Field Of Exercise Physiology Research Articles

An exercise physiologist's guide to metabolomics.

The field of exercise physiology has undergone significant technological advancements since the pioneering works of exercise physiologists in the early to mid-20th century. Historically, the ability to detect metabolites in biofluids from exercising participants was limited to single-metabolite analyses. However, the rise of metabolomics, a discipline focused on the comprehensive analysis of metabolites within a biological system, has facilitated a more intricate understanding of metabolic pathways and networks in exercise. This review explores some of the pivotal technological and bioinformatic advancements that have propelled metabolomics to the forefront of exercise physiology research. Metabolomics offers a unique 'fingerprint' of cellular activity, offering a broader spectrum than traditional single-metabolite assays. Techniques, including mass spectrometry and nuclear magnetic resonance spectroscopy, have significantly improved the speed and sensitivity of metabolite analysis. Nonetheless, challenges persist, including study design and data interpretation issues. This review aims to serve as a guide for exercise physiologists to facilitate better research design, data analysis and interpretation within metabolomics. The potential of metabolomics in bridging the gap between genotype and phenotype is emphasised, underscoring the critical importance of careful study design and the selection of appropriate metabolomics techniques. Furthermore, the paper highlights the need to deeply understand the broader scientific context to discern meaningful metabolic changes. The emerging field of fluxomics, which seeks to quantify metabolic reaction rates, is also introduced as a promising avenue for future research.

Standing on the Shoulders of Giants: Essential Papers in Sports and Exercise Physiology.

The purpose of this survey was to create a list of essential historical and contemporary readings for undergraduate and graduate students in the field of exercise physiology. Fifty-two exercise physiologists/sport scientists served as referees, and each nominated ∼25 papers for inclusion in the list. In total, 396 papers were nominated by the referees. This list was then sent back to the referees, with the instructions to nominate the "100 essential papers in sports and exercise physiology." The referees cast 4722 votes. The 100 papers with the highest number of votes received 51% (2406) of the total number of votes. A total of 37 papers in the list of "100 essential papers" were published >50years ago, and 63 papers were published since 1973. This list of essential studies will provide a perspective on contemporary studies, the "giant's shoulders" to enable young scholars to "see further" or to understand where they have "come from." This compilation is also meant to impress on students that, given the (lack of) technology available in the past, some of the early science required enormous intuitive leaps on the part of historical scientists.

Major clinical outcomes of metabolism and sports physiology: a systematic review

Introduction: In the sports medicine setting, many of the established positive health benefits of exercise have been documented by historic discoveries in the field of exercise physiology. Mitochondrial function is critical in regulating all three of the classic physiological factors that limit endurance performance. Objective: It was to carry out a systematic review to present the main information on exercise physiology in the light of mitochondrial redox activities in sports performance, as well as the guidelines of sports medicine in this regard. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from August to September 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles dated from 2008 to 2023. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 200 articles were found, and of the 77 articles were evaluated in full and 32 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 37 studies with a high risk of bias and 78 studies that did not meet GRADE. It was concluded that sports physicians may seek to use an increasing number of non-invasive techniques to study muscle metabolic functioning, answering how mitochondrial networks interact with O2 kinetics, how to remodel mitochondrial networks to increase performance, and how training affects the interaction between glycogen/lipid storage site and mitochondrial networks. Physiological and psychological demands during training and competition generate fatigue and reduce an athlete's sport-specific performance capacity. The magnitude of this decrease depends on several characteristics of the exercise stimulus, such as type, duration, and intensity, as well as on individual characteristics, such as physical conditioning, profile, and fatigue resistance. Recent evidence suggests that exercise-induced reactive species are essential upstream signals for the activation of redox-sensitive transcription factors and the induction of exercise-associated gene expression. Free radicals and oxidative stress are increasingly included in major reviews of exercise physiology as regulators of responses and adaptations.

