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Burtscher J, Raberin A, Brocherie F, Malatesta D, Manferdelli G, Citherlet T, Krumm B, Bourdillon N, Antero J, Rasica L, Burtscher M, Millet GP. Recommendations for Women in Mountain Sports and Hypoxia Training/Conditioning. Sports Med 2024; 54:795-811. [PMID: 38082199 PMCID: PMC11052836 DOI: 10.1007/s40279-023-01970-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2023] [Indexed: 04/28/2024]
Abstract
The (patho-)physiological responses to hypoxia are highly heterogeneous between individuals. In this review, we focused on the roles of sex differences, which emerge as important factors in the regulation of the body's reaction to hypoxia. Several aspects should be considered for future research on hypoxia-related sex differences, particularly altitude training and clinical applications of hypoxia, as these will affect the selection of the optimal dose regarding safety and efficiency. There are several implications, but there are no practical recommendations if/how women should behave differently from men to optimise the benefits or minimise the risks of these hypoxia-related practices. Here, we evaluate the scarce scientific evidence of distinct (patho)physiological responses and adaptations to high altitude/hypoxia, biomechanical/anatomical differences in uphill/downhill locomotion, which is highly relevant for exercising in mountainous environments, and potentially differential effects of altitude training in women. Based on these factors, we derive sex-specific recommendations for mountain sports and intermittent hypoxia conditioning: (1) Although higher vulnerabilities of women to acute mountain sickness have not been unambiguously shown, sex-dependent physiological reactions to hypoxia may contribute to an increased acute mountain sickness vulnerability in some women. Adequate acclimatisation, slow ascent speed and/or preventive medication (e.g. acetazolamide) are solutions. (2) Targeted training of the respiratory musculature could be a valuable preparation for altitude training in women. (3) Sex hormones influence hypoxia responses and hormonal-cycle and/or menstrual-cycle phases therefore may be factors in acclimatisation to altitude and efficiency of altitude training. As many of the recommendations or observations of the present work remain partly speculative, we join previous calls for further quality research on female athletes in sports to be extended to the field of altitude and hypoxia.
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Affiliation(s)
- Johannes Burtscher
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Building Synathlon, Campus Dorigny, 1015, Lausanne, Switzerland
| | - Antoine Raberin
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Building Synathlon, Campus Dorigny, 1015, Lausanne, Switzerland
| | - Franck Brocherie
- Laboratory Sport, Expertise and Performance (EA 7370), French Institute of Sport, Paris, France
| | - Davide Malatesta
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Building Synathlon, Campus Dorigny, 1015, Lausanne, Switzerland
| | - Giorgio Manferdelli
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Building Synathlon, Campus Dorigny, 1015, Lausanne, Switzerland
| | - Tom Citherlet
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Building Synathlon, Campus Dorigny, 1015, Lausanne, Switzerland
| | - Bastien Krumm
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Building Synathlon, Campus Dorigny, 1015, Lausanne, Switzerland
| | - Nicolas Bourdillon
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Building Synathlon, Campus Dorigny, 1015, Lausanne, Switzerland
| | - Juliana Antero
- Institut de Recherche Bio-Médicale Et d'Épidémiologie du Sport (EA 7329), French Institute of Sport, Paris, France
| | - Letizia Rasica
- Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
| | - Grégoire P Millet
- Institute of Sport Sciences, Faculty of Biology and Medicine, University of Lausanne, Building Synathlon, Campus Dorigny, 1015, Lausanne, Switzerland.
