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Tan L, Li Y, Chen H, Lanzi G, Hu X. Sleep at high altitude: A bibliometric study and visualization analysis from 1992 to 2022. Heliyon 2024; 10:e23041. [PMID: 38163230 PMCID: PMC10755286 DOI: 10.1016/j.heliyon.2023.e23041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 01/03/2024] Open
Abstract
Background As an important monitoring index for adaptation to hypoxia, sleep may reflect the adaptive state of the body at high altitudes. The literature has shown a link between altitude and sleep problems, and sleep changes have become a common problem for individuals at high altitudes, negatively impacting their physical and mental health. As research on high-altitude sleep has gained attention in recent years, the publishing volume has increased worldwide, necessitating a more comprehensive understanding of this field. This manuscript evaluates the key themes and emerging trends in high-altitude sleep over the past few decades and predicts future research directions. Methods Articles related to high-altitude sleep published from 1992 to 2022 were retrieved from the Web of Science Core Collection, and the relevant literature characteristics were extracted after the screening. Then, bibliometric analyses and visualizations were performed using Microsoft Excel, CiteSpace, VOSviewer, and an online analysis platform (http://bibliometric.com). Results A total of 1151 articles were retrieved, of which 368 were included in the analysis, indicating a gradually increasing trend. The United States, Switzerland, and China have made significant contributions in this field. Bloch KE from the University of Zurich was determined to be the most productive and academically influential author in this field. The highest-yielding journal was High Altitude Medicine & Biology. Initially, altitude training was the primary research topic. Currently, research focuses on sleep disorders and sleep apnea. In the coming years, keywords such as "sleep quality," "prevalence," and "obstructive sleep apnea" will attract more attention. Conclusion Our findings will assist scholars to better understand the intellectual structure and emerging trends in this field. Future developments in high-altitude sleep research are highly anticipated, particularly in terms of sleep quality at high altitudes and its associated prevalence. This research is also crucial for the improvement and treatment of symptoms during nocturnal sleep in patients with chronic hypoxia due to cardiopulmonary diseases at high altitudes.
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Affiliation(s)
- Lixia Tan
- Innovation Center of Nursing Research and Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
- Medical College, Tibet University, Lhasa, China
| | - Yong Li
- Innovation Center of Nursing Research and Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Hongxiu Chen
- Innovation Center of Nursing Research and Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | | | - Xiuying Hu
- Innovation Center of Nursing Research and Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
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Chen B, Wu Z, Huang X, Li Z, Wu Q, Chen Z. Effect of altitude training on the aerobic capacity of athletes: A systematic review and meta-analysis. Heliyon 2023; 9:e20188. [PMID: 37809554 PMCID: PMC10559955 DOI: 10.1016/j.heliyon.2023.e20188] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 10/10/2023] Open
Abstract
Purpose With a growing number of athletes and coaches adopting altitude training, the importance for rationalizing and optimizing such training has been emphasized. We conducted a meta-analysis to evaluate the influence of altitude training on athletes' aerobic capacity and to explore the best altitude training method to improve this capacity. Methods We searched Web of Science, SpringerLink, Science Direct, EBSCO, and PubMed databases combined with manual search of the references to collect studies indexed from 1979 to September 2020 on the effect of altitude training on athletes' aerobic capacity. Data from experimental studies that reported hemoglobin levels and maximum oxygen uptake in athletes before and after altitude training, or in athletes performing altitude training in comparison with a control group were analyzed. Data of the populations, intervention, comparison, outcomes and study design were extracted. Review Manager software 5.3 was used for bias evaluation. Results 17 publications were included. In our meta-analysis, altitude training led to higher maximum oxygen uptake [standardized mean difference (SMD) = 0.67, 95% confidence interval (CI) 0.35-1.00, P < 0.001] and hemoglobin level (SMD = 0.50, 95% CI 0.11-0.90, P = 0.013) than training at lower altitude. The result of sensitivity analysis showed that results of meta-analysis were relatively stable, and there was no bias or change in the result of effect size according to the bias test. The results of subgroup analysis showed that high-altitude living and low-altitude training ("Hi-Lo" regime), with a training cycle of about three weeks at an altitude around 2500 m, had better effects than other regimes on the athletes' aerobic capacity. Conclusions Altitude training can improve athletes' aerobic capacity in terms of maximum oxygen uptake and hemoglobin level. Our results are limited by the number and quality of available studies. Therefore, more high-quality studies are needed to verify and extend these findings. Our study can provide scientific suggestions for the training of athletes.
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Affiliation(s)
- Baoxia Chen
- School of Physical Education, Sichuan University, Chengdu, China
| | - Zhusheng Wu
- School of History and Tourism, Sichuan University, Chengdu, China
| | - Xia Huang
- School of History and Tourism, Sichuan University, Chengdu, China
| | - Zhichao Li
- Human Resources and Social Security Department, Sheyang County, Yancheng, China
| | - Qianjin Wu
- School of Physical Education, Shandong University, Jinan, China
| | - Zichao Chen
- School of Physical Education, Sichuan University, Chengdu, China
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3
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Sharma P, Mohanty S, Ahmad Y. A study of survival strategies for improving acclimatization of lowlanders at high-altitude. Heliyon 2023; 9:e14929. [PMID: 37025911 PMCID: PMC10070159 DOI: 10.1016/j.heliyon.2023.e14929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/14/2023] [Accepted: 03/22/2023] [Indexed: 03/30/2023] Open
Abstract
Human Acclimatization and therapeutic approaches are the core components for conquering the physiological variations at high altitude (≥2500 m) exposure. The declined atmospheric pressure and reduced partial pressure of oxygen at high altitudes tend to decrease the temperature by several folds. Hypobaric hypoxia is a major threat to humanity at high altitudes, and its potential effects include altitude mountain sickness. On severity, it may lead to the development of conditions like high-altitude cerebral edema (HACE) or high-altitude pulmonary edema (HAPE) and cause unexpected physiological changes in the healthy population of travelers, athletes, soldiers, and low landers while sojourning at high altitude. Previous investigations have been done on long-drawn-out acclimatization strategies such as the staging method to prevent the damage caused by high-altitude hypobaric Hypoxia. Inherent Limitations of this strategy hamper the daily lifestyle and time consuming for people. It is not suitable for the rapid mobilization of people at high altitudes. There is a need to recalibrate acclimatization strategies for improving health protection and adapting to the environmental variations at high altitudes. This narrative review details the geographical changes and physiological changes at high altitudes and presents a framework of acclimatization, pre-acclimatization, and pharmacological aspects of high-altitude survival to enhance the government efficacy and capacity for the strategic planning of acclimatization, use of therapeutics, and safe de-induction from high altitude for minimizing the life loss. It's simply too ambitious for the importance of the present review to reduce life loss, and it can be proved as the most essential aspect of the preparatory phase of high-altitude acclimatization in plateau regions without hampering the daily lifestyle. The application of pre-acclimatization techniques can be a boon for people serving at high altitudes, and it can be a short bridge for the rapid translocation of people at high altitudes by minimizing the acclimatization time.
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Affiliation(s)
- Poornima Sharma
- Defence Institute of Physiology & Allied Sciences (DIPAS), Defence R&D Organization (DRDO), Timarpur, New Delhi, 110054, India
| | - Swaraj Mohanty
- Defence Institute of Physiology & Allied Sciences (DIPAS), Defence R&D Organization (DRDO), Timarpur, New Delhi, 110054, India
| | - Yasmin Ahmad
- Defence Institute of Physiology & Allied Sciences (DIPAS), Defence R&D Organization (DRDO), Timarpur, New Delhi, 110054, India
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Yu Y, Wang R, Li D, Lu Y. Monitoring Physiological Performance over 4 Weeks Moderate Altitude Training in Elite Chinese Cross-Country Skiers: An Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:266. [PMID: 36612586 PMCID: PMC9820022 DOI: 10.3390/ijerph20010266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/18/2022] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
The current observational study aimed to monitor the physiological performance over 4 weeks of living and training at a moderate altitude in elite Chinese cross-country skiers (8 males, mean age 20.83 ± 1.08 years). Lactate threshold, maximal oxygen uptake, blood, and body composition tests were performed at different time points to investigate the changes in physiological performance. The data were analysed by a one-way repeated measures ANOVA and a paired sample T-test between the test results. During the training camp, systematic load monitoring was carried out. Lactate threshold velocity, lactate threshold heart rate, and upper body muscle mass increased significantly (p < 0.01) after moderate altitude training. Maximum oxygen uptake was reduced compared to pre-tests (p < 0.05). Aerobic capacity parameters (maximal oxygen uptake, haemoglobin, red blood cell count) did not significantly increase after athletes returned to sea level (p > 0.05). These findings suggest that 4 weeks of moderate altitude training can significantly improve athletes’ lactate threshold and upper body muscle mass; no significant improvement in other aerobic capacity was seen. Exposure time, training load, and nutritional strategies should be thoroughly planned for optimal training of skiers at moderate altitudes.
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Affiliation(s)
- Yichao Yu
- The School of Sports Medicine and Rehabilitation, Beijing Sports University, Beijing 100084, China
- The Graduate School, Beijing Sport University, Beijing 100084, China
| | - Ruolin Wang
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC 3053, Australia
| | - Dongye Li
- The School of Sports Medicine and Rehabilitation, Beijing Sports University, Beijing 100084, China
- The Graduate School, Beijing Sport University, Beijing 100084, China
| | - Yifan Lu
- The School of Sports Medicine and Rehabilitation, Beijing Sports University, Beijing 100084, China
- Key Laboratory of Sports and Physical Fitness of the Ministry of Education, Beijing Sport University, Beijing 100084, China
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Westmacott A, Sanal-Hayes NEM, McLaughlin M, Mair JL, Hayes LD. High-Intensity Interval Training (HIIT) in Hypoxia Improves Maximal Aerobic Capacity More Than HIIT in Normoxia: A Systematic Review, Meta-Analysis, and Meta-Regression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14261. [PMID: 36361141 PMCID: PMC9658399 DOI: 10.3390/ijerph192114261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 06/16/2023]
Abstract
The present study aimed to determine the effect of high intensity interval training (HIIT) in hypoxia on maximal oxygen uptake (VO2max) compared with HIIT in normoxia with a Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)-accordant meta-analysis and meta-regression. Studies which measured VO2max following a minimum of 2 weeks intervention featuring HIIT in hypoxia versus HIIT in normoxia were included. From 119 originally identified titles, nine studies were included (n = 194 participants). Meta-analysis was conducted on change in (∆) VO2max using standardised mean difference (SMD) and a random effects model. Meta-regression examined the relationship between the extent of environmental hypoxia (fractional inspired oxygen [FiO2]) and ∆VO2max and intervention duration and ∆VO2max. The overall SMD for ∆VO2max following HIIT in hypoxia was 1.14 (95% CI = 0.56-1.72; p < 0.001). Meta-regressions identified no significant relationship between FiO2 (coefficient estimate = 0.074, p = 0.852) or intervention duration (coefficient estimate = 0.071, p = 0.423) and ∆VO2max. In conclusion, HIIT in hypoxia improved VO2max compared to HIIT in normoxia. Neither extent of hypoxia, nor training duration modified this effect, however the range in FiO2 was small, which limits interpretation of this meta-regression. Moreover, training duration is not the only training variable known to influence ∆VO2max, and does not appropriately capture total training stress or load. This meta-analysis provides pooled evidence that HIIT in hypoxia may be more efficacious at improving VO2max than HIIT in normoxia. The application of these data suggest adding a hypoxic stimuli to a period of HIIT may be more effective at improving VO2max than HIIT alone. Therefore, coaches and athletes with access to altitude (either natural or simulated) should consider implementing HIIT in hypoxia, rather than HIIT in normoxia where possible, assuming no negative side effects.
