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Review Article ©Journal of Sports Science and Medicine (2015) 14, 776-782 http://www.jssm.org Research article Increased Hypoxic Dose after Training at Low Altitude with 9h per Night at 3000m Normobaric Hypoxia Amelia J. Carr 1, Philo U. Saunders 2,3, Brent S. Vallance 4, Laura A. Garvican-Lewis 2,5 and Chris- topher J. Gore 2,6 1 School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Victoria, Australia; 2 Department of Physi- ology, Australian Institute of Sport, Canberra, Australian Capital Territory, Australia; 3 Track and Field, Australian Institute of Sport, Canberra, Australian Capital Territory, Australia; 4 Maribyrnong Sports Academy, Melbourne, Victo- ria, Australia; 5 Research Institute for Sport and Exercise, University of Canberra, Canberra, Australian Capital Territo- ry, Australia; 6 Exercise Physiology Laboratory, Flinders University, Adelaide, South Australia al., 2010). For Australian endurance athletes, Thredbo, New Abstract This study examined effects of low altitude training and a live- South Wales, Australia, is a venue often used for training high: train-low protocol (combining both natural and simulated camps. The 1380 m elevation at Thredbo is comparable to modalities) on haemoglobin mass (Hbmass), maximum oxygen some other training camp venues used by athletes interna- consumption (VO2max), time to exhaustion, and submaximal tionally (Millet et al., 2010); albeit that this elevations is exercise measures. Eighteen elite-level race-walkers were as- in the ‘low altitude’ range of 500 – 2000 m as defined by signed to one of two experimental groups; lowHH (low Hypo- Bartsch et al (2008). Performance improvements have baric Hypoxia: continuous exposure to 1380 m for 21 consecu- been reported after use of this altitude training method tive days; n = 10) or a combined low altitude training and night- (Wilber et al., 2007). However, it has been suggested that ly Normobaric Hypoxia (lowHH+NHnight: living and training the low altitude (Bartsch et al., 2008; Levine and Stray- at 1380 m, plus 9 h.night-1 at a simulated altitude of 3000 m Gundersen, 1997) at such venues is insufficient to stimu- using hypoxic tents; n = 8). A control group (CON; n = 10) lived late red blood cell production and increase hemoglobin and trained at 600 m. Measurement of Hbmass, time to exhaustion and VO2max was performed before and after the training inter- mass (Hbmass) (Levine and Stray-Gundersen, 1992; Rusko vention. Paired samples t-tests were used to assess absolute and et al., 2004; Wilber, 2007), which is one of the key mech- percentage change pre and post-test differences within groups, anisms associated with improvements in VO2max (Schmidt and differences between groups were assessed using a one-way and Prommer, 2010), and performance gains after altitude ANOVA with least significant difference post-hoc testing. Sta- training (Bonetti and Hopkins, 2009). In an early study tistical significance was tested at p < 0.05. There was a 3.7% (Weil et al., 1968), it was reported that exposure to 1600 increase in Hbmass in lowHH+NHnight compared with CON (p = m is insufficient to increase red cell mass. More recently 0.02). In comparison to baseline, Hb increased by 1.2% mass however, continuous exposure to 1800 m elevation (±1.4%) in the lowHH group, 2.6% (±1.8%) in lowHH+NHnight, and there was a decrease of 0.9% (±4.9%) in (Garvican-Lewis et al., 2015) was shown to significantly CON. VO2max increased by ~4% within both experimental con- increase haemoglobin mass, compared to a control condi- ditions but was not significantly greater than the 1% increase in tion. Collectively, these results suggest that the threshold CON. There was a ~9% difference in pre and post-intervention for haematological changes after altitude training may be values in time to exhaustion after lowHH+NH-night (p = 0.03) above 1600 m, and at or below 1800 m. and a ~8% pre to post-intervention difference (p = 0.006) after Live-high: train-low (LHTL) altitude training is an lowHH only. We recommend low altitude (1380 m) combined alternative to the classical method that has been widely with sleeping in altitude tents (3000 m) as one effective alterna- investigated (Bonetti and Hopkins, 2009), whereby ath- tive to traditional altitude training methods, which can improve letes continue to spend a set period of time during the day Hbmass. and night at moderate altitude, but perform training ses- Key words: Hypoxia; hemoglobin mass; live high: train low; sions at much lower altitude or near sea level. LHTL can athletic performance; peak oxygen uptake. be achieved naturally, a method known as hypobaric hypoxia (HH) (Millet et al., 2013) or by simulating ele- vated altitudes, referred to as normobaric hypoxia (NH) Introduction (Millet et al., 2013) using methods such as nitrogen chambers or hypoxic tents (Wilber, 2007), and has been For many athletes, it is common practice to live and train shown to enhance performance in various exercise