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Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
I got some  very nice  test information by  S.M. I like to show you here  what  may be possible with MOXY, once we overcome the initial hesitation.
The fact, that we use a combination of  noninvasive  cardiac heamodynamic testing ( Physio flow )  paired  with the traditional; VO2    equipment ( using mainly information like VE , RF  and therefor TV  as well as  EtCO2  and the  rations of  VO2/HR  and VO2/ RF and SEMG and last but not least  over many years  lactate/ glucose  and  in some cases  ammonia  , all this combination  and data collections over the last  10 - 20 years including  NIRS  , allows us now  to make  some very specific  statements ( sometimes  right sometimes  wrong ) but in any case it  will show you how  much fun it is  once you start looking at performance  from a  real physiological point of view rather  from a mechanical or physical point of view.
 This does not  at all exclude performance in sports  where we easy can collect performance information. Now  you bundle the above equipment into a lab  and into a bank account of close  to 100'000 $    and  now  you see how limited this  combinations are.
  So no wonder  do we have fun  to show you now  how we  can with a 1000$ +  equipment have   a very close information  based on what we learned  and now see with MOXY  and this all in the field.
  So the example  from S.M. is one example of basically all we get in  who can start a great discussion on the different influences  we can see by looking MOXY data's only.
 Here a 5/1/5  bike test. I have not a lot of info, just that it was a bike test  and I have HR  and MOXY info.
 I  like to take a chance  and may go very very wrong but  that is what makes us learn    and see  where and what did not fit  as of yet what we may see.
 So here we go.
What you see here is  HR  ( r  axis ) and SmO2  l axis of the TIP
jeff hr smo2.jpg

You can see the  TIP ( Training intensity profile here based on SmO2 ( MOXYgenation trend)
ARI  ( Active recovery intensity seems  very clear  with the trend of initial deoxygenation ( SmO2  drop ) due to immediate need of  O2  but lag of  CO  and VE )  for new reader here the back up of this  statement  with a physio flow look . See  at the start. but as well see, what we miss, when just doing a "classical " step test  instead of a TIP ( 5/1/5 )


See the start phase  and the HR, SV  and therefor  CO  lag.
 In this lag time we  still need  ATP  and YES it comes as well   from O2.  ( and yes  may be the statement is  here to stay  form   Mb  as the storage area.

Now  back to the TIP/ Look in the STEI  ( structural endurance intensity  )  the second step repeat  ???? ( why a drop in SmO2  during the  same load? .
  the third step than back to a  cl;ear  reaction with a  SmO2  plateau on a  somewhat lower level.
 Than we follow  with the FEI  ( functional endurance intensity )  with  2  clear indication, that  more O2  is used, than  can be supplied  so great utilization but somewhat problem with delivery ???

and last HII  with a very interesting trend in the first load  as  more O2 use than  supplied  ( utilization ) but in the second   repeat  an increase in SmO2 ???  Lets  go  step  by step over the next  few  days.  This TIP is based on O2  utilization   and or trend.
BUT  if you make the TIP based on another  bio feedback, the HR  you will do  the " zoning " slightly different  do you.
 What can you see on the trend we  have  from HR  as a part of the cardiac hemodynamic .
  CO  = HR  x  SV ???  This gives us  the  blue " battle zone " see again here  so easier to follow

jeff hr smo2.jpg 

So this is  very interesting  and  calls  for the following question:
 Why  is the  cardiac system not reacting  as we  would expect.  A  dys balance of  O2  supply  and demand so a drop in SmO2   by this low HR  would   let as expect  and increase in HR  to increase  supply  ( delivery ) of more  O2  to  still keep   the SmO2 in balance ???
 The HII  intensity proofs, that HR  was  not  at its limit  form the frequency.
 What we  do not  know here is, whether this person may simply  has increased the SV  to increase  CO  and keeps the HR stable.
  BUT  if  he  had done that su=successfully  than we  should see a balanced SmO2 on a  lower  level.
 But we do not see that. What we see  at the rest SmO2  rebound by this load is a lack of  rebound of SmO2  to the same level  as before but as well after this load.
 So here is a battle going on between delivery  and utilization  and the   recovery of SmO2  much less high than  before  and after  shows, that the delivery system   Cardiac  or respiration ) need  much more O2  than before  and after  and therefor  the rebound of SmO2  is much lower.
 So something  with delivery is  going strange.
  S.M.  do please not yet  step in  as I like to try  how  far I move myself into  trouble here.
  So if  we see a delivery  question we have to look at the delivery information we  get from MOXY  which is  tHb.  ( trend  for Blood  flow or  blood volume.)  To start out  and make all of you thinking here a  tHb  trend of an other athlete  left and right leg TIP assessment.