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Affiliation(s)
- Ailsa Westmacott
- Sport and Physical Activity Research Institute, University of the West of Scotland, Glasgow G72 0LH, UK
| | - Nilihan E. M. Sanal-Hayes
- Sport and Physical Activity Research Institute, University of the West of Scotland, Glasgow G72 0LH, UK
| | - Marie McLaughlin
- Sport and Physical Activity Research Institute, University of the West of Scotland, Glasgow G72 0LH, UK
| | - Jacqueline L. Mair
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise, Singapore 138602, Singapore
| | - Lawrence D. Hayes
- Sport and Physical Activity Research Institute, University of the West of Scotland, Glasgow G72 0LH, UK
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Park HY, Jung WS, Kim SW, Kim J, Lim K. Effects of Interval Training Under Hypoxia on Hematological Parameters, Hemodynamic Function, and Endurance Exercise Performance in Amateur Female Runners in Korea. Front Physiol 2022; 13:919008. [PMID: 35665230 PMCID: PMC9158122 DOI: 10.3389/fphys.2022.919008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/04/2022] [Indexed: 11/21/2022] Open
Abstract
Interval training under hypoxia (IHT) is commonly used to enhance endurance exercise performance. However, previous studies examining hematologic changes related to the immune system that affect health and conditioning are lacking. This study aimed to evaluate the effects of IHT for 6-weeks on hematological parameters, hemodynamic function, and endurance exercise performance in amateur Korean female runners. Twenty healthy amateur Korean female runners (age: 24.85 ± 3.84 years) were equally assigned to normoxic training group (NTG) for interval training under normoxia (760 mmHg) and hypoxic training group (HTG) for interval training under hypobaric hypoxia (526 mmHg, 3000 m simulated altitude) according to their body composition and endurance exercise performance. All participants performed 120-min of training sessions, consisting of 20-min of warm-up, 60-min of interval training, and 20-min of cool-down. The training program was performed 3-days per week for 6-weeks. Warm-up and cool-down were performed for 20-min at 60% maximal heart rate (HRmax). The interval training sessions comprised 10 repetitions of interval exercise (5-min of exercise corresponding to 90–95% HRmax and 1-min of rest) on a treadmill. All participants underwent measurements of hematological parameters, hemodynamic function, and endurance exercise performance before and after training. Both groups showed a significant increase in erythropoietin (EPO) level and a decrease in monocyte abundance, with EPO showing a greater increase in the HTG than in the NTG. B cell abundance significantly increased in the NTG; hematocrit and neutrophil counts significantly increased, and lymphocyte counts significantly decreased in the HTG. The HTG showed a significant improvement in oxygen uptake, stroke volume index, and end-diastolic volume index compared to the NTG. In addition, both groups showed significant improvements in heart rate, end-systolic volume index, and cardiac output index. The maximal oxygen uptake and 3000 m time trial record were significantly improved in both groups, and the HTG showed a tendency to improve more than the NTG. In conclusion, the IHT was effective in enhancing endurance exercise performance through improved hemodynamic function. Furthermore, hematological parameters of immune system showed a normal range before and after training and were not negatively affected.
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Affiliation(s)
- Hun-Young Park
- Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul, South Korea
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, South Korea
| | - Won-Sang Jung
- Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul, South Korea
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, South Korea
| | - Sung-Woo Kim
- Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul, South Korea
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, South Korea
| | - Jisu Kim
- Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul, South Korea
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, South Korea
| | - Kiwon Lim
- Department of Sports Medicine and Science, Graduate School, Konkuk University, Seoul, South Korea
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul, South Korea
- Department of Physical Education, Konkuk University, Seoul, South Korea
- *Correspondence: Kiwon Lim,
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Research on the Physiological Monitoring and Evaluation of Pre-Competition Altitude Training for Zhejiang Elite Swimmers. PHYSICAL ACTIVITY AND HEALTH 2021. [DOI: 10.5334/paah.91] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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8
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Yan B, Ge X, Yu J, Hu Y, Girard O. Hypoxic re-exposure retains hematological but not performance adaptations post-altitude training. Eur J Appl Physiol 2021; 121:1049-1059. [PMID: 33426576 DOI: 10.1007/s00421-020-04589-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To test the hypothesis that hypoxic re-exposure after return from natural altitude training is beneficial in retaining hematological and performance adaptations. METHODS Eighteen mixed martial art fighters completed a 3-weeks natural altitude training camp at 2418 m. Afterwards, participants were randomly assigned to a living high-training low (12 h/d at a simulated altitude of 2800 m) group (LHTL, n = 9) or a living low-training low group (LLTL, n = 9) for a 3-week sea-level training period. At baseline and after return to sea level, hematological [hemoglobin mass (Hbmass) on days 2, 6, 9, 12, 15 and 21] and performance (3000 m time trial and maximal oxygen uptake on days 4, 6, 9, 15 and 21) markers were assessed. RESULTS Mean Hbmass increased from baseline to day 2 (11.7 ± 0.9 vs. 12.4 ± 1.3 g/kg; + 6.6 ± 7.5%; P < 0.05). While Hbmass remained elevated above baseline in LHTL (P < 0.001), it returned near baseline levels from day 9 in LLTL. Irrespective of groups, mean V̇O2max was only elevated above baseline at day 2 (+ 4.5 ± 0.8%) and day 9 (+ 3.8 ± 8.0%) (both P < 0.05). Compared to baseline, 3000 m running time decreased at day 4 (- 3.1 ± 3.3%; P < 0.05) and day 15 (- 2.8 ± 2.3%; P < 0.05) only. CONCLUSIONS Despite re-exposure to hypoxia allowing a recovery of the hypoxic stimulus to retain Hbmass gains from previous altitude sojourn, there is no performance advantage of this practice above sea level residence. Our results also give support to empirical observations describing alternance of periods of optimal and attenuated performance upon return to sea level.
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Affiliation(s)
- Bing Yan
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Xiaochuan Ge
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
| | - Jiabei Yu
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China.,Beijing Institute of Sports Science, Beijing, China
| | - Yang Hu
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China.
| | - Olivier Girard
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, WA, Australia
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Siebenmann C, Dempsey JA. Hypoxic Training Is Not Beneficial in Elite Athletes. Med Sci Sports Exerc 2020; 52:519-522. [PMID: 31939915 DOI: 10.1249/mss.0000000000002141] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
| | - Jerome A Dempsey
- Department Population Health Sciences, University of Wisconsin-Madison, Madison, WI
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10
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MILLET GRÉGOIREP, BROCHERIE FRANCK. Hypoxic Training Is Beneficial in Elite Athletes. Med Sci Sports Exerc 2020; 52:515-518. [DOI: 10.1249/mss.0000000000002142] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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11
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Park HY, Jung WS, Kim J, Hwang H, Lim K. Efficacy of intermittent hypoxic training on hemodynamic function and exercise performance in competitive swimmers. J Exerc Nutrition Biochem 2018; 22:32-38. [PMID: 30661329 PMCID: PMC6343766 DOI: 10.20463/jenb.2018.0028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 12/11/2018] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Hemodynamic function is a parameter indicating oxygen delivery and utilization capacity and is an important determinant of exercise performance. The present study aimed to determine whether intermittent hypoxic training (IHT) ameliorates hemodynamic function and exercise performance in competitive swimmers. METHODS Twenty competitive swimmers (10 men, 10 women) volunteered to participate in the study. Participants were divided into the normoxic training (NT) group and the hypoxic training (HT) group and were subjected to training in a simulated altitude of 3000 m. We evaluated hemodynamic function profiles over 30 min of submaximal exercise on a bicycle and exercise performance before and after 6 weeks of training, which involved continuous exercise at 80% maximal heart rate (HRmax) for 30 min and interval exercise at 90% of HRmax measured before training for 30 min (ten rounds comprising 2 min of exercise followed by 1 min of rest each round). RESULTS Significant changes in oxygen consumption (decrease) and end-diastolic volume (increase) were observed only in the HT group. Heart rate (HR), cardiac output (CO), and ejection fraction (EF) were significantly reduced in both groups, but the reduction rates of HR and CO were greater in the HT group than in the NT group. Exercise performance measures, including maximal oxygen consumption and 400-m time trial, were significantly increased only in the HT group. CONCLUSION Our findings suggested that 6 weeks of IHT, which involved high-intensity continuous and interval exercise, can effectively improve exercise performance by enhancing hemodynamic function in competitive swimmers.
