Hannah Smith VO2max Testing Kins 3601-04 April Lane Texas Woman’s University November 21, 2012 1 INTRODUCTION VO2max, or maximal oxygen uptake, testing is done when trying to measure and determine a person’s ability to perform an exercise for a long duration with intensity increasing (Quinn, E). This test helps the participant know, typically an athlete, where their fitness level is in terms of energy expenditure during an aerobic exercise. Aerobic exercise involves oxygen constantly being transported throughout the body, lungs, and air. Aerobic exercise is defined as a large muscle group repeatedly being used for a duration over at least 10 minutes all while achieving a heart rate between sixty-eighty percent of one’s maximum heart rate (Balbach, L.). There are several ways to estimate a person’s VO2 max but to receive more accurate results, direct testing should be done. Thus, the VO2max test comes into play. To determine the point in which the participant’s heart rate is at maximal, it must be known at what point the body reaches its maximal aerobic power, otherwise known as maximum oxygen uptake. Thus, the VO2max test comes into play. This test requires the participant’s full effort of undergoing a strict sports performance test of increasing bouts of speed and intensity while data and measurement are collected to view the participant’s concentration and volume of oxygen being inhaled and exhaled (Quinn, E). This procedure will require the body to meet the body’s demand for fuel and supply and in the end; the results will help analyze how much oxygen the participant used. While the intensity is increasing, the participant’s aerobic system will need assistance from anaerobic metabolism until eventually, the muscle’s fatigue reach failure. But until muscle failure is reached, the exercise intensity in the test will continue to increase, therefore, the aerobic system will eventually need the anaerobic system’s assistance due to the fact that some of the carbohydrates won’t be able to be 2 fully oxidized (Quinn, E. 2008). As the intensity, or work rate, increases, so will the body’s demand for energy. However, there is a certain point in which the oxygen consumption will reach a plateau, or max, and this marks the VO2max (Quinn, E). VO2max is determined if a plateau in the individual’s oxygen consumption arises. If no plateau arises, there is a set of secondary criteria requirements that must be met to help determine if the VO2 was met. Respiratory-Exchange-Ratio is one of the factors that could lead to the conclusion if VO2 was met. VO2 max is strongly related to performance, primarily endurance sports, and running and cycling are good tests for this test (Perez-Landaluce J, Fernandez, G., & Rodriguez-A. 2002) (Sjodin B, Jacobs I, Svedenhag J. 1982). It’s been concluded through several studies that VO2 max changes as the intensity in the training increases (Hickson R., Hagberg J., Ehsani A., & Holloszy J. 1981) (Madsen K, Pedersen PK, Djurhuus MS, Klitgaard N. 1993). As a result, as the intensity, or work rate, increases, so does the energy demand by the body, along with oxygen consumption. One reason to test for VO2max is to determine a person’s limitation in an endurance performance. It is reported that most athletes perform at an endurance level that the intensity is too high causing injuries (Coutts, A., Reaburn, P., & Abt, G. 2003) (Billat, V. & Koralsztein, J. 1996) and a demand for more carbohydrate intake occurs which may not always be satisfied (Turnley, J.). It is suggested that creating endurance workouts at an optimal intensity is more efficient because the goals of the individual are still being met as well as avoiding overtraining (Turnley, J.). The purpose of this lab is to compare and contrast the oxygen consumption during increased exercise workloads between a male and female’s performance and identify if 3 VO2max is reached through several factors. The goal is to identify how much oxygen is consumed during each stage, and the total exercise, as well as observe other factors such as heart rate and respiratory-exchange-ratio to help determine if VO2max was reached. One can test the ventilation of oxygen and carbon dioxide through the expired and inhaled air and the maximal level of oxygen consumption can be determined near the end, or at the end, of