THE VALIDITY, RELIABILITY AND PHYSIOLOGICAL FOUNDATIONS OF

A VO2MAX TEST VERSUS A PREDICTIVE MAXIMAL OXYGEN

UPTAKE TEST
Posted by SportScholarly on January 30, 2012 Leave a Comment

Abstract
The aim of this study was to assess the validity, reliability and physiological
underpinnings of an actual VO
2
max test in comparison to a predictive
maximal oxygen uptake test.
Eight male subjects with the following physical characteristics, mean and
standard deviation age 19.75 0.71 year; weight 72.15 11.93 kg; height
1.77 0.11 m performed an incremental treadmill test, starting at 8
.
km
.
h
-1
,
increasing by 2
.
km
.
h
-1
every 3 minutes with a constant increment of 1%. The
subjects heart rate, rating of perceived exhaustion (R.P.E.) and expired air
were collected during the final 60seconds of each 3-minute stage. A multi-
stage fitness test (the bleep test) was also completed until volitional
exhaustion. The subjects heart rate was taken prior to each test and heart
rate and blood lactate were taken post each test. Using a predictive equation:
(0.133 x age) (0.005 x age
2
) + (11.403 x gender [1 = male, 0 = female]) +
(1.462 x PA-R score) + (9.17 x height [m]) (0.254 x body mass) +34.143),
the athletes VO
2
max was calculated.
Of the five criteria identified for VO
2
max, 50% of the subjects achieved two of
the measurable variables on both the laboratory-based and field-based tests.
Mean investigation results were 53.24 ml
.
kg
-1.
min
-1
(7.15) for the laboratory-
based VO
2
max test, predictive VO
2
max testing field-based method mean: 50
ml
.
kg
-1.
min
-1
(7.76) and predictive equation method of VO
2
max testing mean:
59.61 ml
.
kg
-1.
min
-1
(6.27). The predictive equation method of VO
2
max testing
over-predicted by 7.5% in comparison to the predictive field-based
measurement and 1.88% to actual laboratory-based testing. Relationships
between actual VO
2
max testing method and predictive field-based VO
2
max
testing method were comparable (p = 0.50; 95% confidence interval: 44.79 to
61.69 and p = 0.50; 95% confidence interval: 40.82 to 59.18, respectively)
however; the predictive equation method was statistically dissimilar to
prevailing data (p = 0.50; 95% confidence interval: 52.21 to 67.03).
In conclusion, this investigation showed that the multi-stage fitness test under-
predicted VO
2
max results and the predictive equation over-predicted VO
2
max
results, though the multi-stage fitness test was the more relatively accurate
form of measurement despite its disregard of body mass.
Introduction
Measuring oxygen consumption (VO
2
) is understood as the gold standard
physiological parameter to express the aerobic capacity of an athlete
(Pinet, et al., (2008). VO
2
is defined as the amount of oxygen taken up,
transported, and used at the cellular level and is the product of the amount of
oxygen inspired minus the amount of oxygen expired (Plowman and Smith,
2003, p. 124). Maximal oxygen consumption (VO
2
max) is defined by
Wilmore et al., (2008, 179) as the maximal capacity for oxygen consumption
by the body during maximal exertion and can be acknowledged as the
product of cardiac output (Q) and arteriovenous oxygen difference (CaO
2