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박훈영, 임기원, 김지수. Exercise physiology basis and necessity of hypoxic training to improve exercise performance in elite athletes. ACTA ACUST UNITED AC 2018. [DOI: 10.24985/kjss.2018.29.4.737] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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13
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Bejder J, Nordsborg NB. Specificity of “Live High-Train Low” Altitude Training on Exercise Performance. Exerc Sport Sci Rev 2018; 46:129-136. [DOI: 10.1249/jes.0000000000000144] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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14
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Lobigs LM, Sharpe K, Garvican-Lewis LA, Gore CJ, Peeling P, Dawson B, Schumacher YO. The athlete's hematological response to hypoxia: A meta-analysis on the influence of altitude exposure on key biomarkers of erythropoiesis. Am J Hematol 2018; 93:74-83. [PMID: 29027252 DOI: 10.1002/ajh.24941] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 10/04/2017] [Accepted: 10/10/2017] [Indexed: 11/11/2022]
Abstract
Altitude training is associated with changes in blood markers, which can confound results of the Athlete?s Biological Passport (ABP). This meta-analysis aims to describe the fluctuations during- and post-altitude in key ABP variables; hemoglobin concentration ([Hb]), square-root transformed reticulocyte percentage (sqrt(retic%)) and the OFF-score. Individual de-identified raw data were provided from 17 studies. Separate linear mixed effects analyses were performed for delta values from baseline for [Hb], sqrt(retic%) and OFF-score, by altitude phase (during and post). Mixed models were fitted with the hierarchical structure: study and subject within study as random effects. Delta values as response variables and altitude dose (in kilometer hours; km.hr = altitude (m) / 1000 x hours), sex, age, protocol and baseline values as fixed effects. Allowances were made for potential autocorrelation. Within two days at natural altitude [Hb] rapidly increased. Subsequent delta [Hb] values increased with altitude dose, reaching a plateau of 0.94 g/dL [95%CI (0.69, 1.20)] at ~1000 km.hr. Delta sqrt(retic%) and OFF-score were the first to identify an erythrocyte response, with respective increases and decreases observed within 100 to 200 km.hr. Post-altitude, [Hb] remained elevated for two weeks. Delta sqrt(retic%) declined below baseline, the magnitude of change was dependent on altitude dose. Baseline values were a significant covariate (p<0.05). The response to altitude is complex resulting in a wide range of individual responses, influenced primarily by altitude dose and baseline values. Improved knowledge of the plausible hematological variations during- and post-altitude provides fundamental information for both the ABP expert and sports physician.
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Affiliation(s)
- Louisa M. Lobigs
- School of Human Sciences (Exercise and Sports Science); University of Western Australia; Perth WA 6009 Australia
- Aspetar Sports Medicine Hospital, PO Box 29222; Doha Qatar
| | - Ken Sharpe
- Statistical Consulting Centre, School of Mathematics and Statistics; University of Melbourne; Vic 3010 Australia
| | - Laura A. Garvican-Lewis
- Australian Institute of Sport; Canberra 2617 Australia
- Mary Mackillop Institute for Health Research, Australian Catholic University; Melbourne Australia
| | | | - Peter Peeling
- School of Human Sciences (Exercise and Sports Science); University of Western Australia; Perth WA 6009 Australia
- Western Australian Institute of Sport, Mt Claremont; WA 6010 Australia
| | - Brian Dawson
- School of Human Sciences (Exercise and Sports Science); University of Western Australia; Perth WA 6009 Australia
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15
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Millet GP, Chapman RF, Girard O, Brocherie F. Is live high -train low altitude training relevant for elite athletes? Flawed analysis from inaccurate data. Br J Sports Med 2017; 53:923-925. [PMID: 29247024 DOI: 10.1136/bjsports-2017-098083] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2017] [Indexed: 11/04/2022]
Affiliation(s)
- Gregoire P Millet
- Institute of Sport Sciences, Faculty of Biology and Medicine, ISSUL, University of Lausanne, Lausanne, Switzerland
| | - Robert F Chapman
- Department of Kinesiology, HH Morris Human Performance Laboratory, Indiana University, Bloomington, Indiana, USA
| | - Olivier Girard
- Aspetar Orthopaedic and Sports Medicine Hospital, Athlete Health and Performance Research Centre, Doha, Qatar
| | - Franck Brocherie
- Research Department, Laboratory Sport, Expertise and Performance, French Institute of Sport (INSEP), Paris, France
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16
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Kim SH, An HJ, Choi JH, Kim YY. Effects of 2-week intermittent training in hypobaric hypoxia on the aerobic energy metabolism and performance of cycling athletes with disabilities. J Phys Ther Sci 2017. [PMID: 28626339 PMCID: PMC5468214 DOI: 10.1589/jpts.29.1116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The present study aimed at examining changes in aerobic energy metabolism and performance in cycling athletes after 2 weeks of intermittent training in a multistep hypobaric hypoxia environment. [Subjects and Methods] We also aimed at using the findings to propose an efficient training program in hypobaric hypoxia for endurance athletes with disabilities. The study participants were three cycling athletes with physical disabilities from the Korean national team (A, B, and C athletes). They underwent complex (repetition, interval, and continued) training with a roller-type cycle in a multistep hypobaric hypoxia environment (simulated altitude, 4,000 m above sea level). The training was conducted in twelve 60-min sessions for 2 weeks and it was based on the ventilatory threshold intensity, measured in an exercise stress test, conducted prior to training, at constant temperature (23 °C ± 2 °C) and humidity conditions (50% ± 5%). [Results] B and C athletes showed no noticeable changes in relative VO2max and HRmax values after training. A, B, and C athletes all showed increases in all-out time, 2′09″ (13.1%), 2′43″ (18.7%), and 1′22″ (7.4%), respectively after training. Although the relative VO2max and HRmax values were not improved, submaximal exercise performance ability was improved. [Conclusion] Therefore, 2 weeks of intermittent training in a hypobaric hypoxia environment positively affected aerobic energy metabolism and performance.
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Affiliation(s)
- Sang-Hoon Kim
- Department of Medical Science, Korea Paralympic Committee, Republic of Korea
| | - Ho-Jung An
- Department of Physical Therapy, Dongnam Health University, Republic of Korea
| | - Jung-Hyun Choi
- Department of Physical Therapy, Institute for Elderly Health and Welfare, Namseoul University, Republic of Korea
| | - Yong-Youn Kim
- Department of Physical Therapy, Dongnam Health University, Republic of Korea
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Constantini K, Wilhite DP, Chapman RF. A Clinician Guide to Altitude Training for Optimal Endurance Exercise Performance at Sea Level. High Alt Med Biol 2017; 18:93-101. [PMID: 28453305 DOI: 10.1089/ham.2017.0020] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Constantini, Keren, Daniel P. Wilhite, and Robert F. Chapman. A clinician guide to altitude training for optimal endurance exercise performance at sea level. High Alt Med Biol. 18:93-101, 2017.-For well over 50 years, endurance athletes have been utilizing altitude training in an effort to enhance performance in sea level competition. This brief review will offer the clinician a series of evidence-based best-practice guidelines on prealtitude and altitude training considerations, which can ultimately maximize performance improvement outcomes.
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Affiliation(s)
- Keren Constantini
- HH Morris Human Performance Laboratory, Department of Kinesiology, Indiana University , Bloomington, Indiana
| | - Daniel P Wilhite
- HH Morris Human Performance Laboratory, Department of Kinesiology, Indiana University , Bloomington, Indiana
| | - Robert F Chapman
- HH Morris Human Performance Laboratory, Department of Kinesiology, Indiana University , Bloomington, Indiana
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Park HY, Nam SS. Application of "living high-training low" enhances cardiac function and skeletal muscle oxygenation during submaximal exercises in athletes. J Exerc Nutrition Biochem 2017; 21:13-20. [PMID: 28712261 PMCID: PMC5508055 DOI: 10.20463/jenb.2017.0064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 02/28/2017] [Accepted: 03/17/2017] [Indexed: 12/03/2022] Open
Abstract
PURPOSE The aim of this study was to determine the efficiency of the application of living high-training low (LHTL) on cardiac function and skeletal muscle oxygenation during submaximal exercises compared with that of living low-training low (LLTL) in athletes. METHODS Male middle- and long-distance runners (n = 20) were randomly assigned into the LLTL group (n = 10, living at 1000-m altitude and training at 700-1330-m altitude) and the LHTL group (n = 10, living at simulated 3000-m altitude and training at 700-1330-m altitude). Their cardiac function and skeletal muscle oxygenation during submaximal exercises at sea level before and after training at each environmental condition were evaluated. RESULTS There was a significant interaction only in the stroke volume (SV); however, the heart rate (HR), end-diastolic volume (EDV), and end-systolic volume (ESV) showed significant main effects within time; HR and SV significantly increased during training in the LHTL group compared with those in the LLTL group. EDV also significantly increased during training in both groups; however, the LHTL group had a higher increase than the LLTL group. ESV significantly increased during training in the LLTL group. There was no significant difference in the ejection fraction and cardiac output. The skeletal muscle oxygen profiles had no significant differences but improved in the LHTL group compared with those in the LLTL group. CONCLUSION LHTL can yield favorable effects on cardiac function by improving the HR, SV, EDV, and ESV during submaximal exercises compared with LLTL in athletes.
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Affiliation(s)
- Hun-Young Park
- Physical Activity and Performance Institute, Konkuk University, SeoulRepublic of Korea
- Department of Sports Medicine, Kyung Hee University, YonginRepublic of Korea
| | - Sang-Seok Nam
- Department of Sports Medicine, Kyung Hee University, YonginRepublic of Korea
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Park HY, Kim S, Nam SS. Four-week "living high training low" program enhances 3000-m and 5000-m time trials by improving energy metabolism during submaximal exercise in athletes. J Exerc Nutrition Biochem 2017; 21:1-6. [PMID: 28712259 PMCID: PMC5508059 DOI: 10.20463/jenb.2017.0060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 02/18/2017] [Indexed: 11/22/2022] Open
Abstract
[Purpose] This study aimed to determine the effect of a 4-week living high training low (LHTL) versus a living low training low (LLTL) program on energy metabolism during submaximal exercise and 3000-m and 5000-m time trial (TT) in athletes. [Methods] Male athletes (n = 20) were randomly assigned to the LLTL (n = 10, living at 1000 m and training at 700–1330 m) and LHTL (n = 10, living at simulated 3000 m and training at 700–1330 m) groups. We compared energy metabolisms during submaximal exercise on a treadmill and aerobic exercise performance (3000 m and 5000 m TT) before and after 4 weeks of training. [Results] As expected, the LHTL group demonstrated enhanced energy metabolism during submaximal exercise via significant interaction (time × group) in heart rate, oxygen consumption, and carbon dioxide excretion; these variables were significantly decreased in the LHTL group compared with the LLTL group. Additionally, both training groups revealed significantly decreased blood lactate levels during submaximal exercise, 3000 m TT, and 5000 m TT but significant interactions (time × group) in the 3000 m and 5000 m TT. Thus, the LHTL group demonstrated greater improvements in 3000 m and 5000 m TT than the LLTL group via significant interactions. [Conclusion] Our results suggest that 4-week LHTL intervention enhances 3000 m and 5000 m TT by improving energy metabolism during submaximal exercise. The proposed LHTL intervention in this study is a novel and effective method for improving aerobic exercise performance in male athletes.
