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The effect of posture on maximal oxygen uptake in active healthy individuals

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European Journal of Applied Physiology Aims and scope Submit manuscript

Abstract

Purpose

Semi-supine and supine cardiopulmonary exercise testing (CPET) with concurrent cardiac imaging has emerged as a valuable tool for evaluating patients with cardiovascular disease. Yet, it is unclear how posture effects CPET measures. We aimed to discern the effect of posture on maximal oxygen uptake (VO2max) and its determinants using three clinically relevant cycle ergometers.

Methods

In random order, 10 healthy, active males (Age 27 ± 7 years; BMI 23 ± 2 kg m2) underwent a ramp CPET and subsequent constant workload verification test performed at 105% peak ramp power to quantify VO2max on upright, semi-supine and supine cycle ergometers. Doppler echocardiography was conducted at peak exercise to measure stroke volume (SV) which was multiplied by heart rate (HR) to calculate cardiac output (CO).

Results

Compared to upright (46.8 ± 11.2 ml/kg/min), VO2max was progressively reduced in semi-supine (43.8 ± 10.6 ml/kg/min) and supine (38.2 ± 9.3 ml/kg/min; upright vs. semi-supine vs. supine; all p ≤ 0.005). Similarly, peak power was highest in upright (325 ± 80 W), followed by semi-supine (298 ± 72 W) and supine (200 ± 51 W; upright vs. semi-supine vs. supine; all p < 0.01). Peak HR decreased progressively from upright to semi-supine to supine (186 ± 11 vs. 176 ± 13 vs. 169 ± 12 bpm; all p < 0.05). Peak SV and CO were lower in supine relative to semi-supine and upright (82 ± 22 vs. 92 ± 26 vs. 91 ± 24 ml and 14 ± 3 vs. 16 ± 4 vs. 17 ± 4 l/min; all p < 0.01), but not different between semi-supine and upright.

Conclusion

VO2max is progressively reduced in reclined postures. Thus, posture should be considered when comparing VO2max results between different testing modalities.

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Data availability

All data generated or analysed during this study are included in this published article.

Abbreviations

[La−]b :

Blood lactate concentration

avO2-diff:

Arteriovenous oxygen difference

CO:

Cardiac Output

CPET:

Cardiopulmonary exercise testing

DBP:

Diastolic blood pressure

HR:

Heart rate

MRI:

Magnetic resonance imaging

RER:

Respiratory exchange ratio

RR:

Respiratory rate

SaO2 :

Oxygen saturation

SV:

Stoke volume

SBP:

Systolic blood pressure

V T :

Tidal volume

V E :

Minute ventilation

VO2 :

Oxygen consumption

VO2max:

Maximal oxygen uptake

W:

Watts

W peak :

Peak power output

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Funding

GC is supported by the Frans Van De Werf Fund for Clinical Cardiovascular Research and the Mathilde Horlait-Dapsens Scholarship. RW is supported as postdoctoral clinical researcher by the Fund for Scientific Research Flanders. EJH and ALG are supported by National Heart Foundation of Australia Future Leaders Fellowships.

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Authors and Affiliations

  1. Sports Cardiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, 3004, Australia

    Hayley T. Dillon, Guido Claessen, Anniina Lindqvist, Amy Mitchell, Leah Wright, André La Gerche & Erin J. Howden

  2. Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia

    Hayley T. Dillon

  3. Exercise Physiology Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium

    Christophe Dausin

  4. Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium

    Guido Claessen & Rik Willems

  5. National Centre for Sports Cardiology, St Vincent’s Hospital Melbourne, Fitzroy, Australia

    André La Gerche

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  1. Hayley T. Dillon
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  2. Christophe Dausin
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  3. Guido Claessen
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  4. Anniina Lindqvist
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  8. André La Gerche
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  9. Erin J. Howden
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Contributions

CD, EH, HD, GC, RW and ALG contributed to the conception and design of the study. HD, GC, LW, AM, AL conducted the study testing. HD wrote the manuscript; all authors critically revised the manuscript and gave final approval.

Corresponding author

Correspondence to Erin J. Howden.

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All experimental procedures were performed in accordance with the ethical standards of the institutional review boards of the Alfred Health Research Ethics committee and with the 1964 Helsinki Declaration. The study was approved by the Alfred Health Research Ethics Committee (No: 327/19).

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Communicated by I. Mark olfert.

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Dillon, H.T., Dausin, C., Claessen, G. et al. The effect of posture on maximal oxygen uptake in active healthy individuals. Eur J Appl Physiol 121, 1487–1498 (2021). https://doi.org/10.1007/s00421-021-04630-7

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