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DanieleM

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 #1 
This was a single 5 minutes step test (running) with one minute of recovery (each step velocity has been increased by the same amount).
run5_1.png 
Apart from some tHB spikes at the beginning, I could see SmO2 struggles to recover during the 1 minute rest, with a clear compensation from the cardiac system in the last two loads.
Limitation could be respiration or at muscular level (capillarization/mithocondrial density).
Any feedback will be appreciated.

Evans

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 #2 
Hi Daniele,

Can you provide some more context of this athlete performing the test?

Could you post another image w/o the HR response? From the zoomed out appearance, SmO2 doesn't ever reach homeostasis during any stage. I would guess peripheral limitation (utilization issues) and then I would agree transport issues at later stage as well. Perhaps venous occlusion instead at last stage?

Additionally, can you do a rolling average of 8-10 for both tHb and SmO2? 

I would guess this person is not that "trained" or they are fatigued.


 
DanieleM

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 #3 
Hi Evans,

thanks for getting back.
The athlete is moderate trained, perhaps he was not fully rested (four days after an half marathon).
Below the plot with only SmO2 and tHB with 10sec average. 
Step 3 is approximately his half marathon pace.
tip_running_5_1.png 
Same athlete has recently performed a RIP (after a long warmup and some intensity intervals). This time he was fully rested.
RIP was 30 seconds with 90s of recovery.
4th step was a bit slower, while last step was a real full all-out and faster.
rip_running_30_90.png 


Juerg Feldmann

Fortiori Design LLC
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Posts: 1,530
 #4 
Danielle  , sorry  for the delay feel terrible as I hate  when somebody is  so great and posts ideas  and data's  and I fail to respond  fast enough. Sorry
. I like to start  with some great observations  from  Evans:

 SmO2 doesn't ever reach homeostasis during any stage. I would guess peripheral limitation (utilization issues) and then I would agree transport issues at later stage as well. Perhaps venous occlusion instead at last stage?