CVO
2
): VO2 = Q x (CaO
2
CVO
2
) (Withers et al., 2000, p. 114).
Defined by McArdle et al (2009, p. 341) as the amount of blood pumped by
the heart during a 1-minute period, cardiac output is often expressed as: Q =
HR x SV. Heart rate (HR) is the amount of times the heart beats within a 1-
minute period (Wilmore et al., 2008). Stroke Volume (SV) is the amount of
blood ejected from the ventricles with each beat of the heart (Plowman and
Smith, 2003, p. 621). The difference between the amount of oxygen returned
in venous blood and the amount originally carried in atrial blood is known as
arteriovenous oxygen difference (a-VO
2
) (Plowman and Smith, 2003, p. 278)
and reflects the amount of oxygen taken up by the tissues (Wilmore and
Costill, 1999, p. 155). Measuring stroke volume and arteriovenous oxygen
difference can be invasive and ethically problematic to warrant for the analysis
of VO
2
max (Withers et al., 2000). As VO
2
is linearly related to workload and
heart rate (George et al., 2005), VO
2
max is frequently predicted using
submaximal testing methods based on the athletes heart rate response (Mier
and Gibson, 2004).
The most common field-test for prediction of VO
2
max is a multi-stage fitness
test (MFT) (Cooper et al., 2005). Research (Goosey-Tolfrey and Tolfrey, 2008;
Cooper et al., 2005; Lamb and Rogers, 2007) has been performed to analyse
the validity and reliability of the MFT, typically as it does not consider the
subjects body mass or composition. Cooper et al., (2005, p. 25) concluded
that the test can be considered repeatable:
however, while the MFT might prove useful in predicting the more substantial
effect that might accompany aerobic training conducted by a less well trained
subject, there is some doubt as to whether the test is sensitive enough to
monitor the small changes in performance that might accompany the
improved training status of a subject who already has a highly developed
aerobic fitness.
In terms of validity, appropriateness, meaningfulness, and usefulness of the
specific inferences made from test scores (Wainer and Braun, 1988, p. 38),
the same report indicated that it routinely underestimates VO
2
max when
compared to laboratory determinations. Criticisms of the MFT are that it does
not consider VO
2
max in terms of body mass, however it is praised for its cost
effectiveness, easy implementation and mass participation (Gore, 2000).
Previous research (Goosey-Tolfrey and Tolfrey, 2008; Cooper et al., 2005)
has highlighted that the MFT is a reliable measurement method. Reliability
refers to the degree of test score consistency over many replications of a test
or performance task (Meyer, 2010, p. 4).
As acknowledged by Cooper et al., (2005, p. 19), laboratory methods are the
most valid physiological indicator of testing VO
2
max however the feasibility is
poor; therefore the importance of field-based measurement is increased.
Exclusive functional and physiological standards were administered, by the
British Association of Sports Sciences (1997), which identified that exhaustion
can be assumed to be maximal if:
the increase in VO
2
with increasing work rate exhibits a plateau, if heart rate
(HR) is within 10 b.min-1 of the age-predicted maximum, if the respiratory
ratio (RER) is greater than 1.15, if peak blood lactate (La) concentration is
above 8 mmol.l-1 and if the individual is perceived to be exhausted with a
rating of perceived exertion (RPE) equal to, or higher than 18 (Christie and
Lock, 2009, p. 19).
An increase of heart rate, stroke volume, and myocardial contractility is
apparent to fulfill energy demands of the working muscles and is caused by
an increase in sympathetic activity and a decrease of vagal discharge
(Javorka et al., 2002, p. 991).
Hill et al., (1924) hypothesized that lactate increased during exercise because
of the insufficiency of O
2
for the energy necessities of the contracting muscles
(Wasserman et al.,1985). Thoden (1991, p. 109) elucidates that:
increased involvement of anaerobic metabolism as exercise intensity
increaseseventually stimulated a rate of glycogenolysis that exceeds the
capacity of aerobic metabolism to deal with pyruvic acid production, and
increasing amounts end up as lactic acid.
As exercise intensity increases, a steady rate of lactate production is reached
at which blood concentration maintains consistent, representing a balanced
equilibrium between production and uptake of lactate (Wasserman and Whipp,
1975). Further increased intensity instigates lactate to accumulate gradually in
the blood as the rate of efflux from working muscles surpasses the rate of
uptake (Thoden, 1991).
Matthew et al., (1999) created the following equation to predict vo2max using
non-exercise methods: (0.133 x age) (0.005 x age
2
) + (11.403 x gender [1 =
male, 0 = female]) + (1.462 x PA-R score) + (9.17 x height [m]) (0.254 x
body mass) +34.143). The equation is based upon physiological
characteristics of the subject and PA-R score (Physical Activity Readiness
Questionnaire). In situations where testing is impractical, predictive equation
VO
2
max measurement methods may be used.
The purpose of this investigation was two-fold: (i) to assess the validity and
reliability of a laboratory-based, field-based and predictive equation VO
2
max
test (ii) to assess the physiological underpinning of VO
2
max.
Methodology
The ethics committee of Durham University approved the study and all
subjects completed an ethical consent and medical questionnaire prior to the
commencement of the study. 8 male subjects with the following physical
characteristics, mean and standard deviation age 19.75 0.71 year; weight
72.15 11.93 kg; height 1.77 0.11m participated in the study and performed
a laboratory-based VO
2
max (incremental treadmill test) and a field-based
VO
2
max test (multi-stage fitness test). A predictive VO
2
max equation (0.133 x
age) (0.005 x age
2
) + (11.403 x gender [1 = male, 0 = female]) + (1.462 x
PA-R score) + (9.17 x height [m]) (0.254 x body mass) +34.143) was also
performed.
Before the laboratory-based VO
2
max test, the mass of the subjects and their
heart rate, using a heart rate monitor (model: Polar FS1, Polar Electro OY,
Finland) were taken. The subject began exercising on a treadmill (HP Cosmos
4.0 Mercury, Germany) starting at 8
.
km
.
h
-1
, increasing by 2
.
km
.
h
-1
every 3
minutes with a constant increment of 1%. The subjects heart rate, rating of
perceived exhaustion (R.P.E.), using Borg 6-20 scale (Borg, 1982), expired air,
using 100L Douglas Bags (model: Harvard Apparatus, Kent, England) and a
one-way mouth-piece (model: Harvard Apparatus, Kent, England) were
collected during the final 60seconds of each 3-minute stage. The test was
administered until the subject experienced volitional exhaustion. Following the
test, a one-litre sample from each Douglas Bag was analysed using a
Servomex 1440 gas analyser (model: Cranlea, Birmingham, UK) for volume of
expired air. The subjects blood lactate was taken post each test. All gas
analysers were calibrated before each test with known gas concentrations. Air
from the Douglas bags was evacuated using a dry-gas meter (model: Harvard
Apparatus, Kent, England) before the test to ensure accurate results.
A multi-stage fitness test (the bleep test) was also completed until volitional
exhaustion. The MFT was administered in the manner described by Brewer et
al., 1998. An audiocassette tape directed the procedure and preceding the
test, the cassette tape was standardised. The pace of test was dictated by the
audiotape, starting at 8.5km.hr-1 and increased by 0.5km-1minute at every
interval. The subjects were removed from the test via volitional exhaustion or
if they failed to reach an end of the course, by the time the tone was emitted
from the cassette. With knowledge of which level the subject experienced
volitional exhaustion, a VO
2
max (mlkg-1.min-1) score was calculated using a
table provided in the instruction booklet of the MFT.