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Affiliation(s)
- Hun-Young Park
- Performance Activity and Performance Institute, Konkuk University, Seoul, Republic of Korea
| | - Sungho Kim
- Department of Sports Medicine, Kyung Hee University, Yongin-si, Republic of Korea
| | - Sang-Seok Nam
- Department of Sports Medicine, Kyung Hee University, Yongin-si, Republic of Korea
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Endurance, aerobic high-intensity, and repeated sprint cycling performance is unaffected by normobaric “Live High-Train Low”: a double-blind placebo-controlled cross-over study. Eur J Appl Physiol 2017; 117:979-988. [DOI: 10.1007/s00421-017-3586-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 03/08/2017] [Indexed: 10/19/2022]
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Feriche B, García-Ramos A, Morales-Artacho AJ, Padial P. Resistance Training Using Different Hypoxic Training Strategies: a Basis for Hypertrophy and Muscle Power Development. SPORTS MEDICINE-OPEN 2017; 3:12. [PMID: 28315193 PMCID: PMC5357242 DOI: 10.1186/s40798-017-0078-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 02/23/2017] [Indexed: 12/14/2022]
Abstract
The possible muscular strength, hypertrophy, and muscle power benefits of resistance training under environmental conditions of hypoxia are currently being investigated.Nowadays, resistance training in hypoxia constitutes a promising new training strategy for strength and muscle gains. The main mechanisms responsible for these effects seem to be related to increased metabolite accumulation due to hypoxia. However, no data are reported in the literature to describe and compare the efficacy of the different hypertrophic resistance training strategies in hypoxia.Moreover, improvements in sprinting, jumping, or throwing performance have also been described at terrestrial altitude, encouraging research into the speed of explosive movements at altitude. It has been suggested that the reduction in the aerodynamic resistance and/or the increase in the anaerobic metabolism at higher altitudes can influence the metabolic cost, increase the take-off velocities, or improve the motor unit recruitment patterns, which may explain these improvements. Despite these findings, the applicability of altitude conditions in improving muscle power by resistance training remains to be clarified.This review examines current knowledge regarding resistance training in different types of hypoxia, focusing on strategies designed to improve muscle hypertrophy as well as power for explosive movements.
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Affiliation(s)
- Belén Feriche
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Crta Alfacar sn, 18011, Granada, Spain.
| | - Amador García-Ramos
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Crta Alfacar sn, 18011, Granada, Spain
| | - Antonio J Morales-Artacho
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Crta Alfacar sn, 18011, Granada, Spain
| | - Paulino Padial
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Crta Alfacar sn, 18011, Granada, Spain
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Pichon AP, Connes P, Robach P. Effects of acute and chronic hematocrit modulations on blood viscosity in endurance athletes. Clin Hemorheol Microcirc 2016; 64:115-123. [DOI: 10.3233/ch-162050] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Aurélien P. Pichon
- Laboratory Mobility, aging & exercise (MOVE) - EA 6314, Faculty of Sport Sciences, University of Poitiers, Poitiers, France
- Laboratory Hypoxia & Lung - EA 2363, UFR SMBH, University Paris 13, Bobigny, France
- Association pour la Recherche en Physiologie de l’Environnement (ARPE), UFR de Médecine, 74 rue Marcel Cachin, Bobigny, France
| | - Philippe Connes
- Institut Universitaire de France, Paris, France
- Laboratoire CRIS EA647 –Section “Vascular biology and red blood cell”, University of Lyon 1, Villeurbanne, France
- Laboratoire d’Excellence GR-Ex, Paris, France
| | - Paul Robach
- Département Médical, Ecole Nationale des Sports de Montagne, site de l’Ecole Nationale de Ski et d’Alpinisme, Chamonix, France
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Park HY, Hwang H, Park J, Lee S, Lim K. The effects of altitude/hypoxic training on oxygen delivery capacity of the blood and aerobic exercise capacity in elite athletes - a meta-analysis. J Exerc Nutrition Biochem 2016; 20:15-22. [PMID: 27298808 PMCID: PMC4899894 DOI: 10.20463/jenb.2016.03.20.1.3] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 03/02/2016] [Accepted: 03/03/2016] [Indexed: 11/22/2022] Open
Abstract
PURPOSE This study was designed as a meta-analysis of randomized controlled trials comparing effectiveness of altitude/hypoxic training (experimental) versus sea-level training (control) on oxygen delivery capacity of the blood and aerobic exercise capacity of elite athletes in Korea. METHODS Databases (Research Information Service System, Korean studies Information Service System, National Assembly Library) were for randomized controlled trials comparing altitude/hypoxic training versus sea-level training in elite athletes. Studies published in Korea up to December 2015 were eligible for inclusion. Oxygen delivery capacity of the blood was quantified by red blood cell (RBC), hemoglobin (Hb), hematocrit (Hct), erythropoietin (EPO); and aerobic exercise capacity was quantified by maximal oxygen consumption (VO2max). RBC, Hb, Hct, VO2max represented heterogeneity and compared post-intervention between altitude/hypoxic training and sea-level training in elite athletes by a random effect model meta-analysis. EPO represented homogeneity and meta-analysis performed by a fixed effect model. Eight independent studies with 156 elite athletes (experimental: n = 82, control: n = 74) were included in the metaanalysis. RESULTS RBC (4.499×10(5) cell/ul, 95 % CI: 2.469 to 6.529), Hb (5.447 g/dl, 95 % CI: 3.028 to 7.866), Hct (3.639 %, 95 % CI: 1.687 to 5.591), EPO (0.711 mU/mL, 95% CI: 0.282 to 1.140), VO2max (1.637 ml/kg/min, 95% CI: 0.599 to 1.400) showed significantly greater increase following altitude/hypoxic training, as compared with sea-level training. CONCLUSION For elite athletes in Korea, altitude/ hypoxic training appears more effective than sea-level training for improvement of oxygen delivery capacity of the blood and aerobic exercise capacity.
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Affiliation(s)
- Hun-Young Park
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul Republic of Korea
| | - Hyejung Hwang
- Physical Activity and Performance Institute (PAPI), Konkuk University, Seoul Republic of Korea
| | - Jonghoon Park
- Department of Physical Education, Korea University, Seoul Republic of Korea
| | - Seongno Lee
- Department of Physical Education, Hanyang University, Seoul Republic of Korea
| | - Kiwon Lim
- Physical Activity and Performance Institute (PAPI), Konkuk University, SeoulRepublic of Korea; Department of Physical Education, Konkuk University, SeoulRepublic of Korea
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Saugy JJ, Schmitt L, Hauser A, Constantin G, Cejuela R, Faiss R, Wehrlin JP, Rosset J, Robinson N, Millet GP. Same Performance Changes after Live High-Train Low in Normobaric vs. Hypobaric Hypoxia. Front Physiol 2016; 7:138. [PMID: 27148076 PMCID: PMC4835493 DOI: 10.3389/fphys.2016.00138] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 03/30/2016] [Indexed: 01/28/2023] Open
Abstract
PURPOSE We investigated the changes in physiological and performance parameters after a Live High-Train Low (LHTL) altitude camp in normobaric (NH) or hypobaric hypoxia (HH) to reproduce the actual training practices of endurance athletes using a crossover-designed study. METHODS Well-trained triathletes (n = 16) were split into two groups and completed two 18-day LTHL camps during which they trained at 1100-1200 m and lived at 2250 m (P i O2 = 111.9 ± 0.6 vs. 111.6 ± 0.6 mmHg) under NH (hypoxic chamber; FiO2 18.05 ± 0.03%) or HH (real altitude; barometric pressure 580.2 ± 2.9 mmHg) conditions. The subjects completed the NH and HH camps with a 1-year washout period. Measurements and protocol were identical for both phases of the crossover study. Oxygen saturation (S p O2) was constantly recorded nightly. P i O2 and training loads were matched daily. Blood samples and VO2max were measured before (Pre-) and 1 day after (Post-1) LHTL. A 3-km running-test was performed near sea level before and 1, 7, and 21 days after training camps. RESULTS Total hypoxic exposure was lower for NH than for HH during LHTL (230 vs. 310 h; P < 0.001). Nocturnal S p O2 was higher in NH than in HH (92.4 ± 1.2 vs. 91.3 ± 1.0%, P < 0.001). VO2max increased to the same extent for NH and HH (4.9 ± 5.6 vs. 3.2 ± 5.1%). No difference was found in hematological parameters. The 3-km run time was significantly faster in both conditions 21 days after LHTL (4.5 ± 5.0 vs. 6.2 ± 6.4% for NH and HH), and no difference between conditions was found at any time. CONCLUSION Increases in VO2max and performance enhancement were similar between NH and HH conditions.
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Affiliation(s)
- Jonas J Saugy
- Faculty of Biology and Medicine, Institute of Sport Sciences, University of LausanneLausanne, Switzerland; Department of Physiology, Faculty of Biology and Medicine, University of LausanneLausanne, Switzerland
| | - Laurent Schmitt
- Faculty of Biology and Medicine, Institute of Sport Sciences, University of LausanneLausanne, Switzerland; National School of Mountain Sports/National Ski-Nordic CentrePrémanon, France
| | - Anna Hauser
- Faculty of Biology and Medicine, Institute of Sport Sciences, University of LausanneLausanne, Switzerland; Section for Elite Sport, Swiss Federal Institute of SportMagglingen, Switzerland
| | - Guillaume Constantin
- Faculty of Biology and Medicine, Institute of Sport Sciences, University of Lausanne Lausanne, Switzerland
| | - Roberto Cejuela
- Departmental Section of Physical Education and Sports, University of Alicante Alicante, Spain
| | - Raphael Faiss
- Faculty of Biology and Medicine, Institute of Sport Sciences, University of LausanneLausanne, Switzerland; Section for Elite Sport, Swiss Federal Institute of SportMagglingen, Switzerland
| | - Jon P Wehrlin
- Section for Elite Sport, Swiss Federal Institute of Sport Magglingen, Switzerland
| | - Jérémie Rosset
- Faculty of Biology and Medicine, Institute of Sport Sciences, University of Lausanne Lausanne, Switzerland
| | - Neil Robinson
- Swiss Laboratory for Doping Analyses, University of Lausanne Lausanne, Switzerland
| | - Grégoire P Millet
- Faculty of Biology and Medicine, Institute of Sport Sciences, University of LausanneLausanne, Switzerland; Department of Physiology, Faculty of Biology and Medicine, University of LausanneLausanne, Switzerland
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Wehrlin JP, Marti B, Hallén J. Hemoglobin Mass and Aerobic Performance at Moderate Altitude in Elite Athletes. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 903:357-74. [PMID: 27343108 DOI: 10.1007/978-1-4899-7678-9_24] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Fore more than a decade, the live high-train low (LHTL) approach, developed by Levine and Stray-Gundersen, has been widely used by elite endurance athletes. Originally, it was pointed out, that by living at moderate altitude, athletes should benefit from an increased red cell volume (RCV) and hemoglobin mass (Hbmass), while the training at low altitudes should prevent the disadvantage of reduced training intensity at moderate altitude. VO2max is reduced linearly by about 6-8 % per 1000 m increasing altitude in elite athletes from sea level to 3000 m, with corresponding higher relative training intensities for the same absolute work load. With 2 weeks of acclimatization, this initial deficit can be reduced by about one half. It has been debated during the last years whether sea-level training or exposure to moderate altitude increases RCV and Hbmass in elite endurance athletes. Studies which directly measured Hbmass with the optimized CO-rebreathing technique demonstrated that Hbmass in endurance athletes is not influenced by sea-level training. We documented that Hbmass is not increased after 3 years of training in national team cross-country skiers. When athletes are exposed to moderate altitude, new studies support the argument that it is possible to increase Hbmass temporarily by 5-6 %, provided that athletes spend >400 h at altitudes above 2300-2500 m. However, this effect size is smaller than the reported 10-14 % higher Hbmass values of endurance athletes living permanently at 2600 m. It remains to be investigated whether endurance athletes reach these values with a series of LHTL camps.