the test. My hypotheses are that one: the female will have a better relative VO2max, two: the male’s heart rate throughout the test will be higher than the female’s, and three: neither participant will reach their VO2max. METHODS In order to execute this experiment, two participants will used to test their oxygen consumption, or VO2. The male participant is 20 years old with weight at 92 kg and height at 182 cm. The two participants have no medically known injuries or illnesses and have not consumed any substance that would enhance or alter their performance. The male participant exercise consists of recreational sports, done at least two days a week for an average of 40 minutes each session. The female participant’s workout schedule consists of 15-30 minute sessions, 5-6 days a week. Equipment used for this test will include a Cardiac Science TM65 Treadmill, a Quinton Q-Stress computer program, a Polar Electro HR chest band, a Polar HR watch, a blood pressure cuff and manual pump with gauge, a mouth/head piece, nose clip, and a Rate-of-Perceived-Exertion 6-20 scale chart, and electro leads. To begin this experiment, the two participants will begin by prepping for this test. Shaving, abrading, and sanitizing the skin that will come into contact with the 4 electroleads is very important so that more accurate results can occur. North American Registry of Right Ventricular Dysplasia adds that the quality of electrode interfaces is key1. After skin preparation, 10 electrodes will be placed on the skin: RA electrode(midclavicular line, right deltoid fossa), LA electrode(Mid clavicular line, left deltoid fossa), RL electrode(Anterior axillary line, right side, between iliac crest and bottom of rib cage), LL electrode(Anterior axillary line, left side, between iliac crest and bottom of rib cage), V1 electrode (4th intercostal space on right side of sternum), V2 electrode (4th intercostal space on left side of sternum), V3 electrode (Halfway between V2 and V4), V4 electrode (5th intercostal space, midclavicular line, left side), V5 electrode (5th intercostal space, anterior axillary line, left side), and V6 electrode(5th intercostal space, midaxillary line, left side). The machines will then be calibrated and the participant’s and the environment’s information will be entered into the computer software. The electroleads will then be plugged into an ECG machine and heartrate (HR) monitors, blood pressure (BP) equipment, and mouthpiece and nose clip will securely be fitted and attached to each participant. (One participant will go at a time and at random order.) Resting heart rate and blood pressure will be recorded before exercise. The exercise workloads, or exercise intensity, are selected to gradually increase every three minutes by increasing the speed and incline. During each stage, heart rate, rating of perceived exertion, and expired gas will be recorded. The participant will continue to perform the experiment until they reach their maximum effort and feel that they can no longer continue. When this stage is reached, recovery measurements will be recorded as the participant’s heart rate and blood pressure decrease. This experiment will then be 5 repeated by the second participant for comparison. (Participants were encouraged to exercise until exhaustion.) RESULTS (Refer to the Appendix for Table 1, Table 2, Chart A, Figures 1A-D, Figures 2AD, Figure 3, and Figure 4) Table 1 illustrates the recordings for various factors for the female participant. Duration, speed, and grade for each stage are included as well as HR(bpm), BP(mmHg), VO2 (L/min), VO2 (mL/kg/min), RER, VE (L/min), and RPE. Out of six exercise stages, four of the exercise stages were completed. Again, each exercise stage lasted for three minutes and at the start of each new stage, the treadmill’s incline and speed increased. The participant’s resting heart rate before exercise was recorded at 72 beats/minute but soon increased to 117 beats/minute in the first stage of exercise. Her heart rate at the end of the test was measured at 190 beats/minute; a difference of 118 bpm from her resting HR. Her absolute VO2 in the first stage was recorded at 0.95 L/min and then eventually rose to 2.48 L/min in the 4th stage. The relative VO2 in stage one was at 17.59 mL/kg/min and jumped to 45.93 mL/kg/min in the fourth and