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The Oxygen Uptake Response to Incremental Ramp Exercise

Methodogical and Physiological Issues

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Abstract

An incremental ramp exercise is a protocol that is frequently used in the domain of exercise testing to get an insight into the exercise tolerance of both healthy active populations (including athletes) and patients, due to the specific characteristics of the protocol. The continuous and linear increase in work rate is not only less strenuous for populations with a very low exercise capacity but it requires the aerobic metabolism to adapt to the continuously changing conditions. Therefore, this protocol can provide important information on the adaptive capacity of individuals to exercise in non-steady-state conditions. The ramp exercise has also been used in the past two decades to get an insight into the underlying mechanisms of the oxygen uptake (\(\dot V\)O2) response (and kinetics) to exercise. Against the expectations, it has been shown that the parameters that quantify the \(\dot V\)O2 response to ramp exercise do not completely correspond to those obtained from constant work-rate transitions and incremental step exercise. For that reason, it could be concluded that the \(\dot V\)O2 response is specific to ramp exercise, and thus is determined by other mechanisms than those which determine other protocols. Although the \(\dot V\)O2 response to ramp exercise has a high level of reproducibility and a uniform pattern can be observed, especially for the \(\dot V\)O2 response below the gas exchange threshold (GET) [above the GET, the \(\dot V\)O2 response is less clear, some prudence is necessary when interpreting potential differences in the \(\dot V\)O2 response between populations. Several methodological issues (e.g. baseline work rate, ramp slope) exert an important impact on the \(\dot V\)O2 response to ramp exercise. The main purpose of this review is to provide an overview of the methodological and physiological factors that have an impact on the \(\dot V\)O2 response to ramp exercise. It is of importance that exercise physiologists take these factors into consideration, not only prior to the conductance of the ramp exercise in a variety of subjects, but also when interpreting the obtained results.

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References

  1. Krogh A, Lindhard J. The regulation of respiration and circulation during the initial stages of muscular work. J Physiol (London) 1913; 47: 112–36

    CAS  Google Scholar 

  2. Henry FM. Aerobic oxygen consumption and alactic debt in muscular work. J Appl Physiol 1951; 3: 427–38

    PubMed  CAS  Google Scholar 

  3. Linnarsson D. Dynamics of pulmonary gas exchange and heart rate changes at start and end of exercise. Acta Physiol Scand Suppl 1974; 415: 1–68

    PubMed  CAS  Google Scholar 

  4. Whipp BJ, Ward SA, Lamarra N, et al. Parameters of ventilatory and gas exchange dynamics during exercise. J Appl Physiol 1982; 52: 1506–13

    PubMed  CAS  Google Scholar 

  5. Whipp BJ, Wasserman K. Oxygen uptake kinetics for various intensities of constant-load work. J Appl Physiol 1972; 33: 351–6

    PubMed  CAS  Google Scholar 

  6. Buchfuhrer MJ, Hansen JE, Robinson TE, et al. Optimizing the exercise protocol for cardiopulmonary assessment. J Appl Physiol 1983; 55: 1558–64

    PubMed  CAS  Google Scholar 

  7. Boone J, Koppo K, Bouckaert J. The \(\dot V\)O2 response to submaximal ramp cycle exercise: influence of ramp slope and training status. Respir Physiol Neurobiol 2008; 161: 291–7

    Article  PubMed  Google Scholar 

  8. Jones AM, Campbell IT, Pringle JS. Influence of muscle fibre type and pedal rate on the \(\dot V\)O2 -work rate slope during ramp exercise. Eur J Appl Physiol 2004; 91: 238–45

    Article  PubMed  Google Scholar 

  9. Whipp BJ, Davis JA, Torres F, et al. A test to determine parameters of aerobic function during exercise. J Appl Physiol 1981; 50: 217–21

    PubMed  CAS  Google Scholar 

  10. Stegemann J. Beitrag zum dynamik der atmungs-regelung bei leichter muskelarbeit. Z Biol 1958; 110: 449–56

    PubMed  CAS  Google Scholar 

  11. Whipp BJ, Mahler M. Dynamics of gas exchange during exercise. In: West JB, editor. Pulmonary gas exchange. Vol. II. New York: Academic Press, 1980: 33–96

