Effects of endurance exercise under hypoxia on acid-base and ion balance in healthy males

Acute physiological responses and muscle recovery in females: a randomised controlled trial of muscle damaging exercise in hypoxia

BACKGROUND

Studies have investigated the effects of training under hypoxia (HYP) after several weeks in a male population. However, there is still a lack of knowledge on the acute hypoxic effects on physiology and muscle recovery in a female population.

METHODS

This randomized-controlled trial aimed to investigate the acute effects of muscle damaging exercise, performed in HYP and normoxia (CON), on physiological responses and recovery characteristics in healthy females. Key inclusion criteria were recreationally active female participants between the age of 18 to 35 years without any previous surgeries and injuries, whilst key exclusion criteria were acute pain situations, pregnancy, and medication intake. The females conducted a muscle-damaging protocol, comprising 5 × 20 drop-jumps, in either HYP (FiO2: 12%) or CON (FiO2: 21%). Physiological responses, including capillary oxygenation (SpO2), muscle oxygenation (SmO2), heart rate (HR), core- (Tcore) and skin- (Tskin) temperature were assessed at the end of each exercise set. Recovery characteristics were quantified by taking venous blood samples (serum creatine-kinase [CK], C-reactive protein [CRP] and blood sedimentation rate [BSR]), assessing muscle swelling of the quadriceps femoris muscle, maximum voluntary isometric contraction (MVIC) of the knee extensor muscles, countermovement jump (CMJ) performance and muscle soreness ratings (DOMS) at 24-, 48- and 72-hrs post-exercise.

RESULTS

SpO2 (HYP: 76.7 ± 3.8%, CON: 95.5 ± 1.7%, p < 0.001) and SmO2 (HYP: 60.0 ± 9.3, CON: 73.4 ± 5.8%, p = 0.03) values were lower (p < 0.05) in HYP compared to CON at the end of the exercise-protocol. No physiological differences between HYP and CON were observed for HR, Tcore, and Tskin (all p > 0.05). There were also no differences detected for any recovery variable (CK, CRP, BSR, MVIC, CMJ, and DOMS) during the 72-hrs follow-up period between HYP and CON (all p > 0.05).

CONCLUSION

In conclusion, our results showed that muscle damaging exercise under HYP leads to reduced capillary and muscle oxygenation levels compared to normoxia with no difference in inflammatory response and muscle recovery during 72 h post-exercise.

TRIAL REGISTRATION

NCT04902924, May 26th 2021.

Effectiveness, implementation, and monitoring variables of intermittent hypoxic bicycle training in patients recovered from COVID-19: The AEROBICOVID study

Hypoxic exposure is safely associated with exercise for many pathological conditions, providing additional effects on health outcomes. COVID-19 is a new disease, so the physiological repercussions caused by exercise in affected patients and the safety of exposure to hypoxia in these conditions are still unknown. Due to the effects of the disease on the respiratory system and following the sequence of AEROBICOVID research work, this study aimed to evaluate the effectiveness, tolerance and acute safety of 24 bicycle training sessions performed under intermittent hypoxic conditions through analysis of peripheral oxyhemoglobin saturation (SpO₂), heart rate (HR), rate of perceived exertion (RPE), blood lactate concentration ([La^-]) and symptoms of acute mountain sickness in patients recovered from COVID-19. Participants were allocated to three training groups: the normoxia group (G_N) remained in normoxia (inspired fraction of O₂ (FiO₂) of ∼20.9%, a city with 526 m altitude) for the entire session; the recovery hypoxia group (G_HR) was exposed to hypoxia (FiO₂ ∼13.5%, corresponding to 3,000 m altitude) all the time except during the effort; the hypoxia group (G_H) trained in hypoxia (FiO₂ ∼13.5%) throughout the session. The altitude simulation effectively reduced SpO₂ mean with significant differences between groups G_N, G_HR, and G_H, being 96.9(1.6), 95.1(3.1), and 87.7(6.5), respectively. Additionally, the proposed exercise and hypoxic stimulus was well-tolerated, since 93% of participants showed no or moderate acute mountain sickness symptoms; maintained nearly 80% of sets at target heart rate; and most frequently reporting session intensity as an RPE of "3" (moderate). The internal load calculation, analyzed through training impulse (TRIMP), calculated using HR [TRIMP_HR = HR * training volume (min)] and RPE [TRIMP_RPE = RPE * training volume (min)], showed no significant difference between groups. The current strategy effectively promoted the altitude simulation and monitoring variables, being well-tolerated and safely acute exposure, as the low Lake Louise scores and the stable HR, SpO₂, and RPE values showed during the sessions.