final stage for her. The RPE is the Rate-Perceived-Exertion scale chart to determine what difficulty the participant felt they were at and it’s noted in the Table 1 that the participant’s RPE in stage 1 was a 9 and a 20 in the fourth stage. (The RPE’s can be further understood by examining Chart A.) This participant’s RER (respiratory exchange ratio) in stage one was at 0.66 and then climbed to 1.18 in the fourth stage; a 0.52 difference 6 Table 2 illustrates the recordings for various factors for the male participant. Duration, speed, and grade for each stage are included as well as HR(bpm), BP(mmHg), VO2 (L/min), VO2 (mL/kg/min), RER, VE (L/min), and RPE. Out of six exercise stages, four of the exercise stages were completed. Again, each exercise stage lasted for three minutes and at the start of each new stage, the treadmill’s incline and speed increased. The participant’s resting heart rate before exercise was recorded at 72 beats/minute but soon increased to 120 beats/minute in the first stage of exercise. His heart rate at the end of the test was measured at 200 beats/minute; a difference of 128 bpm from his resting HR. His absolute VO2 in the first stage was recorded at 1.59 L/min and eventually rose to 3.54 L/min in the 4th stage. The relative VO2 in stage one was at 17.28 mL/kg/min and jumped to 24.47 mL/kg/min in the fourth and final stage for him. The participant indicated a RPE description of a 9 in the first stage and 20 in the fourth stage. The participant’s RER was measured at 0.81 in the first stage and 1.23 in the fourth and final stage for him; a 0.42 difference. Figure 1A shows a visual of the female participant’s absolute VO2 (L/min) expressed in a line graph. Her oxygen consumption was not recorded during the rest stage so the graph begins at stage 1 (1.7 mph and 10% grade) and ends in the stage where she stopped the testing (stage 4=4.2 mph, 16% incline). The VO2 and intensity graph shows a positive and linear relationship. This participant’s final absolute VO2 is seen at 2.48 L/min. Figure 1B is a visual representation of the male participant’s absolute VO2 (L/min) compared to the intensity, or workload stages. This relationship is also a linear 7 and positive relationship but there is a significant 0.86 L/min increase between stages two and three. This participant’s final absolute VO2 is seen at 3.54 L/min. Figure 1C and 1D are visual representations of comparing both participant’s absolute VO2 during this test next to one another on the same graph, but in different forms. Figure 1C marks the participants’ oxygen consumption in a line chart where it is seen that the male’s plotted line is above the female’s plotted line. Both participant’s VO2 lines are in a positive and linear relationship, both ending in stage 4 but at different values. The bar graph in Figure 1D again shows the values gradually rising but the female participant’s value ended right above 2.4 L/min while his ended just below 3.6 L/min. Figure 2A is a line graph of the female’s relative VO2 intake expressed in mL/kg/min. The line between the intensity and oxygen consumption is linear and positive. Her relative VO2 in stage one starts at 17.59 mL/kg/min, increases to 24.81 mL/kg/min, and then makes a big leap to 37.22 in the third stage. Her VO2 increases by 4.68 mL/kg/min to his fourth and final stage. Figure 2B is another visual to compare his relative oxygen consumption to the workload intensity he experienced. In stage one, his relative VO2 is at 17.28 mL/kg/min, increases to 24.47 mL/kg/min in the second stage, and eventually rises to 38.48 mL/kg/min in the fourth and final stage. Figure 2C and 2D are again comparing both participants’ relative VO2 throughout the exercise stages but in a line and bar graph. In Figure 2C, it is observed that both participants’ VO2 from stage one to stage two are almost identical to each other and only differ in 0.31 mL/kg/min. In the middle of stage two is it’s seen that the lines begin to break apart and the female’s relative VO2 increases more than the male’s relative VO2. 