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Putti GM, Costa GP, Norberto MS, de Carvalho CD, Bertuzzi RCDM, Papoti M. Use of Inter-Effort Recovery Hypoxia as a New Approach to Improve Anaerobic Capacity and Time to Exhaustion. High Alt Med Biol 2024; 25:68-76. [PMID: 38193767 DOI: 10.1089/ham.2023.0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024] Open
Abstract
Putti, Germano Marcolino, Gabriel Peinado Costa, Matheus Silva Norberto, Carlos Dellavechia de Carvalho, Rômulo Cássio de Moraes Bertuzzi, and Marcelo Papoti. Use of inter-effort recovery hypoxia as a new approach to improve anaerobic capacity and time to exhaustion. High Alt Med Biol. 25:68-76, 2024. Background: Although adding hypoxia to high-intensity training may offer some benefits, a significant problem of this training model is the diminished quality of the training session when performing efforts in hypoxia. The purpose of this study was to investigate the effects of training and tapering combined with inter-effort recovery hypoxia (IEH) on anaerobic capacity, as estimated by alternative maximum accumulated oxygen deficit (MAODALT) and time to exhaustion (TTE). Methods: Twenty-four amateur runners performed, for 5 weeks, 3 sessions per week of training consisted of ten 1-minute bouts at 120% (weeks 1-3) and 130% (weeks 4 and 5) of maximum velocity (VMAX) obtained in graded exercise test, separated by a 2-minute interval in IEH (IEH, n = 11, FIO2 = 0.136) or normoxia (NOR, n = 13, fraction of inspired oxygen = 0.209). Before training, after training, and after 1 week of tapering, a graded exercise test and a maximal effort to exhaustion at 120% of VMAX were performed to determine TTE and MAODALT. The results were analyzed using generalized linear mixed models, and a clinical analysis was also realized by the smallest worthwhile change. Results: MAODALT increased only in IEH after training (0.8 ± 0.5 eq.lO2) and tapering (0.8 ± 0.5 eq.lO2), with time x group interaction. TTE increased for the pooled groups after taper (23 ± 11 seconds) and only for IEH alone (29 ± 16 seconds). Clinical analysis revealed a small size increase for NOR and a moderate size increase for IEH. Conclusions: Although the effects should be investigated in other populations, it can be concluded that IEH is a promising model for improving anaerobic performance and capacity. World Health Organization Universal Trial Number: U1111-1295-9954. University's ethics committee registration number: CAAE: 32220020.0.0000.5659.
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Affiliation(s)
- Germano Marcolino Putti
- Escola de Educação Física e Esporte de Ribeirão Preto, Universidade de São Paulo, Ribeirao Preto, Brazil
| | - Gabriel Peinado Costa
- Escola de Educação Física e Esporte de Ribeirão Preto, Universidade de São Paulo, Ribeirao Preto, Brazil
| | - Matheus Silva Norberto
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirao Preto, Brazil
| | | | | | - Marcelo Papoti
- Escola de Educação Física e Esporte de Ribeirão Preto, Universidade de São Paulo, Ribeirao Preto, Brazil
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirao Preto, Brazil
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Huang Z, Yang S, Li C, Xie X, Wang Y. The effects of intermittent hypoxic training on the aerobic capacity of exercisers: a systemic review and meta-analysis. BMC Sports Sci Med Rehabil 2023; 15:174. [PMID: 38115083 PMCID: PMC10731756 DOI: 10.1186/s13102-023-00784-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 12/07/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVE To systematically review the effects of intermittent hypoxic training on the aerobic capacity of exercisers. METHODS PubMed, Embase, The Cochrane Library, and Web of Science databases were electronically searched to collect studies on the effects of intermittent hypoxic training on the aerobic capacity of exercisers from January 1, 2000, to January 12, 2023. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Then, meta-analysis was performed by using Stata SE 16.0 software. RESULTS A total of 19 articles from 27 studies were included. The results of the meta-analysis showed that compared with the control group, the intermittent hypoxic training group had significantly increased maximal oxygen uptake [weighted mean difference = 3.20 (95%CI: 1.33 ~ 5.08)] and hemoglobin [weighted mean difference = 0.25 (95%CI: 0.04 ~ 0.45)]. CONCLUSION Intermittent hypoxic training can significantly improve the aerobic capacity of exercisers. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
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Affiliation(s)
- Zhihao Huang
- School of Big Data and Fundamental Sciences, Shandong Institute of Petroleum and Chemical Technology, Dongying, China
| | - Shulin Yang
- School of Big Data and Fundamental Sciences, Shandong Institute of Petroleum and Chemical Technology, Dongying, China
| | - Chunyang Li
- School of Sports Sciences, Nanjing Normal University, Nanjing, China.