modal- at venues of moderate altitude (i.e. 2000-3000 m) (Millet ities, including running (Stray-Gundersen et al., 2001) and et al., 2010) for periods of time, in order to achieve con- cycling (Hahn and Gore, 2001). LHTL has the advantage tinuous exposure to hypoxia with the intent of improving of preventing a compromise to training intensity, which sea-level performance (Bonetti and Hopkins, 2009; Hahn can occur during continuous altitude exposure (Wilber, et al., 2001; Wilber et al., 2007). This ‘classical’ mode of 2007). Furthermore, providing that the daily and total altitude training is often performed by living and training exposure to altitude is sufficient (Clark et al., 2009; Gore at moderate altitude for several weeks at a time (Millet et et al., 2013), LHTL also stimulates erythropoiesis result- Received: 25 April 2015 / Accepted: 21 September 2015 / Published (online): 24 November 2015 Car et al. 777 ing in gains in Hbmass. Indeed, one study reported a 6% Human Ethics Committee. increase in haemoglobin mass after an 18-day period of LHTL where altitude was progressively increased from Experimental design 2500 m to 3500 m. (Robach et al., 2006). Within our Participants were assigned to one of two independent research group, we have demonstrated improvements in experimental groups or the control group, and the groups Hbmass, as well as a ~4% improvement in treadmill per- were matched for performance ability, training history formance, in elite-level race walkers following simulated and training volume. Participants were not blinded to their LHTL training (Saunders et al., 2010). experimental condition. Conducting LHTL at natural altitude venues is of- The training completed by participants was ten impractical (Hahn and Gore, 2001) because the travel performed during an annual training camp of national and involved to training venues may interfere with athletes’ internationally competitive race walkers, and was training schedules (Wilber, 2007). An alternative is to consistent across the two groups, but was monitored and combine methods of hypoxic training (Millet et al., 2010). adjusted by the AIS race walking coach based on the Specifically, the use of normobaric altitude tents may requirements of individual athletes. Each week, increase the hypoxic dose sufficiently to elicit haemato- participants completed 3-4 continuous light aerobic logical and physiological effects. Neya et al. (2013), sug- walking sessions (which included two hill sessions), 1-2 gested that a more practical approach to conventional light aerobic runs or cross-training sessions, 2 interval- LHTL at natural altitude was to combine three weeks of based sessions at or above race pace intensity, and two living and training at 1300-1800 m, with 10 hours of strength and conditioning sessions. The training described nightly exposure to 3000 m simulated altitude. Therein, above was also consistent with that completed by the travel to low altitude training venues was eliminated, with control group, which was also conducted over a 21-day altitude tents used to provide the additional hypoxic stim- period, as the data were collected during the same training ulus at night. However, such an approach has not been phase in a previous year and supervised by the same applied to the investigation of increases in Hbmass and coach. maximum oxygen consumption (VO2max) in elite athletes, Participants in the low altitude-training group when comparing modified LHTL to both low altitude (lowHH, n = 10) lived and trained at a training camp in training, and a control group training near sea level. Other Thredbo (New South Wales, Australia, 1380 m) for 21 studies have used venues of similar topography and simu- consecutive days. In the combined low-altitude and lated altitude (Brugniaux et al., 2006; Tiollier et al., simulated altitude group (lowHH+NHNight, n = 8), 2005; Povea et al., 2005; Cornolo et al, 2006; Robach et participants were also based at the training camp in al., 2005; 2006), and effects of repeated exposure to low Thredbo (1380 m) for the 21-day duration, but they spent altitudes for several weeks at a time has also been investi- 9 hours overnight at a simulated altitude of 3000 m using gated (Frese and Friedmann-Bette, 2010). However, with- hypoxic tents (Colorado Altitude Training, Louisville, in these studies, the optimised CO rebreathing method Colorado, United States of America), to decrease the (Schmidt & Prommer, 2005) was not used to measure percentage of oxygen in the air. The time each athlete changes in haemoglobin mass; and hypoxic rooms, rather entered and left their altitude tent was recorded each day, than tents were used to achieve the simulated altitude. to ensure each athlete in this group experienced 9 hours of Therefore, the purpose of this investigation was to assess exposure. The fraction of inspired oxygen in the hypoxic -1 changes in Hbmass (g), VO2max (mL.min kg) and time to tents was approximately 17.0%.
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