8 Her final relative VO2 is 45.93 mL/kg/min: 7.45 mL/kg/min higher than his. Figure 2D again shows the participant’s values are neck and neck for the beginning of stage one and two but she makes a big jump during stage 3 and is significantly larger than his final relative VO2 value. Figure 3 is a line graph comparing heart rate to the exercise workloads for both participants. It should be noted that the two participant’s heart rate values are exact during the rest stage. Stage one is where it is seen that the male’s heart rate is higher than the female’s but the difference between the two participants throughout the testing is steady. Although the female’s line is positive and linear, there are more “jagged” patterns compared to a solid and straight line. It is the same situation for him: positive and linear but less “jagged” patterns. Her HR in stage one was recorded at 117bpm, rose to 130bpm, and then increased from 168bpm to 190bpm. His first HR measurement in stage one was at 120bpm. His other HR measurements were recorded at 148bpm, 189bpm, and 200bpm. It should be noted that his final heart rate measurement was 10 beats/minute higher than her final HR measurement. Figure 4 is a line graph depicting each other the participants’ RER throughout the four stages of exercise with an increase in speed and incline. Here, the female and male RER’s do not start close to one another as seen in previous graphs. Her RER is calculated to 0.66 and his at 0.81 in stage one. His RER is higher throughout the testing but both participants’ RER values come very close numerically in the fourth stage: 1.18 (female) and 1.23 (male). 9 CONCLUSION It must be noted that the female participant’s total exercise time on the treadmill was for 12 minutes. This participant did start to begin the fifth stage but immediately stopped the test when the incline and grade begin to increase so the fifth stage is not conclusive for this test. The male participant did begin the fourth stage but a minute into this stage, he stopped the test. Enough data was collected so the fourth stage was included in his VO2max testing. The oxygen consumption in absolute terms were recorded and plotted in graphs for the two participants in Figures 1A-D. Figure 1A-B show that the participants’’ oxygen consumption was not recorded prior to the increasing workloads for the exercise so no comparison can be made for what resting absolute VO2 would have been. However, measurements were recorded for their oxygen consumption during this vigorous test. When looking at the graph, there is a significant increase between stage 2 and 3 for both participants but still moving in a positive relationship. When subtracting the difference between each stage, the observer will see the significant change because there is a 0.67 L/min increase from stage two to three for her and a 0.86 L/min difference for him between stage two and three. When subtracting the difference the speeds for each stage, the largest increase is 0.9mph and it occurs during the transition between stages two and three so that would make sense why both participants consumed significantly more oxygen during this transition than any other stage transitions. Taking that a step further, when the values between each stage are subtracted for each participant, one can see the exact VO2 (L/min) increase that occurred between each stage; that is the ending of the stage and the beginning of the next stage. The difference between stages one and 10 two for her was at 0.9 L/min while his was at 0.66 L/min. From there, his oxygen consumption measurement value and difference value is larger than hers throughout the experiment. However, the difference between stage four and three for both participants are fairly close in that they are 0.04 L/min away from one another: his difference is 0.43 L/min while hers difference value from stage three to four is 0.47 L/min. Remember that these values are not the difference from each other from the stages. Figures 1C-D clearly show that his absolute VO2 is significantly higher than hers throughout this VO2max test as it is true for most males and female, in normal circumstances, considering the fact that women have less-fat free mass and women have less oxygen-carrying capacity due to their low blood hemoglobin content compared to men’s (Wilmore, J., Costill, D., & Kenney, W 2008). Taking a look at Figures 2A-D, relationship is quite opposite in the fact that the female participant value’s for relative VO2 are larger than the man’s values. This is due to the fact that relative VO2 considers the body mass of the