ArticleAnnals of medicine2026
How much of the incremental protocol does a lactate threshold need? Agreement between three-stage and five-stage testing across seven lactate-derived indices in swimmers.
Article in Annals of medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIncremental lactate testing is widely used to characterize the lactate-velocity relationship in swimmers, but the highest-intensity stages increase testing burden and may be difficult to execute consistently.
objectiveTo determine whether a five-stage protocol can be reduced to three stages without materially changing seven lactate-derived velocity indices, and whether model complexity affects reconstruction.
methodsNinety highly trained swimmers completed a 5 × 200 m freestyle incremental test at 80-100% of 200 m personal-best performance. Stage-4 and stage-5 lactate values were reconstructed from the first three stages using participant-specific linear extrapolation and a long short-term memory (LSTM) model. Seven lactate-derived indices were recalculated and compared with full-protocol values using limits of agreement, typical error, ICC(A,1) and equivalence testing.
resultsLactate reconstruction was inaccurate for both models, yet v@Exp-Dmax showed close agreement with the full protocol (bias -0.008 m·s
conclusionsA three-stage protocol may support lower-burden longitudinal monitoring of v@Exp-Dmax, but protocol simplification is index-specific and does not establish physiological threshold validity.
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