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Affiliation(s)
- Jon Peter Wehrlin
- Swiss Federal Institute of Sport, Magglingen, Switzerland. .,Norwegian School of Sport Sciences, Oslo, Norway.
| | - Bernard Marti
- Swiss Federal Institute of Sport, Magglingen, Switzerland
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Stevenson JL, Krishnan S, Inigo MM, Stamatikos AD, Gonzales JU, Cooper JA. Echinacea-Based Dietary Supplement Does Not Increase Maximal Aerobic Capacity in Endurance-Trained Men and Women. J Diet Suppl 2015; 13:324-38. [PMID: 26317662 DOI: 10.3109/19390211.2015.1036189] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To determine if an echinacea-based dietary supplement (EBS) provided at two different doses (a regular dose (RD), 8,000 mg/day, vs. a double dose (DD), 16,000 mg/day) would increase erythropoietin (EPO) and other blood markers involved in improving aerobic capacity and maximal oxygen consumption (VO2max) in endurance-trained men. Secondly, to determine if any sex differences exist between male and female endurance-trained athletes. METHODS Forty-five endurance athletes completed three visits during a 35-day intervention. Participants were randomized into placebo (PLA; n = 8 men, n = 7 women), RD of EBS (n = 7 men, n = 8 women), or DD of EBS (n = 15 men) for the 35-day intervention period. At baseline, weight, body composition, and VO2max were measured. Blood was drawn to measure EPO, ferritin, red blood cells, white blood cells, hemoglobin, and hematocrit. At the mid-intervention visit, blood was collected. At the post-intervention visit, all measurements from the baseline visit were obtained once again. RESULTS There was a significant increase in VO2max for endurance-trained men in PLA (increase of 2.8 ± 1.5 ml kg(-1) min(-1), p = .01) and RD of EBS (increase of 2.6 ± 1.8 ml kg(-1) min(-1), p = .04), but not in DD of EBS (p = .96). Importantly, there was no difference in the change in VO2max between PLA and RD of EBS. For endurance-trained women, VO2max did not change in either treatment (PLA: -0.7 ± 1.7 ml kg(-1) min(-1), p = .31; RD of EBS: -0.2 ± 2.4 ml kg(-1) min(-1), p = .80). There were no significant changes in any blood parameter across visits for any treatment group. CONCLUSIONS This EBS should not be recommended as a means to improve performance in endurance athletes.
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Affiliation(s)
- Jada L Stevenson
- a Department of Nutritional Sciences , Texas Tech University , Lubbock , Texas , USA
| | - Sridevi Krishnan
- a Department of Nutritional Sciences , Texas Tech University , Lubbock , Texas , USA
| | - Melissa M Inigo
- b Department of Exercise and Sports Sciences , Texas Tech University , Lubbock , Texas , USA
| | - Alexis D Stamatikos
- a Department of Nutritional Sciences , Texas Tech University , Lubbock , Texas , USA
| | - Joaquin U Gonzales
- b Department of Exercise and Sports Sciences , Texas Tech University , Lubbock , Texas , USA
| | - Jamie A Cooper
- a Department of Nutritional Sciences , Texas Tech University , Lubbock , Texas , USA
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Lewis NA, Howatson G, Morton K, Hill J, Pedlar CR. Alterations in redox homeostasis in the elite endurance athlete. Sports Med 2015; 45:379-409. [PMID: 25319354 DOI: 10.1007/s40279-014-0276-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The production of reactive oxygen (ROS) and nitrogen species (RNS) is a fundamental feature of mammalian physiology, cellular respiration and cell signalling, and essential for muscle function and training adaptation. Aerobic and anaerobic exercise results in alterations in redox homeostasis (ARH) in untrained, trained and well trained athletes. Low to moderate doses of ROS and RNS play a role in muscle adaptation to endurance training, but an overwhelming increase in RNS and ROS may lead to increased cell apoptosis and immunosuppression, fatigued states and underperformance. OBJECTIVES The objectives of this systematic review are: (a) to test the hypotheses that ARH occur in elite endurance athletes; following an acute exercise bout, in an endurance race or competition; across a micro-, meso- or macro-training cycle; following a training taper; before, during and after altitude training; in females with amenorrhoea versus eumenorrhoea; and in non-functional over-reaching (NFOR) and overtraining states (OTS); (b) to report any relationship between ARH and training load and ARH and performance; and (c) to apply critical difference values for measures of oxidative stress/ARH to address whether there is any evidence of ARH being of physiological significance (not just statistical) and thus relevant to health and performance in the elite athlete. METHODS Electronic databases, Embase, MEDLINE, and SPORTDiscus were searched for relevant articles. Only studies that were observational articles of cross-sectional or longitudinal design, and included elite athletes competing at national or international level in endurance sports were included. Studies had to include biomarkers of ARH; oxidative damage, antioxidant enzymes, antioxidant capacity, and antioxidant vitamins and nutrients in urine, serum, plasma, whole blood, red blood cells (RBCs) and white blood cells (WBCs). A total of 3,057 articles were identified from the electronic searches. Twenty-eight articles met the inclusion criteria and were included in the review. RESULTS ARH occurs in elite endurance athletes, after acute exercise, a competition or race, across training phases, and with natural or simulated altitude. A reduction in ARH occurs across the season in elite athletes, with marked variation around intensified training phases, between individuals, and the greatest disturbances (of physiological significance) occurring with live-high-train-low techniques, and in athletes competing. A relationship with ARH and performance and illness exists in elite athletes. There was considerable heterogeneity across the studies for the biomarkers and assays used; the sport; the blood sampling time points; and the phase in the annual training cycle and thus baseline athlete fitness. In addition, there was a consistent lack of reporting of the analytical variability of the assays used to assess ARH. CONCLUSIONS The reported biochemical changes around ARH in elite athletes suggest that it may be of value to monitor biomarkers of ARH at rest, pre- and post-simulated performance tests, and before and after training micro- and meso-cycles, and altitude camps, to identify individual tolerance to training loads, potentially allowing the prevention of non-functionally over-reached states and optimisation of the individual training taper and training programme.
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Popularity of hypoxic training methods for endurance-based professional and amateur athletes. Physiol Behav 2015; 143:35-8. [DOI: 10.1016/j.physbeh.2015.02.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 02/03/2015] [Accepted: 02/11/2015] [Indexed: 11/24/2022]
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Bonne TC, Lundby C, Lundby AK, Sander M, Bejder J, Nordsborg NB. Altitude training causes haematological fluctuations with relevance for the Athlete Biological Passport. Drug Test Anal 2014; 7:655-62. [DOI: 10.1002/dta.1757] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 10/15/2014] [Accepted: 11/01/2014] [Indexed: 11/10/2022]
Affiliation(s)
| | - Carsten Lundby
- Zurich Center of Integrative Human Physiology; Institute of Physiology, University of Zürich; Switzerland
| | - Anne Kristine Lundby
- Department of Cardiology; Copenhagen University Hospital at Hvidovre; Copenhagen Denmark
| | - Mikael Sander
- Department of Cardiology; Copenhagen University Hospital at Hvidovre; Copenhagen Denmark
| | - Jacob Bejder
- Department of Nutrition, Exercise and Sport Sciences; University of Copenhagen; Denmark
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Saugy JJ, Schmitt L, Cejuela R, Faiss R, Hauser A, Wehrlin JP, Rudaz B, Delessert A, Robinson N, Millet GP. Comparison of "Live High-Train Low" in normobaric versus hypobaric hypoxia. PLoS One 2014; 9:e114418. [PMID: 25517507 PMCID: PMC4269399 DOI: 10.1371/journal.pone.0114418] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Accepted: 11/10/2014] [Indexed: 11/18/2022] Open
Abstract
We investigated the changes in both performance and selected physiological parameters following a Live High-Train Low (LHTL) altitude camp in either normobaric hypoxia (NH) or hypobaric hypoxia (HH) replicating current "real" practices of endurance athletes. Well-trained triathletes were split into two groups (NH, n = 14 and HH, n = 13) and completed an 18-d LHTL camp during which they trained at 1100-1200 m and resided at an altitude of 2250 m (PiO2 = 121.7±1.2 vs. 121.4±0.9 mmHg) under either NH (hypoxic chamber; FiO2 15.8±0.8%) or HH (real altitude; barometric pressure 580±23 mmHg) conditions. Oxygen saturations (SpO2) were recorded continuously daily overnight. PiO2 and training loads were matched daily. Before (Pre-) and 1 day after (Post-) LHTL, blood samples, VO2max, and total haemoglobin mass (Hb(mass)) were measured. A 3-km running test was performed near sea level twice before, and 1, 7, and 21 days following LHTL. During LHTL, hypoxic exposure was lower for the NH group than for the HH group (220 vs. 300 h; P<0.001). Night SpO2 was higher (92.1±0.3 vs. 90.9±0.3%, P<0.001), and breathing frequency was lower in the NH group compared with the HH group (13.9±2.1 vs. 15.5±1.5 breath.min(-1), P<0.05). Immediately following LHTL, similar increases in VO2max (6.1±6.8 vs. 5.2±4.8%) and Hb(mass) (2.6±1.9 vs. 3.4±2.1%) were observed in NH and HH groups, respectively, while 3-km performance was not improved. However, 21 days following the LHTL intervention, 3-km run time was significantly faster in the HH (3.3±3.6%; P<0.05) versus the NH (1.2±2.9%; ns) group. In conclusion, the greater degree of race performance enhancement by day 21 after an 18-d LHTL camp in the HH group was likely induced by a larger hypoxic dose. However, one cannot rule out other factors including differences in sleeping desaturations and breathing patterns, thus suggesting higher hypoxic stimuli in the HH group.
