Incremental exercise test design and analysis - Implications for performance diagnostics in endurance athletes

Physiological variables, such as maximum work rate or maximal oxygen uptake (VO2max), together with other submaximal metabolic inflection points (e.g. the lactate threshold [LT], the onset of blood lactate accumulation and the pulmonary ventilation threshold [VT]), are regularly quantified by sports scientists during an incremental exercise test to exhaustion. These variables have been shown to correlate with endurance performance, have been used to prescribe exercise training loads and are useful to monitor adaptation to training. However, an incremental exercise test can be modified in terms of starting and subsequent work rates, increments and duration of each stage. At the same time, the analysis of the blood lactate/ventilatory response to incremental exercise may vary due to the medium of blood analysed and the treatment (or mathematical modelling) of data following the test to model the metabolic inflection points. Modification of the stage duration during an incremental exercise test may influence the submaximal and maximal physiological variables. In particular, the peak power output is reduced in incremental exercise tests that have stages of longer duration. Furthermore, the VT or LT may also occur at higher absolute exercise work rate in incremental tests comprising shorter stages. These effects may influence the relationship of the variables to endurance performance or potentially influence the sensitivity of these results to endurance training. A difference in maximum work rate with modification of incremental exercise test design may change the validity of using these results for predicting performance, and prescribing or monitoring training. Sports scientists and coaches should consider these factors when conducting incremental exercise testing for the purposes of performance diagnostics.