individuals in weight bearing activities, such as running, and this allows for a more accurate description of each individual’s fitness level and ability (Ohio University). By dividing individual’s body weight (kg) into the absolute VO2 value, the relative VO2 is derived and a more precise comparison can be made between individuals and their aerobic ability. In laymen-terms, an individual with a smaller body weight has less number of cells, thus, has more amount of oxygen they can distribute among their cells. Other factors must be taken in when considering a person’s oxygen consumption. Factors such as medical conditions, body composition, pain threshold, hemoglobin concentration, age, height, weight, gender, environment, and physical activity all help contribute to an individual’s oxygen uptake 11 (Williams, C. 1994). As a reminder, it was noted before the experiment proceeded that the female participant is four years older than the male participant and also exercises more frequently. In most cases, aging can have an effect on VO2max. A study by Jackson, A.S. discovered that as an individual gets older, the VO2max decreases 1.7%/year for women and 1.2%/year for men (Jackson, A.S. 1995). Looking at the absolute and relative VO2 graphs, it would appear that the male participant would have the better fitness level due to his large absolute Vo2 values but that is not the case. When we include their body weight to oxygen consumption per minute, the female’s VO2 values (relative VO2) are much higher than the male’s relative VO2 values, thus she has a bigger aerobic capacity. The greater the oxygen uptake value, the better exercise capacity (Williams, C. 1994). So why is it important or beneficial to have a large VO2 value? One reason is that the person will have a greater capability to perform an exercise at a faster pace than someone who has a lower value (Mier, C. 2009). Exercises relating to VO2 or VO2max include aerobic or endurance performances such as running or rowing and testing can help the exerciser or athlete in knowing where their body stands in terms of fitness capabilities. A study was done to test 428 Swiss female runners’ endurance capacity through VO2max testing. It was concluded that the female runners’ endurance were “superior to the endurance of both the female and male general population” due to their values in the VO2max results (Marti, B. 1988). So the next question is how can it be concluded in this lab test that these two participants reached their VO2max? It is hard to determine based on the fact that both participants went from exercising without significant change in their running form to all 12 of a sudden stating that they wanted to quit the test. As it has been mentioned earlier, VO2max has been reached when the oxygen consumption plateaus even though the exercise intensity is continuing to proceed and increase gradually (Turnley, J.). Looking at Figures 1C and 2C, neither of the participants’ results indicate a plateau. However, VO2max secondary criteria methods are offered to help possibly determine if a person has reached their VO2max without an indication of a plateau in the data. Secondary criteria methods for the VO2max “are used such as peak heart rate (estimated by using the formula 220-age in years[give or take 10]), peak respiratory gas exchange ratio…higher than 1.10…” (Viru, A., & Viru, M. 2001). RER was discussed earlier that a person’s average RER is between .7-1.0 so two questions arise: If on average the range RER is between 0.7-1.1, how can the RER rise above 1.1 and the second question is: what does this tell us? After the calculation is done in figuring out how many carbon dioxides and oxygens there are in a single oxidized glucose, the ratio is 6:6, or 1:1, hence glucose’s RER (CO2 made/O2 used) is 1.0. It is also known that fat’s RER is around 0.7 and protein’s RER is 0.82. However, during moderate-vigorous exercise intensity, CO2 is made by lactate buffering which increases the amount of CO2, therefore increasing the individual’s RER (Wilmore, J., Costill, D., & Kenney, W. 2008). All of that leads to following one of methods for VO2max secondary criteria to test if VO2max was present:RER. Turning the attention now to Figure 4, it is seen where the RER is exhibited between both participants. The female’s RER in stage one