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O\u2082P flattening, defined as the absence of a further increase in O\u2082P despite increasing workload, was assessed visually and confirmed quantitatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twelve participants (35%) demonstrated O\u2082P flattening or decline, nine (27%) exclusively during Treadmill testing. A significant group \u00d7 modality interaction was observed for peak O\u2082P (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), with lower values in participants with flattening than in those showing a continuous rise. (Cycle: 9.9\u2009\u00b1\u20093.2 vs. 13.6\u2009\u00b1\u20092.7\u00a0ml\/min\/beat; Treadmill: 11.8\u2009\u00b1\u20093.7 vs. 16.6\u2009\u00b1\u20093.7\u00a0ml\/min\/beat). In addition, an O\n                      <jats:sub>2<\/jats:sub>\n                      P of \u2264\u200912.8\u00a0ml\/beat on the Cycle increased the likelihood of flattening during maximal Treadmill exercise by 7.5 times (OR 7.5,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>O\u2082P flattening was more frequently observed during treadmill exercise, indicating that O\u2082P trajectories are exercise modality dependent. In individuals with low peak O\u2082P during cycle ergometry, additional assessment using treadmill CPET may offer complementary information.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00421-026-06437-w","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T15:10:18Z","timestamp":1790608218000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exercise modality influences oxygen pulse flattening during incremental cardiopulmonary exercise testing in healthy adults"],"prefix":"10.1007","author":[{"given":"Gur","family":"Mainzer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faris","family":"Khourey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merav","family":"Zucker-Toledano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronen","family":"Bar-Yoseph","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4540-4039","authenticated-orcid":false,"given":"Einat","family":"Kodesh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"6437_CR1","doi-asserted-by":"crossref","unstructured":"Accalai E, Vignati C, Salvioni E, Pezzuto B, Contini M, Cadeddu C, Meloni L, Agostoni P (2021) Non-invasive estimation of stroke volume during exercise from oxygen in heart failure patients, vol 28. 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