| | - Xingchao Xie
- School of Big Data and Fundamental Sciences, Shandong Institute of Petroleum and Chemical Technology, Dongying, China
| | - Yongming Wang
- School of Big Data and Fundamental Sciences, Shandong Institute of Petroleum and Chemical Technology, Dongying, China
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Giovanna M, Solsona R, Sanchez AMJ, Borrani F. Effects of short-term repeated sprint training in hypoxia or with blood flow restriction on response to exercise. J Physiol Anthropol 2022; 41:32. [PMID: 36057591 PMCID: PMC9440585 DOI: 10.1186/s40101-022-00304-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 08/06/2022] [Indexed: 11/10/2022] Open
Abstract
AbstractThis study compared the effects of a brief repeated sprint training (RST) intervention performed with bilateral blood flow restriction (BFR) conditions in normoxia or conducted at high levels of hypoxia on response to exercise. Thirty-nine endurance-trained athletes completed six repeated sprints cycling sessions spread over 2 weeks consisting of four sets of five sprints (10-s maximal sprints with 20-s active recovery). Athletes were assigned to one of the four groups and subjected to a bilateral partial blood flow restriction (45% of arterial occlusion pressure) of the lower limbs during exercise (BFRG), during the recovery (BFRrG), exercised in a hypoxic room simulating hypoxia at FiO2 ≈ 13% (HG) or were not subjected to additional stress (CG). Peak aerobic power during an incremental test, exercise duration, maximal accumulated oxygen deficit and accumulated oxygen uptake (VO2) during a supramaximal constant-intensity test were improved thanks to RST (p < 0.05). No significant differences were observed between the groups (p > 0.05). No further effect was found on other variables including time-trial performance and parameters of the force-velocity relationship (p > 0.05). Thus, peak aerobic power, exercise duration, maximal accumulated oxygen deficit, and VO2 were improved during a supramaximal constant-intensity exercise after six RST sessions. However, combined hypoxic stress or partial BFR did not further increase peak aerobic power.
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Fernández-Lázaro D, Mielgo-Ayuso J, Santamaría G, Gutiérrez-Abejón E, Domínguez-Ortega C, García-Lázaro SM, Seco-Calvo J. Adequacy of an Altitude Fitness Program (Living and Training) plus Intermittent Exposure to Hypoxia for Improving Hematological Biomarkers and Sports Performance of Elite Athletes: A Single-Blind Randomized Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9095. [PMID: 35897470 PMCID: PMC9368232 DOI: 10.3390/ijerph19159095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/23/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022]
Abstract
Athletes incorporate altitude training programs into their conventional training to improve their performance. The purpose of this study was to determine the effects of an 8-week altitude training program that was supplemented with intermittent hypoxic training (IHE) on the blood biomarkers, sports performance, and safety profiles of elite athletes. In a single-blind randomized clinical trial that followed the CONSORT recommendations, 24 male athletes were randomized to an IHE group (HA, n = 12) or an intermittent normoxia group (NA, n = 12). The IHE consisted of 5-min cycles of hypoxia−normoxia with an FIO2 of between 10−13% for 90 min every day for 8 weeks. Hematological (red blood cells, hemoglobin, hematocrit, hematocrit, reticulated hemoglobin, reticulocytes, and erythropoietin), immunological (leukocytes, monocytes, and lymphocytes), and renal (urea, creatinine, glomerular filtrate, and total protein) biomarkers were assessed at the baseline (T1), day 28 (T2), and day 56 (T3). Sports performance was evaluated at T1 and T3 by measuring quadriceps strength and using three-time trials over the distances of 60, 400, and 1000 m on an athletics track. Statistically significant increases (p < 0.05) in erythropoietin, reticulocytes, hemoglobin, and reticulocyte hemoglobin were observed in the HA group at T3 with respect to T1 and the NA group. In addition, statistically significant improvements (p < 0.05) were achieved in all performance tests. No variations were observed in the immunological or renal biomarkers. The athletes who were living and training at 1065 m and were supplemented with IHE produced significant improvements in their hematological behavior and sports performance with optimal safety profiles.
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Affiliation(s)
- Diego Fernández-Lázaro
- Department of Cellular Biology, Genetics, Histology and Pharmacology, Faculty of Health Sciences, Campus of Soria, University of Valladolid, 42003 Soria, Spain; (G.S.); (C.D.-O.)
- Neurobiology Research Group, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain
| | - Juan Mielgo-Ayuso
- Department of Health Sciences, Faculty of Health Sciences, University of Burgos, 09001 Burgos, Spain
| | - Gema Santamaría
- Department of Cellular Biology, Genetics, Histology and Pharmacology, Faculty of Health Sciences, Campus of Soria, University of Valladolid, 42003 Soria, Spain; (G.S.); (C.D.-O.)
| | - Eduardo Gutiérrez-Abejón
- Pharmacological Big Data Laboratory, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain;
- Pharmacy Directorate, Castilla y León Health Council, 47007 Valladolid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (Group CB21/13/00051), Carlos III Institute of Health, 28029 Madrid, Spain
| | - Carlos Domínguez-Ortega
- Department of Cellular Biology, Genetics, Histology and Pharmacology, Faculty of Health Sciences, Campus of Soria, University of Valladolid, 42003 Soria, Spain; (G.S.); (C.D.-O.)
