Spiroergometry

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Face mask on the test person

Spiroergometry or ergospirometry or ergospirography (from Latin spirare: to breathe , Greek ἔργον: work and μέτρον: measure ) is a diagnostic method in which the reaction of the heart , circulation , breathing and metabolism as well as cardiopulmonary performance qualitatively and by measuring respiratory gases during physical exertion is investigated quantitatively .

history

The attempt at work by Lavoisier and Seguin in 1789
Spiroergometry around 1900 in the USA
Spirometry in the field test in Berlin in 1928

→ See also history of ergometry

In 1789, Marie and Antoine Laurent de Lavoisier and Armand-Jean-François Seguin carried out the first experiments to measure the human gas metabolism during physical work. The English doctor William Prout carried out investigations in connection with foot marches in 1813, but could not achieve conclusive results. Between 1855 and 1857, the French physicist Gustav-Adolf Hirn carried out calculations of the mechanical heat equivalent in hermetically sealed chambers. He examined the exhaled air for its carbon dioxide, oxygen and nitrogen content. Charles Schützenberger (1809-1881), a physician who taught at the Medical Clinic of Strasbourg from 1845 to 1880 and then experimented on the island of Jars, introduced spirometric measurements. In 1924, Archibald Vivian Hill discovered maximum oxygen uptake (VO 2 max). He coined the terms O 2 deficit , steady state and O 2 -debt . Hugo Wilhelm Knipping is considered the father of today's spiroergometry .

functionality

The breathing gas measurement is carried out with a spirometry device (breathing gas measuring device) which analyzes the exhaled air (exhaled air) of the test person. The load is controlled with the help of an ergometer . During the measurement, the test person wears a face mask to which a volume sensor for measuring the ventilated air volume and a thin tube, the so-called suction section, are connected. A part of the expired air is fed via the suction section to the gas sensors in the spiroergometry device, where its gas content is analyzed. The percentage of gas in the exhaled air is compared with that of the ambient air. To calculate absolute values, the differences in gas concentrations are multiplied by the ventilated air volume. The gas concentration of each breath can be analyzed with modern methods (breath by breath).

Spiroergometric parameters

The most important respiratory gas parameters recorded during spiroergometry are: minute ventilation (VE), oxygen uptake (VO 2 ), carbon dioxide release (VCO 2 ) and respiratory rate (AF). Further parameters can be calculated from this: Respiratory quotient (RQ = VCO 2 / VO 2 ), breathing equivalent for O 2 (AÄO 2 = VE / VO 2 ), breathing equivalent for CO 2 (AÄCO 2 = VE / VCO 2 ) and tidal volume (AZV = VE / AF).

Maximum oxygen uptake (VO 2 max)

→ See Maximum oxygen uptake

For a long time, the relative maximum oxygen uptake (VO 2 max) based on body weight was considered an important parameter, as this value is easy to measure and shows a good correlation with performance in the aerobic range. However, the gas kinetics at submaximal exercise levels play a greater role in assessing aerobic performance during physical exertion.

Respiratory Compensation Point (RCP)

The respiratory compensation point (RCP) describes the point from which a decrease in the CO 2 concentration in the breath can be determined with increasing physical exertion . It thus corresponds to the subjectively ascertainable increased breathing. The reason for this is the increasing anaerobic energy supply , which leads to an acidification of the blood. According to medical doctrine, this stimulates breathing ( hyperventilation ), which leads to an excessive drop in the CO 2 concentration.

The RCP does not indicate the range of maximum oxygen uptake, but a submaximal range at which an exercise intensity can be maintained for about 60 - 120 minutes (steady state). It thus characterizes the long-term endurance or endurance limit and is comparable, but not identical, to the anaerobic threshold . In the RCP, possible compensation mechanisms and influencing factors such as buffer capacity, lactate metabolism and the vegetative hormonal response are taken into account. There is a closer relationship between RCP and competition performance than with the relative VO 2 max.

application areas

Spiroergometry is used today for the following purposes, among others:

→ See performance diagnostics
With the help of parameters such as VO 2 max or the RCP, longitudinal and cross-sectional comparisons of the endurance performance of the test person are possible.
  • Measurement of energy metabolism
→ See indirect calorimetry
The energy turnover and the substrate turnover ( fat and carbohydrate metabolism) of the test person are calculated using VO 2 and RQ.
  • Investigation of the efficiency of the respiratory system
A comparison with normal values ​​allows conclusions to be drawn from the results of the spiroergometry about the performance of the test person's cardiopulmonary system.

Measurement problems

Hyperventilation is a significant source of error. If this is triggered emotionally, for example by putting on the breathing mask , more CO 2 is exhaled, which does not come from the metabolism, but from the tissue and blood. However, since the O 2 uptake is not increased by hyperventilation, the respiratory quotient increases, which in indirect calorimetry leads to an overdetermined energy expenditure and in performance diagnostics to an incorrect respiratory compensation point.

Web links

Commons : Spirometry  - collection of images, videos and audio files
Commons : Ergometry  - collection of images, videos and audio files

Individual evidence

  1. a b c Wildor Hollmann: Sports medicine . Schattauer, Stuttgart 2000, ISBN 3-7945-1672-9 , p. 332-333 .
  2. Barbara I. Tshisuaka: Schützenberger, Charles. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , p. 1310.
  3. ^ A b c d Hans-Hermann Dickhuth : Introduction to sports and performance medicine . Hofmann, Schorndorf 2000, ISBN 3-7780-8461-5 , p. 202 .
  4. Other authors speak of a "central co-innervation", i. H. a stimulation of the sympathetic nerve activity, which, independently of the CO 2 exhalation necessary to regulate the blood PH, significantly increases the depth and frequency of breathing, cf. for example Uni Jena: Breath regulation ( memento of the original from December 20, 2012 in the Internet Archive ) Info: The archive link was automatically inserted and not yet checked. Please check the original and archive link according to the instructions and then remove this notice. . @1@ 2Template: Webachiv / IABot / www2.uni-jena.de
  5. Dickhuth, HH  ; Yin, L.; Niess, A.; Roecker, K.; Mayer, F.; Heitkamp, ​​HC; Horstmann, T .: Ventilatory, lactate-derived and catecholamine thresholds during incremental treadmill running: relationship and reproducibility . In: International Journal of Sports Medicine . tape 20 , no. 2 , 1999, p. 122-127 .
  6. Wildor Hollmann: Sports medicine . Schattauer, Stuttgart 2000, ISBN 3-7945-1672-9 , p. 385 .