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juergfeldmann

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 #1 
I like to start back here with the permission by Rachel to look at her case  somewhat closer. I like to keep on here just my comments  to keep it sorted  out  and will have I section here. This way  we have a kind of a  very simple tutorial   using this case  and  sometimes  comparing it  with other  but  just information here  and questions separate  as mentioned . Let's see whether it works. Thanks
juergfeldmann

Development Team Member
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Posts: 1,501
 #2 
Okay , Thanks Rachel  and lets start from the real beginning  and we go step by step in the question section  anybody  can kick in and ask  or push in a  specific directions, where the  ideas are unclear  or have to be explained somewhat different.

 Step one  for new MOXY users.
 a) play around to see how it starts  and how to fix it.  Best place is  biceps  as it is a muscle  easy  to control.
b) 1. Either have the MOXY on in a  race  or a hard  workout  and see the reactions by looking first just at SmO2
2. Best is  as in Rachel case look  for a MOXY certified test center  and you  will be   in good hands  to get the data collection done easy  and fats including interpretation.
 This is what Rachel did. Thanks  to Sandy Musson.

Now Protocol for initial assessment. We  do a 5 1 5 meaning 5 min load followed by 1 min complete rest  and followed by a repeat  of the same load  followed  by 1 min rest than 5 min new load  and so on.

 Lots of  space here to discuss  why  but  lets   keep going 5 1 5. Sandy did a great job in collecting the data  and here the first   view we  look at.
 SmO2  as a  feedback  on the Three  intensities.

 This will answer a  question  Ruud answer  to a  reader.
 Can you tell easy  how we know we  deliver more O2  than we use , when we are in a metabolic balance  and  when we utilize  more  than we deliver.


smo2  up flatdonw.jpg


SmO2 up increase  so more delivery of O2 to the  MOXY placement area than is  at that moment used.
SmO2  flat and we have a balanced  O2  delivery  and  O2 utilization  at that moment.
SmO2  drop than we use more O2  at that  moment than we can deliver

 So in real  data  it may look  often like this below
smo2  up flatdonw 2.jpg 


This is what we hope  to have and than it is  simple. Now lets look what we got  from Rachel's assessment  * ( running assessment)

smo2  hr  all.jpg 

A in the first  moment very different picture. So here  we see the limitation of a cook book as in this case we have a very different menu  and we  have to look at  different  to see what is going on  and there are different reasons  why we have this picture. What we know for sure is , that Rachel  reacts like any other person  with a fight and flight reaction. Here what that means
canon.jpg 

So  for CO we have a expected reaction We use HR as a  part of CO . CO is cardiac output  and is the result of HR  x SV  as stroke volume  or how much blood the heart throws out per beat. Now there is where your resting HR  can give some indication A higher RH indicates a  lower SV in most healthy cases. So  drop over time in resting heart rate   can indicate  an increase in SV
So we  do not know  Rachels  RH  and I am not sure whether I have a 1 min resting calibration but may get a feedback from Sandy.
. so we see the first load 2 x  a more or less flat HR  reaction in the same load after the break . the second  2 loads  show an increase in HR  the second time same load as an indication of increase in CO  for sure over HR  we do not know   whether as well over SV.third  load flat   and than  4 th  load a interesting reaction first  which indicates a readjustment of load   so CO reacts at least over HR. last load  an increase in HR  despite same load  as an indication of a  possible compensation  from the cardiac system or a increase due to reduction in SV  by the same load.
Summary HR shows a very expected often seen trend. So why do we have a  strange  looking SmO2 trend.
Again we would expect  something like this running test below.

51 5 Hand selye  Cannon.jpg

My initial  spontaneous  idea  would  be .
1.Repeat the  test but  just the first   2 to 3 double loads to see, whether we have the same reaction.
2. Subcutaneous fat  layer  (Sorry Rachels not personal  but a very  important question as it is a  limitation of any NIRS.
So you can use a  cheap fat skin fold caliper and test and divide  with 2 as you have 2 x in the fold .  The number you have  has to be below the half distance between the light on the MOXY  and the  outer black  dot( optode) than you should be okay
3. Light influence
4.Is the muscle we have the MOXY n really major involved in the activity  we do.

