Sports and Fitness Performance Lab

Exercise & Sports Cardiology Human Performance Laboratory

For competitive athletes & athletic individuals looking to improve physical performance, the ‘Exercise & Sports Cardiology Human Performance Laboratory’ offers an exercise assessment coupled with a health evaluation. During this assessment, cardiopulmonary exercise stress testing assesses Aerobic and Anaerobic threshold, Resting Metabolic Rate, heart rate and caloric expenditure using: Treadmill exercise testing and Cycle ergometry testing. This program is one of a few of its kind in the nation.

 

What is a V02 Max Test?

A VO2 Max Test is a measurement that reflects a person's ability to perform sustained exercise. It is generally considered the best indicator of cardiovascular fitness and aerobic endurance. The actual measurement is "milliliters of oxygen used in one minute per kilogram of body weight." It is suitable for a wide range of individuals, from the sedentary to elite athletes.

 

How is V02 Max Measured

VO2 Max is the maximum rate of oxygen consumption that can be attained during the most intense exercise possible. The measurement requires that the subject breathe into an oxygen consumption analyzer during an all-out effort (usually on a treadmill or bicycle) as part of a graded exercise protocol. These protocols involve specific increases in the speed and intensity of the exercise. While exercising, the person wears a mask to collect all the air he breathes in and out for a measurement of the volume of exhaled gas and the concentration of oxygen in that exhaled gas. This determines how much oxygen is used during each minute of the exercise test.

A person's oxygen consumption rises in a linear relationship with exercise intensity -- up to a point. There are specific physiological markers (AeT, AT) that can be detected throughout the test as oxygen consumption is measured. Eventually, oxygen consumption plateaus even if the exercise intensity increases. When the person is no longer able to keep up with the oxygen demands of his muscles and complete fatigue forces him to stop exercising, then his oxygen consumption has reached a maximum, and VO2 Max can be calculated. The test usually takes between 10 and 15 minutes.

 

Why Test V02 Max?

A complete VO2 Fitness test can give trainers and clients the tools to set realistic goals and assess improvement. Studies show that previously sedentary people training at 75% of aerobic power for 30 minutes, 3 times a week over 6 months increase VO2 Max an average of 15-20%. Many people are inefficient exercisers, with no understanding of what specific heart rate, intensity or duration would best help them reach their specific goals such as fat burning, endurance training, or cardio conditioning. An initial VO2 Max test can clarify the specific target heart rates that will enable each individual to reach their fitness goals more effectively, with less fatigue and fewer injuries. Periodic retesting provides motivating feedback as the fitness program progresses.

The test also determines the number of calories burned during every level of exercise, providing valuable information when designing a weight loss program. And if CO2 is measured during the test, a Respiratory Exchange Ratio (RER) can determine the proportion of energy coming from carbohydrates and fats at various levels of exercise intensity. Since physical conditioning and exercise intensity affect these proportions, this information can be very helpful when designing a workout intended to burn fat.

VO2 Max is a valuable tool for serious athletes to assess performance and evaluate training regimens. Even though extensive training can sometimes cause an athlete to reach a plateau in VO2 Max, he can still use his VO2 Max test results to make further improvements in performance. This is accomplished as he pushes to increase anaerobic threshold (AT) and maintain that threshold for longer periods of time. This enhances both endurance and cardiovascular performance.

 

What is V02 Max, AT, and AeT?

VO2 Max reflects the total capacity of the cardiac, respiratory and muscular systems during an individual's absolute maximum exertion. To achieve an elevated VO2 Max requires that the heart is capable of supplying sufficient blood to the muscle tissue, that the lungs are capable of supplying the needed oxygen to the blood and that the muscle tissue is sufficiently conditioned to use all of the oxygen supplied by the blood. It is a measure of fitness that is adjusted for body size, allowing values to be comparable between individuals.

Anaerobic Threshold (AT) is the exercise intensity level at which the muscles are not supplied enough blood and begin to incur an "oxygen debt." At this exercise level, lactic acid production in the muscles increases and fatigue sets in. Vigorous effort can be sustained for an extended duration at exercise intensity levels below the anaerobic threshold. The anaerobic threshold is measured as a part of a VO2 Max test and is generally on the upper end of sustainable aerobic capacity, on the threshold of transitioning to anaerobic metabolism.

Aerobic Threshold (AeT) is an exercise intensity level where oxygen supply is adequate for the major muscle groups. Below the aerobic threshold, lipid oxidation (fat) is the primary source of energy, indicating a level of effort that can be maintained for many hours. Training just below this exercise intensity level is ideal for a sustained caloric burn. Aerobic Threshold is typically on the lower end of sustainable aerobic capacity and is detected by a KORR™ VO2 Max test.


