by  creating a lot of different  options.

 The beauty in his   assessment is, that he is one of the  not common pictures    and as such a  perfect example  , why we   do not use a cookbook.
  I like to show  first a  typical  common result of a  5/1/5 assessment.
col thb smo2 r leg.jpg  This  is  what  you dream  from.

Now  we had some great feed backs  on here  from Daniele as well on  mails on Ruud's  first   feed backs.
1. The 3 min interval overview. delivery lag  and SmO2.jpg
We used this to show the problem of lag time, when using HR  for guidance of   certain workouts.
 HR in any kind of interval is not  an optimal  tool, but  it was for a long time the only tool.
 So when using  HR in a   center  for all the customers on big screens,  they now  could easy switch with their HR technology  to using a  MOXY as the feedback to have   the next  even better application of individual workout intensities.
 Here the 3 min   workout  from Ruud  with  MOXY info only  tHb  and HR.
smo2 thb all.jpg
The  interpretations we got,  was in all cases the  feedback on a possible   occlusion   situation in this  case. I was  not sure  and  still after all  info's I am hesitant, but  I  may have to accept it  but it could be a very specific  case here   as I had  one or two similar results some years back.
This cases  are what is  so much fun  than to try out certain interventions  to see, whether we  can change physiological reactions and see them live in front  of us.
 Now  next  is Ruuds  great 5 min step test  just moxy info.

thb smo 2  1.jpg  Again an interesting but  not s common tHB reaction   indicating an increase in   blood  flow or volume in the tested are    so either a very  great CO increase  and or a muscular limitation ( vasuclarisation  )with a  weak  CO  overrule   and a trend of  a venous occlusion.

 The discussion than was  to see it in a 5/1/5  as the one minute stop  will show us   either a    occlusion outflow  and or a  systemic    lag  reaction of a    vasoconstriction  and or an over shut in tHB  due to a very  increased  SV  and  CO therefor.
 So let's see  how the 5/1/5  looked like
smo2   thb all.jpg  Well here is the result. A  not often seen  drop in tHB  during the rest period.
 So  the   theory  would suggest,  that  when we get rid of muscle contraction as we rest the cardiac out put , which has a lag  time  will now have no   compression to overrule  and tHB  would increase  during the rest period.  as we  most often actually see.

 Not in Ruud's case. . I looked at it over and over again  very close  and   the tHB  drops as he stops  so mechanical  reaction and  no  BP  lag time at all.  It  seems to be a  classical  occlusion out flow.
What is  unique    or nearly unique is, that he  has this  basically from  the first stop on.
 " normally "    what is normal anyway ? we would expect this below picture  of an occlusion in the harder  end of the test steps.
smo2 thb bike.jpg  Bike test sent to us  from South Africa  Now  is Ruud's  test  result unique.
 No  thanks  to a test we got sent  from Finland  ( Eric )
eric thb smo2.jpg

 Now  last but not least  a  nice  overlap  of Ruud's  5 min step test  , where we  where not sure about the  occlusion as we had  clear two options  and  than  his 5/1/5   assessment , where we got  much more answer's  back  (perhaps not the right   one ?? ).
 Here the  fun overlap.
5min  and 515  overlap.jpg


Development Team Member
Posts: 264
not sure to have understood the conclusion (if any) for Ruud (and Eric) cases.


Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Daniele , not sure  either  . It seems your  conclusion of a  venous  occlusion is the right one.
 There are different options  here  and  different option to get closer to the real reason.
  It may be , that there is a  capillarisation limitation  and as  such the muscle contraction will overrule the cardiac out put pressure.. So  you will now create some different training's  to  see, whether that is  a  possibility. There is one more we can talk later  and it is  shift  o blood volume  from the skin  to the muscle and vica  versa  for  temperature  control . Will show some examples on that.
 In Ruud's 's  case   we have different options  for a  short term  functional assessment to see how he reacts.
 a) increase SV      and as  such  cardiac  output  and see, whether  it overrules  the muscle contraction.
b ) reduce  muscle contraction.
  B is easier  as you can do it immediately ,  a) needs about one day delay time after you did a  plasma expansion workout.
  So  easiest is to start  with b )
 How   increase RPM  so you have less muscle tension by the same  load  and see what happens  with tHb  and SmO2.  If  it r4educes  tension tHB  should go  up later    and    SmO2  can ether go down  or up  but will change.

Development Team Member
Posts: 279
Hi. Just as I was thinking a seeing a bit in my last workout in which I did some Vo2max intervals with a higher than prefered cadence (prefered 88, these intervals around 95-100). My SmO2 was quite acceptable and higher with the intervals than with using more force (lower cadence) for the same wattage. Also ThB also did not seem to go up as strongly and stayed rather flat (and yes did go up more when it became "interesting" if you know what I mean [wink] I will do a TIP next week with higher cadence to see what happens.