Effects of Acute Moderate Hypoxia versus Normoxia on Metabolic and Cardiac Function and Skeletal Muscle Oxygenation during Endurance Exercise at the Same Heart Rate Level

This study aimed to investigate the effects of acute moderate hypoxia (HYP), compared with those of normoxia (NORM), during endurance exercise with the same HR level on metabolic function, skeletal muscle oxygenation, and cardiac function. Twelve healthy men (aged 25.1 ± 2.3 years) completed 30 min of endurance exercise using a cycle ergometer with the same HR level (136.5 ± 1.5 bpm) corresponding to 70% maximal heart rate (HRmax) under NORM (760 mmHg) and HYP (526 mmHg, simulated 3000 m altitude) after a 30 min exposure in the respective environments on different days, in random order. Exercise load, rating of perceived exertion (RPE), metabolic function (saturation of percutaneous oxygen; SpO₂, minute ventilation; oxygen uptake; VO₂, carbon dioxide excretion; respiratory exchange ratio; RER, and oxygen pulse), skeletal muscle oxygen profiles (oxyhemoglobin, oxhb, deoxyhemoglobin, dxhb, total hemoglobin, and tissue oxygenation index; StO₂), and cardiac function (heart rate, stroke volume, cardiac output, end-diastolic volume, end-systolic volume, and ejection fraction) were measured during endurance exercise. HYP showed a lower exercise load with the same RPE during exercise than did NORM. In addition, HYP showed a lower SpO₂, VO₂, oxygen pulse, oxhb, and StO₂, and a higher RER and dxhb during exercise than NORM. We found that HYP showed lower exercise load and VO₂ at the same RPE than NORM and also confirmed a higher anaerobic metabolism and oxygen inflow into skeletal muscle tissue due to the limitation of oxygen delivery capacity.

Effects of Interval Training Under Hypoxia on the Autonomic Nervous System and Arterial and Hemorheological Function in Healthy Women

Purpose

The present study verified the effects of interval training under hypoxia, a novel exercise modality for health promotion, on the autonomic nervous system (ANS) and arterial and hemorheological function in healthy women.

Methods

Twenty healthy Korean women (age: 19–29 [24.85 ± 3.84] years) were equally assigned to interval normoxic training (INT, n = 10; residing and training under normoxia) and interval hypoxic training (IHT, n = 10; residing under normoxia and training under 526 mmHg hypobaric hypoxia) groups. All participants performed 90-min of training sessions composed of 15-min of warm-up, 60-min of interval training, and 15-min of cool-down. The interval training sessions composed of 10 repetitions of interval exercise using a treadmill (5 min of exercise corresponding to 90–95% maximal heart rate [HR] and 1 min of rest). The training was performed 3 days per week for 6 weeks. All participants underwent body composition, HR variability, brachial-ankle pulse wave velocity, flow-mediated dilation (FMD), red blood cell (RBC) deformability and aggregation, and maximal oxygen uptake (VO₂max) measurements before and after training.

Results

There were no significant differences in body composition between the groups. The IHT group showed a significant improvement in the ANS function (root mean square of successive differences, high frequency, and low frequency/high frequency ratio), arterial stiffness, arterial endothelial function (FMD), hemorheological function (RBC deformability and aggregation), and aerobic performance (VO₂max) compared with the INT (all p < 0.05).

Conclusion

In comparison with the interval training under normoxia, the interval training under hypoxia is a novel and effective exercise modality for promoting aerobic performance with the ANS and arterial and hemorheological function in healthy women.

