1
|
Callovini A, Fornasiero A, Savoldelli A, Decet M, Skafidas S, Pellegrini B, Bortolan L, Schena F. Independent, additive and interactive effects of acute normobaric hypoxia and cold on submaximal and maximal endurance exercise. Eur J Appl Physiol 2024; 124:1185-1200. [PMID: 37962573 PMCID: PMC10955012 DOI: 10.1007/s00421-023-05343-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/16/2023] [Indexed: 11/15/2023]
Abstract
PURPOSE To evaluate the independent and combined effects of hypoxia (FiO2 = 13.5%) and cold (- 20 °C) on physiological and perceptual responses to endurance exercise. METHODS 14 trained male subjects ( V . O2max: 64 ± 5 mL/kg/min) randomly performed a discontinuous maximal incremental test to exhaustion on a motorized treadmill under four environmental conditions: Normothermic-Normoxia (N), Normothermic-Hypoxia (H), Cold-Normoxia (C) and Cold-Hypoxia (CH). Performance and physiological and perceptual responses throughout exercise were evaluated. RESULTS Maximal WorkLoad (WL) and WL at lactate threshold (LT) were reduced in C (- 2.3% and - 3.5%) and H (- 18.0% and - 21.7%) compared to N, with no interactive (p = 0.25 and 0.81) but additive effect in CH (- 21.5% and - 24.6%). Similarly, HRmax and Vemax were reduced in C (- 3.2% and - 14.6%) and H (- 5.0% and - 7%), showing additive effects in CH (- 7.7% and - 16.6%). At LT, additive effect of C (- 2.8%) and H (- 3.8%) on HR reduction in CH (- 5.7%) was maintained, whereas an interactive effect (p = 0.007) of the two stressors combined was noted on Ve (C: - 3.1%, H: + 5.5%, CH: - 10.9%). [La] curve shifted on the left in CH, displaying an interaction effect between the 2 stressors on this parameter. Finally, RPE at LT was exclusively reduced by hypoxia (p < 0.001), whereas TSmax is synergistically reduced by cold and hypoxia (interaction p = 0.047). CONCLUSION If compared to single stress exposure, exercise performance and physiological and perceptual variables undergo additive or synergistic effects when cold and hypoxia are combined. These results provide new insight into human physiological responses to extreme environments.
Collapse
Affiliation(s)
- A Callovini
- CeRiSM, Sport Mountain and Health Research Centre, University of Verona, Rovereto, Italy.
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.
| | - A Fornasiero
- CeRiSM, Sport Mountain and Health Research Centre, University of Verona, Rovereto, Italy
- Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
| | - A Savoldelli
- CeRiSM, Sport Mountain and Health Research Centre, University of Verona, Rovereto, Italy
- Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - M Decet
- CeRiSM, Sport Mountain and Health Research Centre, University of Verona, Rovereto, Italy
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - S Skafidas
- CeRiSM, Sport Mountain and Health Research Centre, University of Verona, Rovereto, Italy
| | - B Pellegrini
- CeRiSM, Sport Mountain and Health Research Centre, University of Verona, Rovereto, Italy
- Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
| | - L Bortolan
- CeRiSM, Sport Mountain and Health Research Centre, University of Verona, Rovereto, Italy
- Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
| | - F Schena
- CeRiSM, Sport Mountain and Health Research Centre, University of Verona, Rovereto, Italy
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| |
Collapse
|
2
|
Wait SO, Charkoudian N, Skinner JW, Smith CJ. Combining hypoxia with thermal stimuli in humans: physiological responses and potential sex differences. Am J Physiol Regul Integr Comp Physiol 2023; 324:R677-R690. [PMID: 36971421 PMCID: PMC10202487 DOI: 10.1152/ajpregu.00244.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 03/08/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023]
Abstract
Increasing prevalence of native lowlanders sojourning to high altitudes (>2,500 m) for recreational, occupational, military, and competitive reasons has generated increased interest in physiological responses to multistressor environments. Exposure to hypoxia poses recognized physiological challenges that are amplified during exercise and further complicated by environments that might include combinations of heat, cold, and high altitude. There is a sparsity of data examining integrated responses in varied combinations of environmental conditions, with even less known about potential sex differences. How this translates into performance, occupational, and health outcomes requires further investigation. Acute hypoxic exposure decreases arterial oxygen saturation, resulting in a reflex hypoxic ventilatory response and sympathoexcitation causing an increase in heart rate, myocardial contractility, and arterial blood pressure, to compensate for the decreased arterial oxygen saturation. Acute altitude exposure impairs exercise performance, for example, reduced time to exhaustion and slower time trials, largely owing to impairments in pulmonary gas exchange and peripheral delivery resulting in reduced V̇o2max. This exacerbates with increasing altitude, as does the risk of developing acute mountain sickness and more serious altitude-related illnesses, but modulation of those risks with additional stressors is unclear. This review aims to summarize and evaluate current literature regarding cardiovascular, autonomic, and thermoregulatory responses to acute hypoxia, and how these may be affected by simultaneous thermal environmental challenges. There is minimal available information regarding sex as a biological variable in integrative responses to hypoxia or multistressor environments; we highlight these areas as current knowledge gaps and the need for future research.
