Methodological approach to the first and second lactate threshold in incremental cardiopulmonary exercise testing

Eur J Cardiovasc Prev Rehabil. 2008 Dec;15(6):726-34. doi: 10.1097/HJR.0b013e328304fed4.


Determination of an 'anaerobic threshold' plays an important role in the appreciation of an incremental cardiopulmonary exercise test and describes prominent changes of blood lactate accumulation with increasing workload. Two lactate thresholds are discerned during cardiopulmonary exercise testing and used for physical fitness estimation or training prescription. A multitude of different terms are, however, found in the literature describing the two thresholds. Furthermore, the term 'anaerobic threshold' is synonymously used for both, the 'first' and the 'second' lactate threshold, bearing a great potential of confusion. The aim of this review is therefore to order terms, present threshold concepts, and describe methods for lactate threshold determination using a three-phase model with reference to the historical and physiological background to facilitate the practical application of the term 'anaerobic threshold'.

Publication types

  • Review

MeSH terms

  • Anaerobic Threshold*
  • Biomarkers / blood
  • Energy Metabolism
  • Exercise Test / methods*
  • Exercise Test / standards
  • Exercise*
  • Heart Rate*
  • Humans
  • Lactic Acid / blood*
  • Models, Biological
  • Predictive Value of Tests
  • Pulmonary Gas Exchange*
  • Pulmonary Ventilation*
  • Terminology as Topic


  • Biomarkers
  • Lactic Acid