was recorded at 0.66 and later recorded in stage four at 1.18. This value of 1.18 is definitely over 1.10 value that is mentioned earlier so according to the secondary criteria, she did meet this fulfillment in terms of RER greater than 1.10. Looking at Figure 4, the male’s last RER measurement 13 in stage 4 (remember that this stage was only tested for one minute by the male participant) was 1.23; definitely a lot greater than the 1.10 requirement. He too fulfills this secondary criteria requirement. Looking at the other secondary criteria VO2max method, it is quickly calculated that the female’s estimated HRmax would be at 196bpm and the male’s estimated HRmax would be 200bpm. Taking a look at Table 1 & Table 2, or Figure 3, it is evident through the collected data that the female’s heart rate in the fourth stage was recorded at 190bpm while the male’s HR in stage 4 was measured at 200bpm. If the secondary criteria method for testing VO2max is true, then the male’s HR in stage four indicates that he just reached his predicted HRmax according to the formula (200bpm). The female’s last recorded HR was 190bpm, just 6bpm short of her predicted HRmax. However, it was not recorded in the notes when exactly the HR was manually taken: at the beginning of the stage, at the end, ect. If the 190bpm HR measurement was taken at the beginning of the fourth stage, then it is not noted what the female’s HR was in the middle/end of stage four or even at the beginning of stage 5 when she immediately quit testing. With that being said, her HR could have increased during those 3 minutes of stage four to her predicted HRmax but there is no evidence that it did. There is a good possibility that her HR did increase by 6bpm within those 3 minutes but evidence is needed to make such a statement so with no evidence, the female failed the secondary criteria for VO2max concerning estimated HRmax. There are a number of a number of possible errors that need to be considered when concluding observations and analyzing data. It is important to remember that a male and female were used for this experiment and that their age, gender, body composition, and strength varied, as well as physical activity level or any unknown 14 conditions. This all had a role to effect data. It should also be noted that the participants performed the tests in different ways. The male participant primarily jogged/ran throughout the entire exercise with exception for the first stage. His physical appearance through perspiration and difficulty in keeping up with the set treadmill speed was noted. The female participant on the other hand briskly walked through stages and began to run during the middle of stage three and continued to do so until the test abruptly ended. She was also more occupied with the head and mouth piece. Focus and any distractions help influence exercise performance. It’s also important to note that the female participant was the first to do the test and received the full amount of time for warm up, rest, and recovery (although not discussed in this paper). The male participant however did not receive the full warm up and rest time due to the time criteria that was allowed. This might have affected his performance results. Other possible errors to keep in mind when performing this experiment is if any electronic devices (none were in this case) or any lotion (unknown if any was applied earlier) are on the participant during the test, this can skew the data. Fortunately, a test was conducted to test for electrode connections and are were cleared. Also, if any unused channels are not tied up, this could create a pull on the cords and create errors. Signal artifact is also something to remember because if the ECG readings are not clear, the graph lines from the computer will be hard to read (3M HealthCare 2011). The results may also be compared to a standard set of VO2max values for greater and more accurate comparison between the men and women under the American College of Sports Medicine guideline for VO2max testing (Thompson, W., Gordon, N., & Pescatello, L. 2010). 