Ambulatory Gas Exchange Measurements - Current Status and Future Options

T. Meyer; R. C. R. Davison; W. Kindermann

doi:10.1055/s-2004-830507

International Journal of Sports Medicine, Table of Contents

Int J Sports Med 2005; 26: S19-S27
DOI: 10.1055/s-2004-830507

Ambulatory Gas Exchange Measurements - Current Status and Future Options

T. Meyer¹ , R. C. R. Davison² , W. Kindermann¹

¹Institute of Sports and Preventive Medicine, University of Saarland, Saarbrücken, Germany
²Department of Sport and Exercise Science, University of Portsmouth, Portsmouth, UK

Abstract

This article summarizes the scientific literature on portable devices used for the measurement of gas exchange during exercise. Firstly, the results from validity investigations are reviewed in terms of accuracy, reliability, and influence of additional weight during field testing. On the basis of these findings, at least two of the most often tested portable devices, MetaMax I/II and K2/K4 b², can be regarded as valid, with their results not differing substantially from (stationary) metabolic carts. The second part of the article provides an overview of ambulatory gas exchange applications which have been investigated so far. There is a number of descriptive (cross-sectional) studies that characterize the physiological profiles of different sports. In addition, some diagnostic tests of functional capacity have been validated, and a few investigations have assessed nutritional interventions and their effect on metabolism. Some indicate potential future directions including an evaluation of the efficacy of modifying metabolic pathways during exercise, e. g. by specifically designed training. Also, the extension of descriptive/cross-sectional investigations to typical training sessions will be worthwhile.