Metabolic, Cardiac, and Hemorheological Responses to Submaximal Exercise under Light and Moderate Hypobaric Hypoxia in Healthy Men

Simple Summary

The lower atmospheric partial pressure of oxygen under hypobaric hypoxia decreases oxygen saturation and arteriovenous oxygen difference. Exercise under hypoxia decreases arterial oxygen saturation, which reduces the ability to deliver oxygen to active muscles and consequently worsens aerobic capacity and exercise performance. Previous studies on metabolic and cardiac responses to submaximal exercise under hypoxia have been well documented, but information on hemorheological responses is relatively insufficient. In this regard, a review of hemorheological responses to exercise under hypoxia could provide further information on reduced aerobic capacity and exercise performance caused by acute hypoxia. We conducted a randomized crossover trial to compare the effects of acute exercise under light and moderate hypobaric hypoxia versus normoxia on metabolic parameters, cardiac function, and hemorheological properties in healthy men. The main findings of our study revealed that endurance submaximal exercise under light (596 mmHg, simulated 2000 m) and moderate (526 mmHg, simulated 3000 m) hypoxia induced greater metabolic and cardiac responses than exercise under normoxia. However, exercise under hypobaric hypoxia did not affect hemorheological properties, including erythrocyte deformability and aggregation. These results can be used as basic data for understanding hemorheological responses in light and moderate hypobaric hypoxia.

Abstract

We compared the effects of metabolic, cardiac, and hemorheological responses to submaximal exercise under light hypoxia (LH) and moderate hypoxia (MH) versus normoxia (N). Ten healthy men (aged 21.3 ± 1.0 years) completed 30 min submaximal exercise corresponding to 60% maximal oxygen uptake at normoxia on a cycle ergometer under normoxia (760 mmHg), light hypoxia (596 mmHg, simulated 2000 m altitude), and moderate hypoxia (526 mmHg, simulated 3000 m altitude) after a 30 min exposure in the respective environments on different days, in a random order. Metabolic parameters (oxygen saturation (S_PO₂), minute ventilation, oxygen uptake, carbon dioxide excretion, respiratory exchange ratio, and blood lactate), cardiac function (heart rate (HR), stroke volume, cardiac output, and ejection fraction), and hemorheological properties (erythrocyte deformability and aggregation) were measured at rest and 5, 10, 15, and 30 min after exercise. S_PO₂ significantly reduced as hypoxia became more severe (MH > LH > N), and blood lactate was significantly higher in the MH than in the LH and N groups. HR significantly increased in the MH and LH groups compared to the N group. There was no significant difference in hemorheological properties, including erythrocyte deformability and aggregation. Thus, submaximal exercise under light/moderate hypoxia induced greater metabolic and cardiac responses but did not affect hemorheological properties.

Resistance Training in Hypoxia as a New Therapeutic Modality for Sarcopenia-A Narrative Review

Hypoxic training is believed to be generally useful for improving exercise performance in various athletes. Nowadays, exercise intervention in hypoxia is recognized as a new therapeutic modality for health promotion and disease prevention or treatment based on the lower mortality and prevalence of people living in high-altitude environments than those living in low-altitude environments. Recently, resistance training in hypoxia (RTH), a new therapeutic modality combining hypoxia and resistance exercise, has been attempted to improve muscle hypertrophy and muscle function. RTH is known to induce greater muscle size, lean mass, increased muscle strength and endurance, bodily function, and angiogenesis of skeletal muscles than traditional resistance exercise. Therefore, we examined previous studies to understand the clinical and physiological aspects of sarcopenia and RTH for muscular function and hypertrophy. However, few investigations have examined the combined effects of hypoxic stress and resistance exercise, and as such, it is difficult to make recommendations for implementing universal RTH programs for sarcopenia based on current understanding. It should also be acknowledged that a number of mechanisms proposed to facilitate the augmented response to RTH remain poorly understood, particularly the role of metabolic, hormonal, and intracellular signaling pathways. Further RTH intervention studies considering various exercise parameters (e.g., load, recovery time between sets, hypoxic dose, and intervention period) are strongly recommended to reinforce knowledge about the adaptational processes and the effects of this type of resistance training for sarcopenia in older people.