15 It’s concluded that as exercise intensity increases, so does the amount of oxygen consumed in proportion (Williams, C. 1994). To my best judgment through the observation of the participants’ performance and referring to the RPE scaling and all the data displayed in the charts and graphs, I would conclude that the male participant reached his VO2max, thus, my hypothesis concerning VO2max met was wrong. My hypotheses for the female having the greater relative VO2 and the male having a greater heart rate both throughout the experiment were correct. The VO2max test can be beneficial under sport’s performance training or rehabilitation. This test can be used to determine where an athlete stands in regards to aerobic endurance fitness and if they are training safely within their VO2max%. There are other strategies that could be used to better improve this experiment to achieve more accurate results. One way might be to obtain better measurement collection through more practice if done manually. Also, giving a practice trial might give future participants involved in similar tests a chance to perform more on point since they would be more aware of what to expect. Also having more people participate might be better for comparison and analyzing oxygen consumption throughout different types of people. 16 APPENDIX Female Participant’s Recorded Data Stage Duration (min) Speed (mph) Grade (%) HR (bpm) BP (mmHg) VO2 (L/min) VO2 (ml/kg/min) RER VE (L/min) Rest 1 2 3 4 5 6 Recovery Recovery Recovery 5:00 3:00 6:00 9:00 12:00 (15:00) (18:00) 14:00 16:00 18:00 --1.7 2.5 3.4 4.2 (5.0) (5.5) --3.0 1.0 --10 12 14 16 (18) (20) --1 0 72 117 130 168 190 ----142 116 125 113/72 130/78 135/76 139/79 150/80 ----------- --0.95 1.34 2.01 2.48 ----------- --17.59 24.81 37.22 45.93 ----------- --0.66 0.77 0.97 1.18 ----------- --15.0 21.2 41.0 66.6 ----------- ‘’ Table 1 RPE --9 13 17 20 ----------- Key --- Results not recorded Male Participant’s Recorded Data Stage Duration (min) Speed (mph) Grade (%) HR (bpm) BP (mmHg) VO2 (L/min) VO2 (ml/kg/min) RER VE (L/min) Rest 1 2 3 4 5 6 Recovery Recovery Recovery 5:00 3:00 6:00 9:00 12:00 (15:00) (18:00) 14:00 16:00 18:00 --1.7 2.5 3.4 4.2 (5.0) (5.5) --3.0 1.0 --10 12 14 16 (18) (20) --1 0 72 120 148 189 200 ----150 140 --- 110/78 125/76 128/78 136/78 ------------- --1.59 2.25 3.11 3.54 ----------- --17.28 24.47 33.80 38.48 ----------- --0.81 0.90 1.13 1.23 ----------- --30.02 39.20 76.60 105.10 ----------- Table 2 Key --- Results not recorded 17 RPE --9 14 17 20 ----------- Female Participant's Absolute VO2 6 4.8 VO2 (L/ min) 3.6 Female Participant's Recorded Absolute VO2 2.48 2.4 2.01 1.34 Figure 1A 1.2 0.95 0 Stage 1 Stage 2 Stage 3 Stage 4 Stage 5 Stage 6 Intensity Male Participant's Absolute VO2 6 4.8 3.54 3.6 Male Participant's Recorded Absolute VO2 VO2 (L/ min) 3.11 2.25 2.4 1.59 Figure 1B 1.2 0 Stage 1 Stage 2 Stage 3 Stage 4 Stage 5 Stage 6 Intensity 18 Participants' Absolute VO2 6 4.8 Female Participant 2.4 Male Participant VO2 (L/ min) 3.6 Figure 1C 1.2 0 Stage 1 Stage 2 Stage 3 Stage 4 Stage 5 Stage 6 Intensity Participants' Absolute VO2 6 4.8 3.54 VO2 (L/ min) 3.6 3.11 2.48 2.4 2.25 2.01 Female Participant Male Participant 1.59 1.34 1.2 0 Figure 1D 0.95 Stage 1 Stage 2 Stage 3 Stage 4 Stage 5 Stage 6 Intensity 19 Female Participant's Relative VO2 60 45.93 48 37.22 36 VO2 (mL/ kg/ min) Female Participant's Recorded Relative VO2 24.81 24 17.59 Figure 2A 12 0 Stage 1 Stage 2 Stage 3 Stage 4 Stage 5 Stage 6 Intensity Male Participant's Relative VO2 60 48 38.48 33.8 Male Participant's Recorded Relative VO2 VO2 (mL/ kg/ min) 36 24.47 24 17.28 Figure 2B 12 0 Stage 1 Stage 2 Stage 3 Stage 4 Stage 5 Stage 6 Intensity 20 Participants' Relative VO2 60 48 Female Participant 24 Male Participant VO2 (mL/ kg/ min) 36 Figure 2C 12 0 Stage 1 Stage 2 Stage 3 Stage 4 Stage 5 Stage 6 Intensity Participants' Relative VO2 60 48 45.93 38.48 VO2 (mL/ kg/ min) 37.22 36 Female Participant 33.8 24.81 24.47 Male Participant 24 17.59 17.28 Figure 2D 12 0 Stage 1 Stage 2 Stage 3 Stage 4 Stage 5 Stage 6 Intensity 21 Participants' Heart Rate 220 176 Female Participant 88 Male Participant HR (beat/ min) 132 Figure 3 44 0 Rest Stage 1 Stage 2 Stage 3 Stage 4 Stage 5 Intensity Participants' Respiratory Exchange Ratio (RER) 2 1.6 1.2 1.13 1.23 1.18 Female Participant RER 0.97 0.9 0.81 0.8 Male Participant 0.77 0.66 0.4 0 Stage 1 Figure 4 Stage 2 Stage 3 Stage 4 Stage 5 Stage 6 Intensity 22 Chart A 23 REFERENCES 3M Health-Care Infection Prevention Division. 2011. 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