A two-test protocol (incremental/ramp (IWT) + supramaximal constant-load (CWR)) to affirm max and obviate reliance on secondary criteria has only been validated in highly fit children. In girls (n = 15) and boys (n = 12) with a wide range of VO2max (17–47 ml/kg/min), we hypothesized that this procedure would evince a VO2-WR plateau and unambiguous VO2max even in the presence of expiratory flow limitation (EFL). A plateau in the VO2-work rate relationship occurred in 75% of subjects irrespective of EFL There was a range in RER at max exercise for girls (0.97–1.14; mean 1.06 ± 0.04) and boys (0.98−1.09; mean 1.03 ± 0.03) such that 3/15 girls and 2/12 boys did not achieve the criterion RER. Moreover, in girls with RER > 1.0 it would have been possible to achieve this criterion at 78% VO2max. Boys achieved 92% VO2max at RER = 1.0. This was true also for HRmax where 8/15 girls’ and 6/12 boys’ VO2max would have been rejected based on HRmax being < 90% of age-predicted HRmax. In those who achieved the HRmax criterion, it represented a VO2 of 86% (girls) and 87% (boys) VO2max. We conclude that this two-test protocol confirms VO2max in children across a threefold range of VO2max irrespective of EFL and circumvents reliance on secondary criteria.
Robben, Poole, and Harms are with the Depts. of Kinesiology and Anatomy and Physiology, Kansas State University, Manhattan, KS.