Resting Metabolic Rate

What is Resting Metabolic Rate (RMR)?

Metabolism, quite simply, is the conversion of food to energy.

Metabolic rate is a measure of how much food, or fat, is converted to energy in a day. Resting metabolic rate (RMR) is the measurement of how much food, or energy, is required to maintain basic body functions such as heartbeat, breathing, and maintenance of body heat while you are in a state of rest. That energy is expressed in calories per day. So an RMR measurement shows how many calories you burn at rest, doing nothing more than sitting in a chair.


Resting Metabolic Rate

How Metabolic Testing Works

Indirect calorimetry (a measurement of metabolic rate) relies on the fact that burning 1 calorie (Kilocalorie) requires 208.06 milliliters of oxygen. Because of this very direct relationship between caloric burn and oxygen consumed, measurements of oxygen uptake (VO2) and caloric burn rate are virtually interchangeable.

Oxygen uptake requires a precise measurement of the volume of expired air and of the concentrations of oxygen in the inspired and expired air. The process requires that all of the air a person breathes out be collected and analyzed while they rest quietly. The KORR™ indirect calorimeters contain a precision air flow sensor that measures the volume of expired air, and an oxygen sensor that measures the concentration of oxygen. Once the factors of humidity, temperature and relative humidity are accounted for, the KORR™ instrument provides the most accurate results available in a compact metabolic analyzer.

 

Resting Metabolic Rate

Why Test Metabolic Rate?

  • Proof of "normal" metabolism.
    Most overweight people are convinced they have a slow metabolism. The truth is that statistically, most overweight and obese individuals have average or higher than average metabolic rates. Taking a measurement removes the excuse that they cannot lose weight. Seeing that their bodies can indeed burn calories can be very encouraging and motivating.
  • Stabilize weight loss.
    Regardless of the method used to lose weight, a patient's RMR will decrease after weight loss. The decrease is actually below the level predicted by fat-free mass (FFM) or non-obese counterparts. This makes it very easy for a patient to re-gain weight. Unfortunately this happens even with preventative measures, such as resistance training. It is undoubtedly a factor in the high rate of relapse. Although the cause is unclear, it appears that in most cases, if a patient can maintain his new weight for 6 months, his RMR will eventually rise to the expected level.
    Frequent testing of RMR can be the key to surviving this crucial period. Pinpointing the precise number of calories necessary to maintain may be the most critical piece of information you can give your patient as they come off the high of finally reaching their weight loss goal and re-enters "real" life. True success is the patient who loses weight, and then keeps it off!
  • Pinpoint caloric weight loss zone.
    RMR holds great value when counseling the weight loss patient. When restricting calories, knowing a baseline RMR is invaluable. KORR Metabolic Analyzers calculate a "weight loss zone" for practitioners who wish to create a caloric deficit based on each individual's baseline RMR.
  • Detection and Diagnosis of hypo-metabolism.
    In cases where a patient has a clinically low metabolic rate, further diagnosis and treatment by a physician will be required before successful weight loss can be achieved.
  • Assess the effect of weight loss treatment on metabolism.
    Once calories are restricted, medications are introduced, or an exercise plan has been implemented, the human body will respond. This is especially true of significant interventions, such as bariatric surgery. The caloric goals of a dietary plan will rarely sustain a patient throughout an entire weight loss regimen. The result is the dreaded "plateau." Periodic assessment of RMR will show the effects of the treatments and allow adjustments to the caloric goals.

Nutritional Assessment

  • Proper nutritional care is VITAL for the hospitalized patient. Studies show that hospital stays are reduced an average of 60% when nutritional status is evaluated and needs are met.
  • The formulas that predict caloric needs for nutritional assessment (Harris Benedict, Miffin, etc) are inadequate for certain populations, especially sick or hospitalized patients. RMR is recommended for the following populations:
    • All patients receiving parental or enteral nutrition
    • Hypermetabolic patients (burns, trauma, sepsis, head injury)
    • Starvation-adapted or malnourished patients
    • Extremely obese patients (>=200%of ideal body weight)
    • Patients with non-healing wounds
    • Patients with abnormal body composition (multiple sclerosis, cerebral palsy, cystic fibrosis, spinal cord injury, amputations).
    • Patients who can benefit from education about appropriate calorie intake.

Diagnosis of Hypo-Metabolic Condition

Hypo-metabolism can result from a variety of causes, including:

  • Disease state
  • Genetics
  • Low percentage fat-free mass
  • Hypo-caloric diet
 
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