- Hematology Service of Santa Bárbara Hospital, Castile and Leon Health Network (SACyL), 42003 Soria, Spain
| | - Sandra María García-Lázaro
- Department of Surgery, Ophthalmology, Otorhinolaryngology, and Physiotherapy, Faculty of Health Sciences, Campus of Soria, University of Valladolid, 42003 Soria, Spain;
| | - Jesús Seco-Calvo
- Physiotherapy Department, Institute of Biomedicine (IBIOMED), Campus of Vegazana, University of Leon, 24071 Leon, Spain;
- Psychology Department, Faculty of Medicine, Basque Country University, 48900 Leioa, Spain
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Li Y, Li J, Atakan MM, Wang Z, Hu Y, Nazif M, Zarekookandeh N, Ye HZ, Kuang J, Ferri A, Petersen A, Garnham A, Bishop DJ, Girard O, Huang Y, Yan X. Methods to match high-intensity interval exercise intensity in hypoxia and normoxia - A pilot study. J Exerc Sci Fit 2022; 20:70-76. [PMID: 35024050 PMCID: PMC8728434 DOI: 10.1016/j.jesf.2021.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 12/30/2022] Open
Abstract
The aim of this study was to compare high-intensity interval exercise (HIIE) sessions prescribed on the basis of a maximal value (peak power output, PPO) and a submaximal value (lactate threshold, LT) derived from graded exercise tests (GXTs) in normoxia and hypoxia. Methods: A total of ten males (aged 18–37) volunteered to participate in this study. The experimental protocol consisted of a familiarization procedure, two GXTs under normoxia (FiO2 = 0.209) and two GXTs under normobaric hypoxia (FiO2 = 0.140), and three HIIE sessions performed in a random order. The HIIE sessions included one at hypoxia (HY) and two at normoxia (one matched for the absolute intensity in hypoxia, designated as NA, and one matched for the relative intensity in hypoxia, designated as NR). Results: The data demonstrated that there was significant lower peak oxygen uptake (V̇O2peak), peak heart rate (HRpeak), PPO, and LT derived from GXTs in hypoxia, with higher respiratory exchange ratio (RER), when compared to those from GXTs performed in normoxia (p < 0.001). Among the three HIIE sessions, the NA session resulted in lower percentage of HRpeak (85.0 ± 7.5% vs 94.4 ± 5.0%; p = 0.002) and V̇O2peak (74.1 ± 9.1% vs 88.7 ± 7.7%; p = 0.005), when compared to the NR session. HIIE sessions in HY and NR resulted in similar percentage of HRpeak and V̇O2peak, as well as similar rating of perceived exertion and RER. The blood lactate level increased immediately after all the three HIIE sessions (p < 0.001), while higher blood lactate concentrations were observed immediately after the HY (p = 0.0003) and NR (p = 0.014) sessions when compared with NA. Conclusion: Combining of PPO and LT derived from GXTs can be used to prescribe exercise intensity of HIIE in hypoxia.
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Affiliation(s)
- Yanchun Li
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, 100084, China
| | - Jia Li
- Institute for Health and Sport,(iHeS), Victoria University, Melbourne, 3011, Australia.,College of Physical Education, Southwest University, Chongqin, China
| | - Muhammed M Atakan
- Institute for Health and Sport,(iHeS), Victoria University, Melbourne, 3011, Australia.,Division of Exercise Nutrition and Metabolism, Faculty of Sport Sciences, Hacettepe University, Ankara, 06800, Turkey
| | - Zhenhuan Wang
- Institute for Health and Sport,(iHeS), Victoria University, Melbourne, 3011, Australia
| | - Yang Hu
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, 100084, China
| | - Mostafa Nazif
- Institute for Health and Sport,(iHeS), Victoria University, Melbourne, 3011, Australia
| | - Navabeh Zarekookandeh
- Institute for Health and Sport,(iHeS), Victoria University, Melbourne, 3011, Australia
| | - Henry Zhihong Ye
- School of Biological Sciences, Monash University, Melbourne, 3800, Australia
| | - Jujiao Kuang
- Institute for Health and Sport,(iHeS), Victoria University, Melbourne, 3011, Australia.,Sarcopenia Research Program, Australia Institute for Musculoskeletal Sciences (AIMSS), Melbourne, 3021, Australia
| | - Alessandra Ferri
- Institute for Health and Sport,(iHeS), Victoria University, Melbourne, 3011, Australia
| | - Aaron Petersen
- Institute for Health and Sport,(iHeS), Victoria University, Melbourne, 3011, Australia
| | - Andrew Garnham
- Institute for Health and Sport,(iHeS), Victoria University, Melbourne, 3011, Australia
| | - David J Bishop
- Institute for Health and Sport,(iHeS), Victoria University, Melbourne, 3011, Australia
| | - Olivier Girard
- School of Human Sciences, The University of Western Australia, Perth, 6009, Australia
| | - Yaru Huang
- Department of Physical Education and Art, China Agricultural University, Beijing, 100083, China
| | - Xu Yan
- Institute for Health and Sport,(iHeS), Victoria University, Melbourne, 3011, Australia.,Sarcopenia Research Program, Australia Institute for Musculoskeletal Sciences (AIMSS), Melbourne, 3021, Australia.,Department of Medicine - Western Health, The University of Melbourne, Melbourne, 3021, Australia
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6
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Liu X, Ma C, Wang S, Liang Z, Yang J, Zhou J, Shu Y, He Z, Zong J, Wu L, Peng P, Su Y, Gao M, Shen K, Zhao H, Ruan J, Ji S, Yang Y, Tang T, Yang Z, Luo G, Zeng M, Zhang W, He B, Cheng X, Wang G, Wang L, Lyu L. Screening of osteoporosis and sarcopenia in individuals aged 50 years and older at different altitudes in Yunnan province: Protocol of a longitudinal cohort study. Front Endocrinol (Lausanne) 2022; 13:1010102. [PMID: 36452328 PMCID: PMC9704050 DOI: 10.3389/fendo.2022.1010102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/24/2022] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Musculoskeletal system gradually degenerates with aging, and a hypoxia environment at a high altitude may accelerate this process. However, the comprehensive effects of high-altitude environments on bones and muscles remain unclear. This study aims to compare the differences in bones and muscles at different altitudes, and to explore the mechanism and influencing factors of the high-altitude environment on the skeletal muscle system. METHODS This is a prospective, multicenter, cohort study, which will recruit a total of 4000 participants over 50 years from 12 research centers with different altitudes (50m~3500m). The study will consist of a baseline assessment and a 5-year follow-up. Participants will undergo assessments of demographic information, anthropomorphic measures, self-reported questionnaires, handgrip muscle strength assessment (HGS), short physical performance battery (SPPB), blood sample analysis, and imaging assessments (QCT and/or DXA, US) within a time frame of 3 days after inclusion. A 5-year follow-up will be conducted to evaluate the changes in muscle size, density, and fat infiltration in different muscles; the muscle function impairment; the decrease in BMD; and the osteoporotic fracture incidence. Statistical analyses will be used to compare the research results between different altitudes. Multiple linear, logistic regression and classification tree analyses will be conducted to calculate the effects of various factors (e.g., altitude, age, and physical activity) on the skeletal muscle system in a high-altitude environment. Finally, a provisional cut-off point for the diagnosis of sarcopenia in adults at different altitudes will be calculated. ETHICS AND DISSEMINATION The study has been approved by the institutional research ethics committee of each study center (main center number: KHLL2021-KY056). Results will be disseminated through scientific conferences and peer-reviewed publications, as well as meetings with stakeholders. CLINICAL TRIAL REGISTRATION NUMBER http://www.chictr.org.cn/index.aspx, identifier ChiCTR2100052153.
