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Stuart percival

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 #1 
As promised another complete data set for us to appraise 

Female athlete 
AG national TT champion 
FTP- 164 W

Protocol:
3 X Moxy placement (R and L RF and Deltoid)
5-1-5 test- right leg at 12 o'clock each 1 min rest. Left leg 6 o'clock 
Lactate samples taken midway through (15-30seconds) into 1 min rest phase

jeers can we take this up here please ? 



 
Attached Files
csv MoxySharon.csv (92.94 KB, 14 views)
csv SHARON_DELTOID.csv (200.17 KB, 7 views)
csv SHARON_LRF.csv (200.12 KB, 8 views)
csv SHARON_RRF.csv (207.61 KB, 8 views)
xlsx Workbook1.xlsx (32.61 KB, 10 views)

Stuart percival

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Posts: 78
 #2 
Same protocol as above
Male TT this time


 
Attached Files
xlsx AE_LActate_.xlsx (31.91 KB, 7 views)
csv ALAN_DELTOID.csv (200.04 KB, 8 views)
csv ALAN_LRECFEM.csv (200.13 KB, 8 views)
csv Alan_RRECFEM.csv (209.16 KB, 7 views)
csv MoxyAlanResp.csv (321 Bytes, 8 views)

Stuart percival

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Posts: 78
 #3 
Graphs of R and L rec fem for Alan- Male TT rider

Attached Images
Click image for larger version - Name: LRF_Alan.png, Views: 21, Size: 176.59 KB  Click image for larger version - Name: Untitled.png, Views: 21, Size: 188.63 KB 

CraigMahony

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 #4 
At a very quick glance, I noticed that for Alan that with his right rec fem in the recovery periods his tHb went down from the second 1 minute recovery period onwards. Whereas with his left leg it went up. This to me indicates a strength issue in his right leg. Although this could also have something to do with the recovery position.
juergfeldmann

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 #5 
Here a closer look at  right and left leg tHb reaction Craig is  talking about.



r an left leg  thb.jpg


Below  his  r and left leg  and D  SmO2 to make a more  total picture.

smo2  all three.jpg

CraigMahony

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 #6 
Not very observant am I. The tHb only rebounded up on one occasion. On all other occasions it dropped during recovery for both legs,=.
CraigMahony

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Posts: 178
 #7 
Question. Were they wearing compression clothing?
Stuart percival

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 #8 
No - I stuck the Moxy on with tape provided. The leg Moxy were underneath cycling bib shorts but more to keep in place and and prevent light. I wasn't concerned of compression
juergfeldmann

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 #9 
we may be back  for more in this case.
Here some points.
1  left  and right leg  dysbalance   but which one ( Stuart  to not tell feelings  as it is fun to  have the  2 options and how  you find out  what it is.
2. Interesting  that  this athlete  never  ever  was able  to   increase   SmO2  above  resting level . 2 main reason  to think about  why .
3. Interesting tHb  reactions in legs  (  delta was different )  as we would expect  at least on the one side  to increase  during the 1 min rest.  reasons. we get rid  of muscular  compression due to contradiction but we have an increased  CO  due to lag  time  so we   expect  an increase in tHb. As you can see it  did not happen  and it starts  from the beginning. So BP    reaction may be  not the reason.
 So  first  always look at pedal position.  is the   leg position 3  and 9  clock  so often  rest tension left  to hold this position in  one or the other leg.
 If in 6  and 12 o  clock  look how this athletes  react  with this position in tHb. In   some starter  case  we often  do  o have a  6  and  12  but often   11 and 5  or a  1 and 7 position  so    still some   muscle tension let in a  close   isometric  way.

So  y look  closer  at biased  and  see, whether  the  drop in tHb  goes  with an increase  of HHb  or a  decrease in HHb , Than  what would that mean. 
 Than  you look whether the tHb reaction is no just in the legs,  but as well in the non priority muscle. So  the  question o a  systemic  reaction and if  that i the case  why  or what  can produce  this  or whether it is a local one side  leg reaction  so more  a positional  question.  We  can overlap all three athletes  from Stuart  and see how  that  may look  in all cases  and how  different it may or may not be .

ryinc

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 #10 
I am starting with Sharon case:

General
  • Something seems strange on the 1st step at the 3rd load - the load seems shorter and the recovery longer - what happened here?

Sm02 reactions:
  • In general priority muscles are not showing much desaturation - almost looks as though it could be a normal step test rather than a 5-1-5.
  • Unexpectedly the deltoid is actually the muscle showing the most desaturation, and it shows it on rest. Was there perhaps something going on (e.g. a shift in position during recovery periods?)
  • Lack of desaturation might be due to the muscle chosen - in general my preference is to use RF for well trained cyclists but in this case VL muscle might show more insightful information?

tHb
  • Similar reactions across all three muscles, except in load where the left RF rebounds more significantly - this most likely simply because left leg in 6 o clock position on rest?
  • In general tHb trends upwards during loads, however the reactions on recovery do not look like venous occlusion. The trend seems to follow HR quite closely so probably just CO overcoming muscle tension.
  • There is a suggestion of overshoots of tHb on recovery in the later loads, probably due to C02 build up (particularly looking at deltoid).