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Raeder C, Kämper M, Praetorius A, Tennler JS, Schoepp C. Metabolic, cognitive and neuromuscular responses to different multidirectional agility-like sprint protocols in elite female soccer players - a randomised crossover study. BMC Sports Sci Med Rehabil 2024; 16:64. [PMID: 38448940 PMCID: PMC10916312 DOI: 10.1186/s13102-024-00856-y] [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: 03/15/2023] [Accepted: 02/22/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE Resistance to fatigue is a key factor in injury prevention that needs to be considered in return-to-sport (RTS) scenarios, especially after severe knee ligament injuries. Fatigue should be induced under game-like conditions. The SpeedCourt (SC) is a movement platform for assessing multidirectional sprint performance, typical of game-sports, due to change-of-direction movements in response to a visual stimulus. Designing adequate fatigue protocols requires the suitable arrangement of several loading variables such as number of intervals, sprint distance or work/relief ratio (W:R). Therefore, this study analysed the acute fatigue effects of different SC protocols on metabolic load, cognitive function and neuromuscular performance. METHODS Eighteen female soccer players (mean ± SD; age: 23.1 ± 4.6 years) of the 1st German Division participated in this randomised, crossover study. Using a random allocation sequence, players completed four volume-equated protocols differing in W:R and sprint distance per interval (P1:12 × 30 m, W:R = 1:2 s; P2:12 × 30 m, W:R = 1:3 s; P3:18 × 20 m, W:R = 1:2 s; P4:18 × 20 m, W:R = 1:3 s). Pre- and post-exercise, metabolic load was measured per blood lactate concentration (BLaC), cognitive function per reaction time (RT), and neuromuscular performance including multiple rebound jumps (MRJ height, primary outcome variable; Reactive Strength Index, RSI) and 5 m sprint times (SP5). RESULTS Repeated-measures ANOVA revealed significant main time effects (p < .05) with improved performance post-exercise in RT (504 vs. 482 ms, d = 1.95), MRJ height (24.0 vs. 24.8 cm, d = 0.77), RSI (1.39 vs. 1.43, d = 0.52), and SP5 (1.19 vs. 1.17 s, d = 0.56). There was significant main time (p < .001) and time x protocol interaction effects in BLaC (p < .001). P1 induced higher BLaC values (4.52 ± 1.83 mmol/L) compared to P2 (3.79 ± 1.83 mmol/L; d = 0.74) and P4 (3.12 ± 1.83 mmol/L; d = 1.06), whereas P3 (4.23 ± 1.69 mmol/L) elicited higher BLaC values compared to P4 (d = 0.74). CONCLUSION All protocols caused an improved cognitive function and neuromuscular performance. The former may be related to enhanced noradrenergic activation or exercise specificity which induced an improved stimulus processing. The latter may be explained by a possible post-activation performance enhancement effect on jump and sprint performance. A shorter relief duration in W:R as opposed to sprint distance per interval produced higher BLaC values. The protocols may serve as reference data for improved RTS decision-making in elite female soccer players. TRIAL REGISTRATION Deutsches Register Klinischer Studien (DRKS), No.: DRKS00033496 , Registered 19. Februar 2024, Retrospectively Registered.
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Affiliation(s)
- Christian Raeder
- Department of Arthroscopy Surgery, Sports Traumatology and Sports Medicine, BG Klinikum Duisburg, Duisburg, Germany.
| | - Meike Kämper
- Women´s Soccer Department, MSV Duisburg, Duisburg, Germany
| | - Arthur Praetorius
- Department of Arthroscopy Surgery, Sports Traumatology and Sports Medicine, BG Klinikum Duisburg, Duisburg, Germany
| | - Janina-Sophie Tennler
- Department of Arthroscopy Surgery, Sports Traumatology and Sports Medicine, BG Klinikum Duisburg, Duisburg, Germany
| | - Christian Schoepp
- Department of Arthroscopy Surgery, Sports Traumatology and Sports Medicine, BG Klinikum Duisburg, Duisburg, Germany
- Department of Trauma and Reconstructive Surgery, University Hospital Essen, Essen, Germany
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Liu J, Li S, Liu M, Xu X, Zhang Y, Cheng J, Zhang W. Impaired brain networks functional connectivity after acute mild hypoxia. Medicine (Baltimore) 2022; 101:e30485. [PMID: 36197178 PMCID: PMC9509199 DOI: 10.1097/md.0000000000030485] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study aimed to analyze the changes in brain networks functional connectivity of pilots exposed to simulated hypoxia using resting-state functional magnetic resonance imaging (fMRI). A total of 35 healthy male pilots exposed to 14.5% oxygen concentration (corresponding to an altitude of 3000 m) underwent resting-state fMRI scans. The independent component analysis (ICA) approach was used to analyze changes in the resting-state brain networks functional connectivity of pilots after hypoxic exposure, and 9 common components in brain functional networks were identified. In the functional connections that showed significant group differences, linear regression was used to examine the association between functional connectivity and clinical characteristics. The brain networks functional connectivity after hypoxia exposure decreased significantly, including the left frontoparietal network and visual network 1-area, left frontoparietal network and visual network 2-area, right frontoparietal network and visual network 2-area, dorsal attention network and ventral attention network, dorsal attention network and auditory network, and ventral attention network and visual network 1-area. We found no correlation between the altered functional connectivity and arterial oxygen saturation level. Our findings provide insights into the mechanisms underlying hypoxia-induced cognitive impairment in pilots.
