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27.02.2021 | Original Article

The effect of posture on maximal oxygen uptake in active healthy individuals

verfasst von: Hayley T. Dillon, Christophe Dausin, Guido Claessen, Anniina Lindqvist, Amy Mitchell, Leah Wright, Rik Willems, André La Gerche, Erin J. Howden

Erschienen in: European Journal of Applied Physiology | Ausgabe 5/2021

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Abstract

Purpose

Semi-supine and supine cardiopulmonary exercise testing (CPET) with concurrent cardiac imaging has emerged as a valuable tool for evaluating patients with cardiovascular disease. Yet, it is unclear how posture effects CPET measures. We aimed to discern the effect of posture on maximal oxygen uptake (VO₂max) and its determinants using three clinically relevant cycle ergometers.

Methods

In random order, 10 healthy, active males (Age 27 ± 7 years; BMI 23 ± 2 kg m²) underwent a ramp CPET and subsequent constant workload verification test performed at 105% peak ramp power to quantify VO₂max on upright, semi-supine and supine cycle ergometers. Doppler echocardiography was conducted at peak exercise to measure stroke volume (SV) which was multiplied by heart rate (HR) to calculate cardiac output (CO).

Results

Compared to upright (46.8 ± 11.2 ml/kg/min), VO₂max was progressively reduced in semi-supine (43.8 ± 10.6 ml/kg/min) and supine (38.2 ± 9.3 ml/kg/min; upright vs. semi-supine vs. supine; all p ≤ 0.005). Similarly, peak power was highest in upright (325 ± 80 W), followed by semi-supine (298 ± 72 W) and supine (200 ± 51 W; upright vs. semi-supine vs. supine; all p < 0.01). Peak HR decreased progressively from upright to semi-supine to supine (186 ± 11 vs. 176 ± 13 vs. 169 ± 12 bpm; all p < 0.05). Peak SV and CO were lower in supine relative to semi-supine and upright (82 ± 22 vs. 92 ± 26 vs. 91 ± 24 ml and 14 ± 3 vs. 16 ± 4 vs. 17 ± 4 l/min; all p < 0.01), but not different between semi-supine and upright.

Conclusion

VO₂max is progressively reduced in reclined postures. Thus, posture should be considered when comparing VO₂max results between different testing modalities.

Albouaini K, Egred M, Alahmar A, Wright DJ (2007) Cardiopulmonary exercise testing and its application. Postgrad Med J 83(985):675–682PubMedPubMedCentral

Astorino TA, White AC (2010) Assessment of anaerobic power to verify VO₂max attainment. Clin Physiol Funct Imaging 30(4):294–300PubMed

Astorino T, White A, Dalleck L (2009) Supramaximal testing to confirm attainment of VO₂max in sedentary men and women. Int J Sports Med 30(04):279–284PubMed

Åstrand P-O, Saltin B (1961) Maximal oxygen uptake and heart rate in various types of muscular activity. J Appl Physiol 16(6):977–981PubMed

Barber NJ, Ako EO, Kowalik GT, Cheang MH, Pandya B, Steeden JA, Moledina S, Muthurangu V (2016) Magnetic resonance-augmented cardiopulmonary exercise testing: comprehensively assessing exercise intolerance in children with cardiovascular disease. Circ Cardiovasc Imaging 9(12):e005282PubMed

Barker AR, Williams CA, Jones AM, Armstrong N (2011) Establishing maximal oxygen uptake in young people during a ramp cycle test to exhaustion. Br J Sports Med 45(6):498–503PubMed

Bassett DR Jr, Howley ET (2000) Limiting factors for maximum oxygen uptake and determinants of endurance performance. Med Sci Sports Exerc 32(1):70PubMed

Beniaminovitz A, Mancini DM (1999) The role of exercise-based prognosticating algorithms in the selection of patients for heart transplantation. Curr Opin Cardiol 14(2):114PubMed

Bonzheim SC, Franklin BA, DeWitt C, Marks C, Goslin B, Jarski R, Dann S (1992) Physiologic responses to recumbent versus upright cycle ergometry, and implications for exercise prescription in patients with coronary artery disease. Am J Cardiol 69(1):40–44PubMed

Chin CWL, Khaw HJ, Luo E, Tan S, White AC, Newby DE, Dweck MR (2014) Echocardiography underestimates stroke volume and aortic valve area: implications for patients with small-area low-gradient aortic stenosis. Can J Cardiol 30(9):1064–1072. https://doi.org/10.1016/j.cjca.2014.04.021CrossRefPubMedPubMedCentral

Cotsamire D, Sullivan M, Bashore T, Leier CV (1987) Position as a variable for cardiovascular responses during exercise. Clin Cardiol 10(3):137–142PubMed