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Affiliation(s)
- Jonas J. Saugy
- ISSUL, Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Laurent Schmitt
- National School of Mountain Sports/National Ski-Nordic Centre, Prémanon, France
| | - Roberto Cejuela
- Departmental Section of Physical Education and Sports, University of Alicante, Alicante, Spain
| | - Raphael Faiss
- ISSUL, Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Anna Hauser
- ISSUL, Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Swiss Federal Institute of Sport, Magglingen, Switzerland
| | - Jon P. Wehrlin
- Swiss Federal Institute of Sport, Magglingen, Switzerland
| | - Benjamin Rudaz
- ISSUL, Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Audric Delessert
- ISSUL, Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Neil Robinson
- Swiss Laboratory for Doping Analyses, University of Lausanne, Lausanne, Switzerland
| | - Grégoire P. Millet
- ISSUL, Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- * E-mail:
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Buchheit M, Racinais S, Bilsborough J, Hocking J, Mendez-Villanueva A, Bourdon PC, Voss S, Livingston S, Christian R, Périard J, Cordy J, Coutts AJ. Adding heat to the live-high train-low altitude model: a practical insight from professional football. Br J Sports Med 2014; 47 Suppl 1:i59-69. [PMID: 24282209 PMCID: PMC3903152 DOI: 10.1136/bjsports-2013-092559] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objectives To examine with a parallel group study design the performance and physiological responses to a 14-day off-season ‘live high-train low in the heat’ training camp in elite football players. Methods Seventeen professional Australian Rules Football players participated in outdoor football-specific skills (32±1°C, 11.5 h) and indoor strength (23±1°C, 9.3 h) sessions and slept (12 nights) and cycled indoors (4.3 h) in either normal air (NORM, n=8) or normobaric hypoxia (14±1 h/day, FiO2 15.2–14.3%, corresponding to a simulated altitude of 2500–3000 m, hypoxic (HYP), n=9). They completed the Yo-Yo Intermittent Recovery level 2 (Yo-YoIR2) in temperate conditions (23±1°C, normal air) precamp (Pre) and postcamp (Post). Plasma volume (PV) and haemoglobin mass (Hbmass) were measured at similar times and 4 weeks postcamp (4WPost). Sweat sodium concentration ((Na+)sweat) was measured Pre and Post during a heat-response test (44°C). Results Both groups showed very large improvements in Yo-YoIR2 at Post (+44%; 90% CL 38, 50), with no between-group differences in the changes (−1%; −9, 9). Postcamp, large changes in PV (+5.6%; −1.8, 5.6) and (Na+)sweat (−29%; −37, −19) were observed in both groups, while Hbmass only moderately increased in HYP (+2.6%; 0.5, 4.5). At 4WPost, there was a likely slightly greater increase in Hbmass (+4.6%; 0.0, 9.3) and PV (+6%; −5, 18, unclear) in HYP than in NORM. Conclusions The combination of heat and hypoxic exposure during sleep/training might offer a promising ‘conditioning cocktail’ in team sports.
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Affiliation(s)
- M Buchheit
- Physiology Unit, Football Performance and Science Department, ASPIRE, Academy for Sports Excellence, , Doha, Qatar
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Bonne TC, Lundby C, Jørgensen S, Johansen L, Mrgan M, Bech SR, Sander M, Papoti M, Nordsborg NB. “Live High–Train High” increases hemoglobin mass in Olympic swimmers. Eur J Appl Physiol 2014; 114:1439-49. [DOI: 10.1007/s00421-014-2863-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 02/26/2014] [Indexed: 10/25/2022]
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Aughey RJ, Buchheit M, Garvican-Lewis LA, Roach GD, Sargent C, Billaut F, Varley MC, Bourdon PC, Gore CJ. Yin and yang, or peas in a pod? Individual-sport versus team-sport athletes and altitude training. Br J Sports Med 2013; 47:1150-4. [PMID: 24255910 PMCID: PMC3841751 DOI: 10.1136/bjsports-2013-092764] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2013] [Indexed: 11/04/2022]
Abstract
The question of whether altitude training can enhance subsequent sea-level performance has been well investigated over many decades. However, research on this topic has focused on athletes from individual or endurance sports, with scant number of studies on team-sport athletes. Questions that need to be answered include whether this type of training may enhance team-sport athlete performance, when success in team-sport is often more based on technical and tactical ability rather than physical capacity per se. This review will contrast and compare athletes from two sports representative of endurance (cycling) and team-sports (soccer). Specifically, we draw on the respective competition schedules, physiological capacities, activity profiles and energetics of each sport to compare the similarities between athletes from these sports and discuss the relative merits of altitude training for these athletes. The application of conventional live-high, train-high; live-high, train-low; and intermittent hypoxic training for team-sport athletes in the context of the above will be presented. When the above points are considered, we will conclude that dependent on resources and training objectives, altitude training can be seen as an attractive proposition to enhance the physical performance of team-sport athletes without the need for an obvious increase in training load.
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Affiliation(s)
- Robert J Aughey
- Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Victoria, Australia
- Western Bulldogs Football Club, Melbourne, Victoria, Australia
| | - Martin Buchheit
- Sport Science Department, Physiology Unit, ASPIRE Academy for Sports Excellence, Doha, Qatar
| | - Laura A Garvican-Lewis
- Department of Physiology, Australian Institute of Sport, Canberra, Australian Capital Territory, Australia
- National Institute of Sports Studies, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Gregory D Roach
- Appleton Institute for Behavioural Science, Central Queensland University, Adelaide, South Australia, Australia
| | - Charli Sargent
- Appleton Institute for Behavioural Science, Central Queensland University, Adelaide, South Australia, Australia
| | | | - Matthew C Varley
- Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Victoria, Australia
| | - Pitre C Bourdon
- Sport Science Department, Physiology Unit, ASPIRE Academy for Sports Excellence, Doha, Qatar
| | - Christopher J Gore
- Department of Physiology, Australian Institute of Sport, Canberra, Australian Capital Territory, Australia
- Exercise Physiology Laboratory, Flinders University, Adelaide, South Australia, Australia
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da Costa AV, Costa MDC, de Oliveira SFM, de Albuquerque FL, de Sá Pereira Guimarães FJ, Barbosa TM. Validation of an equation for estimating maximal oxygen consumption of nonexpert adult swimmers. Open Access J Sports Med 2013; 4:19-25. [PMID: 24379705 PMCID: PMC3871046 DOI: 10.2147/oajsm.s39688] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To validate an equation to estimate the maximal oxygen consumption (VO2max) of nonexpert adult swimmers. METHODS Participants were 22 nonexpert swimmers, male, aged between 18 and 30 years (age: 23.1 ± 3:59 years; body mass: 73.6 ± 7:39 kg; height 176.6 ± 5.53 cm; and body fat percentage: 15.9% ± 4.39%), divided into two subgroups: G1 - eleven swimmers for the VO2max oximetry and modeling of the equation; and G2 - eleven swimmers for application of the equation modeled on G1 and verification of their validation. The test used was the adapted Progressive Swim Test, in which there occurs an increase in the intensity of the swim every two laps. For normality and homogeneity of data, Shapiro-Wilk and Levene tests were used, the descriptive values of the average and standard deviation. The statistical steps were: (1) reliability of the Progressive Swim Test - through the paired t-test, intraclass correlation coefficient (ICC), and the Pearson linear correlation (R) relative to the reproducibility, the coefficient of variation (CV), and standard error measurement (SEM) for the absolute reproducibility; (2) in the model equation to estimate VO2max, a relative VO2 was established, and a stepwise multiple regression model was performed with G1 - so the variables used were analysis of variance regression (AR), coefficient of determination (R(2)), adjusted coefficient of determination (R(2)a), standard error of estimate (SEE), and Durbin-Watson (DW); (3) validation of the equation - the results were presented in graphs, where direct (G1) and estimated (G2) VO2max were compared using independent t-test, linear regression (stressing the correlation between groups), and Bland-Altman (the bias agreement of the results). All considered a statistical significance level of P < 0.05. RESULTS On the trustworthiness of the Progressive Swim Test adapted presented as high as observed (R and ICC > 0.80, CV < 10%, and SEM < 2%). In the equation model, VO2max has been considered the third model as recommended due to the values found (AR < 0.01, R = 0795, R(2) = 0633; R(2)a = 0.624, SEE = 7.21, DW = 2.06). Upon validation of the equation, no significant differences occurred between G1 and G2 (P > 0.01), linear regression stressed a correlation between the groups (R > 0.80, P < 0.01), and Bland-Altman plotting of the results was within the correlation limits of 1.96 (95% confidence interval). CONCLUSION The estimating equation for VO2max for nonexpert swimmers is valid for its application through the Progressive Swim Test, providing to contribute in prescribing the swimming lessons as a method of evaluating the physical condition of its practitioners.
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Affiliation(s)
- Adalberto Veronese da Costa
- Department of Physical Education, Bioscience Laboratory of Human Kinetics, Rio Grande do Norte State University, Mossoró, Brazil ; Sport Sciences Trás-os-Montes e Alto Douro University, Research Center in Sport, Health and Human Development, Vila Real, Portugal
| | - Manoel da Cunha Costa
- Superior School of Physical Education, Human Performance Laboratory, Pernambuco State University, Recife, Brazil
| | | | - Fabíola Lima de Albuquerque
- Superior School of Physical Education, Human Performance Laboratory, Pernambuco State University, Recife, Brazil
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Increased hemoglobin mass and VO2max with 10 h nightly simulated altitude at 3000 m. Int J Sports Physiol Perform 2012; 8:366-72. [PMID: 23118056 DOI: 10.1123/ijspp.8.4.366] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE To quantify the changes of hemoglobin mass (Hbmass) and maximum oxygen consumption (VO2max) after 22 days training at 1300-1800 m combined with nightly exposure to 3000-m simulated altitude. We hypothesized that with simulated 3000-m altitude, an adequate beneficial dose could be as little as 10 h/24 h. METHODS Fourteen male collegiate runners were equally divided into 2 groups: altitude (ALT) and control (CON). Both groups spent 22 days at 1300-1800 m. ALT spent 10 h/night for 21 nights in simulated altitude (3000 m), and CON stayed at 1300 m. VO2max and Hbmass were measured twice before and once after the intervention. Blood was collected for assessment of percent reticulocytes (%retics), serum erythropoietin (EPO), ferritin, and soluble transferrin receptor (sTfR) concentrations. RESULTS Compared with CON there was an almost certain increase in absolute VO2max (8.6%, 90% confidence interval 4.8-12.6%) and a likely increase in absolute Hbmass (3.5%; 0.9-6.2%) at postintervention. The %retics were at least very likely higher in ALT than in CON throughout the 21 nights, and sTfR was also very likely higher in the ALT group until day 17. EPO of ALT was likely higher than that of CON on days 1 and 5 at altitude, whereas serum ferritin was likely lower in ALT than CON for most of the intervention. CONCLUSIONS Together the combination of the natural and simulated altitude was a sufficient total dose of hypoxia to increase both Hbmass and VO2max.
