Criteria for maximal oxygen uptake: review and commentary.

Historically, the achievement of maximal oxygen uptake (VO2max) has been based on objective criteria such as a leveling off of oxygen uptake with an increase in work rate, high levels of lactic acid in the blood in the minutes following the exercise test, elevated respiratory exchange ratio, and achievement of some percentage of an age-adjusted estimate of maximal heart rate. These criteria are reviewed relative to their history, the degree to which they have been achieved in published research, and how investigators and reviewers follow them in current practice. The majority of the criteria were based on discontinuous protocols, often carried out over several days. Questions are raised about the applicability of these criteria to modern continuous graded exercise test protocols, and our lack of consistency in the terminology we use relative to the measurement of maximal oxygen uptake.