Results
Actual VO
2
max using a laboratory-based testing method are plotted against a
predictive field-based and predictive equation VO
2
max testing methods (Fig.
1).

Mean VO
2
max values varied significantly, with actual VO
2
max testing
laboratory-based method mean: 53.24 ml
.
kg
-1.
min
-1
(7.15), predictive
VO
2
max testing field-based method mean: 50 ml
.
kg
-1.
min
-1
(7.76), and the
predictive equation method of VO
2
max testing mean: 59.61 ml
.
kg
-1.
min
-
1
(6.27). Relationships between actual VO
2
max testing method and
predictive field-based VO
2
max testing method were relatively similar (p = 0.50;
95% confidence interval: 44.79 to 61.69 and p = 0.50; 95% confidence interval:
40.82 to 59.18, respectively) yet the predictive equation method was
statistically heterogeneous (p = 0.50; 95% confidence interval: 52.21 to 67.03).
The predictive equation method of VO
2
max testing over-predicted by 7.5% in
comparison to predictive field-based measurement, and 1.88% to that of
actual laboratory-based testing.
Maximum HR results using a laboratory-based VO
2
max testing method are
plotted against a predictive field-based VO
2
max testing method (Fig. 2).

Maximum HR means for laboratory-based VO
2
max testing method are fairly
analogous against predictive field-based VO
2
max testing method (191 and
186 b.min-1), yet the standard deviation of the predictive method was 17.78
b.min-1 greater than that of the laboratory-based VO
2
max method.
Blood lactate results taken 4-minutes post-exercise following the laboratory-
based VO
2
max testing method and predictive field-based VO
2
max test are
plotted in Figure 3.

The mean blood lactate values did not differ significantly, with a difference of
only 0.56 between the actual laboratory-based VO
2
max testing method (11.44
mmol.L
-1
; 2.85) and predictive multi-stage fitness test (12 mmol.L
-1
; 3.65).
Discussion
The results demonstrate several significant validity and reliability factors for
various forms of VO
2
max testing methods, combining relevance to the
physiological underpinnings of VO
2.