Continuous Glucose Monitoring in Endurance Athletes: Interpretation and Relevance of Measurements for Improving Performance and Health

Blood glucose regulation has been studied for well over a century as it is intimately related to metabolic health. Research in glucose transport and uptake has also been substantial within the field of exercise physiology as glucose delivery to the working muscles affects exercise capacity and athletic achievements. However, although exceptions exist, less focus has been on blood glucose as a parameter to optimize training and competition outcomes in athletes with normal glucose control. During the last years, measuring glucose has gained popularity within the sports community and successful endurance athletes have been seen with skin-mounted sensors for continuous glucose monitoring (CGM). The technique offers real-time recording of glucose concentrations in the interstitium, which is assumed to be equivalent to concentrations in the blood. Although continuous measurements of a parameter that is intimately connected to metabolism and health can seem appealing, there is no current consensus on how to interpret measurements within this context. Well-defined approaches to use glucose monitoring to improve endurance athletes’ performance and health are lacking. In several studies, blood glucose regulation in endurance athletes has been shown to differ from that in healthy controls. Furthermore, endurance athletes regularly perform demanding training sessions and can be exposed to high or low energy and/or carbohydrate availability, which can affect blood glucose levels and regulation. In this current opinion, we aim to discuss blood glucose regulation in endurance athletes and highlight the existing research on glucose monitoring for performance and health in this population.

The Influence of Energy Balance and Availability on Resting Metabolic Rate: Implications for Assessment and Future Research Directions.

Resting metabolic rate (RMR) is a significant contributor to an individual's total energy expenditure. As such, RMR plays an important role in body weight regulation across populations ranging from inactive individuals to athletes. In addition, RMR may also be used to screen for low energy availability and energy deficiency in athletes, and thus may be useful in identifying individuals at risk for the deleterious consequences of chronic energy deficiency. Given its importance in both clinical and research settings within the fields of exercise physiology, dietetics, and sports medicine, the valid assessment of RMR is critical. However, factors including varying states of energy balance (both short- and long-term energy deficit or surplus), energy availability, and prior food intake or exercise may influence resulting RMR measures, potentially introducing error into observed values. The purpose of this review is to summarize the relationships between short- and long-term changes in energetic status and resulting RMR measures, consider these findings in the context of relevant recommendations for RMR assessment, and provide suggestions for future research.

The Final Pathway of Carbohydrate Oxidation: Revisiting the mLOC

The confirmation of the Intracellular Lactate Shuttle proposed by Brooks and colleagues in 1998 revolutionized the way lactate metabolism was studied in the field of exercise physiology, nutrition, metabolism, and medicine. Previous investigations identified the structure of the mitochondrial Lactate Oxidation Complex (mLOC) which includes MCT1, LDH, COX4, and CD147. While the predominant view in research and textbooks was that pyruvate was imported into the mitochondria to be oxidized it wasn’t until 2009 that Jiang and Colleagues elucidated the mitochondrial pyruvate carrier (mPC). Knowing this, many researchers developed their questions around either pyruvate or lactate metabolism, which may have led to confusion in the field since both substrates play an important role in carbohydrate oxidation. This dilemma led us to the hypothesis that the mPC is in fact an extended member of the mLOC. Mixed skeletal muscle and liver were excised and whole blood was collected post-mortem from (n=5) 4-month-old C57B/l6 mice. Tissues were homogenized in an isotonic solution supplemented with a protease and phosphatase inhibitor. Blood was resuspended in H2O to rupture the cell membranes and the lysates (RBC) were used as negative controls. Mitochondria were isolated by differential centrifugation and resuspended in RIPA buffer. Protein concentrations of tissues were determined using a BCA standard. Western blotting was performed by loading 20 ug of each lysate, separated on an SDS-PAGE gel, and transferred to a PVDF membrane. Membranes were blocked and probed for MCT1(1:1000), mPC1 (1:500), COX4(1:1000), LDHA (1:1000). An SDS-PAGE was repeated and the mPC was excised from the gel. A trypsin digest was performed to isolate the peptides and then analyzed by one-dimensional LCMS/MS at the UC Berkeley QB3 proteomics/mass spectrometry lab. For cDNA preparation, RNA was extracted from 15 mg of skeletal muscle using the Qiagen RNeasy Fibrous tissue kit, reverse transcribed, and concentrated using Quibit ssDNA kit. Quantitative PCR was run on a QuantStudio3 using Power SYBR Green chemistry to confirm the presence of mPC1 in skeletal muscle. Our results revealed that mPC1 was expressed in skeletal muscle along with other genes associated with the mLOC. Immunoblots of mitochondrial lysates contained MCT1, mPC1, LDH, and COX4 in both the skeletal muscle and liver mitochondrial fractions. As expected, MCT1 was also present in RBC lysates as the MCTs are present in both the sarcolemma and mitochondrial membrane. Moreover, LCMS/MS analysis confirmed the presence of mPC1 corroborating our immunoblots. Colocalization using immunocytochemistry confirms the revised mLOC structure. Accordingly, both the pyruvate and lactate transporters assist in maintaining the redox balance and varying rates of carbohydrate oxidation during changing physiological conditions. This promising data has implications for a variety of fields ranging from cancer biology to exercise physiology. NIH Grant #1 R01 AG059715-01 This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