Collapse
Affiliation(s)
- Seaver O Wait
- Department of Public Health and Exercise Science, Appalachian State University, Boone, North Carolina, United States
| | - Nisha Charkoudian
- United States Army Research Institute of Environmental Medicine, Natick, Massachusetts, United States
| | - Jared W Skinner
- Department of Public Health and Exercise Science, Appalachian State University, Boone, North Carolina, United States
| | - Caroline J Smith
- Department of Public Health and Exercise Science, Appalachian State University, Boone, North Carolina, United States
| |
Collapse
|
3
|
Riveros-Rivera A, Penzel T, Gunga HC, Opatz O, Paul F, Klug L, Boschmann M, Mähler A. Hypoxia Differentially Affects Healthy Men and Women During a Daytime Nap With a Dose-Response Relationship: a Randomized, Cross-Over Pilot Study. Front Physiol 2022; 13:899636. [PMID: 35685284 PMCID: PMC9171024 DOI: 10.3389/fphys.2022.899636] [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: 03/18/2022] [Accepted: 04/18/2022] [Indexed: 11/13/2022] Open
Abstract
Context: The use of daytime napping as a countermeasure in sleep disturbances has been recommended but its physiological evaluation at high altitude is limited. Objective: To evaluate the neuroendocrine response to hypoxic stress during a daytime nap and its cognitive impact. Design, Subject, and Setting: Randomized, single-blind, three period cross-over pilot study conducted with 15 healthy lowlander subjects (8 women) with a mean (SD) age of 29(6) years (Clinicaltrials identifier: NCT04146857, https://clinicaltrials.gov/ct2/show/NCT04146857?cond=napping&draw=3&rank=12). Interventions: Volunteers underwent a polysomnography, hematological and cognitive evaluation around a 90 min midday nap, being allocated to a randomized sequence of three conditions: normobaric normoxia (NN), normobaric hypoxia at FiO2 14.7% (NH15) and 12.5% (NH13), with a washout period of 1 week between conditions. Results: Primary outcome was the interbeat period measured by the RR interval with electrocardiogram. Compared to normobaric normoxia, RR during napping was shortened by 57 and 206 ms under NH15 and NH13 conditions, respectively (p < 0.001). Sympathetic predominance was evident by heart rate variability analysis and increased epinephrine levels. Concomitantly, there were significant changes in endocrine parameters such as erythropoietin (∼6 UI/L) and cortisol (∼100 nmol/L) (NH13 vs. NN, p < 0.001). Cognitive evaluation revealed changes in the color-word Stroop test. Additionally, although sleep efficiency was preserved, polysomnography showed lesser deep sleep and REM sleep, and periodic breathing, predominantly in men. Conclusion: Although napping in simulated altitude does not appear to significantly affect cognitive performance, sex-dependent changes in cardiac autonomic modulation and respiratory pattern should be considered before napping is prescribed as a countermeasure.
