Utility of Verification Testing to Confirm Attainment of Maximal Oxygen Uptake in Unhealthy Participants: A Perspective Review

Maximal oxygen uptake (VO2max) is strongly associated with endurance performance as well as health risk. Despite the fact that VO2max has been measured in exercise physiology for over a century, robust procedures to ensure that VO2max is attained at the end of graded exercise testing (GXT) do not exist. This shortcoming led to development of an additional bout referred to as a verification test (VER) completed after incremental exercise or on the following day. Workloads used during VER can be either submaximal or supramaximal depending on the population tested. Identifying a true VO2max value in unhealthy individuals at risk for or having chronic disease seems to be more paramount than in healthy and active persons, who face much lower risk of premature morbidity and mortality. This review summarized existing findings from 19 studies including 783 individuals regarding efficacy of VER in unhealthy individuals to determine its efficacy and feasibility in eliciting a ‘true’ VO2max in this sample. Results demonstrated that VER is a safe and suitable approach to confirm attainment of VO2max in unhealthy adults and children, as in most studies VER-derived VO2max is similar of that obtained in GXT. However, many individuals reveal higher VO2max in response to VER and protocols used across studies vary, which merits additional work identifying if an optimal VER protocol exists to elicit ‘true’ VO2max in this particular population