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Affiliation(s)
- Xingli Liu
- Faculty of Life science and Technology, Kunming University of Science and Technology, Kunming, China
- Medical School, Kunming University of Science and Technology, Kunming, China
- Department of Radiology, The First People’s Hospital of Yunnan Province, Kunming, Yunnan, China
- Department of Radiology, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Cunwen Ma
- Department of Radiology, The People’s Hospital of Wenshan Prefecture, Wenshan, China
| | - Shiping Wang
- Department of Radiology, Anning First people’s Hospital, Kunming University of Science and Technology, Anning, China
| | - Zhengrong Liang
- Department of Radiology, Qujing Second People’s Hospital of Yunnan Province, Qujing, China
| | - Juntao Yang
- Department of Radiology, Dali Bai Autonomous Prefecture People’s Hospital, Dali, China
| | - Jun Zhou
- Department of Radiology, Xishuangbanna Dai Autonomous Prefecture People’s Hospital, Jinghong, China
| | - Yi Shu
- Department of Radiology, Southern Central Hospital of Yunnan Province, Honghe, China
| | - Zhengying He
- Department of Radiology, Diqing Tibetan Autonomous Prefecture People’s Hospital, Xianggelila, China
| | - Jilong Zong
- Department of Radiology, The First People’s Hospital of Zhaotong, Zhaotong, China
| | - Lizhi Wu
- Department of Radiology, Hekou People’s Hospital, Honghe, China
| | - Peiqian Peng
- Department of Radiology, Nujiang People’s Hospital, Nujiang, China
| | - Yi Su
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Meng Gao
- Department of Radiology, The First People’s Hospital of Yunnan Province, Kunming, Yunnan, China
- Department of Radiology, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
| | - Kaiming Shen
- Department of Radiology, The People’s Hospital of Wenshan Prefecture, Wenshan, China
| | - Hong Zhao
- Department of Radiology, Anning First people’s Hospital, Kunming University of Science and Technology, Anning, China
| | - Jilu Ruan
- Department of Radiology, Qujing Second People’s Hospital of Yunnan Province, Qujing, China
| | - Shaoxuan Ji
- Department of Radiology, Dali Bai Autonomous Prefecture People’s Hospital, Dali, China
| | - Yunhui Yang
- Department of Radiology, Xishuangbanna Dai Autonomous Prefecture People’s Hospital, Jinghong, China
| | - Taisong Tang
- Department of Radiology, Southern Central Hospital of Yunnan Province, Honghe, China
| | - Zongfa Yang
- Department of Radiology, Diqing Tibetan Autonomous Prefecture People’s Hospital, Xianggelila, China
| | - Guangyin Luo
- Department of Radiology, The First People’s Hospital of Zhaotong, Zhaotong, China
| | - Meng Zeng
- Department of Radiology, Hekou People’s Hospital, Honghe, China
| | - Weiwan Zhang
- Department of Radiology, Nujiang People’s Hospital, Nujiang, China
| | - Bo He
- Department of Radiology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiaoguang Cheng
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Gang Wang
- Department of Radiology, The First People’s Hospital of Yunnan Province, Kunming, Yunnan, China
- Department of Radiology, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- *Correspondence: Gang Wang, ; Ling Wang, ; Liang Lyu,
| | - Ling Wang
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
- *Correspondence: Gang Wang, ; Ling Wang, ; Liang Lyu,
| | - Liang Lyu
- Faculty of Life science and Technology, Kunming University of Science and Technology, Kunming, China
- Medical School, Kunming University of Science and Technology, Kunming, China
- Department of Radiology, The First People’s Hospital of Yunnan Province, Kunming, Yunnan, China
- Department of Radiology, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- *Correspondence: Gang Wang, ; Ling Wang, ; Liang Lyu,
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Krumm B, Faiss R. Factors Confounding the Athlete Biological Passport: A Systematic Narrative Review. SPORTS MEDICINE - OPEN 2021; 7:65. [PMID: 34524567 PMCID: PMC8443715 DOI: 10.1186/s40798-021-00356-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 08/28/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Through longitudinal, individual and adaptive monitoring of blood biomarkers, the haematological module of the athlete biological passport (ABP) has become a valuable tool in anti-doping efforts. The composition of blood as a vector of oxygen in the human body varies in athletes with the influence of multiple intrinsic (genetic) or extrinsic (training or environmental conditions) factors. In this context, it is fundamental to establish a comprehensive understanding of the various causes that may affect blood variables and thereby alter a fair interpretation of ABP profiles. METHODS This literature review described the potential factors confounding the ABP to outline influencing factors altering haematological profiles acutely or chronically. RESULTS Our investigation confirmed that natural variations in ABP variables appear relatively small, likely-at least in part-because of strong human homeostasis. Furthermore, the significant effects on haematological variations of environmental conditions (e.g. exposure to heat or hypoxia) remain debatable. The current ABP paradigm seems rather robust in view of the existing literature that aims to delineate adaptive individual limits. Nevertheless, its objective sensitivity may be further improved. CONCLUSIONS This narrative review contributes to disentangling the numerous confounding factors of the ABP to gather the available scientific evidence and help interpret individual athlete profiles.