Collapse
Affiliation(s)
- Alain Riveros-Rivera
- Center for Space Medicine and Extreme Environments Berlin, Institute of Physiology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Physiological Sciences, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Thomas Penzel
- Interdisciplinary Center of Sleep Medicine, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Hanns-Christian Gunga
- Center for Space Medicine and Extreme Environments Berlin, Institute of Physiology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Oliver Opatz
- Center for Space Medicine and Extreme Environments Berlin, Institute of Physiology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Friedemann Paul
- Experimental and Clinical Research Center, A Cooperation Between the Max-Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Experimental and Clinical Research Center, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Lars Klug
- Experimental and Clinical Research Center, A Cooperation Between the Max-Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Experimental and Clinical Research Center, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Michael Boschmann
- Experimental and Clinical Research Center, A Cooperation Between the Max-Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Experimental and Clinical Research Center, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Anja Mähler
- Experimental and Clinical Research Center, A Cooperation Between the Max-Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Experimental and Clinical Research Center, Berlin, Germany
- Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| |
Collapse
|
4
|
Castellani JW, Eglin CM, Ikäheimo TM, Montgomery H, Paal P, Tipton MJ. ACSM Expert Consensus Statement: Injury Prevention and Exercise Performance during Cold-Weather Exercise. Curr Sports Med Rep 2021; 20:594-607. [PMID: 34752434 DOI: 10.1249/jsr.0000000000000907] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
ABSTRACT Cold injury can result from exercising at low temperatures and can impair exercise performance or cause lifelong debility or death. This consensus statement provides up-to-date information on the pathogenesis, nature, impacts, prevention, and treatment of the most common cold injuries.
Collapse
Affiliation(s)
- John W Castellani
- United States Army Research Institute of Environmental Medicine, Thermal and Mountain Medicine Division, Natick, MA
| | - Clare M Eglin
- University of Portsmouth, School of Sport, Health and Exercise Science, Portsmouth, United Kingdom
| | | | - Hugh Montgomery
- University College London, Centre for Human Health and Performance, London, United Kingdom
| | - Peter Paal
- Hospitallers Brothers Hospital, Anaesthesiology and Intensive Care Medicine, Salzburg, Austria
| | - Michael J Tipton
- University of Portsmouth, School of Sport, Health and Exercise Science, Portsmouth, United Kingdom
| |
Collapse
|
5
|
Gatterer H, Dünnwald T, Turner R, Csapo R, Schobersberger W, Burtscher M, Faulhaber M, Kennedy MD. Practicing Sport in Cold Environments: Practical Recommendations to Improve Sport Performance and Reduce Negative Health Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9700. [PMID: 34574624 PMCID: PMC8471173 DOI: 10.3390/ijerph18189700] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/30/2021] [Accepted: 09/08/2021] [Indexed: 11/17/2022]
Abstract
Although not a barrier to perform sport, cold weather environments (low ambient temperature, high wind speeds, and increased precipitation, i.e., rain/water/snow) may influence sport performance. Despite the obvious requirement for practical recommendations and guidelines to better facilitate training and competition in such cold environments, the current scientific evidence-base is lacking. Nonetheless, this review summarizes the current available knowledge specifically related to the physiological impact of cold exposure, in an attempt to provide practitioners and coaches alike with practical recommendations to minimize any potential negative performance effects, mitigate health issues, and best optimize athlete preparation across various sporting disciplines. Herein, the review is split into sections which explore some of the key physiological effects of cold exposure on performance (i.e., endurance exercise capacity and explosive athletic power), potential health issues (short-term and long-term), and what is currently known with regard to best preparation or mitigation strategies considered to negate the potential negative effects of cold on performance. Specific focus is given to "winter" sports that are usually completed in cold environments and practical recommendations for physical preparation.
Collapse
Affiliation(s)
- Hannes Gatterer
- Institute of Mountain Emergency Medicine, Eurac Research, 39100 Bolzano, Italy;
| | - Tobias Dünnwald
- Institute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG), UMIT, Private University for Health Sciences, Medical Informatics and Technology, 6060 Hall i.T., Tirol, Austria and Tirol-Kliniken GmbH, 6020 Innsbruck, Austria; (T.D.); (W.S.)
| | - Rachel Turner
- Institute of Mountain Emergency Medicine, Eurac Research, 39100 Bolzano, Italy;
| | - Robert Csapo
- Centre for Sport Science and University Sports, University of Vienna, 1010 Vienna, Austria;
| | - Wolfgang Schobersberger
- Institute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG), UMIT, Private University for Health Sciences, Medical Informatics and Technology, 6060 Hall i.T., Tirol, Austria and Tirol-Kliniken GmbH, 6020 Innsbruck, Austria; (T.D.); (W.S.)