Key words

Metabolism - portable device - oxygen uptake - ventilation - field testing

Full Text

References

1 Atkinson G. What is this thing called measurement error?. Reilly TM, Marfell-Jones M Kinanthropometry VIII: Proceedings of the 8th International Conference of the International Society for the Advancement of Kinanthropometry (ISAK). London; Taylor & Francis 2003: 3-14
2 Atkinson G, Nevill A M. Statistical methods for assessing measurement error (reliability) in variables relevant to sports medicine. Sports Med. 1998; 26 217-238
3 Ballal M A, Macdonald I A. An evaluation of the Oxylog as a portable device with which to measure oxygen consumption. Clin Phys Physiol Meas. 1982; 3 57-65
4 Beneke R, Sievers U, Buschkow S, Erasmus J. Portables Spirometrie-Telemetrie-System vs. Laborspirometer - Gerätevergleich unter Laborbedingungen (Portable spirometry-telemetry-system vs. laboratory metabolic cart - comparison under laboratory conditions). Dtsch Z Sportmed. 1995; 46 403-408
5 Bigard A-X, Guezennec C-Y. Evaluation of the Cosmed K2 telemetry system during exercise at moderate altitude. Med Sci Sports Exerc. 1995; 27 1333-1338
6 Carter J, Jeukendrup A E. Validity and reliability of three commercially available breath-by-breath respiratory systems. Eur J Appl Physiol. 2002; 86 435-441
7 Coen B, Gietzen S, Meyer T, Kindermann W. Influence of a portable spirometer on performance diagnostic parameters in long-distance runners. Int J Sports Med. 1999; 20 (Suppl 1) S26
8 Coetsee M F. Validation of the Cortex MetaMax portable ergospirometry system. S Afr J Res Sport. 1998; 21 11-19
9 Crandall C G, Taylor S L, Raven P B. Evaluation of the Cosmed K2 portable telemetric oxygen uptake analyzer. Med Sci Sports Exerc. 1994; 26 108-111
10 Crouter S, Foster C, Esten P, Brice G, Porcari J P. Comparison of incremental treadmill exercise and free range running. Med Sci Sports Exerc. 2001; 33 644-647
11 Cureton K J, Sparling P B, Evans B W, Johnson S M, Kong U D, Purvis J W. Effect of experimental alterations in excess weight on aerobic capacity and distance running performance. Med Sci Sports. 1978; 10 194-199
12 de Groot G, Schreurs A W, van Ingen Schenau G J. A portable lightweight Douglas bag instrument for use during various types of exercise. Int J Sports Med. 1983; 4 132-134
13 de Koning J J, Foster C, Bobbert M F, Hettinga F, Lampen J. Aerobic and anaerobic kinetics during speed skating competition. Med Sci Sports Exerc. 2003; 35 364
14 Devienne M-F, Guezennec C-Y. Energy expenditure of horse riding. Eur J Appl Physiol. 2000; 82 499-503
15 Dobrosielski D A, Brubaker P H, Berry M J, Ayabe M, Miller H S. The metabolic demand of golf in patients with heart disease and in healthy adults. J Cardiopulm Rehabil. 2002; 22 96-104
16 Doyon K H, Perrey S, Abe D, Hughson R L. Field testing of V·O₂peak in cross-country skiers with portable breath-by-breath system. Can J Appl Physiol. 2001; 26 1-11
17 Eisenmann J C, Brisko N, Shadrick D, Welsh S. Comparative analysis of the Cosmed Quark b² and K4b² gas analysis systems during submaximal exercise. J Sports Med Phys Fitness. 2003; 43 150-155
18 Faggiano P, D'Aloia A, Gualeni A, Lavatelli A, Giordano A. Assessment of oxygen uptake during the 6-minute walking test in patients with heart failure: preliminary experience with a portable device. Am Heart J. 1997; 134 203-206
19 Ferrauti A, Bergeron M F, Pluim B M, Weber K. Physiological responses in tennis and running with similar oxygen uptake. Eur J Appl Physiol. 2001; 85 27-33
20 Ferrauti A, Predel G, Weber K, Rost R. Physiological demand of golf and tennis from a health perspective [Beanspruchungsprofil von Golf und Tennis aus gesundheitssportlicher Sicht]. Dtsch Z Sportmed. 1997; 48 263-269
21 Ferrauti A, Schulz H, Knezevic D, Heck H, Weber K. Measurement of oxygen uptake and energy cost in tennis by means of a portable spirometry-telemetry-system. Int J Sports Med. 1998; 19 S22