In that sense I am going to work on my cadence. My HR does go up with higher cadence of course, but although it "feels" harder (read: a bit unnatural), i spare my legs (as stated above higher SmO2 and less THB uptrend). My muscles seem to be a limiter in the beginning but SV might compensate untill around HR of 162 or so. After that my HR can hardly go up anymore and my HR (better SV) becomes limiter and THB usually rises even more strongly.

However I was thinking whether muscular strength training (squads etc in gym) could also help in this specific instance. Any thoughts on this?

Also a question on how to interpret an occlusion in this case? Is that because "blood flow" becomes too large so low quality bloodflow? Or...?

Development Team Member
Posts: 279
O yes. One more question. What do you mean by a plasma expansion workout? What does such a workout look like??
Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Ruud, here a  short try to answer  some of your nice questions:
1. Also a question on how to interpret an occlusion in this case? Is that because "blood flow" becomes too large so low quality blood flow? Or...?
There is a difference in occlusion pictures when you assess a  reaction  where an activity is included and the occlusion is triggered by a muscle compression, compared to the occlusions  you often read and see, where  you stop  blood flow away somewhere  at a distal arm or leg area  like when doing occlusion testing. So no activity is involved , they just look at  tHb reaction and as there is still a baseline  activity /resting activity, we have  not the same  O2Hb reaction  and HHb  reaction, as when we  create a   contraction occlusion nor do we have a compression outflow.
 In very simple terms  : An occlusion can have three  faces,.
a)  partial occlusion so  venous  system is  compressed    and  as it needs less pressure to compress a venous  system  we have more inflow and less outflow  and we create a  slowly increase in  blood pooling )  ( in some sports they name that muscle pump )
b)  complete  venous occlusion, so  still inflow   over the arterial system but no  outflow so  faster  and definite  pooling
c)  arterial occlusion, so  no  outflow but as well no inflow. 
Here a  perhaps  better explanation  form one of our seminar   sections.

So please  check the pp and please come back , where  you find information unclear  or  you would like to have more add ons  so we can update  our  seminar  papers  top make it better  and easier to understand.

2. However I was thinking whether muscular strength training (squads etc in gym) could also help in this specific instance. Any thoughts on this?

3. O yes. One more question. What do you mean by a plasma expansion workout? What does such a workout look like??

I will sent you  on your mail  some  feedback on the questions 2  and 3. I like to avoid  to  create a " cook book "   on the forum ,as  depending on the trends we see in a TIP (5/1/5) the  ideas   to  improve your limitations  are very different. So please give me some time over the next few  days  and you have some info in your mail.
  Now  as mentioned.
 We  are getting many great critical question  on the use  of MOXY  and  why  we believe it works.
  We love that but we  would as  well like to  get the same critical  question options  for    what we did  or do  in  other ideas.
 So here a  question to Watt users  or  VO2  max users.  which come into my mind. from Ruud's  respond.

Questions :
    a)What is a" VO2 max interval. "
  If you did  one, can you sent  the csv file    to compare  between SmO2  and tHb  reaction  in your 5/1/5  assessment  and your VO2  max
b)  what is your  VO2  max
c)  why do you know it was your VO2  max  in that test ?
d)    So  to do a VO2  max interval you have to have Mask on so you can see, whether you actually reach in each load a VO2  max ?
e)  If we do a VO2  max test (  if there is  such a  thing like a VO2  max  )  perhaps it is a  VO2  peak on that particular  day ? ) Is    it done in a 3 min step test ?
 If  yes  are we sure the VO2  max  is  the same in a 1  min or  5 min  interval ?
 If  you do not have  a  VO2  equipment to control your  VO2 max intensity , what  do you use  HR  at VO2  " max " or wattage  at VO2 " max.
f) are we  sure, that we have every day the same  wattage  and the same  VO2  use no matter  what we did  since the last  VO2  max test.

 No personal  critic  on this  just a  simple question we  our self  ask  when we use  any intensity idea. Is it really what we believe in and   can we  really be sure we  do what it suppose to do ?
 Would it not be nice, if we could see what we do love ?