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Affiliation(s)
- Jie Liu
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shujian Li
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mingxi Liu
- Department of Radiology, Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China
| | - Xianrong Xu
- Department of Air Duty, Air Force General Hospital, Beijing, China
| | - Yong Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- * Correspondence: Jingliang Cheng, Department of MRI, the First Affiliated Hospital of Zhengzhou University, 1 East Construction Road, Erqi District, Zhengzhou 450052, Henan Province, China (e-mail: )
| | - Wanshi Zhang
- Department of Radiology, Air Force General Hospital, Beijing, China
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Augmented muscle glycogen utilization following a single session of sprint training in hypoxia. Eur J Appl Physiol 2021; 121:2981-2991. [PMID: 34228222 DOI: 10.1007/s00421-021-04748-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 06/14/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE This study determined the effect of a single session of sprint interval training in hypoxia on muscle glycogen content among athletes. METHODS Ten male college track and field sprinters (mean ± standard error of the mean: age, 21.1 ± 0.2 years; height, 177 ± 2 cm; body weight, 67 ± 2 kg) performed two exercise trials under either hypoxia [HYPO; fraction of inspired oxygen (FiO2), 14.5%] or normoxia (NOR: FiO2, 20.9%). The exercise consisted of 3 × 30 s maximal cycle sprints with 8-min rest periods between sets. Before and immediately after the exercise, the muscle glycogen content was measured using carbon magnetic resonance spectroscopy in vastus lateralis and vastus intermedius muscles. Moreover, power output, blood lactate concentrations, metabolic responses (respiratory oxygen uptake and carbon dioxide output), and muscle oxygenation were evaluated. RESULTS Exercise significantly decreased muscle glycogen content in both trials (interaction, P = 0.03; main effect for time, P < 0.01). Relative changes in muscle glycogen content following exercise were significantly higher in the HYPO trial (- 43.5 ± 0.4%) than in the NOR trial (- 34.0 ± 0.3%; P < 0.01). The mean power output did not significantly differ between the two trials (P = 0.80). The blood lactate concentration after exercise was not significantly different between trials (P = 0.31). CONCLUSION A single session of sprint interval training (3 × 30 s sprints) in hypoxia caused a greater decrease in muscle glycogen content compared with the same exercise under normoxia without interfering with the power output.
