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Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
I got  2  emails  over the last  few  days  from people I know since many years. Both had the same  question.
 Can I give them  an open  fair  opinion  on what NIRS  equipment they  should buy.
They  specially asked  for   my opinion of  three NIRS  equipment.
 Portamon,  MOXY , BSX.
Now  my  favorite  NIRS is  still Portamon  as I can do  many incredible  ideas  with it.
 So no question about that.
 If  I look  form my  rehab   point of view  or  from a point of  view of many  coaches  and centers I know   than I have to look as well from a  business point of  view.

 Here a  very simple example  I just  had  yesterday.
 We  do some   simple  high school   research  groups  and yesterday  we  tested   16  students  respectively did  16  workouts.
 Now here the simple  situation.
 I  have  1 hour  time  for PE . So I have  either  16 moxy's  or  one portamon or  16 BSX  ( if  I  look  for  run or bike information.) If  I look for  activity information the BSX  is  not usable  for live  nor  for  daily  use in different  activities.
 I can   workout  with 16  students  at the same time all individually guided  over NIRS  or  I can do  for the same amount of Money  1.
What do you prefer. ?
 Second. This  16  students will get assessed  ,so I  have 8  students  having 2  MOXY;s on the body  and have immediately the information I look for  individual   intensity profiles. and I can  do   all 16  in  1  hour    as I have  30 min  for  8. For the same money investment I  can do one   student on one muscle  in 30 minutes  with one portamon.  same investment.
 What  do you prefer ?

 True  there are some information's  I  may not have  with MOXY , I have  with portamon  so  for in depth research  get 2 Portamons  or  you can get 32 Moxy's  and have   much more muscles involved.

2.   With MOXY  and peripedal I  can have a big screen in the center  and can have 8 students on one screen looking at  the   reactions for their  workout like a  squatting  set or  line sprints  or  what ever you like to  do.

 I  test on a weekend for the moment  runners or cyclists.  so I  can take 5  cyclists ( that's all the space  I have ( I  could take more if more space) bringing their own  wattage  trainer in, we test all at the same time  2 MOXY's on each   and  I have a 5/1/5   idea.
 Time  . 60 min.   for 5  athletes. another 60 min  for the results  to be  printed  out  and a  training idea suggestion with it. So 5  test  2 hours  250 $  per test. = ???? / hour
 You make the calculation.
 For me  there is no brainer  for a  decent size  center or a coach  what do buy this days if  money is  tight.
 Start  with 2 MOXY's  and that's it. Forget   lactate , VO2   and    what ever you can get  in cycling. Get a  good wattage  system  and  2 MOXY's  and you are ready to assess and   even  use it for workouts.
 I have some local athletes they rent the MOXY  for a  workout including discussion after  the fact  for 50 $    and they love it.If they like  to use it just as a feedback they pick it up  and  pay 10 $.
  BUT  after  1 assessment  and 2  - 3  times  rent they actually buy a MOXY  including a Garmin watch  and learn how to do this on their own  and just come in  for training advice   and   to discuss  the result  as they learn  and go  ahead.

Interesting equipment  and it is a NIRS based system.
 My problem: Why  do I need  as a coach  for each athlete  one   system   and can not use one on different athletes.
 2. My problem. I  do much more assessment in many  different activities  and not just biking and running, but cross country skiing  strength workouts, roller blading , rowing  ,game sports  like ice hockey and so on.
 . Can I use it ????
. And if  I  can use it in an ice hockey team each player  has to  buy  one or  I have to buy   for a team of 22 ,22 BSX  and can only use it on   one player on the bike    or in running. 490 $  x 22 + ?
  =  how many MOXYs  for  how many different people in how many different sports   for daily use, versus an assessment  about  every 6 weeks.?
 You make the  judgment.
. Summary.
 All  three  tools  are incredible steps  forward in a new direction in physiological testing.
 All have  advantages  and disadvantages.
 At the end of  the day  money is  an important factors  to  make a decision.
 The ch cheapest     solution for the moment is clearly  MOXY  for  coaches and centers  and even individual  athletes.
 Last but not least and I hate this  question.
 Can I use MOXY  to find  my lactate threshold ????. It is a NIRS  equipment.  , so if you believe you need to find  the LT  and you than after you  found the LT  use a calculator to  calculate  Zones based on this  one point  yes  for sure you can do that. BSX is a NIRS . Portamon is a NIRS  MOXY is a  NIRS  and you can find the "LT"  by  looking at  SmO2  or HHb  or O2Hb  or tHb.
Here an example.

 a  three minute  step test you can find the SMO2  " threshold  and this is the "LT " if you like it.
emd resp  limit  with  Vasod.jpg 

But  when adding tHB  you can see, what created the  drop  in SmO2  at a very specific  point. What is  his potential  limitation.. If you like  to  see the " right  shift " of  the non existing lactate curve  you can use  NIRS as well as    when you overlap the  " SMO2  threshold  point will shift to the right as well if you are lucky.

