Dr. K.D.C. Upendra Wijayasiri (MBBS (SL), Dip.Spo.Med (col))

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1 CARDIO- RESPIRATORY EXERCISE FITNESS What does it really mean? Dr. K.D.C. Upendra Wijayasiri (MBBS (SL), Dip.Spo.Med (col)) Sports Physician, Head - Sports Medicine Unit, Colombo South Teaching Hospital, Kalubowila. T.P: upendraanu@yahoo.com / upendra.wija@gmail.com

2 How a player comes to top? Trainin g Physical fitness Menta l fitnes s

3 Components of Physical Fitness

4 CARDIO-RESPIRATORY EXERCISE FITNESS

5 Cardio- Respiratory fitness Respiratory component

6 Cardio- Respiratory fitness Cardiac component

7 Cardio- Respiratory fitness Muscle cell component

8 Cardio- Respiratory fitness Mitochondrial component

9 CARDIO-RESPIRATORY EXERCISE FITNESS TESTING (CPET)

10 CPET - how do we measure it? By using a cycle ergometer (COSMED Italy) Sports medicine unit, CSTH and Department of physiology, Faculty of medical sciences, USJP Elite athletes, Clinical patients Total duration 8-12 min Stages typically 1-3 min in length Exercise intensity increased by W or <5-8% of VO 2 max per stage, at least towards end of test

11 The CPET laboratory

12 Measurements during CPET 1. Work rate : METs, Watts 2. metabolic exchange : VO2max, VCO2max, RER,AT, Blood lactate level 3. Cardiovascular : HR, ECG, BP 4. Respiratory : Pulmonary function tests 5. Respiratory gas exchange: SpO2 6. Symptoms : dyspnea, fatigue, chest pain

13 Maximal O 2 uptake (VO 2 max) The highest rate of wholebody oxygen uptake (VO 2 ) achievable during exercise that utilizes a large muscle mass (e.g., running). An intrinsic biological characteristic of an individual at any particular point in time.

14 Sports classification on CVS Low ( < 40% VO2max) demand Moderate ( 40%- 70% O2max) High ( >70% VO2max) Low (20% MVC) Throwing events, gymnastics, martial arts, climbing Body building, wrestling Cycling, triathlon, decathlon, rowing, boxing Moderate (20-50% MVC) Archery, diving, auto sports Sprint running, jumping, rugby, short distance swimming, Middle distance running, basketball, middle distance swimming High (> 50% MVC) Cricket, billiards, golf, riflery Table tennis, volley ball Long distance running, race

15 CPET testing methods

16 VO 2 max why is it important? VO 2 max is the best overall measure of cardiovascular fitness Sets the upper limit to the production of energy (ATP) via aerobic metabolism (i.e., mitochondrial respiration). Adequately high VO 2 max is a necessary but not a sufficient condition to be an elite endurance athlete.

17 VO 2 max in different groups of athletes

18 VO 2 max what determines it? The primary limiting factor to VO 2 max is maximal cardiac output, and in particular, maximal stroke volume. VO 2 max= (Hr max )x (Sv max )x (avo 2 diff max )

19 Relationship between VO 2 max and maximal cardiac output

20 Role of genetics in determining baseline VO 2 max

21 Role of genetics in determining trainability of VO 2 max From D. Prud'homme et al., 1984, Sensitivity of maximal aerobic power to training is genotype-dependent, Medicine and Science in Sports and Exercise 16(5): Copyright 1984 by American College of Sports Medicine. Adapted by permission.

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23 VO 2 max how do you train it? At least/especially in untrained persons, ordinary endurance exercise training, if of sufficient intensity (i.e., >50-60% of VO 2 max), frequency, and duration will lead to an improvement in VO 2 max, but As an individual becomes more fit, it becomes progressively harder and harder to elicit further improvement, necessitating that the exercise intensity be increased if any further gains are to be achieved.

24 Changes in VO 2 max over time in a world class team pursuit cyclist Jeukendrup AE, Craig NP, Hawley JA. J Sci Med Sport 2000; 3:

25 VO2max and sports performance

26 Training program: Running all-out for 40 min/d, 3 d/wk. Cycling (on an ergometer) 6 x 5 min on, 2 min off, 3 d/wk. Power during intervals set so that subject achieved VO 2 max during each effort. Hickson, Bomze, and Holloszy. J Appl Physiol 1977; 42:

27 VO2max increases with age, training distance and with training experience Ventilation However, after attaining the plateau of VO2max, the increases in performance can still be Pmax VO2max found in athletes Junior Under 23 Senior A 1

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31 Thank you!

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