How the Oxynet web applications are used to crowdsource and interpret cardiopulmonary exercising tests data

The cardiopulmonary exercise test (CPET) is the gold standard procedure to assess an individual’s aerobic fitness. Oxynet is an ongoing research effort to deliver an objective and automatic interpretation of CPET. On its software side, Oxynet consists of a free-to-use crowdsourcing web-application and a free-to-use deep learning inference web-application. Particularly, Oxynet includes a ventilatory threshold detection deep learning algorithm.Oxynet can achieve expert-level performance in the identification of the first and second ventilatory thresholds from CPET data. Accuracy is preserved across individuals with different aerobic fitness. Declared average root mean square errors and worst 90th percentiles in terms of time and oxygen uptake for individuals with low/moderate/high fitness levels are: 7/22/10 (90th = 13/38/18) and 12/17/8 (90th = 43/27/17) s, 22/43/92 (90th = 76/95/246) and 29/56/44 (90th = 69/106/109) mlO2/min, for the first and second ventilatory threshold, respectively.Oxynet can be considered the first example of a deep learning algorithm trained with crowdsourced data in the field of the cardiopulmonary exercising test and triggers new opportunities for collaboration between experts in the field of exercise physiology. This project can potentially provide low-cost and time-efficient universal access to cardiopulmonary exercise test interpretation.

Sports nutrology and gut microbiota

Introduction: Many of the established positive health benefits of exercise have been documented by historic discoveries in the field of exercise physiology. Regular physical training associated with nutritional health has broad health benefits for the gut microbiota, acting positively on almost all organ systems of the body. Objective: It was to analyze the main metabolic pathways modulated by nutrients, gut microbiota, and physical exercise in muscle regeneration and sports performance. Methods: The present study followed a systematic review model (PRISMA). The literary search process was carried out from July to September 2022 and was developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar, with scientific articles from 2004 to 2022. The low quality of evidence was attributed to case reports, editorials, and brief communications, according to the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: We found 132 studies that underwent eligibility analysis, and then 31 of the 52 total studies were selected for this systematic review. According to the GRADE instrument, most studies showed homogeneity in their results, with I2 =98.9% >50%. The Funnel Plot showed a symmetrical behavior, not suggesting a significant risk of bias in studies with a smaller sample size. A healthy gut microbiota and a positive interaction with the immune system, promoted by diligent nutrological care, can be crucial for the muscle-gut axis and can influence the maintenance of muscle mass and its functionality in athletes. However, dysbiosis resulting from a negative interaction with the immune system can influence muscle wasting disorders. These changes can promote systemic inflammation, with overproduction of the pro-inflammatory cytokines TNF-α, IL-1β, and IL-6. Future studies should clarify whether gut microbiota dysbiosis and nutrient depletion are pathophysiologically associated with muscle wasting disorders and whether exercise can positively influence this supposed gut-muscle axis.

Differential control of respiratory frequency and tidal volume during exercise.

The lack of a testable model explaining how ventilation is regulated in different exercise conditions has been repeatedly acknowledged in the field of exercise physiology. Yet, this issue contrasts with the abundance of insightful findings produced over the last century and calls for the adoption of new integrative perspectives. In this review, we provide a methodological approach supporting the importance of producing a set of evidence by evaluating different studies together-especially those conducted in 'real' exercise conditions-instead of single studies separately. We show how the collective assessment of findings from three domains and three levels of observation support the development of a simple model of ventilatory control which proves to be effective in different exercise protocols, populations and experimental interventions. The main feature of the model is the differential control of respiratory frequency (fR) and tidal volume (VT); fR is primarily modulated by central command (especially during high-intensity exercise) and muscle afferent feedback (especially during moderate exercise) whereas VT by metabolic inputs. Furthermore, VT appears to be fine-tuned based on fR levels to match alveolar ventilation with metabolic requirements in different intensity domains, and even at a breath-by-breath level. This model reconciles the classical neuro-humoral theory with apparently contrasting findings by leveraging on the emerging control properties of the behavioural (i.e. fR) and metabolic (i.e. VT) components of minute ventilation. The integrative approach presented is expected to help in the design and interpretation of future studies on the control of fR and VT during exercise.