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Affiliation(s)
- Bastien Krumm
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Raphael Faiss
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland.
- Center of Research and Expertise in Anti-Doping Sciences - REDs, University of Lausanne, Lausanne, Switzerland.
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Influence of post-exercise hot-water therapy on adaptations to training over 4 weeks in elite short-track speed skaters. J Exerc Sci Fit 2021; 19:134-142. [PMID: 33603794 PMCID: PMC7859300 DOI: 10.1016/j.jesf.2021.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/29/2020] [Accepted: 01/03/2021] [Indexed: 11/21/2022] Open
Abstract
This study aimed to investigate the effects of regular hot water bathing (HWB), undertaken 10 min after the last training session of the day, on chronic adaptations to training in elite athletes. Six short-track (ST) speed skaters completed four weeks of post-training HWB and four weeks of post-training passive recovery (PR) according to a randomized cross-over study. During HWB, participants sat in a jacuzzi (40 °C; 20 min). According to linear mixed models, maximal isometric strength of knee extensor muscles was significantly increased for training with HWB (p < 0.0001; d = 0.41) and a tendency (p = 0.0529) was observed concerning V˙O2max. No significant effect of training with PR or HWB was observed for several variables (p > 0.05), including aerobic peak power output, the decline rate of jump height during 1 min-continuous maximal countermovement jumps (i.e. anaerobic capacity index), and the force-velocity relationship. Regarding specific tasks on ice, a small effect of training was found on both half-lap time and total time during a 1.5-lap all-out exercise (p = 0.0487; d = 0.23 and p = 0.0332; d = 0.21, respectively) but no additional effect of HWB was observed. In summary, the regular HWB protocol used in this study can induce additional effects on maximal isometric strength without compromising aerobic and anaerobic adaptations or field performance in these athletes.
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Ambroży T, Maciejczyk M, Klimek AT, Wiecha S, Stanula A, Snopkowski P, Pałka T, Jaworski J, Ambroży D, Rydzik Ł, Cynarski W. The Effects of Intermittent Hypoxic Training on Anaerobic and Aerobic Power in Boxers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9361. [PMID: 33327551 PMCID: PMC7765038 DOI: 10.3390/ijerph17249361] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/13/2020] [Accepted: 12/14/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The aim of the study was to evaluate the effects of intermittent hypoxic training (IHT) on anaerobic and aerobic fitness in elite, national boxers. METHODS The study was conducted over a period of 6 weeks. It comprised 30 national championship boxers, divided into 2 groups: the experimental and control. Both groups performed the same boxing training twice a day (morning and afternoon training). In the afternoon, the experimental group performed training under normobaric conditions in a hypoxic chamber (IHT), while the control group undertook exercise in standard normoxic conditions. In both groups, before and after the 6-week programme, basic anthropometric indices as well as anaerobic (Wingate Test) and aerobic (graded test) fitness were assessed. RESULTS There was a significant increase in anaerobic peak power (988.2 vs. 1011.8 W), mean anaerobic power (741.1 vs. 764.8 W), total work (22.84 vs. 22.39 kJ), and a decrease in fatigue index (20.33 vs. 18.6 W·s-1) as well as time to peak power (5.01 vs. 4.72 s). Such changes were not observed in the control group. In both groups, no significant changes in endurance performance were noted after the training session - peak oxygen uptake did not significantly vary after IHT. CONCLUSIONS Our results have practical application for coaches, as the IHT seems to be effective in improving anaerobic performance among boxers.
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Affiliation(s)
- Tadeusz Ambroży
- Institute of Sports Sciences, University of Physical Education, 31-571 Kraków, Poland; (T.A.); (J.J.); (D.A.)
| | - Marcin Maciejczyk
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, University of Physical Education in Kraków, 31-571 Kraków, Poland; (M.M.); (A.T.K.); (T.P.)
| | - Andrzej T. Klimek
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, University of Physical Education in Kraków, 31-571 Kraków, Poland; (M.M.); (A.T.K.); (T.P.)
| | - Szczepan Wiecha
- Department of Rehabilitation, Faculty of Physical Education and Sport in Biała Podlaska, Józef Piłsudski University of Physical Education, 00-809 Warsaw, Poland;
| | - Arkadiusz Stanula
- Institute of Sport Science, The Jerzy Kukuczka Academy of Physical Education, Mikołowska 72A, 40-065 Katowice, Poland;
| | - Piotr Snopkowski
- Doctoral School, University of Physical Education in Kraków, 31-571 Kraków, Poland;
| | - Tomasz Pałka
- Department of Physiology and Biochemistry, Faculty of Physical Education and Sport, University of Physical Education in Kraków, 31-571 Kraków, Poland; (M.M.); (A.T.K.); (T.P.)