Now just because the current majority of the NIRS studies use the VL   does not mean that this is a smart idea.
 Different running techniques  lie forefoot or heel striker  have different muscle  chain reactions  and as  such the VL  may not  be that heavily used in  certain runners

 Now the SmO2  alone  can not help a lot in this  questions. So  we have to take tHb  into the  picture  to see how  the blood flow trend looks.

bias  all.jpg 


Now I like to use  HHb  blue  and O2Hb  red  biased  to see some easy trends. Bias  means we start  no  values by zero with both  and look how the  react  compare to each other. and  as  HHb  plus O2Hb  equals  tHb  we use tHb on the same graph. Now if we would  color the brown tHb trend  green and  name it SmO2 nobody really would  have an  idea, that we did  this. So the tHb  may indicate that the test was actually  great but the VL  in this runner is not  that heavily involved in the  running  So it is a less involved muscle  and therefor  will only show towards the end  some indication of  what  may be limited.

 as usual a  BUT. It may as well indicate a incredible superior  delivery  of O2  but a  limited  ability  to use O2  so utilization limitation.
 There are  many options but two we like to focus  on.
 a( problem to release O2  from Hb.
b) a  relative  small mitochondria density  so the  great deliver  or O2  can be used  even in hard loads as  much more O2 is delivered  than can be  turned over into  energy  due to the limited mitochondria density.

Now  with this   question  you may have some indication, whether the training she has  done prepared her  for a mitochondria density development. Untrained people show a similar SmO2  reactions  the  can easy deliver  but have no ability  due to lack of capilllarsiation  and  mitochondria density to convert the O2  to energy.

 Now  speculation as I  Know nothing about Rachel  which is fun as I can go very wrong  which is fun too.
Look below closer
She has a  great capillarsiation and as such is most likely  running since a while  and is running in a very smart intensity level as we need  first to develop  capilarsiation    so we  can deliver O2






  before we   produce  mitochondria density.
close  thb  and smo2  all.jpg

Now in this pis  you see a  SmO2  trend but no clear rest   and load  reactions as we see in tHb.
This is  relative common , when we have a MOXY on a less involved  muscle To confirm this  we  would have to add a second  moxy  to a hip extensor  muscle and see whether she is a  hip extensor  runner  and less a  forefoot push off runner. No this is not good or bad  that is just what it is. This type of runners  can run any distance  and no matter whether it is 5  km  or  marathon they have basically one speed  and have a problem to accelerate  for any reason. Now in long distance  if you are not run for a  win you  just go your  pace and you may look slow at the start but pretty good  at the  end.
 If   runners like to change this they may have to do some specific   intermuscular coordination workouts to integrate the calf,  quad , glut and cross ( oblique) abdominal sling into the  running technique.
 Nevertheless to stop here first we have a individual zoning  even rom her VL. first 3  double loads are easy  and O2  is delivered more than needed. 4  th load is just in balance of metabolic  demand and last load is  out of balance. So her critical  levels  are by a HR  of 150 to 170 if you use  HR. Below 150 you have an intensity , where nobody really is in trouble  so any  stimulation you like to achieve  you  do in this intensities like respiratory  games or  coordination  games  or technical changes  for  your running technique if that is a goal. In the 150  to 170  load intensity  you  push the limiter  which is most likely  mitochondria density  to work harder. Linger  runs  will be closer  to 150 plus    shorter  runs  will be closer to 170 minus. Any interval  games  is  above 170. as in this intensity you will need to use  your compensator  to maintain  performance  .

Now  next up . Limiter  in  hard loads  is most liley  your respiration.
 So  t be ahead of the game you  already can work on this  as in case you successfully increase  mitochondria  volumina  you will create  more CO2  and you  will be happy  to get rid  of this  easier with a gret trained  respiratory  system.  Do you need a  MOXY  for your workouts. Yes and no. For the longer once no use your HR as usual for  specific interval rent one  for the moment  from Sandy when we design specific  interval ideas  for you. This can be done inside on a treadmill or outside  with a  cheap garmin watch feedback of  SmO2. so far so good you turn on Rachel's question section




juergfeldmann

Development Team Member
Registered:
Posts: 1,501
 #3 
Part two
  Summary part one. Easy  fast  zoning idea
based on SmO2
close  thb  and smo2  all.jpg

Zone  one (looking for a  smashy name  so help ) it is  from 0 to 360 so step 2 and  half . If you use HR  check HR  and if you use performance look performance as well. Definition of this  zone is.
 Higher O2  supply than demand  so , every body is happy.

Zone  two  ( need better name  ) is from 360 to 600 . look again HR and performance  and you can use both  for intensity  control Definition. This is where we have a metabolic  kind of a balance. So O2   is delivered  and utilized   just nicely balanced.  Some people  look at this intensity  as  MAX LASS  or in cycling it  would be FTP. So  stable metabolic  balanced  situation.
As usual BUT. You can have a very stable  SmO2 in the tested  muscle as  this  muscle works on its optimal  ability  but to maintain the performance you may integrate  a  better intermuscular coordination and   for example in cross country skiing you may if you have no delivery limitation  integrate more  arm  work  to it so you may be able to go  somewhat faster  but the SmO2 in the tested leg muscle is stable.

Last but not least a stable SmO2  alone  or a stable HHb  or O2Hb   what ever you prefer to use  does not mean you are really  in a balanced  O2  delivery  or utilization as many believe. You have to look    at thB   and see what is going on there . So  for all runners  or  cyclists  do a FTP workout and look at NIRS trend. Than repeat  immediately a second one  and look at NIRS  trend   Than come back  and show us the  result as it is the same wattage FTP  power  but is it the same  physiological reaction the second time around.