    Google Scholar 

  12. Wigertz O. Dynamics of ventilation and heart rate in response to sinusoidal work in man. J Appl Physiol 1970; 29: 208–18

    PubMed  CAS  Google Scholar 

  13. Barstow TJ, Molé PA. Linear and nonlinear characteristics of oxygen uptake kinetics during heavy exercise. J Appl Physiol 1991; 71: 2099–106

    PubMed  CAS  Google Scholar 

  14. Trappe S, Harber M, Creer A, et al. Single muscle fibre adaptations with marathon training. J Appl Physiol 2006; 101:721–7

    Article  PubMed  Google Scholar 

  15. Davis JA, Whipp BJ, Lamarra N, et al. Effect of ramp slope on determination of aerobic parameters from the ramp exercise test. Med Sci Sports Exerc 1982; 14: 339–43

    PubMed  CAS  Google Scholar 

  16. Swanson GD, Hughson RL. On the modelling and interpretation of oxygen uptake kinetics from ramp work rate tests. J Appl Physiol 1988; 65: 2453–8

    PubMed  CAS  Google Scholar 

  17. Markovitz GH, Sayre JW, Storer TW, et al. On the issues of confidence in determining the time constant for oxygen uptake kinetics. Brit J Sports Med 2003; 38: 553–60

    Article  Google Scholar 

  18. Meyer K, Schwaibold M, Hajric R, et al. Delayed \(\dot V\)O2 kinetics during ramp exercise: a criterion for cardiopulmonary exercise capacity in chronic heart failure. Med Sci Sports Exerc 1998; 30: 643–8

    Article  PubMed  CAS  Google Scholar 

  19. Beaver WL, Wasserman K, Whipp BJ. A new method for detecting anaerobic threshold by gas exchange. J Appl Physiol 1986; 60: 2020–7

    PubMed  CAS  Google Scholar 

  20. Coyle EF, Sidossis LS, Horowitz JF, et al. Cycling efficiency is related to the percentage of type I muscle fibres. Med Sci Sports Exerc 1992; 24: 782–8

    PubMed  CAS  Google Scholar 

  21. Gaesser GA, Brooks GA. Muscular efficiency during steady state exercise: effects of speed and work rate. J Appl Physiol 1975; 38: 1132–9

    PubMed  CAS  Google Scholar 

  22. Wasserman K, Hansen JE, Sue D, et al. editors. Principles of exercise testing and interpretation. 4th ed. Philadelphia (PA): Lippincot Williams and Wilkins, 2005: 11–53

    Google Scholar 

  23. Hansen JE, Casaburi R, Cooper DM, et al. Oxygen uptake as related to work rate increment during cycle ergometer exercise. Eur J Appl Physiol 1988; 57: 140–5

    Article  CAS  Google Scholar 

  24. Zoladz JA, Rademaker AC, Sargeant AJ. Non-linear relationship between O2 uptake and power output at high intensities of exercise in humans. J Physiol 1995; 488: 211–7

    PubMed  CAS  Google Scholar 

  25. Barstow TJ, Jones AM, Nguyen PH, et al. Influence of muscle fibre type and fitness on the oxygen uptake/power output slope during incremental exercise in humans. Exp Physiol 2000; 85: 109–16

    Article  PubMed  CAS  Google Scholar 

  26. Scheuermann BW, McConnell JHT, Barstow TJ. EMG and oxygen uptake responses during slow and fast ramp exercise in humans. Exp Physiol 2002; 87: 91–100

    Article  PubMed  Google Scholar 

  27. Lucia A, Rivero JP, Serrano AL, et al. Determinants of \(\dot V\)O2 kinetics at high power outputs during a ramp exercise protocol. Med Sci Sports Exerc 2002; 34: 326–31

    Article  PubMed  Google Scholar 

  28. Pedersen PK, Sörensen JB, Jensen K, et al. Muscle fibre type distribution and nonlinear \(\dot V\)O2/power output relationship in cycling. Med Sci Sports Exerc 2002; 34: 655–61

    Article  PubMed  Google Scholar 

  29. Zoladz JA, Duda K, Majerczak J. Oxygen uptake does not increase linearly at high power outputs during incremental exercise test in humans. Eur J Appl Occup Physiol 1998; 77: 445–51

