Research in Sports Medicine

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A novel treadmill protocol for uphill running

assessment: the incline incremental running test
(IIRT)

Ricardo Dantas De Lucas, Bruna Karam De Mattos, Alexandre Da Cunha

Tremel, Luana Pianezzer, Kristopher Mendes De Souza, Luiz Guilherme
Antonacci Guglielmo & Benedito Sérgio Denadai

To cite this article: Ricardo Dantas De Lucas, Bruna Karam De Mattos, Alexandre Da
Cunha Tremel, Luana Pianezzer, Kristopher Mendes De Souza, Luiz Guilherme Antonacci
Guglielmo & Benedito Sérgio Denadai (2021): A novel treadmill protocol for uphill running
assessment: the incline incremental running test (IIRT), Research in Sports Medicine, DOI:
10.1080/15438627.2021.1917405

To link to this article: https://doi.org/10.1080/15438627.2021.1917405

Published online: 19 Apr 2021.

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RESEARCH IN SPORTS MEDICINE
https://doi.org/10.1080/15438627.2021.1917405

A novel treadmill protocol for uphill running assessment: the

incline incremental running test (IIRT)
Ricardo Dantas De Lucas , Bruna Karam De Mattos, Alexandre Da Cunha Tremel,
Luana Pianezzer, Kristopher Mendes De Souza,
Luiz Guilherme Antonacci Guglielmo and Benedito Sérgio Denadai
Physical Effort Laboratory, Sports Centre, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil

ABSTRACT ARTICLE HISTORY

This study aimed to compare the maximal and submaximal Received 4 December 2020
aerobic parameters between two incremental running tests, Accepted 28 March 2021
one being horizontal and the other an incline-based test, KEYWORDS
namely the incline incremental running test (IIRT). Twenty Uphill running; testing;
endurance-trained trail runners completed two incremental incremental exercise; VO2
treadmill tests, until exhaustion. The first test was performed peak; heart rate
using an incline of 1%, with speed increments. Then, the IIRT
was performed with the speed set at 50% of the peak speed
obtained during the previous test, and the incline was incre­
mented. Cardiorespiratory measurements and blood lactate
concentration ([La]) were assessed. The mean peak workload
from the horizontal test was 17.6 ± 1.4 km.h−1 and peak work­
load from IIRT was 17.3 ± 1.3% of incline. The VO2peak and
[La]peak were not significantly different between the proto­
cols. However, the HRpeak was significantly lower at IIRT. In
conclusion, most of the maximal and submaximal aerobic
indices showed no differences between the incremental tests
analysed. The exceptions were the HRpeak and HR at the
lactate turnpoints, that were lower, and the peak O2 pulse
that was greater for the IIRT. Taken together, these data sup­
port the validity of the IIRT as a specific test for the physiolo­
gical assessment of runners involved with uphill
performances.

Introduction
The uphill running presents marked differences compared to level running, espe­
cially related to the characteristics of muscle contraction, i.e. the greater the uphill
incline, the lesser eccentric component of muscle contractions (Garnier et al., 2018;
Minetti et al., 1994). Furthermore, the uphill running elicits high muscle forces and/
or prolonged stride imposed by slower speeds (Padulo et al., 2012) increasing the
energy cost for a given speed. It is well known that in off-road running and
orienteering races, the uphill running ability plays a key role for performance
(Rattray & Roberts, 2012; Zürcher et al., 2005).

CONTACT Ricardo Dantas De Lucas ricardo.dantas@ufsc.br Campus Universitário Trindade, CDS Bloco 5, LAEF,
Florianópolis-SC CEP: 88040-900, Brazil
© 2021 Informa UK Limited, trading as Taylor & Francis Group
2 R. D. DE LUCAS ET AL.