Heart rate
  • Strange heart rate reactions on recovery  at end of 1st load at 2nd step and last step? Why did heart rate increase for a while on recovery?
  • On first load of 2nd step, heart rate increases steadily but on the next load at the same step heart rate flat - is this indicative of stroke volume to rise?
  • Quite a low heart rate overall
  • Heart rate recoveries hardly ever get down to the same level


Sm02.jpg 

ryinc

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 #11 
Heart rate and Thb.bmp.jpg 
bobbyjobling

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 #12 
Good points Ryinc. The inconsitent THb & HR patterns you mentioned could be due to the equipment used; was the test automated using an ERG turbo trainer or manual setup for each step to aid lactate sampling?
I think the reason for HR increasing during the rest period of the last step test might be because she started the next step and stoped.

SmO2 saturation might be due to moxy IR sensor distance to muscle. I too think VL would have been a better choice.
Stuart percival

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 #13 
Hi Ryan

Thanks for the input.

Some important points- As far as I am aware 1st step was 5 min?
We had an issue mid test whereby I hit a button on the CPET machine and the protocol got deleted- Problem with this is the ergometer was connected to the machine so we lost power- I was frantically trying to manually get the power back to the level- This affected the middle part of test for sure and was disappointing.

Sm02-reactions- I discussed this with Juerg as I was concerned during the test we were not desaturating- Sub cutaneous fat % was probably too high for Moxy? hence why we see deltoid reaction and not leg.

I did use RF so maybe VL might be better? i learnt from Juerg to test the Moxy first by actively trying to desaturate pre test to test fat% and Moxy efficacy - A lesson learnt.

Can you expend on these 2 points for me please
however the reactions on recovery do not look like venous occlusion

There is a suggestion of overshoots of tHb on recovery in the later loads, probably due to C02 build up (particularly looking at deltoid)


ryinc

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Posts: 360
 #14 

Stuart, first keep in mind I am no expert either, everything here is just what I have learnt (or think I have learnt!) following the forum over a year or two. In other words, don't take anything i say with any level of authority!

I am also going to answer your questions in a way that will hopefully illuminate the thinking process, rather than necessarily provide clear cut answers. This is not intended to be patronising or opaque – please don’t interpret that way if that is how it comes across. I am simply trying to respect the culture Juerg has tried to instill on the forum of each person coming to their own thinking conclusion, and so that the threads serve as a source of a thinking process to future readers too rather than a set of “cookbook” answers (as Juerg would put it). 

However, if it still is not clear then ask further questions about what is not clear as this helps to further highlight how people are thinking about this.

However the reactions on recovery do not look like venous occlusion

A venous occlusion would occur when the compression of the muscle due to the load actually blocks outflow of the blood – what would happen if the "exit" for the blood at the muscle is blocked?  Next, think about how the mix of oxygenated vs dexoygenated blood might change if the venous outflow is blocked. Now think what trend tHb and Sm02 would show during the load, and then think what would happen on the release of the load when the occlusion is released?   

Once you have it clear in your mind – have a look at what we see here on the female athlete,  does it look like what you would expect a venous occlusion to look like? Also go have a look at your world’s race file, where Juerg circled certain periods of interest. It was suggested by some that there might be a venous occlusion although there was debate about this, and it has still not been settled yet – but form your own view why or why not could it be a venous occlusion?

Then go have a look at the case studies section, I recently shared a picture of what I thought was a trend of venous occlusions – what are the similarities and/or differences?

Going a step further,  if we do see a venous occlusion what might that tell us about the athlete?

There is a suggestion of overshoots of tHb on recovery in the later loads, probably due to C02 build up (particularly looking at deltoid)

The deltoid muscle will be a “non-priority” muscle during cycling activity – so looking at the trends of this muscle will often tell you a lot more about systemic reactions, than “priority” muscles (e.g. the legs) which show the result of reactions taking place at the muscle itself (i.e. local reactions) due to the load as well as broader systemic reactions. Now if you look at the peaks that tHb reaches on recovery of the deltoid muscle in the female athlete and how these change through the assessment? What do you see? Now you need to think what is causing this, on the one hand it could simply be cardiac output has increased on the other it could be vasodilation (i.e. widening of blood vessels). One of the things that stimulates vasodilation is C02? Now why might there be more C02 around at the later loads, and what could this possibly indicate?