    Article  CAS  Google Scholar 

  30. Bickham DC, Gibbons C, Le Rossignol PF. \(\dot V\)O2 is attenuated above the lactate threshold in endurance-trained runners. Med Sci Sports Exerc 2004; 36: 297–301

    Article  PubMed  Google Scholar 

  31. Lucia A, Hoyos J, Santalla A, et al. Kinetics of \(\dot V\)O2 in professional cyclists. Med Sci Sports Exerc 2002; 34: 320–5

    Article  PubMed  Google Scholar 

  32. Zoladz JA, Korzeniewski B. Physiological background of the change point in \(\dot V\)O2 and the slow component of oxygen uptake kinetics. J Physiol Pharmacol 2001; 52: 167–84

    PubMed  CAS  Google Scholar 

  33. Poole DC, Schaffartzik W, Knight DR, et al. Contribution of exercising legs to the slow component of oxygen uptake kinetics in humans. J Appl Physiol 1991; 71: 1245–53

    PubMed  CAS  Google Scholar 

  34. Gollnick PD, Piehl K, Saltin B. Selective glycogen depletion pattern in human muscle fibres after exercise of varying intensity and at varying pedalling rates. J Physiol (London) 1974; 241: 45–57

    CAS  Google Scholar 

  35. Cannon DT, White AC, Andriano MF, et al. Skeletal muscle fatigue precedes the slow component of oxygen uptake kinetics during exercise in humans. J Physiol 2011; 589: 727–39

    Article  PubMed  CAS  Google Scholar 

  36. Zoladz JA, Gladden BL, Hogan MC, et al. Progressive recruitment of muscle fibers is not necessary for the slow component of \(\dot V\)O2 kinetics. J Appl Physiol 2008; 105: 575–80

    Article  PubMed  Google Scholar 

  37. Gore CJ, Clark RJ, Shipp NJ, et al. CPX/D underestimates \(\dot V\)O2 in athletes compared with an automated Douglas bag system. Med Sci Sports Exerc 2003; 35: 1341–7

    Article  PubMed  Google Scholar 

  38. Day JR, Rossiter HB, Coats EM, et al. The maximally attainable \(\dot V\)O2 during exercise in humans: the peak vs. maximum issue. J Appl Physiol 2003; 95: 1901–7

    CAS  Google Scholar 

  39. Data on file, Boone J, 2007

  40. Hughson RL, Inman MD. Oxygen uptake kinetics from ramp work tests: variability of single test values. J Appl Physiol 1986; 61: 373–6

    PubMed  CAS  Google Scholar 

  41. Data on file, Boone J, 2006

  42. Hintzy-Cloutier H, Zameziati K, Belli A. Influence of the base-line determination on work efficiency during sub-maximal cycling. J Sports Med Phys Fitness 2003; 43: 51–6

    PubMed  CAS  Google Scholar 

  43. Kautz SA, Neptune RR. Biomechanical determinants of pedalling energetics: internal and external work are not independent. Exerc Sport Sci Rev 2002; 30: 159–65

    Article  PubMed  Google Scholar 

  44. Neptune RR, Kautz SA. Muscle activation and deactivation dynamics: the governing properties in fast cyclical human movement performance. Exerc Sports Sci Rev 2001; 29:76–81

    Article  CAS  Google Scholar 

  45. Hansen EA, Andersen JL, Nielsen JS. Muscle fibre type, efficiency and mechanical optima affect freely chosen pedal rate during cycling. Acta Physiol Scand 2002; 176: 185–94

    Article  PubMed  CAS  Google Scholar 

  46. Takaishi T, Ono T, Yasuda Y. Relationship between muscle fatigue and oxygen uptake during cycle ergometer exercise with different ramp slope increments. Eur J Appl Physiol 1992; 65: 335–9

    Article  CAS  Google Scholar 

  47. Beelen A, Sargeant AJ. Effect of prior exercise at different pedalling frequencies on maximal power in humans. Eur J Appl Physiol 1993; 66: 102–7