State of Knowledge on Molecular Adaptations to Exercise in Humans: Historical Perspectives and Future Directions.

For centuries, regular exercise has been acknowledged as a potent stimulus to promote, maintain, and restore healthy functioning of nearly every physiological system of the human body. With advancing understanding of the complexity of human physiology, continually evolving methodological possibilities, and an increasingly dire public health situation, the study of exercise as a preventative or therapeutic treatment has never been more interdisciplinary, or more impactful. During the early stages of the NIH Common Fund Molecular Transducers of Physical Activity Consortium (MoTrPAC) Initiative, the field is well-positioned to build substantially upon the existing understanding of the mechanisms underlying benefits associated with exercise. Thus, we present a comprehensive body of the knowledge detailing the current literature basis surrounding the molecular adaptations to exercise in humans to provide a view of the state of the field at this critical juncture, as well as a resource for scientists bringing external expertise to the field of exercise physiology. In reviewing current literature related to molecular and cellular processes underlying exercise-induced benefits and adaptations, we also draw attention to existing knowledge gaps warranting continued research effort. © 2021 American Physiological Society. Compr Physiol 12:3193-3279, 2022.

A multi-mode triboelectric nanogenerator for energy harvesting and biomedical monitoring

In the field of exercise physiology, it is of great significance to monitor human body motion status and physiological functions for assessing physical quality and training load. However, the wearable electronics as the mainstream monitoring solution have power consumption and bulk-size issues that limit sustainable operation. Here, we present a multi-mode stretchable and wearable triboelectric nanogenerator (msw-TENG) for biomechanical energy harvesting and physiological functions sensing. The msw-TENG fabricated by a liquid metal and silicone achieves stretchable and highly conductive characteristics at the same time, and realizes conformal contact with skin. The msw-TENG mainly includes contact separation/stretch/press modes, which can be randomly transformed according to the actual applications. The device converts the biomechanical energy of limb movement into electrical energy for directly lighting up commercial LEDs. Additionally, the radial artery pulse signal, joint bending angle and limb stability can be detected in real-time. As a multifunctional biomedical active sensor that is exempt from needing an extra power source, the proposed msw-TENG holds great potentials in the future of exercise monitoring and rehabilitation therapy.

Identification of Non-Invasive Exercise Thresholds: Methods, Strategies, and an Online App.

During incremental exercise, two thresholds may be identified from standard gas exchange and ventilatory measurements. The first signifies the onset of blood lactate accumulation (the lactate threshold, LT) and the second the onset of metabolic acidosis (the respiratory compensation point, RCP). The ability to explain why these thresholds occur and how they are identified, non-invasively, from pulmonary gas exchange and ventilatory variables is fundamental to the field of exercise physiology and requisite to the understanding of core concepts including exercise intensity, assessment, prescription, and performance. This review is intended as a unique and comprehensive theoretical and practical resource for instructors, clinicians, researchers, lab technicians, and students at both undergraduate and graduate levels to facilitate the teaching, comprehension, and proper non-invasive identification of exercise thresholds. Specific objectives are to: (1) explain the underlying physiology that produces the LT and RCP; (2) introduce the classic non-invasive measurements by which these thresholds are identified by connecting variable profiles to underlying physiological behaviour; (3) discuss common issues that can obscure threshold detection and strategies to identify and mitigate these challenges; and (4) introduce an online resource to facilitate learning and standard practices. Specific examples of exercise gas exchange and ventilatory data are provided throughout to illustrate these concepts and a novel online application tool designed specifically to identify the estimated LT (θLT) and RCP is introduced. This application is a unique platform for learners to practice skills on real exercise data and for anyone to analyze incremental exercise data for the purpose of identifying θLT and RCP.

A Pilot Study of miRNA Expression Profile as a Liquid Biopsy for Full-Marathon Participants.

Exosomal microRNA (miRNA) in plasma and urine has attracted attention as a novel diagnostic tool for pathological conditions. However, the mechanisms of miRNA dynamics in the exercise physiology field are not well understood in terms of monitoring sports performance. This pilot study aimed to reveal the miRNA dynamics in urine and plasma of full-marathon participants. Plasma and urine samples were collected from 26 marathon participants before, immediately after, 2 h after, and one day after a full marathon. The samples were pooled, and exosomal miRNAs were extracted and analyzed using next-generation sequencing. We determined that the exosomal miRNA expression profile changed under time dependency in full marathon. New uncharacterized exosomal miRNAs such as hsa-miR-582-3p and hsa-miR-199a-3p could be potential biomarkers reflecting physical stress of full marathon in plasma and urine. In addition, some muscle miRNAs in plasma and urine have supported the utility for monitoring physical stress. Furthermore, some inflammation-related exosomal miRNAs were useful only in plasma. These results suggest that these exosomal miRNAs in plasma and/or urine are highly sensitive biomarkers for physical stress in full marathons. Thus, our findings may yield valuable insights into exercise physiology.