To the best of our knowledge, the testing protocols applied to assess uphill running
fitness are limited to incremental tests performed at selected inclines. A clear limitation
related to these protocols is that the runner performs an incremental speed test always
against an arbitrary incline (Lemire et al., 2020; Paavolainen et al., 2000; Pringle et al.,
2002). For instance, Paavolainen et al. (2000) set an incline of 12% for an uphill incre­
mental test, aiming to investigate neuromuscular and physiological factors as determi­
nants of peak horizontal and uphill treadmill running performance, in a sample composed
of middle-distance runners, triathletes and cross-country skiers. Pringle et al. (2002) used
two incremental ramp protocols using 0% and 10% gradients, in a sample of non-athlete
subjects, in order to obtain the physiological parameters for assessing VO2 kinetics. In
another example, Zürcher et al. (2005) analysed the uphill running capacity of elite and
junior orienteers, by using an incremental step test with an incline of 22%. Lemire et al.
(2020) used an incline of 15% to compare maximal physiological parameters with hor­
izontal and downhill tests, in a sample of endurance-trained runners. Finally, Scheer et al.
(2018) proposed a specific incremental “trail test”, simultaneously using both speed and
incline increases throughout a ramp protocol, using a sample of highly trained trail
runners.
Many of these studies had reported greater VO2peak values for uphill tests when
comparing to level grade running (Paavolainen et al., 2000; Pringle et al., 2002;
Scheer et al., 2018), while other reported no difference (Balducci et al., 2016; Lemire
et al., 2020). The likely greater VO2peak value has been attributed to an increased
muscle mass activation during uphill running (Sloniger et al., 1997), and by the
specificity of uphill training from the sample (Scheer et al., 2018). In contrast,
Balducci et al. (2016) compared three different incremental protocols (at 0, 12.5
and 25% slopes) and found no difference in VO2peak and HRpeak, although the
energy costs were quite different among them.
Contrary, Scheer et al. (2018) compared the physiological responses among three
incremental protocols. They used two level tests (i.e. ramp and step protocols) and
one test that they named as “trail test”, and consisted of simultaneously increase
speed and incline. However, one should still consider that these tests do not
replicate the outdoor uphill situation, when steeper gradients are performed at
slower speeds than those achieved by aforementioned studies. For instance, Scheer
et al. (2018) reported maximum speed and incline values for the “trail test” of
14.5 ± 0.6 km.h−1 and 10 ± 1%, respectively. Thus, the likely differences in the
physiological variables, such as VO2peak, HRpeak and blood lactate ([La]) responses,
between incline and level running tests might be influenced by the protocol
designs (Bentley et al., 2007; Lemire et al., 2020).
A possibility to overcome the limitation of protocol design (i.e. arbitrary inclines
against speed increments) is to use a constant speed and apply increments of inclines
during the incremental test. Thus, supposedly, the incline-incremented test could allow
the runners to reach their maximal gradient performance at a “slow” and constant
speed, resulting in the evaluation of the physiological responses and the individual
ability to run up steep inclines. To the best of our knowledge, no studies have been
analysed comparing the cardiorespiratory and [La] responses using this kind of afore­
mentioned uphill protocol.
 RESEARCH IN SPORTS MEDICINE 3

Following this context, the aim of this study was to analyse and compare the
maximal and submaximal aerobic indices between two incremental running tests,
one being a traditional speed-based test and the other an incline-based test,
namely the incline incremental running test (IIRT). Our main hypothesis is that
the maximal physiological variables will not present differences between the incre­
mental running protocols, allowing for the use of IIRT for uphill running
assessments.

Methods
Participants
The subjects were 18 male (age 37.5 ± 5.3 years; height 179.8 ± 4.8 cm; body mass
72.1 ± 8.7 kg) and 2 female (age 34.1 ± 7.1 years; height 166.2 ± 7.5 cm; body mass
57.9 ± 5.4 kg) endurance-trained trail runners. All athletes were involved in on- and off-
road endurance races for at least 4 years, and trained an average of 52 ± 15 km·wk−1 of
running, with a weekly frequency of 4.1 ± 0.8. Inclusion criteria for male and female
participants, required them having completed a 10 km run under 45 min and 50 min,
respectively, within the previous 12 months. In addition, participants were asked about
the occurrence of any lower-limb injuries in the last 4 months, which were considered an
exclusion criteria. The study was approved by the Institutional Ethics Committee and was
carried out in line with the Declaration of Helsinki.