- Austrian Society for Alpine and High-Altitude Medicine, 6414 Mieming, Austria; (M.B.); (M.F.)
| | - Martin Burtscher
- Austrian Society for Alpine and High-Altitude Medicine, 6414 Mieming, Austria; (M.B.); (M.F.)
- Department of Sport Science, University Innsbruck, 6020 Innsbruck, Austria
| | - Martin Faulhaber
- Austrian Society for Alpine and High-Altitude Medicine, 6414 Mieming, Austria; (M.B.); (M.F.)
- Department of Sport Science, University Innsbruck, 6020 Innsbruck, Austria
| | - Michael D. Kennedy
- Athlete Health Lab, Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| |
Collapse
|
6
|
Ewalts M, Dawkins T, Friend AT. Hypoxia research: to control or not to control? That is the question. J Physiol 2021; 599:2141-2142. [PMID: 33590893 DOI: 10.1113/jp281192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- Michiel Ewalts
- Bangor School of Sport, Health and Exercise Sciences, Bangor University, Bangor, UK
| | - Tony Dawkins
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Alexander T Friend
- Bangor School of Sport, Health and Exercise Sciences, Bangor University, Bangor, UK
| |
Collapse
|
7
|
Tipton M. Experimental Physiology special issue: Extreme environmental physiology. Exp Physiol 2020; 106:1-3. [PMID: 33382514 DOI: 10.1113/ep089151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 10/08/2020] [Indexed: 11/08/2022]
Affiliation(s)
- Mike Tipton
- Extreme Environments Laboratory, School of Sport, Health & Exercise Science, University of Portsmouth, Portsmouth, UK
| |
Collapse
|
8
|
Keramidas ME, Kölegård R, Eiken O. Hypoxia gradually augments metabolic and thermoperceptual responsiveness to repeated whole-body cold stress in humans. Exp Physiol 2020; 105:2123-2140. [PMID: 33140429 PMCID: PMC7756580 DOI: 10.1113/ep089070] [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: 09/05/2020] [Accepted: 10/30/2020] [Indexed: 12/02/2022]
Abstract
New Findings What is the central question of this study? In male lowlanders, does hypoxia modulate thermoregulatory effector responses during repeated whole‐body cold stress encountered in a single day? What is the main finding and its importance? A ∼10 h sustained exposure to hypoxia appears to mediate a gradual upregulation of endogenous heat production, preventing the progressive hypothermic response prompted by serial cold stimuli. Also, hypoxia progressively degrades mood, and compounds the perceived thermal discomfort, and sensations of fatigue and coldness.
Abstract We examined whether hypoxia would modulate thermoeffector responses during repeated cold stress encountered in a single day. Eleven men completed two ∼10 h sessions, while breathing, in normobaria, either normoxia or hypoxia (PO2: 12 kPa). During each session, subjects underwent sequentially three 120 min immersions to the chest in 20°C water (CWI), interspersed by 120 min rewarming. In normoxia, the final drop in rectal temperature (Trec) was greater in the third (∼1.2°C) than in the first and second (∼0.9°C) CWIs (P < 0.05). The first hypoxic CWI augmented the Trec fall (∼1.2°C; P = 0.002), but the drop in Trec did not vary between the three hypoxic CWIs (P = 0.99). In normoxia, the metabolic heat production (M˙) was greater during the first half of the third CWI than during the corresponding part of the first CWI (P = 0.02); yet the difference was blunted during the second half of the CWIs (P = 0.89). In hypoxia, by contrast, the increase in M˙ was augmented by ∼25% throughout the third CWI (P < 0.01). Regardless of the breathing condition, the cold‐induced elevation in mean arterial pressure was blunted in the second and third CWI (P < 0.05). Hypoxia aggravated the sensation of coldness (P = 0.05) and thermal discomfort (P = 0.04) during the second half of the third CWI. The present findings therefore demonstrate that prolonged hypoxia mediates, in a gradual manner, metabolic and thermoperceptual sensitization to repeated cold stress.
Collapse
Affiliation(s)
- Michail E Keramidas
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Roger Kölegård
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Ola Eiken
- Division of Environmental Physiology, Swedish Aerospace Physiology Center, KTH Royal Institute of Technology, Stockholm, Sweden
| |
Collapse
|