a) SmO2 doesn't ever reach homeostasis during any stage
That is  so interesting. Yes besides  perhaps the first  step  he  really  has no homeostasis  at all and his  O2  utilization  appears  to  always be higher than his delivery ? On the other side  his HR  shows  at least in the first 3 steps a homeostasis  and perhaps   still close to a  flat HR  in step 4 ?
 So  his cardiac system seems not  to  be stimulated to increase  at least not  over HR the CO ?  yes it may be he increased  CO  over SV. So his  minus balance of  dropping SmO2  seems not  to challenge a higher delivery drive . At least not  for  CO . We  do  not have  feedback on respiration directly.  What we have is an interesting connection perhaps that  after 3  steps  with a flat HR we have  by the  step 4  the highest SmO2  recovery  and than reduced  SmO2 recovery at rest. * as Danielle  points out.  Now here a limitation of  MOXY  and tHb reactions in running.
I am not sure how they started  and stopped the steps  but the most common way is that the treadmill keeps running and the  runner jumps  of the treadmill by splitting up  and land  on each side of the edge of  the treadmill. Than jumps back on and often using the rail if possible on the side  doing this. Now this  gives  some very  specific  reactions on tHb. The jump of  and landing  will create an explosive  contraction and eccentric  landing. This in many cases  shows  up as a sudden steep  drop in tHb  due to contraction followed by  a  spike back up. Now  we would expect  at rest  tHb  would go  much nicer  up. Problem now is, that standing in that split position is  often not relaxed  and as  such  tHb  will be lower than expected  due to  ongoing muscle contraction. additionally the SmO2  will not spike  as high as  O2  is used in this relative  tense  1 min standing.
 This creates the dilemma of respiration limitation versus simply not being relaxed.
Look the interesting  kind of  "hump" in SmO2  before it reaches the peak level ?? Is this  due to the  jump  and than  the  short time before he tries  to relax ?
So  from this point   I would be  kind of careful to  give a clear  feedback on what  may create this reaction.
 More interesting is again the SmO2 trend  as a  steady  drop in   all but one step.
 This indicates  that he  utilizes  more than he  can deliver.
 Now  when we  talk about delivery  we have to add something to it.
 The opposite  form delivery , the " get rid of " situation. Delivery  would  be in simply terms : Delivery of blood  and as  such hopefully loaded  Hb.
 The cardiac system  is the " blood pump  and as  such seems to be not in a hurry to try to  deliver  more  blood to try to keep SmO2  balanced.?? see 3   - 4 steps  no  actual compensation reaction over  HR.
 So  it may deliver enough blood as we  see a  drop in tHb  but not really a  brutal  compression reaction nor  do we see a  clear  venous occlusion trend. Extreme compression  and  venous (  and for sure  arterial occlusion )  would reduce   reload  due to  reduction in back flow of  blood to the right ventricle. We  do not see a  clear indication of this.
 So we  have to go a  step further in the delivery  which  would lead us to the  respiration . . Question here is, whether the respiratory system is  working properly.
 Here my  thoughts.
 If  he has a respiratory limitation  as a  " weakness' of  actual volume  movement  so  VE / min ) or he has a respiration limitation due to a fatigue  of the diaphragm  from a previous overload , than he  has  two possible reactions ( to keep it  easy ). a) he  simply  can not move the needed VE  to get rid  of the production of CO2 in the load  so he will increase  CO2  and as  such will shift O2  diss curve to the right  allowing him to take O2  easy  or easier  and as  such  keeps going. So  this would show up  if you can compare with another assessment, that he  has a much higher RF  by the same load but a much lower TV. So he may in fact  blow the same amount of VE in a VO2  assessment, but  the %  dead space  due to  high RF  and low TV is  shifted . His VO2  will show a  higher than usual FeO2 %  and a   lower  EtCO2  so it looks as he  " burns " more fat  as RER is lower  when in fact he  accumulated  during the 5 min more CO2 and as  such is  in the body  hyper capnic  but in the VO2  mask he is  hypocapnic. Screwing up  any idea  of RER  + RQ  and as  such the interesting  theory  of   being bale to tell how much carbs or Fat we suppose to burn. For all people combining VO2  and NIRS  that is the interesting dilemma. We  will see a  sharp  drop of SmO2  due to  hypercapnic. in the body, but a  drop in et co2  due to this reaction of increase in dead space %. So we have during the load a  low RER  and we would expect a high closer  to 1  RER  but than when we  do nothing RER  goes  up  as we now get rid of CO2  during the 1 min rest. This is one nice  example you can play  with  what we  call time lag  due to the equipment lag time plus the lag time between  cellular reactions  and end result of a reaction  we  have  at the mask  form a VO2  equipment. I will show   this month how you can see live this  time lag  in some very simple experiments.
 So this is one  possible reason  for SmO2  always dropping.
 Another reason is  location off respiration or better airflow  due to fatigue  of  the diaphram and expiratory muscles. If  some previous  workouts  or in this case 1/2 marathon  overloaded the respiratory systems  than we  will breath  much more apical  so we use the upper lobes  and as  such we have a  much less optimal ability to move O2  into the blood. Ass  such  we will have a lower SpO2  to start with  and  we  therefor as we   breath shallower  and faster  again have the situation of a  lower loading % in the lungs  and this will increase as time goes on. Now this  are all great theories.
 What  to do as a coach.
 2  simple options :
 1. Use next time an SpO2  sensor  and check his SpO2. Hypercapnia   = right shift of  O2  diss curve +   SmO2  drops  but as well SDpO2  as  harder to load.
2. If he  would breath hypocapnic < very very unlikely  than SpO2  would go up  but yes  SmO2  as well. Now  just to add  for  people using lactate  and try to  read lactate trends  from SmO2  reaction.
 This example  will throw  the idea over board  as  when you  test lactate  and you go hypercapnic  lactate will drop  so  will  SmO2  so  far  so good but  when you go hypocapnic  lactate will go  up  so  will SmO2.
3. If  you have neither  lactate nor SpO2  sensor. Simple wait  another 4  - 6 days  and make a  test same loads  after  recovery  and see, whether  we have the same SmO2  reaction.
 Fatigued  of respiratory  muscles  will take  if  hard  pushed up to 1 week to recover  so after a  1/2 marathon not  an unusual  picture  at all.  so in this case    another assessment  after  recovery would be fun to look at  and see, whether we have a different outcome  plus whether we see that respiration may be the current limiter ?