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Robach P, Lundby C. Is live high-train low altitude training relevant for elite athletes with already high total hemoglobin mass? Scand J Med Sci Sports 2012; 22:303-5. [PMID: 22612361 DOI: 10.1111/j.1600-0838.2012.01457.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Amon M, Keramidas ME, Kounalakis SN, Mekjavic IB. The effect of a sleep high-train low regimen on the finger cold-induced vasodilation response. High Alt Med Biol 2012; 13:32-9. [PMID: 22429230 DOI: 10.1089/ham.2011.1044] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
The present study evaluated the effect of a sleep high-train low regimen on the finger cold-induced vasodilation (CIVD) response. Seventeen healthy males were assigned to either a control (CON; n=9) or experimental (EXP; n=8) group. Each group participated in a 28-day aerobic training program of daily 1-h exercise (50% of peak power output). During the training period, the EXP group slept at a simulated altitude of 2800 meters (week 1) to 3400 m (week 4) above sea level. Normoxic (CIVD(NOR); CON and EXP groups) and hypoxic (CIVD(HYPO); F(I)O(2)=0.12; EXP group only) CIVD characteristics were assessed before and after the training period during a 30-min immersion of the hand in 8°C water. After the intervention, the EXP group had increased average finger skin temperature (CIVD(NOR): +0.5°C; CIVD(HYPO): +0.5°C), number of waves (CIVD(NOR): +0.5; CIVD(HYPO): +0.6), and CIVD amplitude (CIVD(NOR): +1.5°C; CIVD(HYPO): +3°C) in both CIVD tests (p<0.05). In contrast, the CON group had an increase in only the CIVD amplitude (+0.5°C; p<0.05). Thus, the enhancement of aerobic performance combined with altitude acclimatization achieved with the sleep high-train low regimen contributed to an improved finger CIVD response during cold-water hand immersion in both normoxic and hypoxic conditions.
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Affiliation(s)
- Mojca Amon
- Department of Automation, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia.
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Millet GP, Faiss R, Pialoux V. Point: Hypobaric hypoxia induces different physiological responses from normobaric hypoxia. J Appl Physiol (1985) 2012; 112:1783-4. [PMID: 22267386 DOI: 10.1152/japplphysiol.00067.2012] [Citation(s) in RCA: 127] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Grégoire P Millet
- ISSUL Institute of Sport Sciences-Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Batiment Vidy, CH-1015, Lausanne, Switzerland.
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Gough CE, Saunders PU, Fowlie J, Savage B, Pyne DB, Anson JM, Wachsmuth N, Prommer N, Gore CJ. Influence of altitude training modality on performance and total haemoglobin mass in elite swimmers. Eur J Appl Physiol 2012; 112:3275-85. [PMID: 22234397 DOI: 10.1007/s00421-011-2291-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Accepted: 12/13/2011] [Indexed: 11/26/2022]
Abstract
We compared changes in performance and total haemoglobin mass (tHb) of elite swimmers in the weeks following either Classic or Live High:Train Low (LHTL) altitude training. Twenty-six elite swimmers (15 male, 11 female, 21.4 ± 2.7 years; mean ± SD) were divided into two groups for 3 weeks of either Classic or LHTL altitude training. Swimming performances over 100 or 200 m were assessed before altitude, then 1, 7, 14 and 28 days after returning to sea-level. Total haemoglobin mass was measured twice before altitude, then 1 and 14 days after return to sea-level. Changes in swimming performance in the first week after Classic and LHTL were compared against those of Race Control (n = 11), a group of elite swimmers who did not complete altitude training. In addition, a season-long comparison of swimming performance between altitude and non-altitude groups was undertaken to compare the progression of performances over the course of a competitive season. Regardless of altitude training modality, swimming performances were substantially slower 1 day (Classic 1.4 ± 1.3% and LHTL 1.6 ± 1.6%; mean ± 90% confidence limits) and 7 days (0.9 ± 1.0% and 1.9 ± 1.1%) after altitude compared to Race Control. In both groups, performances 14 and 28 days after altitude were not different from pre-altitude. The season-long comparison indicated that no clear advantage was obtained by swimmers who completed altitude training. Both Classic and LHTL elicited ~4% increases in tHb. Although altitude training induced erythropoeisis, this physiological adaptation did not transfer directly into improved competitive performance in elite swimmers.
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Affiliation(s)
- Clare E Gough
- Department of Physiology, Australian Institute of Sport, PO Box 176, Belconnen, Canberra, ACT, 2616, Australia.
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40
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Siebenmann C, Robach P, Jacobs RA, Rasmussen P, Nordsborg N, Diaz V, Christ A, Olsen NV, Maggiorini M, Lundby C. "Live high-train low" using normobaric hypoxia: a double-blinded, placebo-controlled study. J Appl Physiol (1985) 2011; 112:106-17. [PMID: 22033534 DOI: 10.1152/japplphysiol.00388.2011] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The combination of living at altitude and training near sea level [live high-train low (LHTL)] may improve performance of endurance athletes. However, to date, no study can rule out a potential placebo effect as at least part of the explanation, especially for performance measures. With the use of a placebo-controlled, double-blinded design, we tested the hypothesis that LHTL-related improvements in endurance performance are mediated through physiological mechanisms and not through a placebo effect. Sixteen endurance cyclists trained for 8 wk at low altitude (<1,200 m). After a 2-wk lead-in period, athletes spent 16 h/day for the following 4 wk in rooms flushed with either normal air (placebo group, n = 6) or normobaric hypoxia, corresponding to an altitude of 3,000 m (LHTL group, n = 10). Physiological investigations were performed twice during the lead-in period, after 3 and 4 wk during the LHTL intervention, and again, 1 and 2 wk after the LHTL intervention. Questionnaires revealed that subjects were unaware of group classification. Weekly training effort was similar between groups. Hb mass, maximal oxygen uptake (VO(2)) in normoxia, and at a simulated altitude of 2,500 m and mean power output in a simulated, 26.15-km time trial remained unchanged in both groups throughout the study. Exercise economy (i.e., VO(2) measured at 200 W) did not change during the LHTL intervention and was never significantly different between groups. In conclusion, 4 wk of LHTL, using 16 h/day of normobaric hypoxia, did not improve endurance performance or any of the measured, associated physiological variables.
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Affiliation(s)
- Christoph Siebenmann
- Center for Integrative Human Physiology, Institute of Physiology, University of Zurich, Zurich, Switzerland
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Abstract
It is possible to plan an altitude training (AT) period in such a way that the enhanced physical endurance obtained as a result of adaptation to hypoxia will appear and can be used to improve performance in competition. Yet finding rationales for usage of AT in highly trained swimmers is problematic. In practice AT, in its various forms, is still controversial, and an objective review of research concentrating on the advantages and disadvantages of AT has been presented in several scientific publications, including in no small part the observations of swimmers. The aim of this article is to review the various methods and present both the advantageous and unfavourable physiological changes that occur in athletes as a result of AT. Moreover, AT results in the sport of swimming have been collected. They include an approach towards primary models of altitude/hypoxic training: live high + train high, live high + train low, live low + train high, as well as subsequent methods: Intermittent Hypoxic Exposure (IHE) and Intermittent Hypoxic Training (IHT). Apnoea training, which is descended from freediving, is also mentioned, and which can be used with, or as a substitute for, the well-known IHE or IHT methods. In conclusion, swimmers who train using hypoxia may be among the best-trained athletes, and that even a slight improvement in physical endurance might result in the shortening of a swimming time in a given competition, and the achievement of a personal best, which is hard to obtain by normal training methods, when the personal results of the swimmer have reached a plateau.
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Robertson EY, Saunders PU, Pyne DB, Aughey RJ, Anson JM, Gore CJ. Reproducibility of performance changes to simulated live high/train low altitude. Med Sci Sports Exerc 2010; 42:394-401. [PMID: 19927018 DOI: 10.1249/mss.0b013e3181b34b57] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
UNLABELLED Elite athletes often undertake multiple altitude exposures within and between training years in an attempt to improve sea level performance. PURPOSE To quantify the reproducibility of responses to live high/train low (LHTL) altitude exposure in the same group of athletes. METHODS Sixteen highly trained runners with maximal aerobic power (VO2max) of 73.1 +/- 4.6 and 64.4 +/- 3.2 mL x kg(-1) x min(-1) (mean +/- SD) for males and females, respectively, completed 2 x 3-wk blocks of simulated LHTL (14 h x d(-1), 3000 m) or resided near sea level (600 m) in a controlled study design. Changes in the 4.5-km time trial performance and physiological measures including VO2max, running economy and hemoglobin mass (Hb(mass)) were assessed. RESULTS Time trial performance showed small and variable changes after each 3-wk altitude block in both the LHTL (mean [+/-90% confidence limits]: -1.4% [+/-1.1%] and 0.7% [+/-1.3%]) and the control (0.5% [+/-1.5%] and -0.7% [+/-0.8%]) groups. The LHTL group demonstrated reproducible improvements in VO2max (2.1% [+/-2.1%] and 2.1% [+/-3.9%]) and Hb(mass) (2.8% [+/-2.1%] and 2.7% [+/-1.8%]) after each 3-wk block. Compared with those in the control group, the runners in the LHTL group were substantially faster after the first 3-wk block (LHTL - control = -1.9% [+/-1.8%]) and had substantially higher Hb(mass) after the second 3-wk block (4.2% [+/-2.1%]). There was no substantial difference in the change in mean VO2max between the groups after the first (1.2% [+/-3.3%]) or second 3-wk block (1.4% [+/-4.6%]). CONCLUSIONS Three-week LHTL altitude exposure can induce reproducible mean improvements in VO2max and Hb(mass) in highly trained runners, but changes in time trial performance seem to be more variable. Competitive performance is dependent not only on improvements in physiological capacities that underpin performance but also on a complex interaction of many factors including fitness, fatigue, and motivation.