Currie PJ, Kelly MJ, Pitt A (1983) Comparison of supine and erect bicycle exercise electrocardiography in coronary heart disease: accentuation of exercise-induced ischemic ST depression by supine posture. Am J Cardiol 52(10):1167–1173PubMed

Egaña M, O’Riordan D, Warmington S (2010) Exercise performance and VO₂ kinetics during upright and recumbent high-intensity cycling exercise. Eur J Appl Physiol 110:39–47. https://doi.org/10.1007/s00421-010-1466-yCrossRefPubMed

Egana M, Green S (2005) Effect of body tilt on calf muscle performance and blood flow in humans. J Appl Physiol 98(6):2249–2258PubMed

Esposito F, Mathieu-Costello O, Shabetai R, Wagner PD, Richardson RS (2010) Limited maximal exercise capacity in patients with chronic heart failure: partitioning the contributors. J Am Coll Cardiol 55(18):1945–1954PubMedPubMedCentral

Ferrazza AM, Martolini D, Valli G, Palange P (2009) Cardiopulmonary exercise testing in the functional and prognostic evaluation of patients with pulmonary diseases. Respiration 77(1):3–17. https://doi.org/10.1159/000186694CrossRefPubMed

Folkow B, Haglund U, Jodal M, Lundgren O (1971) Blood flow in the calf muscle of man during heavy rhythmic exercise. Acta Physiol Scand 81(2):157–163PubMed

Forbregd TR, Aloyseus MA, Berg A, Greve G (2019) Cardiopulmonary capacity in children during exercise testing; the differences between treadmill, and upright and supine cycle ergometry. Front Physiol 10:1440PubMedPubMedCentral

Forton K, Motoji Y, Deboeck G, Faoro V, Naeije R (2016) Effects of body position on exercise capacity and pulmonary vascular pressure-flow relationships. J Appl Physiol 121(5):1145–1150PubMed

Gnehm P, Reichenbach S, Altpeter E, Widmer H, Hoppeler H (1997) Influence of different racing positions on metabolic cost in elite cyclists. Med Sci Sports Exerc 29(6):818–823. https://doi.org/10.1097/00005768-199706000-00013CrossRefPubMed

Guazzi M, Adams V, Conraads V, Halle M, Mezzani A, Vanhees L, Arena R, Fletcher GF, Forman DE, Kitzman DW, Lavie CJ, Myers J, European Association for Cardiovascular P, Rehabilitation, American Heart A (2012) EACPR/AHA Scientific Statement. Clinical recommendations for cardiopulmonary exercise testing data assessment in specific patient populations. Circulation 126(18):2261–2274. https://doi.org/10.1161/CIR.0b013e31826fb946

Hill A, Lupton H (1922) The oxygen consumption during running. J Physiol 56(1):32–33

Howden EJ, Bigaran A, Beaudry R, Fraser S, Selig S, Foulkes S, Antill Y, Nightingale S, Loi S, Haykowsky MJ (2019) Exercise as a diagnostic and therapeutic tool for the prevention of cardiovascular dysfunction in breast cancer patients. Eur J Prev Cardiol 26(3):305–315PubMed

Howley ET, Bassett DR, Welch HG (1995) Criteria for maximal oxygen uptake: review and commentary. Med Sci Sports Exerc 27:1292–1292PubMed

Hughson RL, Xing HC, Borkhoff C, Butler GC (1991) Kinetics of ventilation and gas exchange during supine and upright cycle exercise. Eur J Appl Physiol 63(3–4):300–307

Katz S, Arish N, Rokach A, Zaltzman Y, Marcus E-L (2018) The effect of body position on pulmonary function: a systematic review. BMC Pulm Med 18(1):159–159. https://doi.org/10.1186/s12890-018-0723-4CrossRefPubMedPubMedCentral

Kramer B, Massie B, Topic N (1982) Hemodynamic differences between supine and upright exercise in patients with congestive heart failure. Circulation 66(4):820–825PubMed

La Gerche A, Claessen G, Van de Bruaene A, Pattyn N, Van Cleemput J, Gewillig M, Bogaert J, Dymarkowski S, Claus P, Heidbuchel H (2013) Cardiac MRI: a new gold standard for ventricular volume quantification during high-intensity exercise. Circ Cardiovasc Imaging 6(2):329–338PubMed

Lancellotti P, Pellikka PA, Budts W, Chaudhry FA, Donal E, Dulgheru R, Edvardsen T, Garbi M, Ha JW, Kane GC (2017) The clinical use of stress echocardiography in non-ischaemic heart disease: recommendations from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. J Am Soc Echocardiogr 30(2):101–138PubMed

Larsen RT, Christensen J, Tang LH, Keller C, Doherty P, Zwisler A-D, Taylor RS, Langberg H (2016) A systematic review and meta-analysis comparing cardiopulmonary exercise test values obtained from the arm cycle and the leg cycle respectively in healthy adults. Int J Sports Phys Ther 11(7):1006–1039PubMedPubMedCentral