Cheers
Ryan

juergfeldmann

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 #15 
Ryan,
 What  can I say  other than
Thank you thank you thank you.
This is  what I am dreaming  of  since many years. I is a wonderful present  to me, seeing, that  the way like to move information is  exactly  what  happens here. Thinking  instead of believing.
 And it  worked. And  it is  in englsih instead in "swenglish "  swiss and English and it is great and it makes sense.

So  this  step  now  help me  to move  forward to the next phase. Meaning  that I will  add  if  needed  or  if it make sense  a some additional thoughts  to it but more important  I like to get  rid of the 5/1/5 protocols it is ugly  and will show  you  here how  over time  you actual assess as you go ahead. The  5/1/5is a base line a foundation to be  able to  do  physiological assessments in the go and  during the assessment or  actual training  you  do one or the other step  to see, what is limiting  just now  and what is compensating   just now   for the limiter.
 But  first  nothing really  to add to   the  section  you wrote on occlusion  and  CO2 reaction. Exactly  same thinking here. Same here as well  there are NO experts in anything , there are  just people  who believe  they  are experts  and give  their  expert opinion  with  often little  values. Same  is  true  for me , No expert  but  an aging student  with limited  options  to keep learning as we progress   and the risk  to throw  own ideas over board  as new   information's may  show  up. So  if  I add some thoughts    does not mean that is the proper  answer it is  just some thoughts   for possible open discussions  with  often different outcomes  than I may see.

Example. The three  red  circles in the  RR where we  have an increase in tHb. Initial thought s like  I think Craig was  look at a possible    occlusion ( outflow reaction.
 Ryan pitched in much  smarter  no occlusion   when we  look at SmO2   so   yes I looed  closer HHb  and O2Hb  and   yes  no occlusion. Still looking   closer  as it is  fascinating  the HR  respond  certainly  at the end  so  here s where the  wattage  trend will  be needed as well to see how he physiologically  worked  and fun would have been a  non priority muscle.

So  same  feedback on   non priority  muscles  towards the end of an assessment or  hard  workout . Non priority muscles  give a much better feedback on systemic reactions  than local once.
 Once we progress  more towards  training guidance  and  end the interpretation phase  of NIRS  you ill see that  in many cases  the placement of a MOXY on a non priority muscles gives  you much more feedback. Cardiac  and respiratory limitations are much easier seen on non priority muscles  as they are the last  resort  for   shifting  O2  or  balancing  homeostasis  as there  is the place where you  have to  " give " up    or  can afford  to give up  for survival. Take   freezing  survival ideas  as  an example.

Now assessing  and feedback  during a  5/1/5 .  As you have live  information  you will learn to see  initial trend indicating  some  directions  your body  is heading too.

Example. Respiratory muscle weakness. You  stop   for the 1 min rest  and you see in the leg   or  in the  arm or in both a hesitation  of  SmO2  recovery  but a very  fast  tHB recovery. The time lag in respiratory reactions is   +- 15 seconds. Now  you are not sure is it just a  short  lag   behind from the respiration and the slowly increase in CO2  will finally  kick in and increase respiratory  work  or  is it   just starting to show a respiratory limitation. So  you not increase  the load  but add a  third   same load  5 min section, but ask  the  athlete to change his  respiration.
Example you see he is breathing  fast  high RF   ask him now  to breath slower and deeper.
  If  he has a  specific   respiratory limitation what   do you may expect  you may see and he may feel.?

Depending on reality you see and  ideas  you expected  you than can react  and do the  opposite  fast  and  shallow.  Sorry Ruud  and some other reader but that's  where  the  key  element  and connections is to classical  feedbacks  like lactate and VO2  reactions  like RER..
Example  :  you are a coach  and feels very comfortable  with  Max Lass  ideas.
  Here what you can doo. Bike on Max Lass  or FTP   coaches  or athletes   load on FTP  wattage.
 So  in simple terms  you are in a steady state of  homeostasis.

Lets  take Max Lass   load. You  are 5 - 8 min stable let's  say  lactate 3.4  3.3  3.5   readings every 3 min   for 9 min.
 Now  you see in NIRS a  tend in  the 1 min rest  after the  9 min  like a  trend in a respiratory  limitation. delayed  SmO2  reaction and   fast tHb  increase.. You go back to the same load   give some  time 5 + min  again  you even can take  another lac  sampling.. Now   Max Lass again. Now   change your  natural respiration  you had    to a   slow  and Deep  respiration or be sure  you  breath a lower VE    so  you   know  you go hypercapnic  ( CO2  accumulation ) What will you see in SmO2  and  in lactate. Than  think the opposite  go hypocapnic  what will you see.  More later  as I am in the airport    to  Santa Ana  today climbing  demo  and NIRS  and tomorrow   wresting coach  from  turkey  and emo  on  respiration and NIRS for this   association and country.
Ryan thanks  again
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