Procedures
All the tests were conducted in a laboratory with controlled environmental conditions (air
temperature at 18–19°C and relative humidity at 60–70%), and a motor-driven treadmill
was used (Super ATL, Imbrasport, Porto Alegre, Brazil). Participants reported to the
laboratory on two separate days over a period of approximately one week, in order to
perform two maximal incremental tests. Each subject was tested at the same time of day
(± 1 h) to minimize the effects of diurnal biological variation. The athletes refrained from
high-intensity and/or long distance training for at least 48 h prior to testing. In addition,
they replicated their diet as closely as possible before each test that was performed at
least 3 h of latest meal.
The first incremental step test was performed with the slope set at 1%, and
initial speed at 10 km·h−1 or 12 km·h−1 (depending on the subjects best 10 km
performance). For those participants with their best 10 km performance under
38 min, we started the test at 12 km·h−1, and for the others we started at
10 km·h−1. Every 3-min the speed was increased by 1 km·h−1, until the subject
stopped due to volitional exhaustion (Machado et al., 2013). If the last stage was
not fully completed, the peak treadmill speed (Speak) was calculated using
a proportion of time spent at that stage, as suggested by Kuipers et al. (2003).
After at least 48 hours, the IIRT was performed as follows: the speed was set at 50% of
the Speak, the incline started at 3% or 5%, and was incremented by 2% every 3-min. Based
on a pilot study and observations made from the uphill runner’s performances, we
determined that 50% of Speak fits well within the results to produce a similar number of
4 R. D. DE LUCAS ET AL.

stages between the tests. The same criteria applied for the initial speed setting (i.e. best
10 km performance) was used here, that is, runners with 10 km performances under
38 min started at 5%, while the others started at 3%. Whether the last stage was not fully
completed, the same aforementioned calculation was applied. The external workload
parameters for the tests were speed in km·h−1 and inclination in %, for speed-based and
IIRT, respectively.
All physiological measurements were obtained by identical procedures for both the
tests. At the end of each test stages, samples (25 μl) of earlobe capillary blood were taken
(within 15 to 20-s) and immediately analysed for blood lactate concentration ([La]) using
an enzyme electrode system (YSI 2700, Yellow Springs, USA). The cardiorespiratory data
were measured continuously using an open circuit system with a breath-by-breath
analyser (Cosmed Quark CPET. Rome. Italy). The breath-by-breath data were then ana­
lysed for oxygen consumption (VO2), carbon dioxide production (VCO2) and pulmonary
ventilation (VE). The gas-analysis system was calibrated before each test using the
manufacturer’s recommendations. From the breath-by-breath gas samples, VO2peak
was calculated by the highest 30-s average value. Heart rate (HR) was recorded continu­
ously during the test by a HR monitor integrated into the gas analyser, and the HRpeak
was obtained from the highest 10-s average value. Oxygen pulse (O2-pulse) was assessed
by the ratio of VO2 and HR as suggested by Whipp et al. (1996).
The attainment of VO2peak was defined using the criteria proposed by Howley
et al. (1995). After the completion of each incremental test, 7 out of 13 subjects
rested for 15 min and subsequently performed a VO2peak verification test. The
verification test consisted of running to volitional exhaustion at a speed of
0.5 km·h−1 or an inclination 1% higher than Speak and Inclinepeak of the incremental
phase, respectively [16]. Strong encouragement (verbally) was provided throughout
the tests.
The first lactate turnpoint (LT1) was defined as the first increase of [La] above resting
level and it was identified through visual inspection of [La] vs. workload, by two experi­
enced researchers. The second lactate turnpoint (LT2) was identified according to an
individualized procedure proposed by Berg et al. (1990). This procedure has been demon­
strated to present more validity to identify maximal lactate steady state, than fixed [La]
concentration (De Souza et al., 2012; Grossl et al. 2012).