| | - Janusz Jaworski
- Institute of Sports Sciences, University of Physical Education, 31-571 Kraków, Poland; (T.A.); (J.J.); (D.A.)
| | - Dorota Ambroży
- Institute of Sports Sciences, University of Physical Education, 31-571 Kraków, Poland; (T.A.); (J.J.); (D.A.)
| | - Łukasz Rydzik
- Institute of Sports Sciences, University of Physical Education, 31-571 Kraków, Poland; (T.A.); (J.J.); (D.A.)
| | - Wojciech Cynarski
- Institute of Physical Culture Studies, College of Medical Sciences, University of Rzeszów, 35-310 Rzeszów, Poland;
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10
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Coombs GB, Cramer MN, Ravanelli N, Imbeault P, Jay O. Normobaric hypoxia does not alter the critical environmental limits for thermal balance during exercise‐heat stress. Exp Physiol 2020; 106:359-369. [DOI: 10.1113/ep088466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 03/18/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Geoff B. Coombs
- School of Human Kinetics, Faculty of Health Sciences University of Ottawa ON Canada
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences University of British Columbia (Okanagan) Kelowna BC Canada
| | - Matthew N. Cramer
- School of Human Kinetics, Faculty of Health Sciences University of Ottawa ON Canada
- Defence Research and Development Canada Toronto Research Centre Toronto ON Canada
| | - Nicholas Ravanelli
- Cardiovascular Prevention and Rehabilitation Centre and Research Centre Montreal Heart Institute Montreal QC Canada
- Département de pharmacologie et physiologie Université de Montréal Montreal QC Canada
| | - Pascal Imbeault
- School of Human Kinetics, Faculty of Health Sciences University of Ottawa ON Canada
| | - Ollie Jay
- School of Human Kinetics, Faculty of Health Sciences University of Ottawa ON Canada
- University of Sydney, Faculty of Medicine and Health Thermal Ergonomics Laboratory Sydney NSW Australia
- University of Sydney Charles Perkins Centre Sydney NSW Australia
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11
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Takei N, Kakinoki K, Girard O, Hatta H. Short-Term Repeated Wingate Training in Hypoxia and Normoxia in Sprinters. Front Sports Act Living 2020; 2:43. [PMID: 33345035 PMCID: PMC7739589 DOI: 10.3389/fspor.2020.00043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 03/31/2020] [Indexed: 12/22/2022] Open
Abstract
Repeated Wingate efforts (RW) represent an effective training strategy for improving exercise capacity. Living low-training high altitude/hypoxic training methods, that upregulate muscle adaptations, are increasingly popular. However, the benefits of RW training in hypoxia compared to normoxia on performance and accompanying physiological adaptations remain largely undetermined. Our intention was to test the hypothesis that RW training in hypoxia provides additional performance benefits and more favorable physiological responses than equivalent training in normoxia. Twelve male runners (university sprinters) completed six RW training sessions (3 × 30-s Wingate “all-out” efforts with 4.5-min recovery) in either hypoxia (FiO2: 0.145, n = 6) or normoxia (FiO2: 0.209, n = 6) over 2 weeks. Before and after the intervention, participants underwent a RW performance test (3 × 30-s Wingate “all-out” efforts with 4.5-min recovery). Peak power output, mean power output, and total work for the three exercise bouts were determined. A capillary blood sample was taken for analyzing blood lactate concentration (BLa) 3 min after each of the three efforts. Peak power output (+ 11.3 ± 23.0%, p = 0.001), mean power output (+ 6.6 ± 6.8%, p = 0.001), and total work (+ 6.3 ± 5.4% p = 0.016) significantly increased from pre- to post-training, independently of condition. The time × group × interval interaction was significant (p = 0.05) for BLa. Compared to Pre-tests, BLa values during post-test were higher (+ 8.7 ± 10.3%) after about 2 in the normoxic group, although statistical significance was not reached (p = 0.08). Contrastingly, BLa values were lower (albeit not significantly) during post- compared to pre-tests after bout 2 (−9.3 ± 8.6%; p = 0.08) and bout 3 (−9.1 ± 10.7%; p = 0.09) in the hypoxic group. In conclusion, six RW training sessions over 2 weeks significantly improved RW performance, while training in hypoxia had no additional benefit over normoxia. However, accompanying BLa responses tended to be lower in the hypoxic group, while an opposite pattern was observed in the normoxic group. This indicates that different glycolytic and/or oxidative pathway adaptations were probably at play.