A substantial difference in means between the various testing methods,
ranging from 50-59(ml.kg
-1
.min
-1
) as shown in figure 1, is in agreement with
research (Climstein et al., 1993; Malek et al., 2004; Lamb and Rogers, 2007)
that predictive equation methods over-predict in comparison to actual
laboratory-based testing. The equation used in this study, (0.133 x age)
(0.005 x age
2
) + (11.403 x gender [1 = male, 0 = female]) + (1.462 x PA-R
score) + (9.17 x height [m]) (0.254 x body mass) +34.143), produced by
Matthews et al., (1999) included only self-reported variables of age, gender,
suggested physical activity, height and weight. The conclusive accuracy rating
of the suggested model was said to be conventional at 36% (Matthews, et al.,
1999) yet in this study, the predictive equation over-estimated VO
2
max by
10.7%. Moon et al., (2011) found that possible invalidity of predictive
equations may be because of disregard of additional physiological variables
(blood volume, fat-free mass, urinary creatine excretion and total body
potassium). Also, the predictive equation method is dependent upon
questionnaire scores, which could be subject to bias.
VO
2
max criteria is shadowed by controversy despite its comprehensive use
(Christie and Lock, 2009), and research by Christie and Lock (2009) saw only
27% (5 out of 18) of subjects met all proposed criteria. In this study, for the
two criteria that were measureable (if heart rate is within 10 b.min-1 of the
age-predicted maximum and if blood lactate is above 8 mmol.l-1), only 50% of
the subjects met the criteria in both the laboratory-based and field-based
testing methods.
The criteria in relation to HR, that the subjects maximum HR must be within
10 b.min-1 of the age-predicted maximum (220-age), is met, as can be
identified in Figure 2. Mean HR for the laboratory based testing method: 191
b.min-1 (3.96) falls 9.25 b.min-1 away from the average age-predicted HR:
220-19.75 b.min-1 = 200.25 b.min-1. With the field-based testing method of
the MFT, the mean maximum HR, 186 b.min-1 (21.74), was significantly
inferior to that of the required 191 b.min-1 to fit the VO
2
max criterion, possibly
due to subjects lacking motivation and not performing at maximal effort.
Figure 3 highlights mean laboratory-based results of 11.44 mmol.L
-1
(2.85)
and field-based results of 12 mmol.L
-1
(3.65), are both in accordance with the
VO
2
max criteria (British Association of Sport Sciences, 1998) that blood
lactate must be measured as above 8 mmol.l-1 to be presumed that the
subject is working at maximal exhaustion. Such a rise and accumulation of
blood lactate is the consequence of a dynamic transferal between pyruvate
production by glycolysis and pyruvate consumption by the mitochondria
(Gladden, 2000) and that lactate utilization no longer matches lactate
production rates. This could be explained through the tendency for the lactate
dehydrogenase enzyme in fast-twitch muscle fibres to favour the conversion
of pyruvate to lactate (McArdle, Katch and Katch, 2009, p. 871). In this study,
blood lactate was measured, however this does not accurately represent
muscle lactate, reducing validity of the measurement (McArdle, Katch and
Katch, 2009).
Complementing preceding research (Goosey-Tolfrey and Tolfrey, 2008), the
agreement between MFT and laboratory-based test, as displayed in Figure 1,
was not significantly varied. Supporting previous research (Cooper et al.,
2005), the predictive MFT VO
2
max method provided consistently lower
VO
2
max values than the laboratory-based method. As Gore (2000) suggested,
the validity of the MFT is dubious because it disregards VO
2
max in relation to
body mass, therefore the results are absolute rather than relative. The MFT
differed from the laboratory-based VO
2
max, the gold-standard form of
measurement Cooper et al., (2005) by 3.24 ml.kg
-1
.min
-1,
agreeing with
previous research (Aziz, Tan and Teh, 2005) and suggesting the method is a
valid field-based measurement of maximal aerobic exertion.
A limitation with this study is sample size, and that the subjects held
homogenous characteristics all being male, undergraduate, sport students.
Their sporting background suggests they are likely to have performed the
MFT previously and be familiar with the intensities and pacing strategies
required.
Technical error, for example as a result of apparatus calibration, and
physiological complexities, such as if the subject does not reproduce
consistent effort levels, can hinder the laboratory-based methods reliability
(Withers et al., 2000). Also, the subject may feel restricted during the
laboratory-based VO
2
max testing due to the equipment inconvenience
required to collect the expired air (Astrand et al., 2003).
Laboratory-based VO
2
max testing is the most valid and reliable form of
VO
2
measurement (Singh et al., 1994), however due to finance and
equipment requirements, is often not feasible. Therefore, in conclusion, and
following analysis of the study and the results produced, it is recommended
that the MFT is used as an appropriate field-based method of measurement
due to its accessibility, reasonable validity and practicality.

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