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Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
The  ever increase in interest in practical application  for MOXY   during  workouts in  and  for different activities  opens a  very regular questions  mailed to me :
 Placement of MOXY.

1. For professional coaches the answer is  easy and simple. You place the MOXY  on the same place as the placement of the SEMG electrodes. These are used  since over 1/2  century, so most coaches are very familiar with this placements  and there are great guides out there for basically all sports and   more localized activities. The limitation is similar, as you have to have a direct surface to muscle contact  due to penetration depth.( example a gluteaus medius  or minimus  can't be  tested or any of the deeper  rotatores like gemelli , obturatorius  and the famous piriformis ) So  coaches like cycling coaches  , cross country coaches,  running coaches,   swimming coaches have therefor a very easy task to place the MOXY.
The fixation for us was never a problem as we use a tape like the:
Cover-Roll stretch from BSN medical GmbH Hamburg Germany  10 cm x 9.2 m
 We  put the  MOXY in a  small plastic  zip lock bag or wrap it in cellophane wrap.
 If  we test in extreme light  and the  MOXY is not covered by clothes like bike shorts  or  any other cloth we use  a small piece of the 3 M Vet Rap ( Latex free)  to cover over the MOXY  to get rid  of risk of light. Any  small black  piece of cloth will do it.
We never  as of yet  had any problem  or  lost a  MOXY  even under the most extrem conditions like during an  ice hockey game  or a soccer game in rain or even during swimming . Last week  we  even tried it on a  local wrestler during a  fight and we had it placed on a hamstrings muscle and on an upper trapezius muscle.
 I  can recall a  short feedback on here somewhere, where  the person had some problems  with attaching it and I do not know what he used .( So please  come and ask  and we  can try to solve a problem  instead  that every body goes  to the starter  problems. We play with this since   many many years in all different sports  so lot's of practical experience    and   solutions. 
Not optimal is, if you use a  wrap around  and or  any kind of compression sleeves  for forearm or legs, as it  can influence the tHb   and as  such  some  results.

2. Now there are  some  thoughts to the placement.

 a)  Are you interested in the systemic  reaction in a  sport activity, where  lot's of muscle mass is involved.
 2. Or  are  you interested in  more local  reactions unilateral  or bilateral.

 If you look for  SmO2 trends  and tHb trends  for systemic feed backs, you place the MOXY on a muscle group  which is not involved in the actual muscle pattern for that sport or  only very  little.

If you are looking for local  trends  you place the  moxy on a muscle which is one of the main  muscle groups  for this particular sport. As  coaches  and or as  training centers  we suggest using at least 2  ,optimal 4 MOXY  equipment.
  Yes the  question is cost.
  My answer :  How much  do you pay for a decent VO2  test equipment ???
 What do you get out of this information.
  How much do you pay for 4 MOXY's ??
  and what  do you get out of this information.
 Which of the 2  equipment's  can you use  as well for a workout  or during a race ????
 Which equipment can you use  for strength workout , quality control  during a  strength workout. Planning and controlling  interval loads  and sets  and rest periods.

Comparing  left and right  trends or involved  and less involved   feedback. Which one  does not need  any replacement  after a while  like a  O2  sensor or a CO2  sensor or  some new   masks  . Which one  needs very little cleaning  and no risk of contamination.If you have  4 moxy how many people could you test  at the same time  with   similar or more info than  with  one VO2  equipment ?

 You can give the answer  as it is  NOT a test.
  So here some  placements   and some thoughts to it.

 Speed skating:  Quadriceps  vastus lateralis.  if more MOXY's available   both  legs  as   certainly in   short track there will be  in many athletes an actual structural difference between inside  and outside  leg.
 And  as well one MOXY on a not involved or minimal involved muscle. So  if you choose an  arm muscle take the insight  arm delta pars acromialis.  Cross country skiing:  Skate skiing. Vastus lateralis  left and right  and an upper body muscle ( triceps )  if you do not look left and right get a  Vastus  lateralis, triceps  and  intercostal muscle  7/8.
Diagonal skiing, Gluteal    and triceps and intercostal
 Downhill skiing   vastus lateralis  left and right  and rear delta.
Ski jumping vastus  medialis  and gluteal 
 Ice hockey  vastus lateralis higher than in   skiing ( ( covered  by pants)  and  any upper body muscle like  rear delta or triceps.
Swimming depending on   technique  but nice is  gluteal muscle  and  lattisimus  dorsi  and  intercostal
Soccer  : vastus lateralis  and   any upper body  arm muscle    and intercostal.
Handball and volleyball  vastus lateralis  and  any upper body.
Tennis  and badminton :vastus  lateralis  and intercostal  and  any arm muscle on the   dominant arm side.
Running:  Vastus lateralis  and  delta  pars acromialis  and  intercostal.
  ( Not optimal is the calf muscle due to changes in running technique in the field. Downhill running ends up often as a heel striker  and up hill as a forefoot running so we see, extremely changes in tHb  as well as in SmO2 [wink]
 Vastus  laterlais  left and right  and  delta pars  acromialis .
or intercostal.
  Not optimal   again is the calf muscle due to changes in techniques  with heel drop  and or   toe  push as well as cleat placement. Cycling in the flat  often can change the ankle activity  versus  cycling on a  hill or out of the saddle. The calf muscle  has  a very strong  variation in tHb  and SmO2  in this port when you look in the field.