Statistical analyses
All values are presented as means ± SD. All of the variables presented Gaussian
distribution. To compare the mean values between the level and uphill running,
a Student t-test for paired samples was used, except for the treadmill workload
(speed vs. incline) that were compared with an unpaired t-test, due to the different
units of measurement (i.e. km/h or %).
The agreement between maximal parameters derived from the tests was analysed
through bias ± 95% limits of agreement (LoA) provided by Bland Altman plot analysis
(Bland & Altman, 1986). The association between all variables provided from the tests
were analysed by Pearson product moment-correlation. Statistical significance was set at
P < 0.05 for all analyses. All analyses were carried out using the GraphPad Prism software
(v 5.0 GraphPad Prism Inc. San Diego, USA).
 RESEARCH IN SPORTS MEDICINE 5

In addition, to analyse the magnitude of the differences between all variables, the
effect size (Cohen’s d) was calculated as the difference between the means divided by the
mean standard deviation to characterize the practical significance rather than the statis­
tical significance. The following criteria for effect size were used: < 0.1 = trivial, 0.1–­
0.3 = trivial/small, 0.3–0.5 = small, 0.5–0.7 = small/moderate, 0.7–1.1 = moderate,
1.1–1.3 = moderate/large, 1.3–1.9 = large, 1.9–2.1 = large/very large and > 2.1 = very
large (Batternham & Hopinks, 2006).

Results
Maximal workload and physiological parameters obtained in the tests are presented in
Table 1. Complementary, the total number of steps completed in both tests were 8.7 ± 0.8

Table 1. Mean ± SD of physiological peak variables compared between speed-based and incline-
based (i.e. IIRT) incremental tests.
Variables Speed-based Incline-based p-value Cohens’ d r
Peak Workload 17.6 ± 1.4 17.3 ± 1.3 0.41 0.26 0.70*
(km.h−1 and %)
VO2peak 4440 ± 664 4561 ± 692 0.08 0.18 0.94*
(mL.min−1)
VO2peak 60.4 ± 5.7 61.7 ± 7.3 0.07 0.20 0.91*
(mL.kg−1.min−1)
HRpeak 183 ± 9 178 ± 9 <0.001 0.55 0.93*
(beats.min−1)
O2-pulse peak 23.9 ± 3.3 25.2 ± 3.7 <0.001 0.37 0.94*
(mL.beat−1)
VEmax 153 ± 29 150 ± 27 0.20 0.12 0.94*
(L.min−1)
[Lac]peak 8.6 ± 2.4 9.4 ± 2.8 0.40 0.31 0.28
(mM)
Abbreviations: VO2peak, peak oxygen uptake; HRpeak, peak heart rate; O2-pulse peak, peak oxygen pulse; VEmax,
maximal pulmonary ventilation; [Lac]peak, peak blood lactate concentration
*p < 0.01

and 8.3 ± 0.5 (p = 0.07) for speed- and incline-based tests, respectively.
The mean Speak reached during the level test was 17.6 ± 1.4 km.h−1, and then the IIRT
was performed at an average speed of 9 km.h−1. The Inclinepeak obtained during this test
was 17.3 ± 1.3%, and it presented a high correlation with Speak (r = 0.70; R2 = 0.50;
p = 0.0003). The VO2peak, [La]peak and VEmax were not significantly different between
both tests, whilst HRpeak and peak O2-pulse were the only maximal variables that
presented significant difference. In addition, high correlations were observed for VO2
peak, HRpeak and peak O2-pulse (Figure 1, panels A, B, C). The agreement analyses
between these variables are also shown on Figure 1 (panels D, E, F). The bias ± LoA for
VO2peak was −1.2 ± 6.1 ml.kg−1.min−1 (i.e. the limits of agreement represented about 10%
of the peak value). For HRpeak, the bias ± LoA was 5 ± 6 bpm, where the LoA represented
about 3.3% of the peak.
Mean VO2peak (n = 7) of incremental and verification tests were 63.6 ± 2.2 ml.kg−1.
min−1 and 62.9 ± 3.5 ml.kg−1.min−1 for level running (p = 0.44); and 65.2 ± 2.4 and
64.7 ± 3.3 ml.kg−1.min−1 for uphill running (p = 0.61).
6 R. D. DE LUCAS ET AL.

Figure 1. Correlation and agreement analysis between speed-based and incline-based (IIRT) tests, for
VO2peak (panels A & D), HRpeak (panels B & E), and O2-pulse peak (panels C & F).