Exercise Physiology From 1980 to 2020: Application of the Natural Sciences.

The field of exercise physiology has enjoyed tremendous growth in the past 40 years. With its foundations in the natural sciences, it is an interdisciplinary field that is highly relevant to human performance and health. The focus of this review is on highlighting new approaches, knowledge, and opportunities that have emerged in exercise physiology over the last four decades. Key among these is the adoption of advanced technologies by exercise physiologists to address fundamental research questions, and the expansion of research topics to range from molecular to organismal, and population scales in order to clarify the underlying mechanisms and impact of physiological responses to exercise in health and disease. Collectively, these advances have ensured the position of the field as a partner in generating new knowledge across many scientific and health disciplines.

Translational Medicine and Exercise Prescription (TMEP): Advancing the Era of Exercise Medicine

Translational Medicine and Exercise Prescription (TMEP): Advancing the Era of Exercise Medicine

Impact of paternal exercise on physiological systems in the offspring

A significant number of studies have demonstrated that paternal exercise modulates future generations via effects on the sperm epigenome. However, comprehensive information regarding the effects of exercise performed by the father on different tissues and their clinical relevance has not yet been explored in detail. This narrative review is focused on the effects of paternal exercise training on various physiological systems of offspring. A detailed mechanistic understanding of these effects could provide crucial clues for the exercise physiology field and aid the development of therapeutic approaches to mitigate disorders in future generations. Non-coding RNA and DNA methylation are major routes for transmitting epigenetic information from parents to offspring. Resistance and treadmill exercise are the most frequently used modalities of planned and structured exercise in controlled experiments. Paternal exercise orchestrated protective effects over changes in fetus development and placenta inflammatory status. Moreover paternal exercise promoted modifications in the ncRNA profiles, gene and protein expression in the hippocampus, left ventricle, skeletal muscle, tendon, liver and pancreas in the offspring, while the transgenerational effects are unknown. Paternal exercise demonstrates clinical benefits to the offspring and provides a warning on the harmful effects of a paternal unhealthy lifestyle. Exercise in fathers is presented as one of the most logical and cost-effective ways of restoring health in the offspring and, consequently, modifying the phenotype. It is important to consider that paternal programming might have unique significance in the developmental origins of offspring diseases.

Potential Association of Circulating MicroRNA-181c and MicroRNA-484 Levels with Cardiorespiratory Fitness after Myocardial Infarction: A Pilot Study.

ABSTRACTObjectives:In the field of exercise physiology, there has been great interest in exploring circulating microRNAs (miRs) as potential biomarkers. However, it remains to be determined whether circulating miRs reflect cardiorespiratory fitness. The aim of this study was to investigate the association between circulating levels of specific miRs and cardiorespiratory fitness evaluated by cardiopulmonary exercise testing (CPET) after acute myocardial infarction (MI).Methods:Twenty patients who had had an acute MI were included. All patients underwent CPET in the convalescent phase. Quantitative real-time polymerase chain reaction analyses for miR-181 members (a/b/c) and miR-484 were performed to determine the expression levels in the peripheral blood of the included patients and healthy control subjects (n=5).Results:Post-MI patients showed impaired exercise tolerance and ventilatory efficiency in CPET analysis. Compared with controls, circulating levels of miR-181a and 181c were gradually and significantly elevated through the 1st to 7th days after acute MI, whereas miR-181b and miR-484 were not. Circulating miR levels did not correlate with clinical or echocardiographic parameters. However, circulating levels of miR-181c and miR-484 on the 7th day showed significant positive correlations with the anaerobic threshold and peak oxygen consumption from CPET analysis. Moreover, miR-181c levels were inversely associated with the ventilatory inefficiency index. Patients with high exercise capacity after MI showed significantly higher expressions of circulating miR-181c and miR-484 than those with low exercise capacity.Conclusions:The results of this pilot study suggest that circulating levels of miR-181c and miR-484 after acute MI may be predictive biomarkers of post-MI cardiorespiratory fitness.

