The following organs are the focus of performance diagnostics:
Various devices and examination methods are available for the examination.
These include examinations of the
In principle, performance diagnostics are also suitable for recreational athletes and non-athletes. Patients with heart disease, for example, undergo performance diagnostics after heart bypass surgery or stent implantation. The aim for these patients is slowly increasing physical exercise training.
The most common area of application is sport, especially competitive sport.
Typical examples of its use in popular sports are
- Preparation for a marathon
- Preparation for an extreme competition (e.g. desert competition or crossing the Alps)
In these cases, the primary aim is to determine whether there are any health concerns that speak against exercise.
The most important examination results of the heart (at rest and during exercise) are
- Number of heartbeats (heart rate: between 50 and 200 beats/minute)
- Volume of blood ejected (cardiac output: 80-200 ml/beat; cardiac output per minute: 4-36 l/minute)
- Muscle work of the heart (visible on ECG and cardiac echocardiography)
The most important examination results of the lungs (at rest and during exercise) are
- Number of breaths (respiratory rate 10-50/minute)
- Volume of air inhaled and exhaled (tidal volume: 500-3000 ml/minute)
- Oxygen requirement at rest (150-300ml), during exercise (up to 6 liters/minute)
The most important test results for muscle strength and metabolism are
- Lactic acid (lactate 0.5-1.5mmol/l at rest, increase to > 10mmol/l at maximum load)
- Maximum strength in weightlifting (1RM = one-repetition maximum is the maximum weight that the athlete can lift once)
The procedure is standardized in order to be able to compare individual measurement results between the tests (sometimes months or years apart).
First, the doctor determines and documents body measurements such as height and weight. Doctors also determine the heart rate under resting conditions. This is usually done using a heart rate monitor. Normally, the patient continues to wear this during the subsequent exercise test in order to document the heart rate during exercise.
Doctors then carry out a sport-specific exercise test. This is usually done on a treadmill or bicycle ergometer.
Performance test on the bicycle ergometer @ rh2010 /AdobeStock
The increase in load is also standardized, which is why it is also referred to as a step test. The defined intervals are 3 minutes. This is followed by a continuous increase in load.
Athletes usually reach their performance limit after 20 to 30 minutes. The heart rate increases with increasing exertion. The maximum heart rate depends on the athlete's training status and age.
The functionality of the metabolism and energy utilization are examined by means of a lactate test. During the lactate test, the athlete takes a short break between the individual intervals. During these breaks, the doctor takes blood from the earlobe. This allows him to determine the athlete's lactate level.
Alternatively, spiroergometry is used to examine metabolic activity in more detail. The continuous measurement of respiratory gases (oxygen and carbon dioxide) is carried out using a breathing mask. A break between the individual exercise intervals is not necessary with spiroergometry.
Spiroergometry is a procedure to check the resilience of the lungs and cardiovascular system @ StefanBartenschlager /AdobeStock
It is important for the athlete's training success to know their own performance and to align their training plan accordingly.
The so-called anaerobic threshold can be determined from the lactate values and the increase over time. This is the point at which the metabolism with oxygen (aerobic) changes to without oxygen (anaerobic). This is the limit of endurance capacity. Below this threshold, the athlete can usually achieve a long-duration endurance performance (marathon run).
The majority of the training load for endurance athletes should be below the anaerobic threshold. However, shorter and more intensive training units in the area of the anaerobic threshold are also important in order to increase performance.
Through such high-intensity training units, athletes can set targeted training stimuli and shift their anaerobic threshold. This makes it possible to maintain higher speeds for longer.
Lactate used to be the villain in endurance sports, as it was assumed that lactate would lead to a loss of performance.
There are now also positive aspects, as athletes now know how they can use lactate to their advantage. A continuous increase in performance through specific training methods leads to an increase in lactate concentration.
An increased concentration in turn leads to a higher lactate tolerance. This means that the better the athlete copes with the increased lactate concentration, the less performance is lost.
The normal lactate value at rest is 0.5 - 1 mmol/l.
It initially rises slightly with increasing exertion and rises steeply from a value of 4 mmol/l. When the value rises steeply depends on the individual.
The lactate curve illustrates the threshold between aerobic (with oxygen) and anaerobic (without oxygen) metabolism. The so-called anaerobic threshold.
With increasing training, this threshold shifts to the right (i.e. towards greater exertion). This shift to the right is visible between the performance tests and is proof of a positive training effect.
Lactateis measured using a blood sample from the earlobe @ M. Siegmund /AdobeStock
VO2max is an abbreviation for the maximum amount of oxygen that an athlete can absorb.
The unit is ml/kilogram of body weight/minute (ml/kgKG/min).
A good value for women is > 45, for men > 51. Professional endurance athletes can reach up to 80. This means that the athlete can take in more than 6 liters/minute of oxygen.
Non-athletes can also carry out a performance test, which is useful for training planning.
One aim can be to improve fitness without endangering health or overstraining the body. The latter is associated with a significantly increased risk of injury.
Performance diagnostics is an individual health service (IGel) that is only covered by health insurance in exceptional cases. You should clarify whether the costs will be covered in advance. The costs amount to approx. 150-250 €.