Graduate Program in Exercise Science and Sports, University of Rio de Janeiro State, Rio de Janeiro, Brazil.
Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State, Rio de Janeiro, Brazil.
PLoS One. 2021 Feb 17;16(2):e0247057. doi: 10.1371/journal.pone.0247057. eCollection 2021.
The 'verification phase' has emerged as a supplementary procedure to traditional maximal oxygen uptake (VO2max) criteria to confirm that the highest possible VO2 has been attained during a cardiopulmonary exercise test (CPET).
To compare the highest VO2 responses observed in different verification phase procedures with their preceding CPET for confirmation that VO2max was likely attained.
MEDLINE (accessed through PubMed), Web of Science, SPORTDiscus, and Cochrane (accessed through Wiley) were searched for relevant studies that involved apparently healthy adults, VO2max determination by indirect calorimetry, and a CPET on a cycle ergometer or treadmill that incorporated an appended verification phase. RevMan 5.3 software was used to analyze the pooled effect of the CPET and verification phase on the highest mean VO2. Meta-analysis effect size calculations incorporated random-effects assumptions due to the diversity of experimental protocols employed. I2 was calculated to determine the heterogeneity of VO2 responses, and a funnel plot was used to check the risk of bias, within the mean VO2 responses from the primary studies. Subgroup analyses were used to test the moderator effects of sex, cardiorespiratory fitness, exercise modality, CPET protocol, and verification phase protocol.
Eighty studies were included in the systematic review (total sample of 1,680 participants; 473 women; age 19-68 yr.; VO2max 3.3 ± 1.4 L/min or 46.9 ± 12.1 mL·kg-1·min-1). The highest mean VO2 values attained in the CPET and verification phase were similar in the 54 studies that were meta-analyzed (mean difference = 0.03 [95% CI = -0.01 to 0.06] L/min, P = 0.15). Furthermore, the difference between the CPET and verification phase was not affected by any of the potential moderators such as verification phase intensity (P = 0.11), type of recovery utilized (P = 0.36), VO2max verification criterion adoption (P = 0.29), same or alternate day verification procedure (P = 0.21), verification-phase duration (P = 0.35), or even according to sex, cardiorespiratory fitness level, exercise modality, and CPET protocol (P = 0.18 to P = 0.71). The funnel plot indicated that there was no significant publication bias.
The verification phase seems a robust procedure to confirm that the highest possible VO2 has been attained during a ramp or continuous step-incremented CPET. However, given the high concordance between the highest mean VO2 achieved in the CPET and verification phase, findings from the current study would question its necessity in all testing circumstances.
CRD42019123540.
“验证阶段”已经成为传统最大摄氧量（VO2max）标准的补充程序，用于确认在心肺运动测试（CPET）期间已经达到了最大可能的 VO2。
比较不同验证阶段程序中观察到的最高 VO2 反应与之前的 CPET，以确认 VO2max 可能已经达到。
通过 PubMed 检索 MEDLINE、Web of Science、SPORTDiscus 和 Wiley 检索 Cochrane，以确定涉及健康成年人、间接测热法测定 VO2max 和包含附加验证阶段的踏车或跑步机 CPET 的研究。使用 RevMan 5.3 软件分析 CPET 和验证阶段对最高平均 VO2 的汇总影响。由于使用的实验方案多样性，采用随机效应假设进行荟萃分析效应量计算。I2 用于确定 VO2 反应的异质性，并使用漏斗图检查主要研究中平均 VO2 反应的偏倚风险。使用亚组分析测试性别、心肺适应性、运动方式、CPET 方案和验证阶段方案的调节效应。
系统评价共纳入 80 项研究（总样本量为 1680 名参与者；473 名女性；年龄 19-68 岁；VO2max 为 3.3 ± 1.4 L/min 或 46.9 ± 12.1 mL·kg-1·min-1）。在进行荟萃分析的 54 项研究中，CPET 和验证阶段的最高平均 VO2 值相似（平均差异=0.03[95%CI=-0.01 至 0.06]L/min，P=0.15）。此外，验证阶段的差异不受任何潜在调节因素的影响，如验证阶段强度（P=0.11）、使用的恢复类型（P=0.36）、采用的 VO2max 验证标准（P=0.29）、相同或隔日验证程序（P=0.21）、验证阶段持续时间（P=0.35），甚至根据性别、心肺适应性水平、运动方式和 CPET 方案（P=0.18 至 P=0.71）。漏斗图表明不存在显著的发表偏倚。
验证阶段似乎是一种可靠的程序，可以确认在斜坡或连续递增 CPET 期间已经达到了最大可能的 VO2。然而，鉴于 CPET 和验证阶段中达到的最高平均 VO2 之间的高度一致性，当前研究的结果将质疑其在所有测试情况下的必要性。
PROSPERO 注册号：CRD42019123540。