 Here from  one  of  my favorite  teachers  at  my University in Bern Switzerland.
 Prof . Schoenholzer. The father of  high altitude  ideas    and  an incredible  scientist in the real    meaning   of the word.
 Here  the 2  first  pictures he  showed us   at the at time on  an overhead projector  to start  an incredible series  of meaning full and  self critical  lectures  over the  many years  I  was able to enjoy him.

unseen real.jpg 


Development Team Member
Posts: 279
Yes indeed. It is intensity based. Based on power (106%-120%) of FTP. I don't know exactly (as also FTP is variable, let alone drift in measurement tools or anything like that) if I am actually training "at the right spot". Also I don't know if I did something else (perhaps lower intensity) if it would induce similar or different (or better) training adaptations. It is in some way vague I agree on that and I wellcome any training opportunity to train more specific which could lead to (better) adaptations in less time on my specific limiters and can also build further more specifically on my strenghts. The thing that it is with training with power is that although on an individual level it is (on individual physiological level adaptations) "guesswork", it does (eventually) work (most) of the times (sooner or later) to enhance performance (it is in essence a performance based metric training is based on). An anchorpoint (whether daily different or not) is something which does give one a "hold on", a reference point from which to work further. As said I wellcome any opportunity or vision which can make work more specific to reap more benefits, with less (hard) training (starting point: why strain the body more than needed). That's why I am eager to learn about Moxy and apply it, because I feel there is more to it.

Development Team Member
Posts: 279
Some feedback wrt the venous occlusion graphs in the .ppt. For a layman I would suggest to add some pictures of the occlusion types. Now you show them in graphs in a technical way (i.e, how it would look like with a Moxy measurement). If you try to make some sort of picture for every (or maybe 1) occlusion example people (like me), will understand it more easily. Also (if I may, otherwise delete this [wink] ):

1) start of with showing a graph in total so users can see the overall trends that occur and simply state what is happening overall (it can be as simple as: " we see an increase in SmO2 for this and this part when the load (e.g watts) go up and a decrease in HR and thB in this and that part, etc)
2) Try to divide the graphs into sections, and make some small zoom ins on each section and try to explain a bit more on what you see and :
3) formulate (if it cannot be directly concluded from the specific workload or test) what the hypothesis is. Can be like:
Based on section A I believe we see an example of a venous occlusion. We do not know for sure, because we would have to do a xyz test to get a better clue
4) and this part is more tricky. If you get to a good conclusion which might hold for lets say 95% of cases, there might be some very little bit of clue which kind of (let's say 80%) of cases could be a remedy (or training form) for the specific limiter/ compensator. And i know (especially since lately [wink] that everyone is different, and that full exploitation of one s capabilities come at the individual level, but eventually can hold more or large group than just the individual.

The above is not a complete cookbook, but is is a kind of structure which will guide people like me through the steps. There can always be a sort of standardization in analysis to a certain extent I believe and seeing the same kind of structure over and over again is not a weakness but something very strong since it shows the capability to make difficult things more easy (and hence a lower step to take for a lot of people).

I also know that from my own profession in which I have to deal with more complex stuff when combining words with strong (for 90% standard) visualisation you have a very strong combination to get people in the boat and they might start rowing themselves. Otherwise people (although very eager to learn!) might step out of the boat out of frustration (or don't even want to come into the boat).

Hope this helps to enhance some of your documentation. It is in no ways critique, just trying to help.
Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Ruud, wowww that is great. Yes it was a critic  but critic  is needed  and it was a super positive critic . I will work  on your proposal over the next few days  and will sent it to you  for proof reading. I will try to take you 5/1/5  info  and the  other info's  an will pick  the suggestions  you make  if possible  from your  data  so it  maybe easier to get your feeling combined  with what we  can see or not see.
 Than we can look at the options  you  made  a good point of training  solutions.

The main challenge  is :
 1.  We  would like to show    how MOXY  or better NIRS  can be used as a  real time bio marker  so  we do not  have  to relay  on  calculation and speculations , when we  plan to work out in a specific    intensity or  with a specific  goal to improve a specific  limitation.
 So the main difference  therefor is that we do not look for a maximal all out   end performance or  maximal  performance   for any information, but as many  e mails show  people can see, that we look for intensities , where a specific system  either  fails  or  will depend  on a   compensation.
 In other words.
 we use  physiological feedback  to find  "  let's name it   " Zoning's"
 So the first step is  for coaches  and individuals  to be able to  find this limitations  and or  compensators.
 . I  still have to find any current  test idea, which is able to  do that  and not just  speculates  on a maximal end point  or a  artificially produce    threshold    like LT, and than  as well can create the info  we  can find with  NIRS.

 Now  over the last few Years the numbers of  individual  teams  and coaches   understanding this changes is  very fast growing.
2. Now  what  comes up is the next  most likely much bigger challenge.
 Now  I  get daily mails in  with the  question:

 Juerg now I  really know  what is the limitation in may clients,  but now I am completely lost.
 The fact that  the coach now knows the limitation is much harder to swallow  than  just using a %  of a  calculation.
 Now he has  to kind of  "proof" himself  and his client, that the training  we  create  in fact   improves the limiter  so performance is increasing.

 So now  that is the really great points you make:
  What do I do now  with the limitation . 
This is the next big    chapter  and it will take  some  work   to show  how you now  use  the actual information you have and use MOXY  and watt  and HR  and RF  and what ever  easy bio markers  you can get  and or afford and than  workout  on the specific  tasks  you  try  to improve  and than add them back into the  team  of the  overall performance.