22 Frederick E C, Daniels J, Hayes J. The effect of shoe weight on the aerobic demands of running. Bachl N, Prokop L, Suckert R Proceedings of the World Congress on Sports Medicine, Vienna, 1982. Vienna; Urban & Schwarzenberg 1984: 616-625
23 Friedmann B, Frese F, Bärtsch P. Ergospirometriesysteme vs. Douglas-Bag-Methode: Evaluation einer stationären und einer portablen Meßeinheit (Ergospirometry systems vs. Douglas-Bag-method: evaluation of a laboratory device and a portable system). Dtsch Z Sportmed. 1998; 49 67-70
24 Greig C, Saunders D, Renfree A, Lewis S, Young A. Reliability of oxygen uptake measured in very elderly women using the MetaMax 3 B system. Mester J, King G, Strüder H, Tsolakidis E, Osterburg A Book of Abstracts of the 6th Annual Congress of the European College of Sport Science, 15th Congress of the German Society of Sport Science. Köln; Sport und Buch Strauss 2001: 616
25 Hausswirth C, Bigard A X, Le Chevalier J M. The Cosmed K4 telemetry system as an accurate device for oxygen uptake measurements during exercise. Int J Sports Med. 1997; 18 449-453
26 Heller J. Energy cost and cardiorespiratory demands of nunchaku exercise. J Sports Med Phys Fitness. 2000; 40 217-222
27 Hoff J, Wisloff U, Engen L C, Kemi O J, Helgerud J. Soccer specific aerobic endurance training. Br J Sports Med. 2002; 36 218-221
28 Humphrey S JE, Wolff H S. The oxylog. J Physiol. 1977; 267 12
29 Hynynen E, Kalliokoski K, Häkkinen K, Rusko H K. Physiological comparison of classical vs. free style skiing in adolescent cross-country skiers, Jyväskylä, Finland, 19 - 23 July 2000. Avela J, Komi PV, Komulainen J Proceedings - 5th Annual Congress of the European College of Sport Science. Jyväskylä; Gummerus Kirjapaino Oy 2000: 337
30 Ikegami Y, Hiruta S, Ikegami H, Miyamura M. Development of a telemetry system for measuring oxygen uptake during sports activities. Eur J Appl Physiol. 1988; 57 622-626
31 Jacobs P L, Olvey S E, Johnson B M, Cohn K A. Physiological responses to high-speed, open-wheel racecar driving. Med Sci Sports Exerc. 2002; 34 2085-2090
32 Jensen K, Franch J, Kärkkäinen O, Madsen K. Field measurements of oxygen uptake in elite orienteers during cross-country running using telemetry. Scand J Med Sci Sports. 1994; 4 234-238
33 Jensen K, Johansen L, Kärkkäinen O P. Economy in track runners and orienteers during path and terrain running. J Sports Sci. 1999; 17 945-950
34 Jones A M, Doust J H. A 1 % treadmill grade most accurately reflects the energetic cost of outdoor running. J Sports Sci. 1996; 14 321-327
35 Jones N L, Kane J W. Quality control of exercise test measurements. Med Sci Sports. 1979; 11 368-372
36 Kannagi T, Bruce R A, Hossack K F, Chang K, Kusumi F, Trimble S. An evaluation of the Beckman Metabolic Cart for measuring ventilation and aerobic requirements during exercise. J Cardiac Rehab. 1983; 3 38-53
37 Kawakami Y, Nozaki D, Matsuo A, Fukunaga T. Reliability of measurement of oxygen uptake by a portable telemetric system. Eur J Appl Physiol. 1992; 65 409-414
38 Kemi O J, Hoff J, Engen L C, Helgerud J, Wisloff U. Soccer specific testing of maximal oxygen uptake. J Sports Med Phys Fitness. 2003; 43 139-144
39 Kerdok A E, Biewener A A, McMahon T A, Weyand P G, Herr H M. Energetics and mechanics of human running on surfaces of different stiffnesses. J Appl Physiol. 2002; 92 469-478
40 Kervio G, Carre F, Ville N S. Reliability and intensity of the six-minute walk test in healthy elderly subjects. Med Sci Sports Exerc. 2003; 35 169-174
41 King G A, McLaughlin J E, Howley E T, Bassett Jr D R, Ainsworth B E. Validation of Aerosport KB1-C portable metabolic system. Int J Sports Med. 1999; 20 304-308