    Article  CAS  Google Scholar 

  48. Sargeant AJ. Human power output and muscle fatigue. Int J Sports Med 1994; 15: 116–21

    Article  PubMed  CAS  Google Scholar 

  49. Zoladz JA, Duda K, Majerczak J. \(\dot V\)O2/power output relationship and the slow component of oxygen uptake kinetics during cycling at different pedaling rates: relationship to venous lactate accumulation and blood acid-base balance. Physiol Res 1998; 47: 427–38

    PubMed  CAS  Google Scholar 

  50. Fukuba Y, Hayashi N, Koga S, et al. \(\dot V\)O2 kinetics in heavy exercise is not altered by prior exercise with a different muscle group. J Appl Physiol 2002; 92: 2467–76

    Article  PubMed  Google Scholar 

  51. Jones AM, Koppo K, Burnley M. Effect of prior exercise on metabolic and gas exchange responses to exercise. Sports Med 2003; 33: 949–71

    Article  PubMed  Google Scholar 

  52. Jones AM, Carter H. Oxygen uptake-work rate relationship during two consecutive ramp exercise tests. Int J Sports Med 2004; 25: 415–20

    Article  PubMed  CAS  Google Scholar 

  53. Boone J, Bouckaert J, Barstow TJ, et al. Influence of priming high intensity exercise on the deoxy[hb+Mb] response to ramp exercise. Eur J Appl Physiol 2012; 112: 1143–52

    Article  PubMed  Google Scholar 

  54. Marles A, Mucci P, Legrand R, et al. Effect of prior exercise on the \(\dot V\)O2/work rate relationship during incremental exercise and constant work rate exercise. Int J Sports Med 2006; 27: 345–50

    Article  PubMed  CAS  Google Scholar 

  55. Crow MT, Kushmerick MJ. Chemical energetics of slow-and fast-twitch muscles of the mouse. J Gen Physiol 1982; 79: 147–66

    Article  PubMed  CAS  Google Scholar 

  56. Kushmerick MJ, Meyer RA, Brown RT. Regulation of oxygen uptake consumption in fast- and slow-twitch muscle. Am J Physiol 1992; 236: C598–606

    Google Scholar 

  57. Willis WT, Jackman MR. Mitochondrial function during heavy exercise. Med Sci Sports Exerc 1994; 26: 1347–54

    PubMed  CAS  Google Scholar 

  58. Vollestad NK, Blom PCS. Effect of varying exercise intensity on glycogen depletion in human muscle fibres. Acta Physiol Scand 1985; 125: 395–405

    Article  PubMed  CAS  Google Scholar 

  59. Barstow TJ, Jones AM, Nguyen PH, et al. Influence of muscle fibre type and pedal frequency on oxygen uptake kinetics of heavy exercise. J Appl Physiol 1996; 81: 1642–50

    PubMed  CAS  Google Scholar 

  60. Mogensen M, Bagger M, Pedersen PK, et al. Cycling efficiency in humans is related to low UCP3 content and to type I fibres but not to mitochondrial efficiency. J Physiol 2006; 571: 669–81

    Article  PubMed  CAS  Google Scholar 

  61. Medbø JI. Type I and type II fibres work with the same mechanical efficiency during bicycling. In: Maréchal G, Carraro U (eds). Muscle and mobility. Vol. 2. Hampshire: Intercept Ltd, 1990: 303–8

    Google Scholar 

  62. Costill DL, Fink WJ, Pollock ML. Muscle fibre composition and enzyme activities of elite distance runners. Med Sci Sports Exerc 1976; 8: 96–100

    CAS  Google Scholar 

  63. Casaburi R, Storer TW, Ben-Dov I, et al. Effect of endurance training on possible determinants of \(\dot V\)O2 during heavy exercise. J Appl Physiol 1987; 62: 199–207

    PubMed  CAS  Google Scholar 

  64. Hagberg JM, Hickson RC, Ehsani AA, et al. Faster adjustment to and recovery from submaximal exercise in the trained state. J Appl Physiol 1980; 48: 218–24

    PubMed  CAS  Google Scholar 

  65. Koppo K, Bouckaert J, Jones AM. Effects of training status and exercise intensity on phase II \(\dot V\)O2 kinetics. Med Sci Sports Exerc 2004; 36: 225–32