 If you have  any other sport in mind  please mail and we  can  have some suggestions  on where  an how to place the MOXY  and why. Have  a great  time  with playing with your new  toy  and come back with  information and critical questions.

mary ann

Development Team Member
Posts: 7
For climbing I would consider doing a baseline; Using 2 on upper body and 2 on lower body to see weight distribution of climber's effort using face terrain with large holds.  Being able to measure simultaneously may limit measuring non-used muscle. From there I would consider forearm and tricep for upper body and calf/quad for lower body.

Ideas to expand the test for different climbing styles; For a crack climb, might consider placing on forearm, calf and opposite quad.  Would also be fun to compare Sm02 response if the climb had a long approach or hike before reaching the start of the climb (low Sm02 to start?).  Could utilize a treadmill TIP test to assess the climber's Sm02 response to hike with/ without weight of a pack.  I attached the VersaClimber study we did last April to show how a full Moxy TIP could be completed while focusing on sport specific parameters.
Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
This post created a lot of great feed backs  and suggestions  but as well  some  very intriguing points  to discuss.
 First some critical points  to NIRS/MOXY. It is  a  super great direct feedback live  from your   delivery  and utilization situation in your assessed  area. This means we  now  what happens in your assessed  are  and  can make some conclusion's  based  on what may change the delivery  and or utilization in your assessed area.
 You see ,what I mean.
 I  can have an  ankle in a cast  and still bike  and I  can have a  MOXY on the other calf  muscle  and   I  can tell you what happens in the calf , where the MOXY is in. That's it . I can't tell you whether the same happened   on the other side.
 True  this is  an extreme situation  but  it  proofs the point.So I  can  run or ski or  bike  and I can have a MOXY on a calf  and a quadriceps  or  a moxy on a hamstrings  and a  quadriceps.
Both will  tell me  hat  may have caused the change in utilization an  delivery.
 This may not happen at the   same time.
 So if people  do research , looking for a break point or threshold on a  NIRS  trace like  O2HB  or HHb   or SmO2  in the moxy case, than they have to  do this    searching for a BP  on   different muscles    to be sure, that  lactate trend really fits together with all BP  from all different muscles.
 So  if  I   compare a  O2Hb  or HHb  or SmO2  on the calf and on a quadriceps in any sport  but let's  stay with biking  and running, than I will have the BP  on different intensities.
 There are different reasons.
 a)  involvement of the muscle in the overall performance.
 A  fore foot runner has  a much higher calf involvement  than a  heel striker for example.
. b)  the muscle fiber  composition of calf  and  quadriceps  are very different  as the calf  has  much higher  STF  % and one of the highest of many muscles in the body.
 So the ability to utilize  O2  in the calf  is very different than in the quadriceps  and as  such we have a much earlier  change in H +  concentration in the  quadriceps  than in the calf.
 If  we add the higher %  of  involvement for the activity to it , we will have  a much earlier  shift of   the O2  diss curve to the right  and as  such a much earlier drop in SmO2.
 Depending on the activity we  may as well have a very different reaction on the delivery systems   ( blood vessels  from one to the other muscle.)
 Here an example  form a  Cross country  erg  assessment.

The RF is  the quadriceps    and H  stands  for hamstrings. The regular reader can see, what   the   delivery challenge  was of each of this muscles  and it is very different.
 So the   chance, that  both contribute the same  amount of lactate to the system is  ?????
 The chance that the   lactate threshold   if that is existing is reached      by  both muscles  at the same time   is ????? And  so on. The BP  for NIRS  , what ever mathematics  you  will use is  most unlikely  at the same place ????  as the slope  of the  SmO2  drop will be very  different

Quad  and hamstrings  cross country skiing..jpg 

So making a  conclusion on a  systemic  collection of  lactate  and  who  of this  2 muscles  may have  contributed  to the   appearance of lactate in your finger is a  long stretch  away  form  any  save conclusion.
. The lactate  we   normally test is a  summary of  lactate production and removal  and left over  form somewhere in the body  produced  in excess  from some muscle groups  and   not used   as much form other s  and than  it  may show up   at  some times after it all happened.
 The  protocols  we choose will create a    calculated  speculation with a very uncertain   outcome.
 What is the time  we test  and step length  and so much more. It is unreal that we believe this is   accurate  and validated  and what ever we complain about accuracy.

 Now  why all of this. I got  a mail with this    section which is    as it looks form a discussion in this direction. I do not know  how they all do  or did  this so I can be very wrong   or  missed  some very great step forward  n  lactate testing.

@ Stephen, our initial testing was completed on both the thigh muscle (vastus lateralis) as well as the calf muscle (gastrocnemius). Both of these muscle groups are engaged significantly during both cycling and running. Both produced strong, measurable lactate responses. We ultimately chose a calf solution as our first model based on the results of end user A/B testing. To accurately measure LT, the device must be placed over the calf muscle using the included compression sleeve as this is a major muscle group involved in the exercise. Hope this answers your questions!