l r leg thb JF.jpg 
Rember  relative  numbers  as the chance that we  hit  exactly the same  place  left and right is  zero  so  simply look at the trend.
  One  interesting not  when ever you test. At the one minute rest always have the same  resting pedal position or  stand the same way on the tredmill edge  and so on.
T2  is  the left leg  and here it was always  at 12.00 o clock psosition. This is  what we  expect   in a TIP  at rest.
 So here the  tHb  from our  discussion point  from S.M.

jeff thb.jpg 

There is  somewhat a pattern but very different. So the " delivery "  is  somewhat   different.
  1. we have to rule out  the  case, where the client may be restless  at   the one minute  rest  and or  pedaling back wards  . If he really was  doing nothing  and had the same leg  always at the same position  and or even   one up one down we would expect  at the rest a much different  reaction of tHb  than  we see here  as we  should see  an increase in tHb  at the rest  period  at least in the very low intensities  till perhaps to FEI  and  HII. Do we see this.
 What  factores  can influence tHb.  and  what is tHb influencing  in return.
Have a great  evening and we will be back  for more.

Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
So  first  question is always.
 What  do we do " wrong " or  did we manipulated  the  results  due  to some  changes in the setup.
 In many cases the  actual protocol  will often decide the physiological reactions.
 " Classical" 3 minute protocols  or  ideas like a Wingate  have little  to do  with physiological information's. They are simply a set of loads  who will create a set of results, which can be compared  with each other without  a lot of  full physiological feed backs. I do not like to go  again in this  discussion, but like  for new readers  to show you a great example.
2 test differetn MOXY information.jpg

This is a great example  done  by a research project   from the RED BULL research group. The 2  circles  show you 2  " test protocols.  I like to  name it 2  loads, with different length of steps  before loading more wattage. It was collected  with a Portamon  from Artinis.  Yellow  and purple are the  traces  we look  at.. tHb  and  Hb diff.  where Hb difference trend  is  close to SmO2 trend. Even  without  having a lot of  information  it  seems easy to  see, that the 2 different step length have a  incredible influence on the reaction in Oxygenation ( Utilization and  delivery.)
 When we take SmO2  or  on here Hb diff  as  an indication of  utilization  and tHb  as  an indication  of delivery, than we  can easy understand, that the protocols  directly create an end result based on the time  we offer  to the different physiological system to try to react.
. The  relative fast increase in load in the second  circle    gives a great  indication how the increase in mechanical muscle tension on the blood flow  directly   is linked  to the drop in tHb . As  such we have   as well an immediate  reduction in O2  supply  ( delivery )  and  we have to dig into the available O2  supply  and storage are  and as  such  SmO2  ( Hb diff )  have to drop.
 HR  or better  CO  ( HR x SV)   as well as VE  from the respiration point of view  VE = RF  x TV   will have  as indirect    delayed  reaction   a very different influence on the performance.
 In short the   test  step protocols  directly will influence the   end result  and as  such will not give any information on limiter  and  compensator  with exception of the end result.
   So we have  one  point in this assessment  and the rest as so often is calculated  from  which end point the 5  or the  shorter minute step test. ??

So  back to S.M  case.
  We have this interesting reaction of the tHb  in a  TIP 5/1/5  protocol.
 The TIP  suppose to show us, what happens in the 1 min break.
 In short. I suddenly stop using my  leg muscles in biking. Meaning I  stop  suddenly the demand of  O2  ( ATP )  but the delivery systems like Respiration, Cardiac  as well as  the vascular   delivery situation  will   not  immediately stop  as there is a lag time.
 (  correction )   the mechanical reaction on the vascular system, the  muscle tension created by the load  will immediately stop . what  may lag behind is  vasoconstriction  or  dilatation reaction due to   "chemical" reflex  situation )

Or in very simple  terms. The sudden stop will show the  "use " of O2  from the muscles involved in the movement.  and the sudden start will again confirm  the need  of O2  to restart the load.  This  when we look at SmO2.  When we look at  tHb  we should as well see a  trend in  stop and start, as we  unload  mechanical the muscle  and reload  with an initial muscle contraction.  To recap here the  tHb reaction in the S,M. case

jeff thb.jpg 

As you can see, there  are  some up and downs,  but in no way  do they look as a nice pattern of  load  and deload.
Why  and what happens.
1. If this is  a  first time assessment  I would repeat it  and have a  MOXY on the left and the right side.