 Lets  see, whether I can make  a  simple example.
 You have a 4  men rowing team.
 Member  number 3  has a  coordination problem  with stroke rate  and his   highest still efficient  stroke rate is  39.
 The other three  feel very comfortable to go  43  and higher.
 To maintain the rest of the teams ability on this higher stroke rate level  and  work in a 4 men team I have to find a solution.
 In this  case you train  in a one men boat  on coordination  and strength with the weaker rower   and you work with him in the team  by  simply giving him a less resistance Ore so  we drilled  simply  holes in his  paddle and he was able to actually  with less resistance  go  to the higher coordination..
 So in your case if we see a   occlusion trend  we   can work on the  different options.
a) increase  vascularisation
b) increase  absolute strength
c) increase  SV  and therefor   cardiac out put .
 The key is now  to avoid, that with for example a "VO2 max " load you simply not only kill the limiter very early on , but you completely may overload the compensator  as well and  than it is getting hard to avoid  over training.
 So   what ever you decide  to    work on  from the three options  to  overcome the weakness you can choose as you can do this in different intensities  and   by  trying to just load  one system  to the limit  before the other once  may start to compensate.
. Will work some  training ideas out  for you  and than you  can try them out. Will mail  some options  over the weekend.

 The idea of using MOXY was to offer a  testing  or better assessment tool  so you can find your limitations  and  strength  points.
  Than you workout  with your believes  and retest and see, whether  the  formulas  and the ideas  to improve  certain physiological points really worked  for you. So you still can use  %  of watt. If it works  great, if not ????
 Or you can start to use  live feedback  like in your case  with MOXY  and than combine  with other info's  you like to  gather.
 It was not the idea  to  give here  coaching and or training advice. .
 But    depending on the fast increase  in MOXY users  we  may have to start doing this  as we  for the moment plan to work on this  with coaches one by  one  who have specific  goals  in mind. We offer  the  assessment tool  and they than    try out their believes  re assess  and  we share  information's  and feed backs.  In any case   no matter whether their system is  or was working , with MOXY we can  now see, what the stimulation created   as an effect  and it does not matter, whether it was the planned  one or not , but we learned  what  on this specific  person the stimulus created  as a functional  and or  structural change. 
Okay time  for work  and  first  plan to   sent you some of the  explanations in graphs  you suggested . Thanks so much  for your great involvement .
Here a PP  we use  with our   Grade  11  and  12 students  as a worksheet. Perhaps it helps  otherwise take it apart .

Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
short feedback.
 Remember the  unease  I  expressed  , that Ruud's  5/1/5    looks    different  than what we " normally " would see  and that I  am not convinced ( but have no  way to  show it   " yet " ) that it is not a real venous occlusion   reaction. My  question  is still out there why we see  this reaction in Ruud.
 It is still possible  but very unusual
 So  I have some great  mails  with him  and here a  short update.
His 5/1/5  was not really a  5/1/5  it was a  5  with a    very low   but still moving 1 min   rest in between.
 So we have some interesting reactions no matter  how low the wattage   may be.
 the second  part is  what we discussed      before, the  application of the NIRS. If you use a compression stocking  and or very     tight   cycling pants  or even what we  delivered  for a while a  circular fixation you may change blood flow.
 Here a picture  after  many  many try outs over  some years  on how  to use a  NIRS ( this is  a portamon fixation.)
PortaMon 004.jpg 
Wrap it in a  plastic  bag or cellophane  wrap  to   protect it  from sweat  and dirt.
PortaMon 005.jpg 
Use a  cover roll stretch tape to fix it on the   muscle

PortaMon 006.jpg  Cover it up  with a "light shield"  so a black  towel or  black loose  cycling pants or  shirt
 Avoid  using  compression sleeves  
 Last but not least body position.
 Now all three  possibilities  of changing physiological reactions  are in the 5/1/5    from Ruud. So he will do another one to see whether this  has a  reaction and or not
. Summary :  Very tight  pants, no  complete  stop in between intervals. changing position    between  rest and load on handle bar.
 For MOXY users    just try  out  how it changes  between aero position  to handle bar position and  upright no handle bar , as well as  one leg  at 6  o clock  and  than change to 12. 00 clock.
 Physiology is  a very interesting  situation as it reacts   very different than just a simple   load  reading of speed  and or wattage  or  weight.
 Than we can include   heat  and cold.
 I sent  Ruud  some internal study   pictures   from   many year back  on heat,  cold , position and timing change  on SmO2  and tHb.
 Thanks so much Ruud  for  all the great feedback  .  This is fun to have  as it opens a  very new  way of discussing    activities  and   rehabilitation.

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