" Both of these muscle groups are engaged significantly during both cycling and
 That is  true  and  if we run  in the field  they even change the  w way they support us. So uphill running will change the %  of  calf  involvement compared to the down hill running  for example.

 Sitting on a bike in different positions will do the same.
 The fact  that the fibers  are very different will create  a very different  NIRS  trend  and BP  and as  such    we will have a problem to know , which muscle contributed to the increase of a  classical lactate curve.

 Now  they make a super interesting point:

Both produced strong, measurable lactate

That is  amazing if they  actually  where able to test independently the lactate production in the calf  and the quadriceps . Than  actually see the same  NIRS reactions despite the points  above  and  even  more  extreme that the lactate production w in both muscles  would actually be the same level as they increase load.
The testing of individual  lactate reactions in different muscles   on live  people  is  potential possible but  very complex  and not  live in the way , that the y have to take  some  muscle samples  and prepare it  like this :

  connette  muscel smapling of metabo.jpg 
So    if they were able to  actually test  the lactate production/ utilization and release  to the systemic  blood   individually, than they are  a huge step ahead  of what was done  and  for sure, when they where able to do this in   big enough numbers  so the  result   has some statistical values.. If they use a  simple  hand held  lactate analyzers  , than the statement is  going up in smoke.
Summary. We  do not think , that it is possible    to take a  O2HB  and or HHb trace  from a muscle  and compare this  with a systemic  lactate   reaction  due to the fact , that one is direct  information and the  other ( lactate ) is  an indirect speculation  to say the least. Again,  we may have to at least start to discuss  and late perhaps  accept the    fact, that lactate today is not what it suppose to be   many years back.
 If we  accept the  lactate as a  very  great   transporter  ( carrier  and    buffer support  and energy delivery to name some advantages  , than we may have to  go back and review ideas like workouts    to create a lactate tolerance.. Why would there be a need to learn to tolerate lactate in fact    some great research suggests, that  supplementing a muscle activity with lactate will allow the performance to  be  strong for a longer time.

I am sure we  will be back on this ongoing discussion. We simply think , take NIRS  for what it is a great direct feedback  for  local  and   in some cases  for systemic reactions  and let's  work that way look what we see  and   combien existing informations  with the new  data collections  and be open   for some hard questions.
 The same old  questions of the   classical idea, that   O2 is not involved in short term  activitis like  100 m sprint  or  weight lifting or jumps in figure skating. ????

Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
Got some nice   mail back on that.
 The content in  one sentence.
 Proof  that you really will see a difference between left  and right calf  or  other muscles.
. 1. There are  very few people , who are   absolutely  even  with their   ability of coordination  or strenght. There are some sports  where we  are  actually incredible asymmetric  like  shorty track speed skating, or  rowing in an  9 men  rowing boat.
, but even in  sports  who look symmetrically we  may have  much more asymmetric   reactions than we think.
 Here an assessment on a  top class cyclists of his left and right leg , testes d during our Seattle seminar a few weeks  back.
all three smo2.jpg

And  to get a head of the next questions  here  the overall view  of the same athlete  so see different trends  ( not absolute numbers ) in tHb
D R all feedback.jpg 

Now  here  nice  example sent to us  from a  cycling test  where we looked  at NIRS information right and left  calf  muscle.

SMO2 BOTH.jpg 

and here  for  the complete  view  HHb  and Os Hb  from both

  Now  what would be nice is  to see  some data  from the  e mail writer , where he can show  absolute   symmetric  reactions in  SmO2  and  tHb  or  HHb  O2Hb  with their  ideas  and    than we can  move the discussion n a  fair     field. We than can even    combine the idea, on how we know, which Break pint  from which leg  first to the systemic  lactate  curve .  Than we  can follow up  an discuss  , why the curve  only fits  when we  have a  33 min step versus some other protocols.
  Here  what I mean . 3  lactate curves  f taken on the same person. Which one   suppose to show us the  lactate threshold  . ?

lac dynam 2 5 tip.jpg 

The   performance (  speed ) was    the same  as  was the treadmill and the incline the same, Same time of the  Day  and a same amount of  rest days in between. So we simply  where looking at the lactate values  by the same speed  with different protocols .
 You give us the feedback  on what and  which is the   proper  lactate threshold .


Development Team Member
Posts: 5
I see here missing guide where tu put Moxy for different sports. 

Well I tried to get data form RF when running, all good. VL would be good as well. But where I struggle is calf, where when running the data are not displayed  correctly. 

Could we create a pool of photos where to put moxy for different sports? 

Development Team Member
Posts: 178
@jankubes it has been suggested elsewhere in this forum that the calf is not a good place to put the moxy as the incline you run on changes the stress, compression, etc even when the relative intensity is the same.

Development Team Member
Posts: 369
Andri did an interesting discussion on youtube (search nirsport science) which touched on placement for lactate testing

Development Team Member
Posts: 5
Hi, I know ( but if there is any "guide" where to post it. It would help athletes, cause they dont study
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