Will Hylton

April 6, 2016

Introduction
VO2 max is a measurement of the maximum amount of oxygen that can be used by an
individual. VO2 max is a key physiological determinant of an athletes running performance, and
that it is an important objective of a training program to improve it (Powers 2015). While it can
also be used to by healthcare professionals to determine health risk factors in patients. VO2 max
testing takes place in a variety of different modalities, whether that be cycling/running, or
submaximal/maximal. Also, the modality of these test varies in direct measurement of VO2 max
through the use of a metabolic cart, or estimation of VO2 max using field tests (Powers 2015).
Though, it is considered to be the gold standard to use a metabolic cart in the testing of VO2
max, estimation modalities may in some cases be more appropriate when testing large groups or
specific populations where maximal testing may become dangerous.
Submaximal Exercise testing is used by exercise professionals to indicate their patient,
subject, or athletes cardiorespiratory capacity in order to determine a specific exercise
prescription or determine possible risk factors exercise could possibly induce. Submaximal
cardiorespiratory fitness testing takes into account the linear response heart rate (HR) has to
work rate (time), or the intensity of exercise (Haff 2012). By using these two measurements
professionals are able to calculate a persons VO2 max, or the maximum rate of oxygen
consumption within the mitochondria of muscle cells during oxidative phosphorylation.
However, submaximal testing is not the gold standard for VO2 max determination, since it only
gives a prediction of the amount of the persons maximum oxygen intake. While maximal testing
requires expensive equipment (i.e. VO2 max cart) or it requires subjects to work until complete
exhaustion/cover as much distance as possible in a given amount of time, as seen in the Cooper
Test and beep test, it gives an exact measurement of the persons cardiorespiratory capacity.

Will Hylton

April 6, 2016

Though, in some cases submaximal tests, like the Queens Step Test, Rockport walking test,
YMCA cycling test, and the Ebbeling treadmill test, are more practical since it they can be done
in the field or some populations would be at risk during a maximal test (Haff 2012).
Direct measurement of VO2 max is usually taken using a graded exercise test on a
treadmill, or by the means of indirect calorimetry using a cycle ergometer. These test begin a
lower workloads and progressively increase in intensity. In each of the tests conducted a
metabolic cart was used allowing VO2 to be continuously measured throughout the test. The
measurements observed provides an excellent index of the heart capacity to pump blood.
However, these tests can drastically be affected by a number of factors including mode of
exercise, and means of obtaining measurements (i.e. predictions vs. metabolic cart) (Haff 2012).
The purpose of this paper is to indicate and compare differences in VO2 max obtained directly
and indirectly, or measured and predicted, and to compare the different modalities of exercise
(running and cycling). It can be assumed that direct VO2 max measurements in running
modalities will yield higher VO2 max measurements when compared to cycling modalities, and
will give a more accurate and valid VO2 max than estimated VO2 max tests.

Results
Table 1: Comparison of Male and Female Mean VO2 max (ml/kg/min)

Test
Cooper 12 min
Run
Rock Port Walk

Mean VO2 Max

(Male)
44.5
45.3

Mean VO2 max

(Female)
37.2
41.6

SD (Male)
15.2
6.7

SD
(Female
)
13.0
5.3

Will Hylton
Beep Test
Queens Step
Test
YMCA Cycling
Test
Ebbeling
Treadmill Test
Treadmill Test
(Metabolic
Cart)
Cycling Test
(Metabolic
Cart)

April 6, 2016
40.5

31.8

5.1

6.9

60.6

40.7

7.4

3.9

44.9

44.3

11.15

13.9

56.4

47.6

7.1

8.3

53.7

50.8

11.3

5.8

45.2

30.6

8.3

7.2

The table above displays the differences in male and female VO2 maxes under the
different tests, or modalities, used. In all of the test males displayed a higher VO2 max than
females. Within the submaximal tests males averaged a VO2 max of 45.36.72 ml/kg/min in the
Rockport Walk test, while the females average 41.66.72 ml/kg/min. In the Queens Step Test
males averaged 60.67.4 ml/kg/min, and females averaged 40.73.88 ml/kg/min. Males
averaged 44.911.15 ml/kg/min in the YMCA Cycling test, and females averaged 44.313.89
(ml/kg/min). For the Ebbeling Treadmill test males displayed a 56.47.1 ml/kg/min VO2 max,
while females displayed a 47.68.28 ml/kg/min. In maximal cardiorespiratory capacity tests
males averaged 44.515.17 ml/kg/min in the Cooper 12 min Run test and 40.55.07 ml/kg/min
in the Beep Test. Females averaged 37.213.04 ml/kg/min in Cooper test, and 31.86.94
ml/kg/min in the Beep Test. The treadmill modality when utilizing a metabolic cart yielded a
53.711.3 ml/kg/min in males, and 50.85.8 ml/kg/min in females. The cycling test measured a
VO2 max of 45.28.3 ml/kg/min in males, and 30.67.2 ml/kg/min in females. The graph below
displays a comparison of estimated and measured VO2 max in running and in cycling.