    Article  PubMed  Google Scholar 

  66. Boone J, Koppo K, Barstow TJ, et al. Aerobic fitness, muscle efficiency and motor unit recruitment during ramp exercise. Med Sci Sports Exerc 2010; 42: 402–8

    PubMed  Google Scholar 

  67. Mallory LA, Scheuermann BW, Hoelting BD, et al. Influence of peak \(\dot V\)O2 and muscle fibre type on the efficiency of moderate exercise. Med Sci Sports Exerc 2002; 34: 1279–87

    Article  PubMed  Google Scholar 

  68. Neder JA, Nery LE, Peres C, et al. Reference values for dynamic responses to incremental cycle ergometry in males and females aged 20 to 80. Am J Respir Crit Care Med 2001; 164: 1481–6

    Article  PubMed  CAS  Google Scholar 

  69. Kilding AE, Jones AM. \(\dot V\)O2 ‘overshoot’ during moderate-intensity exercise in endurance-trained athletes: The influence of exercise modality. Respir Physiol Neurobiol 2008; 160: 139–46

    Article  PubMed  Google Scholar 

  70. Koppo K, Whipp BJ, Jones AM, et al. Overshoot in \(\dot V\)O2 following the onset of moderate-intensity cycle exercise in trained cyclists. Eur J Appl Physiol 2004; 93: 366–73

    Article  PubMed  CAS  Google Scholar 

  71. Barclay CJ. Mechanical efficiency and fatigue of fast and slow muscles of the mouse. J Physiol 1996; 497: 781–94

    PubMed  CAS  Google Scholar 

  72. Prieur F, Benoit H, Busso J, et al. Effect of endurance training on the \(\dot V\)O2 -work rate relationship in normoxia and hypoxia. Med Sci Sports Exerc 2005; 37: 664–9

    Article  PubMed  Google Scholar 

  73. Gross MA, Breil FA, Lehamn AD, et al. Seasonal variation of \(\dot V\)O2 max and the \(\dot V\)O2 -work rate relationship in elite alpine skiers. Med Sci Sports Exerc 2009; 41: 2084–9

    Article  PubMed  Google Scholar 

  74. Gimenes AC, Neder JA, Dal Corso S, et al. Relationship between work rate and oxygen uptake in mitochondrial myopathy during ramp-incremental exercise. Braz J Med Biol Res 2011; 44: 354–60

    PubMed  CAS  Google Scholar 

  75. Itoh H. Oxygen uptake: work rate relationship in patients with heart disease. Med Sci Sports Exerc 1992; 37: 374–80

    Google Scholar 

  76. Jones S, Elliot PM, Sharma S, et al. Cardiopulmonary responses to exercise in patients with hypertrophic cardiomyopathy. Heart 1998; 80: 60–7

    PubMed  CAS  Google Scholar 

  77. Toyofuku M, Takaki H, Sugimachi M, et al. Reduced oxygen uptake increase to work rate increment (Δ \(\dot V\)O2/DW) is predictable by \(\dot V\)O2 response to constant work rate exercise in patients with chronic heart failure. Eur J Appl Physiol 2003; 90: 76–82

    Article  PubMed  Google Scholar 

  78. Balady GJ, Arena R, Sietsema K. Clinician’s guide to cardiopulmonary exercise testing in adults: a scientific statement from the American Heart Association. Circulation 2010; 122: 191–225

    Article  PubMed  Google Scholar 

  79. Lewis MI, Belman MJ, Monn SA, et al. The relationship between oxygen consumption and work rate in patients with airflow obstruction. Chest 1994; 106: 366–72

    Article  PubMed  CAS  Google Scholar 

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Acknowledgements

No funding was received for the preparation of this review. The authors have no conflicts of interest to declare that are directly relevant to the content of this review. The authors would like to thank Jacques Bouckaert and Wim Derave for their insightful comments and remarks and their contribution to the paper.

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  1. Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium

    Jan Boone & Jan Bourgois

  2. Centre of Sports Medicine, Ghent University Hospital, Ghent, Belgium

    Jan Boone & Jan Bourgois

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Correspondence to Jan Boone.

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Boone, J., Bourgois, J. The Oxygen Uptake Response to Incremental Ramp Exercise. Sports Med 42, 511–526 (2012). https://doi.org/10.2165/11599690-000000000-00000

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