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Faiss R, Rapillard A. Repeated Sprint Training in Hypoxia: Case Report of Performance Benefits in a Professional Cyclist. Front Sports Act Living 2020; 2:35. [PMID: 33345027 PMCID: PMC7739633 DOI: 10.3389/fspor.2020.00035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 03/20/2020] [Indexed: 11/21/2022] Open
Abstract
Repeated sprint training in hypoxia (RSH) has gained unprecedented popularity among the various strategies using hypoxia as an additional stimulus to improve performance. This case study reports the benefits of 150 repeated sprints in normobaric hypoxia over 10 days in a professional cyclist. After 3 weeks of endurance training in November, the cyclist performed five RSH sessions at a simulated altitude of 3,300 m on his own bicycle attached to an indoor trainer in a hypoxic chamber (FiO2 14.1 ± 0.1%, PiO2 94.6 ± 1.4 mm Hg). Each session consisted of four blocks of seven all-out sprints of 6 s interspersed with 14 s active recovery (for a total of 126 s per block). After 12 min of warm-up with a single isolated 6 s reference sprint, the sessions included a first and a second sprinting block with 4 min 54 s active recovery in-between. After 9 min 54 s active recovery including an isolated 6 s reference sprint, a third and a fourth block were performed with 4 min 54 s active recovery in-between, before an active cool-down of 9 min 54 s. The total duration was thus of 50 min per session for a total hypoxic exposure of 250 min exercising. Power output and heart rate were monitored at 1 Hz. Lactate concentration ([La]) and pulse oxygen saturation (SpO2) were measured at the start and end of each block during the first and fifth training session. Basal SpO2 was of 83% during session one and 85.5% during session five. When comparing the first and fifth training session, peak power increased for the best 1 s value (+8%) and the best 5 s average (+10%) to reach 1,041 W and 961 W, respectively. Average power for all blocks (including active recoveries) increased from 334 to 354 W with a similar average heart rate during the sessions (146'.min−1). Peak [La] was increased from 12.3 to 13.8 mmol.l−1. In conclusion, this case report illustrates a 10-days RSH intervention perceived as efficient in a professional cyclist and shown to improve total work (6-s sprints) produced for a similar physiological strain.
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Affiliation(s)
- Raphael Faiss
- Research and Expertise in anti-Doping sciences (REDs), Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Arnaud Rapillard
- Clinique romande de réadaptation, SUVACare, Sport Medicine Unit, Sion, Switzerland
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Liu J, Li S, Qian L, Xu X, Zhang Y, Cheng J, Zhang W. Effects of acute mild hypoxia on cerebral blood flow in pilots. Neurol Sci 2020; 42:673-680. [PMID: 32654008 DOI: 10.1007/s10072-020-04567-3] [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: 03/07/2020] [Accepted: 07/02/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Pilots often face and need to overcome a diverse range of unfavorable conditions, of which hypoxic exposure is the most common. Studies have reported that hypoxia can induce a decrease in cerebral blood flow (CBF) in the brains of both humans and animals. Hypoxia and the associated cerebral hemodynamic changes can contribute to cognitive performance deficits that may endanger flight safety and increase the risk of accidents. AIM In this study, we aimed to identify region-specific alterations in CBF in male pilots after exposure to hypoxia. MATERIAL AND METHODS We used 3D pseudo-continuous arterial spin labeling sequences in 35 healthy male pilots (mean age: 30.6 ± 4.82 years) under simulated hypoxic conditions with a 3.0-T magnetic resonance imaging scanner. The generated CBF maps were measured and averaged in several regions of interest. RESULTS Hypoxia decreased CBF in various brain regions, including the right temporal and bilateral occipital lobes, the anterior and posterior lobes of the cerebellum, the culmen and declive, and the inferior semilunar lobule of the cerebellum. CONCLUSION These changes may impact the functional activity of the brains of pilots experiencing hypoxia in flight, but the related mechanisms require further investigation.
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Affiliation(s)
- Jie Liu
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Dong Road, Erqi District, Zhengzhou, Henan Province, China
| | - Shujian Li
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Dong Road, Erqi District, Zhengzhou, Henan Province, China
| | - Long Qian
- GE Healthcare China, Floor 1, Yongchang North Road, Beijing Economic and Technological Development Zone, Beijing, China
| | - Xianrong Xu
- Department of Air Duty, The Air Force General Hospital in Beijing, No. 30 Fucheng Road, Haidian District, Beijing, West Diaoyutai, China
| | - Yong Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Dong Road, Erqi District, Zhengzhou, Henan Province, China
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, No.1 Jianshe Dong Road, Erqi District, Zhengzhou, Henan Province, China.
| | - Wanshi Zhang
- Department of Radiology, The Air Force General Hospital in Beijing, No. 30 Fucheng Road, Haidian District, Beijing, West Diaoyutai, China
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