Will Hylton

April 6, 2016
60
50
40
30
20

VO2 Max (ml/kg/min)

10
0

VO2 Max Test

Figure 1: Comparison of measured VO2 max (via metabolic cart) and predicted VO2 max
in males and females.
The graph above displays the differences in measured VO2 max and predicted VO2 max,
along with differences in testing modalities. In the graded exercise test on the treadmill the
metabolic cart test averaged a VO2 max test of 53.7 ml/kg/min in males and 50.8 ml/kg/min in
females. While the predicted VO2 max test averaged 49.5 ml/kg/min in males, and 39.8
ml/kg/min in females. Cycling was the other modality used to measure VO2 max. Measured
VO2 max on the ergometer measured a VO2 max of 45.2 ml/kg/min in males, and 30.6 in
females. However, predicted cycling VO2 max test yielded 44.9 in males, and 44.3 in females.
Discussion
It can be seen in the results above that submaximal tests displayed higher results than
maximal tests. In submaximal testing males averaged a 52.5 ml/kg/min VO2 max, which would
classify the males in the 85th percentile, and excellent, when compared to all 20-29 year olds.

Will Hylton

April 6, 2016

However, in maximal testing males only averaged a VO2 max of 42.4 ml/kg/min, which places
them in the 40th percentile, and ranked as fair. The same trend can be seen in females where they
averaged 43.6 ml/kg/min in submaximal testing, placing them in the 75th percentile, and ranked
as having a good VO2 max, compared to other 20-29 year olds. While in maximal testing
females averaged 33.81 ml/kg/min, categorizing them in the poor ranking, and in the 30th
percentile among their age group.
It can be seen in the graph above that in the majority of tests measured VO2 max yielded
higher scores when compared to predicted VO2 max, as well as higher in running modalities
when compared to cycling. Many different factors can cause discrepancies in these
measurements of VO2 max, and possibly give a misrepresentation of the groups actual
cardiorespiratory capacity. One of the biggest factors in maximal testing is the effort put forth by
the subjects. In most cases subjects do not complete the tests to their complete maximum
capacity, or to complete exhaustion. Therefore in these cases where VO2 max is decided by the
distance covered, like in the Cooper 12 min run test and beep test, if the subject does complete
the test to the absolute best of their ability or to failure a true representation of their VO2 max
cannot be determined. Another source of error in the submaximal tests comes from the difficulty
to read a subjects heart rate while they are exercising. In the YMCA cycling test and the
Ebbeling Treadmill test administrators must take a subjects heart rate while they are moving and
exercising, without the use of a heart rate monitor. Palpating a subjects heart rate can prove to be
an extremely difficult task even for experienced test administrators, and an incorrect heart rate
can sway the subjects results greatly since it is one of the determining factors in the subjects VO2
max in submaximal testing. Also, environmental factors, such as temperature and humidity.
Therefore, the cold temperatures of the days the Rockport and Cooper tests were performed

Will Hylton

April 6, 2016

could have an impact on the results of the test. Males when compared to females displayed a
much lower VO2 max due to their differences in HR and heart size. Since males have larger
hearts and higher stroke volumes, meaning their heart is able to pump more blood and oxygen
out per beat. This allows for their HR to decrease and their submaximal VO2 max to increase
(Antelmi 2004).
Cardiorespiratory fitness is defined as the ability of the body to take in and use oxygen
(VO2 max) (Fitchett 1985). Physiologically it is easy to see why heart rate can be used to
determine VO2 max, and why it is important to get an accurate measurement of ones heart rate
in order for submaximal tests to be valid. The Fick equation states VO2 max= Q (cardiac output)
x a-VO2 difference. Broken down even farther Q= HR x Stroke Volume (SV). This simply
means that cardiac output is equal to HR times the amount of blood the heart is able to extract
per beat. With increased fitness levels heart rate decreases, however, stroke volume increases
drastically. This indicates that as fitness level increases the heart does not have to work as hard to
get oxygen into the nutrients since more blood is being pumped out per beat (Campos-Vazquez
2015). An increase in stroke volume allows the HR to decrease while still increasing cardiac
output, and therefore, VO2 max. However, when utilizing a metabolic cart another key factor of
VO2 max is taken into account, a-VO2 difference. A-VO2 difference is the difference in the
oxygen content of the blood between the arterial blood and the venous blood. It is an indication
of how much oxygen is removed from the blood in capillaries as the blood circulates in the body.
A metabolic cart includes gas analyzers for oxygen and carbon dioxide, allowing for the
exchange of oxygen entering and leaving the lungs to be measured.
Another factor that can play a role in VO2 max testing is the modality of the test. Cycling
and running are the two most common modalities used in cardiorespiratory fitness testing. In