Leite SAO, Monk AM, Upham PA, Chacra AR, Bergenstal RM (2009) Low cardiorespiratory fitness in people at risk for type 2 diabetes: early marker for insulin resistance. Diabetol Metab Syndr 1(1):8. https://doi.org/10.1186/1758-5996-1-8CrossRefPubMedPubMedCentral

Leyk D, Eßfeld D, Hoffmann U, Wunderlich H-G, Baum K, Stegemann J (1994) Postural effect on cardiac output, oxygen uptake and lactate during cycle exercise of varying intensity. Eur J Appl Physiol 68(1):30–35

Lindhard J (1915) Ueber das Minutenvolum des Herzens bei Ruhe und bei Muskelarbeit. Pflüger’s Archiv für die gesamte Physiologie des Menschen und der Tiere 161(5–7):233–383

Lopes AD, Alouche SR, Hakansson N, Cohen M (2014) Electromyography during pedaling on upright and recumbent ergometer. Int J Sports Phys Ther 9(1):76–81PubMedPubMedCentral

Martin J, Spirduso W (2001) Determinants of maximal cycling power: crank length, pedaling rate and pedal speed. Eur J Appl Physiol 84(5):413–418PubMed

McMichael J, Sharpey-Schafer E (1944) Cardiac output in man by a direct fick method: effects of posture, venous pressure change, atropine, and adrenaline. Br Heart J 6(1):33PubMedPubMedCentral

Meyer T, Faude O, Scharhag J, Urhausen A, Kindermann W (2004) Is lactic acidosis a cause of exercise induced hyperventilation at the respiratory compensation point? Br J Sports Med 38(5):622–625PubMedPubMedCentral

Midgley AW, McNaughton LR, Polman R, Marchant D (2007) Criteria for determination of maximal oxygen uptake. Sports Med 37(12):1019–1028PubMed

Mizumi S, Goda A, Takeuchi K, Kikuchi H, Inami T, Soejima K, Satoh T (2018) Effects of body position during cardiopulmonary exercise testing with right heart catheterization. Physiol Rep 6(23):e13945PubMedPubMedCentral

Morris DM, Londeree BR (1997) The effects of bicycle crank arm length on oxygen consumption. Can J Appl Physiol 22(5):429–438PubMed

Myers J (2005) Applications of cardiopulmonary exercise testing in the management of cardiovascular and pulmonary disease. Int J Sports Med 26(S1):S49–S55PubMed

Oldham WM, Lewis GD, Opotowsky AR, Waxman AB, Systrom DM (2016) Unexplained exertional dyspnea caused by low ventricular filling pressures: results from clinical invasive cardiopulmonary exercise testing. Pulm Circ 6(1):55–62PubMedPubMedCentral

Pescatello LS, Riebe D, Thompson PD (2014) ACSM’s guidelines for exercise testing and prescription. Lippincott Williams & Wilkins, Philadelphia

Piepoli M, Corra U, Agostoni P, Belardinelli R, Cohen-Solal A, Hambrecht R, Prevention TFotIWGoCR (2006) Working Group on Cardiac Rehabilitation and Exercise Physiology of the European Society of Cardiology. Statement on cardiopulmonary exercise testing in chronic heart failure due to left ventricular dysfunction: recommendations for performance and interpretation. Part I: definition of cardiopulmonary exercise testing parameters for appropriate use in chronic heart failure. Eur J Cardiovasc Prev Rehabil 13(2):150–164

Poliner LR, Dehmer GJ, Lewis SE, Parkey RW, Blomqvist CG, Willerson JT (1980) Left ventricular performance in normal subjects: a comparison of the responses to exercise in the upright and supine positions. Circulation 62(3):528–534PubMed

Poole DC, Jones AM (2017) Measurement of the maximum oxygen uptake VO₂max: VO₂peak is no longer acceptable. J Appl Physiol 122(4):997–1002PubMed

Poole DC, Wilkerson DP, Jones AM (2008) Validity of criteria for establishing maximal O₂ uptake during ramp exercise tests. Eur J Appl Physiol 102(4):403–410PubMed

Quinn TJ, Smith SW, Vroman NB, Kertzer R, Olney WB (1995) Physiologic responses of cardiac patients to supine, recumbent, and upright cycle ergometry. Arch Phys Med Rehabil 76(3):257–261PubMed

Reybrouck T, Heigenhauser GF, Faulkner JA (1975) Limitations to maximum oxygen uptake in arms, leg, and combined arm-leg ergometry. J Appl Physiol 38(5):774–779PubMed

Rossiter HB, Kowalchuk JM, Whipp BJ (2006) A test to establish maximum O₂ uptake despite no plateau in the O₂ uptake response to ramp incremental exercise. J Appl Physiol 100(3):764–770. https://doi.org/10.1152/japplphysiol.00932.20055CrossRefPubMed

