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UK: Locations that offer CPET/VO2max testing

Discussion in 'Laboratory and Genetic Testing' started by Andy, Jul 13, 2018.

  1. Andy

    Andy Senior Member (Voting Rights)

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    The idea of this thread is, as the thread title says, to list those places in the UK that offer this type of testing. Our familiarity is with the term CPET (2 day or otherwise), it may be better known by sports scientists as VO2 max.

    So to start, @chicaguapa said
    in this thread, https://www.s4me.info/threads/conce...nagement-of-cfs-me-davenport-et-al-2010.4937/
     
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  2. adambeyoncelowe

    adambeyoncelowe Senior Member (Voting Rights)

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  3. arewenearlythereyet

    arewenearlythereyet Senior Member (Voting Rights)

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  4. arewenearlythereyet

    arewenearlythereyet Senior Member (Voting Rights)

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    Also these are the top sports science unis in the uk according to this site


    Where can I study Sports Science in the UK?
    To learn more about the best Sports Science courses in the UK, find details on the top ten ranking Sports Science universities in the Guardian University Guide 2019 below:

    1. University of Leeds
    2. University of Bath
    3. Loughborough University
    4. University of Birmingham
    5. Kingston University
    6. University of Aberdeen
    7. Durham University
    8. Bangor University
    9. University of Glasgow
    10. Staffordshire University
    http://www.studyin-uk.com/studyuk/sports-science/
     
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  5. Ryan31337

    Ryan31337 Senior Member (Voting Rights)

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  6. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

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    One key aspect to note is that the CPET protocol for healthy people can differ from that used in ME/CFS studies, specifically the rate at which the power is increased. This can lead to less time on the bike, but also less precision of the data.

    Solent Sports Science Lab (mentioned above) says:

    When I did the first CPET test I had 23 "stages" before exhaustion, which suggests smaller increases in power for each stage. So I suggest taking them up on the offer to "tailor" the protocol to match ME/CFS studies. Having said that though, I don't really recommend doing the test at all unless you are forced to for insurance reasons or whatever. I found it quite hard, though it was not a permanent set back.
     
  7. Sbag

    Sbag Senior Member (Voting Rights)

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    I know Northampton hospital does it but don't know how much.
     
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  8. Ryan31337

    Ryan31337 Senior Member (Voting Rights)

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    This is a good point. The incremental work ramp rate is usually given in watts, I think I did 15W though can't be sure.

    Not sure if your CPET was done in a sports centre @Snow Leopard, but the 3x I did were in a clinical setting and sounded a little different. The power ramp was constant with no discernible stages and the clinical protocol aimed for the test to be finished (i.e. you should be at your VO2max) in 8-12 minutes.
     
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  9. adambeyoncelowe

    adambeyoncelowe Senior Member (Voting Rights)

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  10. Cinders66

    Cinders66 Senior Member (Voting Rights)

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    I'm not remotely capable of doing this, but if it's so widely available and not hugely expensive it's sad no one in the uk has had the interest or been persuaded to undertake a study. At £300/pp , 50 tests would cost £15 000, then the scientific analysis paper writing costs. Could those who're contacting or attending raise the issue to see if anyone might be interested?
     
  11. Ryan31337

    Ryan31337 Senior Member (Voting Rights)

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    CPET abnormalities in our patient group are usually quite non-specific.

    The CPET can give some indication of where the limitation lies but no distinct cause in most cases. For me it was concluded that there was likely no respiratory limitation but moderate functional impairment from cardiovascular limitation. They couldn't say much more than that. You can drill down a little further with the sort of invasive CPET protocol that Systrom uses, looking at filling pressures & oxygen extraction to better identify the limitation - but its still not going to give you a cause.

    I imagine where it has a bit more use is in providing objective results from drug trials, which I understand is exactly what Systrom is doing with upcoming Mestinon trials.
     
  12. Cinders66

    Cinders66 Senior Member (Voting Rights)

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    It's less about cause than about establishing our abnormal PEM weakness on exertion, through 2 day testing. The research contrasting us with MS has been interesting, larger studies establishing the abnormal response which IOM considered very important hence SEID and then, for uk benefits, contrasting with depression, IBS, pots , auto immune illness and heart and liver disease would imo be worthwhile.
    The MS /ME testing also added in gene expression measuring and immune measures which I'm guessing are expensive.

    I'm interested in what you say about mrstonin trials, I wasn't aware of this, It's CFS?
     
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  13. Ryan31337

    Ryan31337 Senior Member (Voting Rights)

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    Hi @Cinders66,

    Check out these threads & videos:
    https://www.s4me.info/threads/dr-david-m-systrom-at-bwh-has-evidence-of-sfpn-in-some-patients.4855/
    https://www.s4me.info/threads/webin...-international-tuesday-jan-16-7-8pm-est.1917/
    https://www.s4me.info/threads/dr-oaklander-sfnp-video-small-fibers-big-pain.4890/

    These guys are seeing similar results in a good subset of their syndromic patients: CFS, Fibro, POTS etc.

    They are also seeing day 1 abnormalities in CPET results, so establishing a worsening from PEM is a secondary concern really. My expectation is that many of those that take 2 days to show abnormality probably just have less autonomic dysfunction at baseline compared to the day 1 patients like myself.

    Ryan
     
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  14. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

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    My test was done in a university clinic.
    It depends on the setup, some recent equipment may automatically ramp the power up in almost continuous steps. Some equipment require the power to be ramped up manually in steps, 10-15w is common. However the protocol/rate of increase for athletes can be at a faster rate or use larger steps.

    Indeed. The equipment is often just sitting there unused, it ultimately just requires the time of a PhD student/postdoc and a supervisor and it can be done very cheaply.

    I have not seen any highly specific and replicated findings on 1 day CPET. Many patients have VO2Peak in the normal range (despite many people suggesting patients are severely deconditioned). VO2Peak numbers are easily biased from study to study as some patients are not encouraged enough to reach a true VO2Max (hint, if you weren't about to pass out, you hadn't reached maximal exertion).

    The single replicated finding (across all studies that have tested this) is the reduction in performance at the ventilatory threshold on the 2 day CPET.
     
    Last edited: Jul 14, 2018
  15. chicaguapa

    chicaguapa Established Member (Voting Rights)

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    Solent priced the 2-day CPET using the CFS protocol at the cost of a returning lactate test, so it may be that contacting the relevant university will yield a different price to what's shown on their websites.
     
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  16. chicaguapa

    chicaguapa Established Member (Voting Rights)

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    I had a long conversation today with the guys at Solent who did the tests. Their view is that it's not necessary to exercise to exhaustion on day 2 and that you just have to exercise to gas exchange threshold and then you can stop. This is if you just want to show that that the threshold has decreased on the second day. This may help if anyone is thinking of doing it there, or somewhere else, and isn't comfortable with the idea of pushing too far twice.
     

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