Based on blood lactate responses, the LT1 was detected at 12.5 ± 1.1 km.h−1 (71% of
Speak) and 7.6 ± 1.8% (44% of Inclinepeak) for traditional and IIRT, respectively. In addition,
 RESEARCH IN SPORTS MEDICINE 7

the LT2 was found at 14.7 ± 1.4 km.h−1 (84% of Speak) and 11.5 ± 1.9% (66% of Inclinepeak),
respectively. For both LT the mean [La] did not present differences (Table 2).

Table 2. Mean ± SD values of lactate turnpoints obtained from speed-based and incline-based (i.e.
IIRT) incremental tests.
First Lactate Turnpoint
Speed-based Incline-based p-value r Cohens’ d
Workload (km.h−1 or %) 12.5 ± 1.1 (71.0%) 7.6 ± 1.8 (43.9%) <0.01 0.60 3.39
(% max)
VO2 (mL.kg−1.min−1) 44.5 ± 4.6 (73.6%) 44.9 ± 6.3 (72.7%) 0.72 0.67 −0.07
(% peak)
HR (beats.min−1) 147 ± 9 (80.3%) 141 ± 7 (79.2%) 0.01 0.62 0.75
(% peak)
[La] (mM) 1.6 ± 0.4 1.5 ± 0.5 0.66 0.36 0.10
Second Lactate Turnpoint
Speed-based Incline-based p-value r Cohens’ d
Workload (km.h−1 or %) 14.7 ± 1.4 11.5 ± 1.9 (66.4%) <0.01 0.55 1.79
(% max) (83.5%)
VO2 (mL.kg-1.min-1) 53.1 ± 4.7 54.1 ± 5.8 (87.6%) 0.32 0.78* −0.19
(% peak) (87.9%)
HR (beats.min-1) 166 ± 6 160 ± 7 (89.8%) <0.01 0.92* 0.92
(% peak) (90.7%)
[La] (mM) 2.9 ± 0.4 3.0 ± 0.5 0.76 0.32 −0.07
Abbreviations: VO2, oxygen uptake; HR, heart rate; [Lac], blood lactate concentration
* p < 0.05.

Discussion
The aim of the present study was to compare maximal and submaximal aerobic indices
obtained from an uphill incremental test (i.e. IIRT) with those obtained from a traditional
horizontal test, in endurance runners. The hypothesis of the current study was not
confirmed, since we found differences in some cardiorespiratory variables between the
tests, although they were highly correlated. Based on the peak variables, the main finding
of the current study was the significant differences for HR and O2-pulse, but not for VO2,
VE and [La]. The same difference pattern was detected when considering the lactate
turnpoints (Table 2).
Most of the studies comparing incremental level-grade and incline treadmill running
have analysed only VO2peak by using uphill protocols which involve a constant incline
(ranging from 10 to 22%) and increments of speed by step or ramp protocols (Lemire
et al., 2020; Paavolainen et al., 2000; Pringle et al., 2002; Zürcher et al., 2005). One
limitation when comparing such protocols to level treadmill running is that a likely
great eccentric muscle contraction component still occurs during the last stages of
these protocols. On the other hand, if a constant speed is set (i.e. ~50% vVO2max) and
an incline-incremented test is performed, it would be possible to measure the maximum
gradient reached when running at such speed, triggering a higher intramuscular force
and a more concentric muscle contraction pattern (Minetti et al., 1994). In this way, we
believe that it could mimic better the conditions of hilly running.
In the present study, there was no difference between VO2peak when comparing the
IIRT to the traditional speed-incremented test, and a high correlation was observed for
8 R. D. DE LUCAS ET AL.