42 La Mere V J, Brown K, Wigglesworth J K, Edwards J E. Reproducibility between three metabolic systems and validation by Douglas bag method. Med Sci Sports Exerc. 1993; 25 (Suppl 5) S9
43 Larsson P, Henriksson-Larsén K. The use of dGPS and simultaneous metabolic measurements during orienteering. Med Sci Sports Exerc. 2001; 33 1919-1924
44 Larsson P U, Wadell K ME, Jakobsson E JI, Burlin L U, Henriksson-Larsén K B. Validation of the MetaMax II portable metabolic measurement system. Int J Sports Med. 2004; 25 115-123
45 Lewillie L, Sneppe R. Telemetric measurement of the respiratory function. Ergonomics. 1968; 11 77-81
46 Lloyd R, Cooke C B. The oxygen consumption associated with unloaded walking and load carriage using two different backpack designs. Eur J Appl Physiol. 2000; 81 486-492
47 Lota M J. Portable radio-spirometer for telemetric studies of pulmonary ventilation. Arch Physiol Med. 1967; 48 311-316
48 Lothian F, Farrally M R, Mahoney C. Validity and reliability of the Cosmed K2 to measure oxygen uptake. Can J Appl Physiol. 1993; 18 197-206
49 Louhevaara V, Ilmarinen J. Comparison of three field methods for measuring oxygen consumption. Ergonomics. 1985; 28 463-470
50 Lucía A, Fleck S J, Gotshall R W, Kearney J T. Validity and reliability of the Cosmed K2 instrument. Int J Sports Med. 1993; 14 380-386
51 MacDougall J D, Hughson R, Sutton J R, Moroz J R. The energy cost of cross-country skiing among elite competitors. Med Sci Sports Exerc. 1979; 11 270-273
52 Macfarlane D J. Automated metabolic gas analysis systems - a review. Sports Med. 2001; 31 841-861
53 MacSween A, Johnson N J, Armstrong G, Bonn J. A validation of the 10-meter incremental shuttle walk test as a measure of aerobic power in cardiac and rheumatoid arthritis patients. Arch Phys Med Rehabil. 2001; 82 807-810
54 McLaughlin J E, King G A, Howley E T, Bassett Jr D R, Ainsworth B E. Validation of the COSMED K4 b² portable metabolic system. Int J Sports Med. 2001; 22 280-284
55 McNeill G, Cox M D, Rivers J PW. The Oxylog oxygen consumption meter: a portable device for measurement of energy expenditure. Am J Clin Nutr. 1987; 45 1415-1419
56 Meyer T, Gabriel H HW, Auracher M, Scharhag J, Kindermann W. Metabolic profile of 4 hours cycling in the field with varying amounts of carbohydrate supply. Eur J Appl Physiol. 2003; 88 431-437
57 Meyer T, Georg T, Becker C, Kindermann W. Reliability of gas exchange measurements from two different spiroergometry systems. Int J Sports Med. 2002; 22 593-597
58 Meyer T, Welter J-P, Scharhag J, Kindermann W. Maximal oxygen uptake during field running does not exceed that measured during treadmill exercise. Eur J Appl Physiol. 2003; 88 387-389
59 Miles D S, Cox M H, Verde T J. Four commonly utilized metabolic systems fail to produce similar results during submaximal and maximal exercise. Sport Med Train Rehab. 1994; 5 189-198
60 Myers M J, Steudel K. Effect of limb mass and its distribution on the energetic cost of running. J Exp Biol. 1985; 116 363-373
61 Novitsky S, Segal K R, Chatr-Aryamontri B, Guvakov D, Katch V L. Validity of a new portable indirect calorimeter: the AeroSport TEEM 100. Eur J Appl Physiol. 1995; 70 462-467
62 Oka Y, Utsuyama N, Noda K, Kimura M. Studies of radio telemetering on EKG and respiratory movements during running, jumping and swimming. Med Electron Biol Engin. 1963; 1 578-579
63 Onorati P, Antonucci R, Valli G, Berton E, De Marco F, Serra P, Palange P. Non-invasive evaluation of gas exchange during a shuttle walking test vs. a 6-min walking test to assess exercise tolerance in COPD patients. Eur J Appl Physiol. 2003; 89 331-336
64 Palange P, Forte S, Onorati P, Manfredi F, Serra P, Carlone S. Ventilatory and metabolic adaptations to walking and cycling in patients with COPD. J Appl Physiol. 2000; 88 1715-1720
65 Peel C, Utsey C. Oxygen consumption using the K2 telemetry system and a metabolic cart. Med Sci Sports Exerc. 1993; 25 396-400
