Lessons from history for VO₂ max and the VO₂ plateau, part 1, 1920 – 1961: original concepts were based on discontinuous exercise protocols

Purpose: The maximal rate of oxygen uptake ((Formula presented.) max) has an early history (1920–1961) based on discontinuous incremental exercise protocols. Regardless, debate continues on many sub-topics and methodologies involved in this measure. There could be lessons to learn about the relevance, or not, of content within the accumulating knowledge of this topic if there is a detailed account of the research of this time-period. Methods: Manuscript references were retrieved from PubMed and Google Scholar for the targeted topics and time-period. Results: In 1923 and 1924, Hill proposed that during discontinuous incremental exercise bouts, there is eventually a levelling in (Formula presented.) despite increasing exercise intensity or sustained effort. Subsequent researchers in the 1950’s described this ‘levelling in (Formula presented.) ’ observation as a plateau, which functioned to verify (Formula presented.) max. However, when critiquing the data from studies with valid methodology, evidence of a (Formula presented.) plateau at or near (Formula presented.) max was only seen in a subset of participants in 1924 (2 of 7), with added evidence in 1959 (2 of 4) and 1961 (4 of 5). Collectively, 50% of the subjects were unable to attain a (Formula presented.) plateau response at (Formula presented.) max. Conclusion: Despite major limitations to the published research and data interpretations prior to 1961, such work led to the incorrect (not evidence-based) expectation that all participants should demonstrate a (Formula presented.) plateau at or near (Formula presented.) max. The inter-connectedness of (Formula presented.) max and the (Formula presented.) plateau concepts thereby became engrained into the pre-1970s, and perhaps later, epistemology of exercise physiology.