Will Hylton

April 6, 2016

running test upper body and trunk muscles play a larger role in keeping the body erect, and can
increase heart rate in some cases or in less trained individuals. At higher heart rates during
submaximal tests can display a lower VO2 max and yield an invalid result (Hausswirth 2001).
However, it is evident that VO2 max running yielded higher VO2 maxes in almost all test,
excluding predicted female running and predicted female cycling. A lower VO2 max exhibited
during cycling can be attributed to the muscle mass recruited during exercise. During cycling,
the work rate will be divided over a smaller number of muscle bers than during running. The
metabolic stress per muscle ber may be greater as a greater amount of energy per ber is
required. It is possible that this increased stress level and energy requirement per ber can only
be met by an increased carbohydrate utilization (Achten 2003). This difference in VO2 max
could also be attributed to a decreased ventilation in cycling as compared to running. When in a
seated position, such as in cycling, ventilation can be impaired due to the compression of
inspiratory and expiratory muscles. If ventilation is impaired all aspects of the Fick equation will
be altered. HR will increased due to a decrease in the amount of oxygen uptake if ventilation
muscles are altered, thus, decreasing stroke volume, and therefore, cardiac output (Achten 2003).
With these components decreased there will be more deoxygenated blood in the arteries
decreasing VO2 difference.
As stated earlier, test that do not utilize a metabolic cart only provide a prediction of VO2
max, leaving the most valid way to determine an individuals VO2 to be through direct
measurement. This indicates some level of a threat to internal validity within VO2 prediction test
due to an increase risk of human error in the measurements of HR and in cases, such as in the 1.5
mile run test, where maximum effort is require (Kline 1987). Without perfect measurement of
HR or an all-out maximum effort exerted an exact measurement of VO2 max is impossible to

Will Hylton

April 6, 2016

gain. This indicates that the most valid tests for measuring VO2 max are in fact those that utilize
a metabolic cart. It can also be assumed that due to differences in muscle utilization and
ventilation tests that utilize running as means of measuring VO2 max will yield higher in almost
all cases (Kline 1987). In the measuring of VO2 max all components of the Fick equation, as
well as the training of the individual in each modality, play an important role in performance in
each test. As with any test of performance, training and repeated measurements by subjects and
administrators will always become the deciding factor in valid and accurate measurements.

Will Hylton

April 6, 2016
References

1. Achten J, Venables MC, Jeukendrup AE. Fat oxidation rates are higher during running
compared with cycling over a wide range of intensities. Metab Clin Exp [Internet]. 2003
6;52(6):747-52.
2. Antelmi I, De Paula RS, Shinzato AR, Peres CA, Mansur AJ, Grupi CJ. Influence of age,
gender, body mass index, and functional capacity on heart rate variability in a cohort of
subjects without heart disease. Am J Cardiol [Internet]. 2004;93(3):381-5.
3. Campos-Vazquez M, Mendez-Villanueva A, Gonzalez-Jurado J, Len-Prados JA,
Santalla A, Suarez-Arrones L. Relationships between rating-of-perceived-exertion- and
heart-rate-derived internal training load in professional soccer players: A comparison of
on-field integrated training sessions. International Journal of Sports Physiology &
Performance [Internet]. 2015 07;10(5):587-92
4. Fitchett MA. Predictability of VO2 max from submaximal cycle ergometer and bench
stepping tests. Br J Sports Med [Internet]. 1985 Jun;19(2):85-8.
5. Haff GG. Labratory Manutal for Exercise Physiology. Champaign, IL: Human Kinetics;
2012.
6. Hausswirth C, Vallier J, Lehenaff D, Brisswalter J, Smith D, Millet G, Dreano P. Effect of
two drafting modalities in cycling on running performance. Med Sci Sports Exerc
[Internet]. 2001;33(3):485-92.
7. Kline GM, Porcari JP, Hintermeister R, Freedson PS, Ward A, McCarron RF, Ross J,
Rippe JM. Estimation of VO2max from a one-mile track walk, gender, age, and body
weight. Med Sci Sports Exerc [Internet]. 1987;19(3):253-9.
8. Powers SK, Howley ET. Exercise Physiology Theory and Application to Fitness and
Performance. Ninth. New York, NY: McGraw-Hill Education; 2015.