Cellular and molecular exercise physiology

Exercise physiology has evolved as a main area of investigation, in which the central goal is to better understand how the physiological systems respond to an acute bout of exercise and how these systems adapt to different types of exercise training. For many years and until now, exercise physiology field have been grounded in the fundamentals of biology and human physiology. However, during the last century, scientific knowledge has changed our understanding of biological sciences, allowing the integration of different areas, and increasing the focus on many sub-areas like cellular and molecular investigation. The development of new experimental techniques in the last years provided detailed information about cellstructure and function and, as a result, we could better understand not only the human body physiology, but also many diseases and their pathophysiology. Therefore, this present review intends to discuss more about cellular and molecular exercise physiology area, focusing on historical and methodological approaches, and highlighting the future perspectives for scientific knowledge and their practical application in health and exercise.

Cellular and molecular exercise physiology

Exercise physiology has evolved as a main area of investigation, in which the central goal is to better understand how the physiological systems respond to an acute bout of exercise and how these systems adapt to different types of exercise training. For many years and until now, exercise physiology field have been grounded in the fundamentals of biology and human physiology. However, during the last century, scientific knowledge has changed our understanding of biological sciences, allowing the integration of different areas, and increasing the focus on many sub-areas like cellular and molecular investigation. The development of new experimental techniques in the last years provided detailed information about cellstructure and function and, as a result, we could better understand not only the human body physiology, but also many diseases and their pathophysiology. Therefore, this present review intends to discuss more about cellular and molecular exercise physiology area, focusing on historical and methodological approaches, and highlighting the future perspectives for scientific knowledge and their practical application in health and exercise.

Developing and validating equations to predict O2 peak from the 6MWT in Childhood ALL Survivors

Introduction The 6-Minute Walking Test (6MWT) is a safe, standardized and well utilized method to assess the functional capacity. Recently, it was reported that the published prediction equations cannot accurately predict a valid maximal oxygen consumption (V̇O2 peak) value in cancer survivors. Thus, the aim of this study was to establish and to validate a new equation based on the 6MWT to predict V̇O2 peak in childhood acute lymphoblastic leukemia (ALL) survivors. Methods A total of 200 childhood ALL survivors were enrolled in this study, among which 168 participants underwent a cardiopulmonary exercise test and a 6MWT to assess their functional capacity and their cardiorespiratory fitness. In addition, participants completed a physical activity questionnaire. Participants were randomly divided in two groups to establish the equations (n = 118 (70%)) and to validate it (n = 50 (30%)). Multiple linear regression analyses were used to determine a new prediction equation for V̇O2 peak from 6MWT using clinical and specific variables related to the disease. The accuracy in between V̇O2 peak measured and V̇O2 peak predicted were assessed using the Bland and Altman method. Results The new establish clinical V̇O2 peak equation is: V̇O2 peak (mL.kg−1.min−1) = (−0.283*age(years)) − (0.099*weight(kg)) + (0.071*6MWD(meters)) −(0.135*HR end(bpm)) + 22.789 with a mean bias of 2.67 mL.kg−1.min−1 (95% CI (−9.64 to 14.98)). The new establish disease-specific V̇O2 peak equation is: V̇O2 peak (mL.kg−1.min−1) = (−0.236*age(years)) − (0.094*weight(kg)) −(0.120*HR end(bpm)) + (0.067*6MWD(meters)) + (0.065*MVLPA(min/day)) − (0.204*DT(years)) + 25.145 with a mean bias of 2.51 mL.kg−1.min−1 (95% CI (−9.98 to 15.01)). Conclusion This is the first study that predicted V̇O2 peak from a 6MWT using clinical and specific variables related to the disease of childhood ALL survivors. The availability of these newly established V̇O2 peak equations makes them an accurate tool to provide a better follow-up and better adapted physical training for survivors. We invite researchers to use our assessment procedures for their further studies. IMPLICATIONS FOR REHABILITATION It is critical to understand the cardiorespiratory fitness of the childhood ALL survivors The maximal oxygen consumption (i.e., V̇O2 peak) is recognized as the gold standard to measure the patient’s cardiorespiratory fitness in the field of exercise physiology This study is novel and reports the validation of two new VO2 peak equations, from 6MWT, by using clinical and disease-specific variables of childhood ALL survivors The availability of such validated equations can better facilitate the follow-up of survivors' cardiorespiratory fitness, by relevant health care professionals and exercise physiologists.