both absolute and relative values. In addition, the Bland Altman analysis provided ± 95%
LoA of ± 6.1 ml.kg.min−1, showing an acceptable agreement between the tests.
Comparing to other studies that evaluated maximal variables between incline and
horizontal incremental running, our results contrast with most (Carter & Dekerle, 2013;
Paavolainen et al., 2000; Pringle et al., 2002; Scheer et al., 2018). These studies have
reported higher VO2peak values for incline tests when comparing to the level grade
tests. The results were mainly attributed to increased muscle mass activation during the
uphill running (Paavolainen et al., 2000; Sloniger et al., 1997), albeit Scheer et al. (2018)
suggested that the characteristics of participants (i.e. uphill trained runners) could partly
explain the differences within the studies. Scheer et al. (2018) compared maximal phy­
siological responses from two standard incremental protocols (i.e horizontal step and
ramp tests) with a “trail test” which combined speed and incline increments in a ramp
protocol. They studied a group of highly trained trail runners and found significantly
higher VO2peak (+4%) for the “trail test” in comparison to the step or ramp tests. On the
other hand, Lemire et al. (2020) did not find differences for maximal physiological indices
between incremental (i.e. 2-min step) tests performed at 0% and 15%. These authors
reported peak speed of 18.7 km.h−1 and 9.3 km.h−1, respectively for horizontal and uphill
protocols. Interestingly, this uphill peak speed represented 50% of maximal speed
obtained from the horizontal test, agreeing in parts with the proposal of IIRT.
Indeed, the reason for these contrasting findings might be attributed to the differences
in the test designs. The outstanding difference is related to the source of workload
increments, and the length of steps. While the present protocol was based on incline
increments using a “low” running speed, the others were based on increments of speed
against a constant incline (Carter & Dekerle, 2013; Lemire et al., 2020; Paavolainen et al.,
2000), or increasing both together using a ramp protocol (Scheer et al., 2018). It seems
that the incline-incremented test decreases the eccentric component of muscle contrac­
tion (i.e. decreasing the usage of stored elastic energy) especially close to the maximal
workload, due to its submaximal speed (i.e. 50% Speak). Thus, one could speculate that
during this kind of protocol there is no augmented muscle mass activation compared to
the horizontal test. Nevertheless, further investigations are needed to confirm this
hypothesis.
Interestingly, we observed higher HRpeak during speed-based test compared to IIRT.
This result was confirmed by the agreement analysis, which produced bias ± 95%LOA
values of 5 ± 6 bpm, although they were highly correlated (Figure 1, D and E). Of note, the
subjects in this study were highly motivated during both tests, and it was felt that the
subjects performed to the best of their ability. Partially, it was confirmed by VO2max
verification test results. Once again, the protocol characteristics could explain this note­
worthy finding. We speculate that an enhanced calf muscle pump could trigger a higher
central venous pressure (Notarius & Magder, 1996), which could influence the HR
response. Thus, the greater calf muscle activation would enhance venous return via
peripheral muscle pump (Smith et al., 1976). Based on Frank-Starling law (Stein et al.,
1980), the greater the ventricular diastolic volume, the more the myocardial fibres are
stretched during diastole, triggering a greater ventricle force of contraction. Thus, the
ventricular output increases as the preload (end-diastolic pressure) increases. In this
sense, the augmented venous return probably triggered a greater cardiac preload, thus
 RESEARCH IN SPORTS MEDICINE 9

