A recent and controversial review1 suggests that the measurement of maximal oxygen intake is passé. The author concludes (p. 554) “It is now time to develop novel testing methods....That the measured VO2max is a relatively poor predictor of both the performance potential of athletes with similar athletic ability and of the changes in performance that occur with continued training should encourage both basic and applied sports scientists to reconsider the real value of this iconic test.”

A number of the arguments that are advanced in this review seem to need correction or refutation. Specifically, this riposte will examine whether a maximal treadmill test is an unrealistic procedure for athletes, whether a unimodal approach to testing is appropriate in sports medicine, and whether an alternative laboratory test will be developed to categorise the performance of individual athletes. Comments will also be made on the place of maximal oxygen intake assessment in various areas of science, sports medicine and clinical medicine.

IS THE MAXIMAL TREADMILL TEST AN UNREALISTIC PROCEDURE FOR ATHLETES?

Noakes argues1 that the treadmill test is an unrealistic approach to the testing of athletes for three reasons: the duration of the exercise is not known to the subject, there is a steep and progressive increase in the intensity of exercise, and the person who is tested has no control over the ultimate intensity of effort. All of these criticisms may be true of the test protocol used in some laboratories. However, the standard recommendation is for a treadmill test lasting 9–11 minutes, and this should be explained to the subject. The appropriate treadmill slope and speed should be ascertained by preliminary submaximal testing; this allows the definitive test to commence close to maximal steady-state effort, thereby avoiding a steep ramp of intensity. Moreover, the maximal …