66 Pinnington H C, Wong P, Tay J, Green D, Dawson B. The level of accuracy and agreement in measures of F_EO2, F_ECO2 and V_E between the Cosmed K4b² portable, respiratory gas analysis system and a metabolic cart. J Sci Med Sport. 2001; 4 324-335
67 Poortmans J R, Colinet C, Lehner C, Francaux M. Energy system utilization during wall climbing. Med Sci Sports Exerc. 2000; 32 (Suppl 5) S161
68 Reiser M, Meyer T, Kindermann W, Daugs R. Transferability of workload measurements between three different types of ergometer. Eur J Appl Physiol. 2000; 82 245-249
69 Reybrouck T, Deroost F, van der Hauwaert L G. Evaluation of breath-by-breath measurement of respiratory gas exchange in pediatric exercise testing. Chest. 1992; 102 147-152
70 Schulz H, Helle S, Heck H. The validity of the telemetric system CORTEX X1 in the ventilatory and gas exchange measurement during exercise. Int J Sports Med. 1997; 18 454-457
71 Sheel A W, Seddon N, Knight A, McKenzie D C, Warburton D ER. Physiological responses to indoor rock-climbing and their relationship to maximal cycle ergometry. Med Sci Sports Exerc. 2003; 35 1225-1231
72 Siler W L. Is running style and economy affected by wearing respiratory apparatus?. Med Sci Sports Exerc. 1993; 25 260-264
73 Smekal G, von Duvillard S P, Pokan R, Lang K, Baron R, Tschan H, Hofmann P, Bachl N. Respiratory gas exchange and lactate measures during competitive orienteering. Med Sci Sports Exerc. 2003; 35 682-689
74 Smekal G, von Duvillard S P, Pokan R, Tschan H, Baron R, Hofmann P, Wonisch M, Bachl N. Changes in blood lactate and respiratory gas exchange measures in sports with discontinuous load profile. Eur J Appl Physiol. 2003; 89 489-495
75 Stegmann H, Kindermann W, Schnabel A. Lactate kinetics and individual anaerobic threshold. Int J Sports Med. 1981; 2 160-165
76 Terrier P, Ladetto Q, Merminod B, Schutz Y. Measurement of the mechanical power of walking by satellite positioning system (GPS). Med Sci Sports Exerc. 2001; 33 1912-1918
77 Torvik P-O, Helgerud J. The validity of the portable metabolic test system Cortex MetaMax. Müller E, Schwameder H, Raschner C, Lindinger S, Kornexl E Tagungsband Int. Congress on Science and Skiing. Hamburg; Dr. Kovacs-Verlag 2001: 641-654
78 Troosters T, Vilaro J, Rabinovich R, Casas A, Barbera J A, Rodriguez-Roisin R, Roca J. Physiological responses to the 6-min walk test in patients with chronic obstructive pulmonary disease. Eur Respir J. 2002; 20 564-569
79 Versteeg P GA, Kippersluis G J. Automated systems for measurement of oxygen uptake during exercise testing. Int J Sports Med. 1989; 10 107-112
80 Vogiatzis I, De Vito G, Rodio A, Madaffari A, Marchetti M. The physiological demands of sail pumping in Olympic level windsurfers. Eur J Appl Physiol. 2002; 86 450-454
81 Welk G J, Blair S N, Wood K, Jones S, Thompson R W. A comparative evaluation of three accelerometry-based physical activity monitors. Med Sci Sports Exerc. 2000; 32 489-497
82 Wideman L, Stoudemire N M, Pass K A, McGinnes C L, Gaesser G A, Weltman A. Assessment of the Aerosport TEEM 100 portable metabolic measurement system. Med Sci Sports Exerc. 1996; 28 509-515
83 Wu Y J, Chen S Y, Lin M C, Lan C, Lai J S, Lien I N. Energy expenditure of wheeling and walking during prosthetic rehabilitation in a woman with bilateral transfemoral amputations. Arch Phys Med Rehabil. 2001; 82 265-269
84 Zapf J, Fröhlich H, Lämmle T, Burtscher M, Schmidt W. Breathing gas analysis at extreme altitudes by a portable ergospirometry system during standardised exercise testing and real ascent up to 7000 m. Int J Sports Med. 2002; 23 S79

T. Meyer

Institute of Sports and Preventive Medicine, University of Saarland, Faculty of Clinical Medicine

Campus, Bldg. 39.1

66123 Saarbrücken

Germany

Phone: + 49(0)681-3023750

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