inducing a greater stroke volume (while reducing HR for the same cardiac output) during
the IIRT.
Indeed, considering the oxygen pulse as an indirect measure of stroke volume (Whipp
et al., 1996), one could observe that the peak O2-pulse was higher for IIRT (Table 1).
However, we did not measure the stroke volume directly, to confirm this noteworthy
hypothesis. It is interesting that in the study of Lemire et al. (2020), there were found
a greater VO2peak for “trail test” but no difference for HRpeak. This data suggest that O2-
pulse was higher for “trail test” (~ 23.8 ml/beat), in comparison with horizontal step and
ramp tests (~ 22.6 ml/beat), although the authors did not discuss about this variable.
Nonetheless, this lower HR response should be considered when applying this kind of
uphill testing/training protocol, and the physiological mechanism behind the observed
cardiovascular differences should be deeply investigated. To the best of our knowledge,
only the study of Zürcher et al. (2005) reported significantly lower HRpeak when an uphill
(188 ± 9 bpm) was compare to an incremental level (192 ± 8 bpm) testing in a group of
experienced orienteering. The uphill test used in aforementioned study was an incremen­
ted speed against a fixed incline of 22%, where the maximal speed reached was about 8 to
9 km.h−1. Although the authors did not present a reasonable explanation for that
difference, one can suppose that similar mechanism presented herein could support
those results. Other recent studies (Balducci et al., 2016; Lemire et al., 2020; Scheer
et al., 2018) did not find differences for HRpeak comparing incremental with different
incline protocols.
Regarding VEmax, there was no difference observed between the tests agreeing with
previous studies that compared the horizontal and uphill tests (Lemire et al., 2020; Scheer
et al., 2018). In relation to [La]peak, our results showed no difference between the
protocols, and both mean values attained the secondary criteria to consider tests as
maximal. Zürcher et al. (2005) and Lemire et al. (2020) also reported no differences for
[La]peak, when they compared horizontal with incline tests by using gradients of 22% and
15% respectively.
With respect to the submaximal parameters, [La] response for incremental exercises
has been extensively studied, with special attention being paid to the identification of two
lactate breakpoints (Bentley et al., 2007; Hofmann & Tschakert, 2011).
However, to the best of our knowledge only one study had compared the LT to the
uphill incremental running tests (Kolkhorst et al., 1996). Kolkhorst et al. (1996) compared
the lactate turnpoints (by using fixed [La] concentrations) between uphill and horizontal
incremental running tests. They used a fixed incline of 5% for uphill testing. As expected,
the speeds related to first LT (i.e. 2 mM) and second LT (i.e. 4 mM) were significantly lower
for uphill compared to 0% gradient. However, the VO2 at each LT did not present
differences when the tests were compared. Our study partially agreed with this result,
since the VO2 related to LT1 and LT2 did not present significant differences between the
protocols. The same was observed when analysed by percentage peak values for both
VO2 and HR. The percentage of occurrence of LT for both tests achieved the expected
values reported in the literature for athletes (Jones & Carter, 2000).
However, in line with the HRpeak result, the absolute values of HR associated to LT1
and LT2 were significantly lower for IIRT. It might be justified by the same hypothesis of an
augmented venous return, which triggers a greater stroke volume for a given cardiac
output (i.e. Fick equation). These results might be important when prescribing uphill
10 R. D. DE LUCAS ET AL.

training assuming the HR as the intensity criterion (Achten & Jeukendrup, 2003). Indeed,
the interval training focused on uphill running could be performed using the model of the
IIRT, in order to provide a more realistic stimulus.
The novelty of the uphill treadmill test presented here, is that the inclination is
incremented to a maximal gradient whilst the speed is maintained at 50% of Speak. The
main reason for setting this speed was to mimic the outdoor conditions, i.e. the steeper
the incline the slower the running pace.
Anyway, an obvious limitation of this protocol is the dependence of a previous
incremental test to individualize the speed of IIRT. The possibility to overcome this
limitation is determining this average speed from running performance, which is related
to maximal aerobic speed. For a broad range of distance runners, the performance (i.e.
time-trial) of distances between 1500 m and 2000 m could be useful for this purpose
(Bellenger et al., 2015; Denadai et al., 2006), therefore avoiding the need to perform two
incremental tests.
The IIRT seems to present greater ecological validity compared to the others incline
protocols proposed in the literature, since running at steep hills the speed becomes
relatively slow. Finally, the IIRT could be useful for uphill performance prediction, for
uphill training prescription, and for comparing VO2 and HR kinetics between uphill and
level running. Those suggestions should be tested in future studies.

Conclusions
In conclusion, most of the maximal and submaximal aerobic indices were not different
between the incremental tests analysed, except for HRpeak, and the HR at the lactate
turnpoints which were lower. Another exception was the peak O2 pulse that was greater
for IIRT, triggering insights about likely underlying cardiovascular mechanisms in this
protocol. In addition, most of physiological variables showed good correlations and
agreement between the tests. Taken together, these data support the validity to use
the IIRT as a specific test for physiological assessment of runners involved with uphill
performances (i.e. orienteers and trail runners).

Disclosure statement
No potential conflict of interest was reported by the author(s).

Funding
This work was supported by the Conselho Nacional de Desenvolvimento Científico e Tecnológico
(CNPq) [Edital Universal 2016].

ORCID
Ricardo Dantas De Lucas http://orcid.org/0000-0002-8566-3086
Luiz Guilherme Antonacci Guglielmo http://orcid.org/0000-0001-6757-5050
Benedito Sérgio Denadai http://orcid.org/0000-0003-0775-1889
 RESEARCH IN SPORTS MEDICINE 11

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