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Affiliation(s)
- Naoya Takei
- Department of Sports Sciences, The University of Tokyo, Tokyo, Japan.,Murdoch Applied Sports Science Laboratory, Murdoch University, Perth, WA, Australia
| | | | - Olivier Girard
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, WA, Australia
| | - Hideo Hatta
- Department of Sports Sciences, The University of Tokyo, Tokyo, Japan
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12
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Girard O, Brocherie F, Goods PSR, Millet GP. An Updated Panorama of "Living Low-Training High" Altitude/Hypoxic Methods. Front Sports Act Living 2020; 2:26. [PMID: 33345020 PMCID: PMC7739748 DOI: 10.3389/fspor.2020.00026] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 03/06/2020] [Indexed: 12/16/2022] Open
Abstract
With minimal costs and travel constraints for athletes, the “living low-training high” (LLTH) approach is becoming an important intervention for modern sport. The popularity of the LLTH model of altitude training is also associated with the fact that it only causes a slight disturbance to athletes' usual daily routine, allowing them to maintain their regular lifestyle in their home environment. In this perspective article, we discuss the evolving boundaries of the LLTH paradigm and its practical applications for athletes. Passive modalities include intermittent hypoxic exposure at rest (IHE) and Ischemic preconditioning (IPC). Active modalities use either local [blood flow restricted (BFR) exercise] and/or systemic hypoxia [continuous low-intensity training in hypoxia (CHT), interval hypoxic training (IHT), repeated-sprint training in hypoxia (RSH), sprint interval training in hypoxia (SIH) and resistance training in hypoxia (RTH)]. A combination of hypoxic methods targeting different attributes also represents an attractive solution. In conclusion, a growing number of LLTH altitude training methods exists that include the application of systemic and local hypoxia stimuli, or a combination of both, for performance enhancement in many disciplines.
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Affiliation(s)
- Olivier Girard
- School of Human Sciences, Exercise and Sport Science, University of Western Australia, Perth, WA, Australia
| | - Franck Brocherie
- Laboratory Sport, Expertise and Performance, EA 7370, French Institute of Sport (INSEP), Paris, France
| | - Paul S R Goods
- School of Human Sciences, Exercise and Sport Science, University of Western Australia, Perth, WA, Australia.,Western Australian Institute of Sport (WAIS), Perth, WA, Australia
| | - Gregoire P Millet
- Faculty of Biology and Medicine, Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
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13
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Intermittent Hypoxic Training at Lactate Threshold Intensity Improves Aiming Performance in Well-Trained Biathletes with Little Change of Cardiovascular Variables. BIOMED RESEARCH INTERNATIONAL 2019; 2019:1287506. [PMID: 31662969 PMCID: PMC6778904 DOI: 10.1155/2019/1287506] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 08/13/2019] [Accepted: 08/27/2019] [Indexed: 02/06/2023]
Abstract
The main objective of this research was to evaluate the efficacy of intermittent hypoxic training (IHT) on aiming performance and aerobic capacity in biathletes. Fourteen male biathletes were randomly divided into a hypoxia group (H) (n = 7), which trained three times per week in a normobaric hypoxic environment (FiO2 = 16.5%, 2000 m a.s.l.) with lactate threshold intensity (LT) determined in hypoxia, and a control group (C) (n = 7), which exercised under normoxic conditions with LT intensity determined in normoxia. The training program included three weekly microcycles, followed by three days of recovery. The main part of the interval workout consisted of four 7 min (1st week), 8 min (2nd week), or 9 min (3rd week) running bouts at treadmill separated by 2 minutes of active recovery. After the warm-up and during the rest between the bouts, the athletes performed aiming to the target in the standing position with a sporting rifle (20 s). The results showed that the IHT caused a significant (p < 0.05) increase in retention time in the target at rest (RT9rest) by 14.4% in hypoxia, whereas RT postincremental test (RT9post) increased by 27.4% in normoxia and 26.7% in hypoxia. No significant changes in this variable were found in group C. Additionally, the capillary oxygen saturation at the end of the maximal effort (SO2capillary max) in hypoxia increased significantly (p < 0.001) by ∼4% after IHT. The maximal workload during the incremental test (WRmax) in normoxia also increased significantly (p < 0.001) by 6.3% after IHT. Furthermore, in absolute and relative values of VO2max in normoxia, there was a propensity (p < 0.07) for increasing this value by 5% in group H. In conclusion, the main findings of this study showed a significant improvement in resting and postexercise aiming performance in normoxia and hypoxia. Furthermore, the results demonstrated beneficial effects of the IHT protocol on aerobic capacity of biathletes.
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14
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Recent Data on Cellular Component Turnover: Focus on Adaptations to Physical Exercise. Cells 2019; 8:cells8060542. [PMID: 31195688 PMCID: PMC6627613 DOI: 10.3390/cells8060542] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 05/31/2019] [Accepted: 06/02/2019] [Indexed: 12/22/2022] Open
Abstract
Significant progress has expanded our knowledge of the signaling pathways coordinating muscle protein turnover during various conditions including exercise. In this manuscript, the multiple mechanisms that govern the turnover of cellular components are reviewed, and their overall roles in adaptations to exercise training are discussed. Recent studies have highlighted the central role of the energy sensor (AMP)-activated protein kinase (AMPK), forkhead box class O subfamily protein (FOXO) transcription factors and the kinase mechanistic (or mammalian) target of rapamycin complex (MTOR) in the regulation of autophagy for organelle maintenance during exercise. A new cellular trafficking involving the lysosome was also revealed for full activation of MTOR and protein synthesis during recovery. Other emerging candidates have been found to be relevant in organelle turnover, especially Parkin and the mitochondrial E3 ubiquitin protein ligase (Mul1) pathways for mitochondrial turnover, and the glycerolipids diacylglycerol (DAG) for protein translation and FOXO regulation. Recent experiments with autophagy and mitophagy flux assessment have also provided important insights concerning mitochondrial turnover during ageing and chronic exercise. However, data in humans are often controversial and further investigations are needed to clarify the involvement of autophagy in exercise performed with additional stresses, such as hypoxia, and to understand the influence of exercise modality. Improving our knowledge of these pathways should help develop therapeutic ways to counteract muscle disorders in pathological conditions.