Here  an example with a  dys balance pattern of delivery between left and right.
 Courtesy  to Jon  from Boulder.
thb r l.jpg

You can see the difference, but you still have some indication in both traces, where we load  and unload

Even the most religious VO2 max user  and FTP user  has to agree, that this  could never been detected in any of the current test ideas.

Now in   Jon 's case it is   not  as " bad" compared  to S.M case, where it is really hard to see a  decent 5/1/5  pattern in  tHb.

So is there   something very different.  In S.M case we have a test  back from march  so let's see, what  tHb trends  where  than.

jeff 1 and 3 thb.jpg

As you can see the dark brown is  the first test   and now we have the light brown.
 So a dramatical change in the way tHb  ( blood flow  and   blood volume react.
  So is it a  delivery change  based on a structural change  or a functional reaction??
lets  see the  SmO2  reaction  than  and now  as well as  Delivery "  over  HR bio marker.

jeff hr and SmO2  1 3.jpg 
You can see in the overlap that at the low intensity HR  are  identical  and SmO2 in the first  load  of the same   double load.
 After that we have a  clear trend of a lower HR   and a lower SmO2  reaction in the second  test.

Indication. "  Cardiac  reaction:  lower HR by the same loads.( If  they did the same steps / hopefully )  Lower  HR    would than mean  CO = HR  x SV  so   what ever they did  change the cardiac hemodynamic to a much bigger  SV  by the same load  or a lower  HR. So in case we  now  add some specific  functional cardiac training to it we have a  much higher CO in a few weeks.
 Good or Bad ???

The SmO2 trend indicate a much  lower SmO2  as an indication of a  change in utilization. There are different reason why we  can utilize better. ( Functional  and structural again ).

There are different way we  can train the heart ( right ventricular stimulation or  left ventricular stimulation)  so called cardiac  remodeling.
 Now  I do not like to go into training suggestions  as there is a risk of a cook book.
 What ever S.M.  and her   help in the back ground did  change some very nice  structural  situation.
 Here  my speculation based on what we see here.
1. Improved  cardiac  delivery.
 Improved  utilization  supper.
  Where is the problem now.
  . The  drop in SmO2    still indicates a delivery problem.
  Could be vasularisation  or 
 but the low intensity double step  seem to refute this suggestion in fact  compared to the first test it is   more likly improved as well.
 The increase in cardiac  reaction  ( structural ) the improvement of  vasuclarisation, the  improvement of  O2 utilization  can be done  over  some very simple  respiratory workout  ideas.
 ( We  do not like to  show  what this person did  again as it was based on his  first test result  and  as  such  should not be copied  from any body.
 What I believe  was done here, was a very specific    intense  training  with a  steady hyper capnic  situation.
  Now this  seems to strong in this person, that he manipulated  his respiration during g this test as he is used  to but it is not efficient  for a  race or a  hard  workout. He now has  the limiter in actual  ventilation of  air. He  has to improve his VE  form where ever hie  is  to try to double the VE  he can move, so respiration can play  with CO2  whether he likes  to  be hyper capnic  in a work with or  hypo capnic  and=in a race  he  just let's nature  do  its  work.
 The tHb indicates  a manipulation of  respiration which overruled the mechanical  pressure  of load and unload.  Next step in this case is  to   lift the limiter respiration  up to the great respond  he  or she created  with the training over the last  few month  ( since march )  thanks S.M  for this incredible data  feedback  and god luck with your corresponding  long distance coach  in Switzerland . You are  a great team  and lot's of  fun to listen in to your  regular conversation. Last  but not least I like to show   without explanation  just let the picture  talk the  structural the change in utilization.
  Look at the red only as it is O2 Hb  and as  such a similar trend as  SmO2  would have. You can see  the difference e now    and  form than.

jeff 2 hhb o2hb.jpg 

jeff  3 o2hb hhb.jpg

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