DanieleM

Development Team Member
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Posts: 264
 #5 
Hi Juerg,

first of all, the test has been performed on the field with speed calculated by Garmin. Not perfect but acceptable.

We have repeated the test last week in a well rested condition.
Unfortunately there has been some spikes on tHB during the loads(perhaps the moxy was not well shielded) which makes the graph difficult to be read but I hope it can still give some hints. 
The recovery level for instance was always lower except for step 1.
After the step test, he performed a kind of RIP 30seconds very high intensity with 90 seconds recovery.
tip_rip_running.png 
 


Juerg Feldmann

Fortiori Design LLC
Registered:
Posts: 1,530
 #6 
Daniele   thanks  and congratulation for doing the assessment outside, as this is the real deal. Do you have  both test as a csv  file so I can overlap it  and see what more  questions we have.. Great  to see this practical applications  and the limitation we  may have  once in a  while  despite great technology.
Juerg Feldmann

Fortiori Design LLC
Registered:
Posts: 1,530
 #7 
Here some additional observation we  get thanks  to Daniele's  great field  assessment.
 I  wrote :
 I am not sure how they started  and stopped the steps  but the most common way is that the treadmill keeps running and the  runner jumps  of the treadmill by splitting up  and land  on each side of the edge of  the treadmill. Than jumps back on and often using the rail if possible on the side  doing this. Now this  gives  some very  specific  reactions on tHb. The jump of  and landing  will create an explosive  contraction and eccentric  landing. This in many cases  shows  up as a sudden steep  drop in tHb  due to contraction followed by  a  spike back up.

Now If  I understand  properly  the athlete in this test is doing the assessment in the filed, which makes a lot of sense.
 So the 1 min rest  and or better the short few seconds  to the rest  situation after the load period  will be different than I speculated. My  thoughts where on the situation we see often in 5/`1/5 on a treadmill.
 The reaction we see in tHb in Daniele's  case would be a reflection of  slowing down  after the  load  and is a very interesting  picture. If we can have the csv  file  I can increase the view  to a very close p situation and we than can play around  and make some  thoughts on what  we may see in eccentric   slow down situations. Here an add on . I will show  some eccentric  workouts we do  for a  specific  race coming up and how many reps  we do  or better  can be done.
 35 years back a  friend of mine did  as his  Ph.D  study  for medicine a  study on eccentric   downhill running  and the effect on the parallel  and serial elastic elements in the muscles. They did some great assessment including biopsies  with some interesting results. Now  that many years later the result  from that  time  is confirmed  on what we see with NIRS  with the difference  of  a  nonbiopsy  situation, which is much nicer  and everybody including me  who ever  was involved in muscle biopsy  will appreciate this  situation very much. Author    of that study  was G Schuetz.
DanieleM

Development Team Member
Registered:
Posts: 264
 #8 
I've attached the excel sheet for the two cases.
Please consider that in the second assessment (athlete fresher) last step was run a bit faster than first assessment (3min35sec/km vs 3min45/50sec/km).
Also, as I wrote, during the second assessment, the athlete performed a RIP assessment once finished the TIP.
Please let me know if you have troubles with the files.
Thanks

 
Attached Files
xlsx Tip_running_1.xlsx (66.30 KB, 13 views)
xlsx Tip_running_2.xlsx (124.24 KB, 12 views)

Juerg Feldmann

Fortiori Design LLC
Registered:
Posts: 1,530
 #9 
Daniele  thanks  for the csv  super fun  to see different feedback's  and will be here  with a  whole set of close up views  and feedback's. Juerg
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