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15
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McKeown DJ, Simmonds MJ, Kavanagh JJ. Reduced blood oxygen levels induce changes in low-threshold motor unit firing that align with the individual’s tolerance to hypoxia. J Neurophysiol 2019; 121:1664-1671. [DOI: 10.1152/jn.00071.2019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This study aimed to quantify how acute hypoxia impacts firing characteristics of biceps brachii motor units (MUs) during sustained isometric elbow flexions. MU data were extracted from surface electromyography (EMG) during 25% maximal voluntary contractions (MVC) in 10 healthy subjects (age 22 ± 1 yr). Blood oxygen saturation (SpO2) was then stabilized at 80% by reducing 1% of the fraction of inspired oxygen every 3 min for 35 min. MU data were once again collected 1 h and 2 h following the 35-min desaturation phase. Although MVC remained unaffected during 2 h of 80% SpO2, subject-specific changes in MU firing rate were observed. Four of 10 subjects exhibited a decrease in firing rate 1 h postdesaturation (12 ± 11%) and 2 h postdesaturation (16 ± 12%), whereas 6 of 10 subjects exhibited an increase in firing rate 1 h (9 ± 6%) and 2 h (9 ± 4%) postdesaturation. These bidirectional changes in firing rate were strongly correlated to the desaturation phase and the subjects’ SpO2 sensitivity to oxygen availability, where subjects who had decreased firing rates reached the target SpO2 20 min into the desaturation phase ( R2 = 0.90–0.98) and those who had increased firing rates reached the target SpO2 35 min into the desaturation phase ( R2 = 0.87–0.98). It is unlikely that a single mechanism accounted for these subject-specific changes in firing rate. Instead, differences in intrinsic properties of the neurons, afferent input to the motoneurons, neuromodulators, and sympathetic nerve activity may exist between groups. NEW & NOTEWORTHY The mechanisms of compromised motor control when exposed to hypoxia are largely unknown. The current study examined how severe acute hypoxia affects motor unit firing rate during sustained isometric contractions of the bicep brachii. The response to hypoxia was different across subjects, where motor unit firing rate increased for some individuals and decreased for others. This bidirectional change in firing rate was associated with how fast subjects desaturated during hypoxic exposure.
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Affiliation(s)
- Daniel J. McKeown
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Queensland, Australia
| | - Michael J. Simmonds
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Queensland, Australia
| | - Justin J. Kavanagh
- School of Allied Health Sciences, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Queensland, Australia
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16
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Viscor G, Torrella JR, Corral L, Ricart A, Javierre C, Pages T, Ventura JL. Physiological and Biological Responses to Short-Term Intermittent Hypobaric Hypoxia Exposure: From Sports and Mountain Medicine to New Biomedical Applications. Front Physiol 2018; 9:814. [PMID: 30038574 PMCID: PMC6046402 DOI: 10.3389/fphys.2018.00814] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 06/11/2018] [Indexed: 12/14/2022] Open
Abstract
In recent years, the altitude acclimatization responses elicited by short-term intermittent exposure to hypoxia have been subject to renewed attention. The main goal of short-term intermittent hypobaric hypoxia exposure programs was originally to improve the aerobic capacity of athletes or to accelerate the altitude acclimatization response in alpinists, since such programs induce an increase in erythrocyte mass. Several model programs of intermittent exposure to hypoxia have presented efficiency with respect to this goal, without any of the inconveniences or negative consequences associated with permanent stays at moderate or high altitudes. Artificial intermittent exposure to normobaric hypoxia systems have seen a rapid rise in popularity among recreational and professional athletes, not only due to their unbeatable cost/efficiency ratio, but also because they help prevent common inconveniences associated with high-altitude stays such as social isolation, nutritional limitations, and other minor health and comfort-related annoyances. Today, intermittent exposure to hypobaric hypoxia is known to elicit other physiological response types in several organs and body systems. These responses range from alterations in the ventilatory pattern to modulation of the mitochondrial function. The central role played by hypoxia-inducible factor (HIF) in activating a signaling molecular cascade after hypoxia exposure is well known. Among these targets, several growth factors that upregulate the capillary bed by inducing angiogenesis and promoting oxidative metabolism merit special attention. Applying intermittent hypobaric hypoxia to promote the action of some molecules, such as angiogenic factors, could improve repair and recovery in many tissue types. This article uses a comprehensive approach to examine data obtained in recent years. We consider evidence collected from different tissues, including myocardial capillarization, skeletal muscle fiber types and fiber size changes induced by intermittent hypoxia exposure, and discuss the evidence that points to beneficial interventions in applied fields such as sport science. Short-term intermittent hypoxia may not only be useful for healthy people, but could also be considered a promising tool to be applied, with due caution, to some pathophysiological states.
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Affiliation(s)
- Ginés Viscor
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
| | - Joan R. Torrella
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
| | - Luisa Corral
- Exercise Physiology Unit, Department of Physiological Sciences, Faculty of Medicine and Health Sciences, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Antoni Ricart
- Exercise Physiology Unit, Department of Physiological Sciences, Faculty of Medicine and Health Sciences, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Casimiro Javierre
- Exercise Physiology Unit, Department of Physiological Sciences, Faculty of Medicine and Health Sciences, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Teresa Pages
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
| | - Josep L. Ventura
- Exercise Physiology Unit, Department of Physiological Sciences, Faculty of Medicine and Health Sciences, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
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