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Affiliation(s)
- Eileen Y Robertson
- Department of Physiology, Australian Institute of Sport, Canberra, Australia
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Millet GP, Roels B, Schmitt L, Woorons X, Richalet JP. Combining hypoxic methods for peak performance. Sports Med 2010; 40:1-25. [PMID: 20020784 DOI: 10.2165/11317920-000000000-00000] [Citation(s) in RCA: 232] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
New methods and devices for pursuing performance enhancement through altitude training were developed in Scandinavia and the USA in the early 1990s. At present, several forms of hypoxic training and/or altitude exposure exist: traditional 'live high-train high' (LHTH), contemporary 'live high-train low' (LHTL), intermittent hypoxic exposure during rest (IHE) and intermittent hypoxic exposure during continuous session (IHT). Although substantial differences exist between these methods of hypoxic training and/or exposure, all have the same goal: to induce an improvement in athletic performance at sea level. They are also used for preparation for competition at altitude and/or for the acclimatization of mountaineers. The underlying mechanisms behind the effects of hypoxic training are widely debated. Although the popular view is that altitude training may lead to an increase in haematological capacity, this may not be the main, or the only, factor involved in the improvement of performance. Other central (such as ventilatory, haemodynamic or neural adaptation) or peripheral (such as muscle buffering capacity or economy) factors play an important role. LHTL was shown to be an efficient method. The optimal altitude for living high has been defined as being 2200-2500 m to provide an optimal erythropoietic effect and up to 3100 m for non-haematological parameters. The optimal duration at altitude appears to be 4 weeks for inducing accelerated erythropoiesis whereas <3 weeks (i.e. 18 days) are long enough for beneficial changes in economy, muscle buffering capacity, the hypoxic ventilatory response or Na(+)/K(+)-ATPase activity. One critical point is the daily dose of altitude. A natural altitude of 2500 m for 20-22 h/day (in fact, travelling down to the valley only for training) appears sufficient to increase erythropoiesis and improve sea-level performance. 'Longer is better' as regards haematological changes since additional benefits have been shown as hypoxic exposure increases beyond 16 h/day. The minimum daily dose for stimulating erythropoiesis seems to be 12 h/day. For non-haematological changes, the implementation of a much shorter duration of exposure seems possible. Athletes could take advantage of IHT, which seems more beneficial than IHE in performance enhancement. The intensity of hypoxic exercise might play a role on adaptations at the molecular level in skeletal muscle tissue. There is clear evidence that intense exercise at high altitude stimulates to a greater extent muscle adaptations for both aerobic and anaerobic exercises and limits the decrease in power. So although IHT induces no increase in VO(2max) due to the low 'altitude dose', improvement in athletic performance is likely to happen with high-intensity exercise (i.e. above the ventilatory threshold) due to an increase in mitochondrial efficiency and pH/lactate regulation. We propose a new combination of hypoxic method (which we suggest naming Living High-Training Low and High, interspersed; LHTLHi) combining LHTL (five nights at 3000 m and two nights at sea level) with training at sea level except for a few (2.3 per week) IHT sessions of supra-threshold training. This review also provides a rationale on how to combine the different hypoxic methods and suggests advances in both their implementation and their periodization during the yearly training programme of athletes competing in endurance, glycolytic or intermittent sports.
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Affiliation(s)
- Gregoire P Millet
- ISSUL, Institute of Sport Science, University of Lausanne, Lausanne, Switzerland.
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Raggi F, Vallesi G, Rufini S, Gizzi S, Ercolani E, Rossi R. ELF Magnetic Therapy and Oxidative Balance. Electromagn Biol Med 2009; 27:325-39. [DOI: 10.1080/15368370802493271] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Affiliation(s)
- Philo U. Saunders
- Department of Physiology, Australian Institute of Sport, Canberra, Australia
| | - David B. Pyne
- Department of Physiology, Australian Institute of Sport, Canberra, Australia
- University of Canberra, Canberra, Australia
- Australian National University, Canberra, Australia
| | - Christopher J. Gore
- Department of Physiology, Australian Institute of Sport, Canberra, Australia
- Exercise Physiology Laboratory, Flinders University, Adelaide, Australia
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Pialoux V, Mounier R, Brugniaux JV, Rock E, Mazur A, Richalet JP, Robach P, Coudert J, Fellmann N. Thirteen days of "live high-train low" does not affect prooxidant/antioxidant balance in elite swimmers. Eur J Appl Physiol 2009; 106:517-24. [PMID: 19340451 DOI: 10.1007/s00421-009-1046-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2009] [Indexed: 11/25/2022]
Abstract
We investigated the impact of 13 days of "living high-training low" (LHTL) on the antioxidant/prooxidant balance in elite endurance swimmers. Eighteen elite swimmers from the French Swimming Federation were submitted to a 13-day endurance training and divided into two groups: one group trained at 1,200 m and lived in hypoxia (2,500-3,000 m simulated altitude) and the second group trained and lived at 1,200 m. The subjects performed an acute hypoxic test (10 min at 4,800 m) before and 1 day after the training period. Plasma levels of advanced oxidation protein products (AOPP), malondialdehydes (MDA), ferric reducing antioxidant power (FRAP), and lipid-soluble antioxidants were measured before and after the 4,800 m tests. After the training, MDA and AOPP responses to the 4,800 m test were lower than before training for both groups (+10 vs. +2%; P = 0.01 for MDA and +80 vs. +14%; P = 0.01 for AOPP). Thirteen days of LHTL did not modify antioxidant status (FRAP and lipid-soluble antioxidants) despite intakes in vitamins A and E below the recommended daily allowances. The LHTL did not affect the antioxidant status in elite swimmers; however, the normoxic endurance training induced preconditioning mechanisms in response to the 4,800 m test.
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Affiliation(s)
- Vincent Pialoux
- Laboratoire de Biologie des Activités Physiques et Sportives, Faculté de Médecine, 63000 Clermont-Ferrand, France.
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Time course of haemoglobin mass during 21 days live high:train low simulated altitude. Eur J Appl Physiol 2009; 106:399-406. [PMID: 19294411 DOI: 10.1007/s00421-009-1027-4] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2009] [Indexed: 10/21/2022]
Abstract
The aim of this study was to determine the time course of changes in haemoglobin mass (Hb(mass)) in well-trained cyclists in response to live high:train low (LHTL). Twelve well-trained male cyclists participated in a 3-week LHTL protocol comprising 3,000 m simulated altitude for ~14 h/day. Prior to LHTL duplicate baseline measurements were made of Hb(mass), maximal oxygen consumption (VO(2max)) and serum erythropoietin (sEPO). Hb(mass) was measured weekly during LHTL and twice in the week thereafter. There was a 3.3% increase in Hb(mass) and no change in VO(2max) after LHTL. The mean Hb(mass) increased at a rate of ~1% per week and this was maintained in the week after cessation of LHTL. The sEPO concentration peaked after two nights of LHTL but there was only a trivial correlation (r = 0.04, P = 0.89) between the increase in sEPO and the increase in Hb(mass). Athletes seeking to gain erythropoietic benefits from moderate altitude need to spend >12 h/day in hypoxia.
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Abstract
Reticulocytes are the transitional cells from erythroblasts to mature erythrocytes. Reticulocytes are present in blood for a period of 1-4 days and can be recognized by staining with supravital dyes, such as new methylene blue, or fluorescent markers, which couple residual nucleic acid molecules, a hallmark of the immature forms of erythrocytes. Although reticulocytes could be counted through a microscope (there is a standard of International Committee for Standardisation in Haematology for manual counting), this method is reported to be time consuming, inaccurate and imprecise. The integration of the reticulocyte count in automated haematology systems allowed the widespread use of these parameters, although the lack of calibration material and different markers, technologies and software used in automated systems could engender discrepancies among data obtained from different analytical systems.The importance of reticulocytes in sports medicine derives from their sensitivity, the highest among haematology parameters, in identifying the bone marrow stimulation, especially when recombinant human erythropoietin is fraudulently used. Automated systems are also able to supply information on volume, density and the haemoglobin content of reticulocytes. Some of the related parameters are also used in algorithms for identifying abnormal stimulation of bone marrow as reticulocytes haematocrit. The pre-analytical variability of reticulocytes (transportation, storage, biological variability) should be taken into account in sports medicine also. Reticulocytes remain stable for almost 24 hours at 4 degrees C from blood drawing, they are affected by transportation, and biological variability is not high in general. It could be remarked, however, that the intra-individual variability is high when compared with other haematological parameters such as haemoglobin and haematocrit. The intervals of data reported in athletes are very similar to reference intervals characterizing the general population.The reticulocyte count shows some modifications after training and during the competition season. The variability induced by exercise cannot be overlooked since the so-called haematological passport, a personal athlete's document in which haemoglobin and other parameters are registered, may be introduced by sports federations. Exposure to naturally high altitude and 'living high-training low' programmes determined contentious results on reticulocytes. Simulated high altitude induced by intermittent hypobaric hypoxia does not modify reticulocytes, despite an increase in erythropoietin serum concentration. The variability among athletes competing in different sport disciplines is apparently limited. The knowledge of the behaviour of reticulocytes in training and competitions is crucial for defining their role in an antidoping control context. It is important for sport physicians and clinical pathologists to know the reticulocyte variability in the general population and in athletes, the pre-analytical warnings, the different methodologies for counting reticulocytes and the derived parameters automatically available, and, finally, the possible influence of training, competitions, type of sport and altitude.
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Affiliation(s)
- Giuseppe Banfi
- IRCCS Istituto Galeazzi, via R. Galeazzi 4, Milan, Italy.
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Saunders PU, Telford RD, Pyne DB, Hahn AG, Gore CJ. Improved running economy and increased hemoglobin mass in elite runners after extended moderate altitude exposure. J Sci Med Sport 2008; 12:67-72. [PMID: 18069063 DOI: 10.1016/j.jsams.2007.08.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2007] [Revised: 08/17/2007] [Accepted: 08/18/2007] [Indexed: 11/18/2022]
Abstract
There is conflicting evidence whether hypoxia improves running economy (RE), maximal O(2) uptake (V(O)(2max)), haemoglobin mass (Hb(mass)) and performance, and what total accumulated dose is necessary for effective adaptation. The aim of this study was to determine the effect of an extended hypoxic exposure on these physiological and performance measures. Nine elite middle distance runners were randomly assigned to a live high-train low simulated altitude group (ALT) and spent 46+/-8 nights (mean+/-S.D.) at 2860+/-41m. A matched control group (CON, n=9) lived and trained near sea level ( approximately 600m). ALT decreased submaximal V(O)(2) (Lmin(-1)) (-3.2%, 90% confidence intervals, -1.0% to -5.2%, p=0.02), increased Hb(mass) (4.9%, 2.3-7.6%, p=0.01), decreased submaximal heart rate (-3.1%, -1.8% to -4.4%, p=0.00) and had a trivial increase in V(O)(2max) (1.5%, -1.6 to 4.8; p=0.41) compared with CON. There was a trivial correlation between change in Hb(mass) and change in V(O)(2max) (r=0.04, p=0.93). Hypoxic exposure of approximately 400h was sufficient to improve Hb(mass), a response not observed with shorter exposures. Although total O(2) carrying capacity was improved, the mechanism(s) to explain the lack of proportionate increase in V(O)(2max) were not identified.
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Affiliation(s)
- P U Saunders
- Department of Physiology, Australian Institute of Sport, Australia.
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