Rothe CF (1986) Physiology of venous return: an unappreciated boost to the heart. Arch Intern Med 146(5):977–982. https://doi.org/10.1001/archinte.1986.00360170223028CrossRefPubMed

Rowell LB (1962) Factors affecting the prediction of the maximal oxygen intake from measurements made during submaximal work with observations related to factors which may limit maximal oxygen intake. University of Minnesota, Minneapolis

Rowell LB (1974) Human cardiovascular adjustments to exercise and thermal stress. Physiol Rev 54(1):75–159PubMed

Sawyer BJ, Tucker WJ, Bhammar DM, Gaesser GA (2015) Using a verification test for determination of V [combining dot above] O₂max in sedentary adults with obesity. J Strength Cond Res 29(12):3432–3438PubMed

Saynor ZL, Barker AR, Oades PJ, Williams CA (2013) Reproducibility of maximal cardiopulmonary exercise testing for young cystic fibrosis patients. J Cyst Fibros 12(6):644–650PubMed

Schwartz RE, Asnis PD, Cavanaugh JT, Asnis SE, Simmons JE, Lasinski PJ (1991) Short crank cycle ergometry. J Orthop Sports Phys Ther 13(2):95–100PubMed

Scott A, Antonishen K, Johnston C, Pearce T, Ryan M, Sheel AW, McKenzie DC (2006) Effect of semirecumbent and upright body position on maximal and submaximal exercise testing. Meas Phys Educ Exerc Sci 10(1):41–50

Sedgeman D, Dalleck L, Clark IE, Jamnick N, Pettitt R (2013) Analysis of square-wave bouts to verify VO2max. Int J Sports Med 34(12):1058–1062PubMed

Shen WF, Roubin GS, Fletcher PJ, Choong CYP, Hutton BF, Harris PJ, Kelly DT (1985) Effects of upright and supine position on cardiac rest and exercise response in aortic regurgitation. Am J Cardiol 55(4):428–431PubMed

Stenberg J, Astrand P, Ekblom B, Royce J, Saltin B (1967) Hemodynamic response to work with different muscle groups, sitting and supine. J Appl Physiol 22(1):61–70PubMed

Takahashi T, Tanabe K, Nakayama M, Osada N, Yamada S, Ishiguro T, Itoh H, Murayama M (1995) Cardiopulmonary response during supine and sitting bicycle exercises. J Phys Ther Sci 7(1):33–38

Terkelsen KE, Clark AL, Hillis WS (1999) Ventilatory response to erect and supine exercise. Med Sci Sports Exerc 31(10):1429–1432PubMed

Too D (1990) Biomechanics of cycling and factors affecting performance. Sports Med 10(5):286–302PubMed

Too D, Landwer G (2000) The effect of pedal crank arm length on joint angle and power production in upright cycle ergometry. J Sports Sci 18:153–161. https://doi.org/10.1080/026404100365054CrossRefPubMed

Walsh-Riddle M, Blumenthal JA (1989) Cardiovascular responses during upright and semi-recumbent cycle ergometry testing. Med Sci Sports Exerc 21(5):581–585PubMed

Wasserman K, Hansen JE, Sue DY, Whipp BJ, Froelicher VF (1987) Principles of exercise testing and interpretation. J Cardiopulm Rehabil Prev 7(4):189

Weatherwax R, Richardson T, Beltz N, Nolan P, Dalleck L (2016) Verification testing to confirm VO₂max in altitude-residing, endurance-trained runners. Int J Sports Med 37(07):525–530PubMed

Wood RE, Hills AP, Hunter GR, King NA, Byrne NM (2010) VO₂max in overweight and obese adults: do they meet the threshold criteria? Med Sci Sports Exerc 42(3):470–477PubMed

Wood WA, Deal AM, Reeve BB, Abernethy AP, Basch E, Mitchell SA, Shatten C, Hie Kim Y, Whitley J, Serody JS, Shea T, Battaglini C (2013) Cardiopulmonary fitness in patients undergoing hematopoietic SCT: a pilot study. Bone Marrow Transplant 48(10):1342–1349. https://doi.org/10.1038/bmt.2013.58CrossRefPubMed

Titel: The effect of posture on maximal oxygen uptake in active healthy individuals
verfasst von: Hayley T. Dillon
Christophe Dausin
Guido Claessen
Anniina Lindqvist
Amy Mitchell
Leah Wright
Rik Willems
André La Gerche
Erin J. Howden
Publikationsdatum: 27.02.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Applied Physiology / Ausgabe 5/2021
Print ISSN: 1439-6319
Elektronische ISSN: 1439-6327
DOI: https://doi.org/10.1007/s00421-021-04630-7

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