Juerg Feldmann

Fortiori Design LLC
Posts: 1,530
uups  got a fast respond  on the discussion of  existing or not existing lactate curve.
 I    am not able  to get into the discussion  on that anymore. I have re  read  and learn  from people  having a much better understanding on that  and a much more critical look. After  40 years of  discussion on this  I like to move  forward  to the next  very interesting topic.
 Direct  feedback of  energy  trend  during exercises.
 NIRS is one possible affordable tool.
 So my  simple question to myself  was :
 Why  would I look on a direct feedback  energy supply   ( O2 ),  than I see that live  and now I would go back  40 years  and use  lactate as  a  clearly indirect feedback on something we  at that time could not  test  but now we  can  and  " abuse  " a step forward NIRS  to   force it    backwards  just  to be  able to defend   my  old  ideas  on lactate threshold or  lactate balance point  as I  am feeling bad  if I have to go back to my  patients  and athletes  to tell them  that lactate balance point or  the  25 different LT  concepts  are  now  no used  anymore. What is the problem  to adjust to some  interesting  most likely  nice  to be used  concepts.

 It is all about energy use  delivery  and utilization. The old idea  of  using  the lactate PRO  was to find  somehow a  nice  way to   see,when a performance may  need  some help    from both the O2  dependent and independent energy supply , which anyway always  work  together  so   the  delivery question  comes up  when  and why  do I  start to limit   O2  delivery   to the working muscles. If that is the case  I will use different options  to try to " survive "  or compensate. One of them is  to increase if  possible the buffer ability of H +  as long as possible and  one  indirect marker  is  lactate..
 But  with NIRS i  do not have to  speculate  as i can see it now   as live as it  can get.
Depending on the limitation  as  so many times mentioned, we may see a compensation from lactate to increase buffer  and the compensation is successful so lactate goes  up but  performance keeps  going as I  successfully   use  lactate  ( plus other options )  to keep intracellular the H + in balance. )  now I have  an increase in lactate   but not  an  actual " threshold "as of yet.
. This   and other reasons create  situations., where lactate and nIRS  go very different.
 Here just  without explanation   some pictures from hundred,  if not thousands  we  did.
 This was used at the start of  our NIRS adventure , where we  where desperate  to show, that NIRS  can be used  to find a LT.
 We  failed , which does not mean we are right  and others may   proof  us  wrong  as so often it is done many ideas.

 Below  some  just pictures no explanation as the picture  and  NIRS trends  are  self  explanations  really on the different options we  can see depending on the limitation  and or the compensation.

Red in NIRS  " language" is O2Hb  ( oxygenated  Hb)
 Blue is  HHb ( deoxygenated Hb )
 in this pic  yellow  is tHb  ( O2Hb  plus HHb)
 we use brown in MOXY  info as we often have  in prints a  white  back ground  so yellow is hard  to be seen.
  purple  here is Hb difference  and green is TSI  %  The green number is TSI %  as a  number.

Classic Curve - Why does HHb somewhat plateau (2).png 

O2 - HHb up MARKER h-i.png Graham.png 
grham  one NIRS.png

You can see  three step test  where the limiters where three different reasons and you can see  three times  very different trends  with some looking great if we  try to find  a  " threshold [wink] or break point  and some looking very different and hard  to find a  similar ideas   to find a break point or " threshold"
 There will be always a certain amount    if we  do  hundreds  of  test, where some specific    trend  may show up more often. I think   but that'  is just me, that over all this years  the most common  clear picture  was, when the limiter  was  respiration than we have a most common picture  when looking  at SmO2  and tHb  . Problem.
 Many  people do not think , that respiration is ever a limitation  so this is hard  than  to discuss.

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