anciendaze
Senior Member
- Messages
- 1,841
There's an even simpler way to falsify any hypothesis based on volition which I noticed in looking at some individual results patients supplied us before these publications when they were tested for disability claims: the peak power output was the same on day-1 and day-2. If you can detect a patient holding his/her breath there does not appear to be any other way to voluntarily control the transition from aerobic to anaerobic metabolism.There are objective indicators of maximal effort built into the CPET. One of those is the Respiratory Quotient (or Respiratory Exchange Rate), which is the ratio of CO2 exhaled to O2 inhaled. This cannot be controlled or faked by the patient. If the RQ gets to 1.1 or higher, the patient has exerted maximal effort, and accusations of slacking off are completely absurd at that point...
There are disputes within the research community, unrelated to ME/CFS, about exactly what constitutes the threshold for this switch, which we would do well to avoid, where possible.