Verification testing to confirm VO₂max attainment in persons with spinal cord injury

Abstract

Data show similar VOpeak between incremental and verification tests in SCI, suggesting that VER confirms VOmax attainment. However, in AB participants completing arm ergometry, VER is essential to validate appearance of 'true' VOpeak.

Is a verification phase useful for confirming maximal oxygen uptake in apparently healthy adults? A systematic review and meta-analysis

“…Finally, the present systematic review and meta-analysis comprised only apparently healthy adults and it is still unclear to what extent the use of the verification phase procedure is applicable to special or clinical populations. A growing number of studies have included special or clinical populations such as obese adults [ 132 , 133 ], breast and prostate cancer survivors [ 134 ], wheelchair athletes [ 135 ], individuals with spinal-cord injuries [ 136 ], patients with heart failure [ 137 ] or cystic fibrosis [ 138 – 140 ], and pediatric populations [ 141 – 147 ], including children with spina bifida in an outpatient condition [ 148 ], and adolescents with cystic fibrosis [ 149 ].…”

Exoskeleton-assisted walking improves pulmonary function and walking parameters among individuals with spinal cord injury: a randomized controlled pilot study

“…Respiratory complications are common after SCI that account for 5.4% of the causes of death [ 4 ] and have a great impact on reducing quality of life and life expectancy. On the other hand, pulmonary capacity may have implications for exercise performance because oxygen is essential for organ system metabolism [ 5 ]. Hence, a good pulmonary function (PF) is of vital importance for individuals with SCI.…”

Utility of Verification Testing to Confirm Attainment of Maximal Oxygen Uptake in Unhealthy Participants: A Perspective Review

“…Fourteen studies utilized primary (VO 2 plateau) and secondary criteria (RERmax, HRmax, RPE, and/or blood lactate concentration) to verify attainment of VO 2 max from GXT, although five studies did not report that any VO 2 max criteria were used. Cycling was the modality used in 14 of 19 studies, with 1 study employing arm ergometry [ 23 ] and 4 studies using treadmill exercise in overweight to obese adults [ 12 ], adults with hypertension [ 22 ], athletes with spinal cord injury [ 24 ], and children with spina bifida [ 25 ]. The most widely used protocol to assess VO 2 max during GXT was a traditional ramp test ( n = 10 studies), although in nine studies, a step incremental test was used.…”

“…Table 3 denotes VO 2 max values measured in response to GXT and VER for the studies included in this review. Results from 13 of 19 studies [ 5 , 9 , 10 , 11 , 12 , 13 , 23 , 24 , 25 , 28 , 29 , 30 , 33 ] revealed no significant difference in mean VO 2 max between protocols, although in 7 of these studies [ 9 , 10 , 12 , 13 , 25 , 28 , 29 ], individual participants revealed meaningfully higher VO 2 max (≥3% higher) with VER compared to GXT. Nevertheless, in six studies [ 14 , 22 , 26 , 27 , 31 , 32 ] the VER-derived VO 2 max was significantly higher than GXT, with participants’ VO 2 max ranging from 19–40 mL/kg/min.…”

“…Moreover, no individual results were presented which is important since attaining a ‘true’ VO 2 max is an individual phenomenon. Recent work in adults with cancer [ 22 ], hypertension [ 23 ], and obesity [ 13 ] reveal that a sizable amount of individuals exhibit an underestimation in ramp-derived VO 2 max and a higher VO 2 max value when supramaximal VER is performed, which supports its efficacy in inactive individuals. However, across all studies, the participant population, testing protocol used, and criteria employed to confirm VO 2 max incidence vary, which does not allow identification of a standard VER protocol in clinical populations.…”