So in sports, where you have no direct feedback of power you can find a  MAX lass if  you love that word  or you can find a   FTP  or  perhaps  functional  optimal intensity FOI by using MOXY and searching for a balanced the highest speed  with the    balanced  SmO2 trend. So really we can use  MOXY in any sport  for the  metabolic  optimal balance  level.

 Now the point here I often get is . What would I buy  as a cyclist a  power meter or a MOXY.
Here my answer. If  you are a mathematician you better get a power meter as you can speculate  and predict  nearly anything you like   the only  thing you can predict is performance. The only way to  know  what your  performance is,  is go out  and perform.

If you are interested on how  you  function  than I would use a  MOXY
 In cycling or any sport  with the great ability to have a very objective  ability  to  look at  current performance the dream is to have both  as they feed  from each other. This way  you can go to FTP

look whether   you are really in the metabolic balance  or  whether today  your FTP is hared  so SmO2  will drop over time  or you are  fitter  and SmO2  may increase over time. Now  you adjust   as you go  if you like to have a  stable intensity in a metabolic balanced  zone.

Zone 3  ( need a word ) is 600 and up  so look at HR and performance  and you are set  to go  for intensities  where you not only overload the limiter  but as well challenge the compensator  and SmO2  drops  as an indication that you use  for the moment more than you  can deliver.
Now  you have a  tool to   control your intensity  for overloading or stimulate  everybody.
Summery.
Zone one , no panic  for anybody so great intensity to specific target a system you like to an idea like coordination  and so on.
Zone 2  Limiter is   pushed but compensator  do not   kick in.
Zone 3  every body has to contribute.

 Now  we have  as discussed to know the limiter.

Now  the guy  who wrote yesterday   and argued  limiter  has to face a counter point discussion now.

I argued nicely . Limitation is  mitochondria density and respiration in all out.
  Today  I will take that apart.
 I still will go  with respiration a a limiter in all out.
 BUT if  I argued that the vastus lateralis in Rachel's running  may be not that involved  so  we have naturally in a non-involved  or minimal involved muscle  minimal  or very low  muscle activity  and therefore  very little compression. So may point of great vascularisation is easy to take apart as  we do not have in a minimal involved muscle a  fight between  compression  and CO pressure. So the CO  even  if it is weak will win  and we see a great increase in tHB  form baseline  as we see in   many or most  minimal or non-involved muscles ,* Exception very unfit people(.
 So the great reaction of tHB above resting values is  an indication of increased blood flow  and  an indication of a good capillary net work but not  immediately a sign for a great CO as there is no compression challenge.
 So  my point.  Rachels  relative high HR indicates a  high HR  * smile ( but it  could indicate a  smaller  SV. So  if  Rachel limiter is   CO  or muscle strength  we  would see In a  more involved muscle this battle between muscle compression  and CO  and who would win.
 We  would see that  as well  that when tHb  drops  due to muscle compression overruling  CO  we  will see an increase in HR at the same time as a lower   blood return  will reduce preload  and SV  would drop  and HR  will compensate to    maintain the needed  CO
  Summary.  It could be that CO  is a limiter  and in CO the SV  as HR  reacts  nicely.
The  low CO  would create a delivery limitation  due to compression.. This contradicts the  info we have from VL  but if she does not use it  heavy  than she has a good delivery  there.
. Now  if it is a  CO limitation than a non-involved muscle  would show a  deliver  reduction when  CO is too weak and we shift   blood in the locomotor  muscles  from one area  to the other. Very uncommon   that this happens in the leg  to leg. So an upper body moxy would give the answer.
 As mentioned in an other section. CO  and muscle compression work   against  each other . So  a CO limitation has to be adresse either over HR if that  can be worked on or  over SV.
Or  we work  on strength to increase the relative %  used in running  based on an increase in maximal contraction strength.
 Summary
  More  confusion  but it is fun. How  to  get  some better  ideas. Retest on a  hip extensor  muscle  and  at the same time one  on a non-involved upper body  section like delta  pars  acromialis.

 More to come as we go along  and we have t look  what we  work on  and how  with the  potential limiters  and how we know  after  the training period  whether  we addressed  the proper limiter  with a minimal time involvement.

 So next we have to decide  of a  limiter   and than go  and do it  working on that limier   with an idea  and rests in about 4 to 6 week  depending on the feeling of Rachels   body feedback . Lots  of fun ahead of us.

juergfeldmann

Development Team Member
Registered:
Posts: 1,501
 #4 
Daniele  absolutely  a great  thought.
Can we please leave te discussion to the questions to Rachel  and I  keep here the thoughts I go through when looking  at an assessment with all the  positive and less  optimal  ideas.
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