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e-ISSN 1734-2260 from 2005
ISSN 1429-0022 from 1997 till 2004
Indexed in: SportDiscus; EBSCO; Index Copernicus
Medicina Sportiva 2010 vol. 14, Issue 1
Copyright ® 2010 Medicina Sportiva
Editorial
Read article »
Testing of alpinists in normoxic and hypoxic conditions, before and after high-altitude expeditions
Anton Ušaj
Read article »
Altitude and best performances in human locomotion
Pietro Enrico di Prampero
Read article »
Some metabolic responses to reduced breathing frequency during constant load exercise
Jernej Kapus, Anton Ušaj, Venceslav Kapus
Read article »
The influence of altitude training on selected blood parameters and lactate curves during swimming
Boro Štrumbelj, Anton Ušaj
Read article »
Two deaths in two days: a case report of mountaineering fatalities on Mount Rainier
Travis W. Heggie, Jacob D. Jorgenson
Read article »
"CO2PING": Acute Mountain Sickness, stress and the role of the right cerebral hemisphere
Robb Waanders
Read article »
Occupational aspects of work in hypoxic conditions – the new recommendation of the Medical Commission of the Union Internationale des Associations d’Alpinisme (UIAA MedCom)
Thomas Küpper, Jim S. Milledge, David Hillebrandt, Jana Kubalova, Urs Hefti, Buddha Basnayt, Ulf Gieseler, Suzanne Arnold, Volker Schoffl
Read article »
Letters to the Editor
Read article »
Testing of alpinists in normoxic and hypoxic conditions, before and after high-altitude expeditions
Anton Ušaj
The aim of the review was to present experimental results performed in the past 3 years in the Laboratory of Biodynamics. These results have brought to a novel point of view on alpinist adaptations influenced by climbing to (acclimatization) and descent from (deacclimatization) high-altitude expedition. Alpinists were tested before and after expeditions in normoxic and hypoxic conditions. The reduction of body weight, which accompanied alpinists during high-altitude expedition, affects some other parameters because of the increased relative energetic expenditure for the same absolute work. Heart rate (HR) increased its values. However, because of possible simultaneous influence of training, which influences HR in opposite direction (decrease), values not show adaptation, probably due to masking of the phenomenon. Ventilation is parameter, which was affected by high-altitude hypoxia and reduced body weight in the same direction. Why increased VE observed during testing in normoxic conditions after high-altitude expedition was not observed also during testing in hypoxic conditions is not known. Arterial oxygen saturation is still elevated after a month of deacclimatization during testing in hypoxia. This was effect of acclimatization. Better oxygenation of arterial blood and brain was not found after a three weeks of deacclimatization from high-altitude expedition. However, it seems that a certain level of enhanced oxygenation persisted in exercising leg muscles. Local muscle oxygenation seems to be important during climbing at all. We observed forearm muscles oxygenation and found that muscles have been more oxygenated in trained alpinists and less in untrained.
Key words: acclimatization, deacclimatization, reacclimatization, training
Read article »
Altitude and best performances in human locomotion
Pietro Enrico di Prampero
During locomotion on land, on flat terrain in the absence of wind, metabolic power (E) increases with speed (s): E = C·s = α·s + β·s3, where α and β are constant, α·s the power utilised against non aerodynamic forces, and β·s3 (= Eair) that dissipated against air resistance. At maximal aerobic speed, Eair is about 97 % of the total in track cycling and about 8 % in running. At altitude, Eair is reduced in direct proportion with the air density, and hence with the barometric pressure (for a given temperature). Hence the metabolic power at a given speed is less, and conversely, the speed for a given power is larger. However, altitude leads also to a fall of maximal O2 consumption (¦O2max), so its net results on performance are set by the balance between these two conflicting effects, as discussed below. The maximal endurance speed depends on ¦O2max: E = ¦O2max = α·ssl + β·ssl3, where sl denotes sea level. At altitude: A ¦O2max = α·sa + k·β·sa3 , where A and k are the fractional decreases of ¦O2max and of β, and the subscript a denotes altitude. Therefore the optimum altitude for aerobic performances can be calculated, provided that α and β are known: for cycling it amounts to about 3.8 km, where sa/ssl = 1.046, whereas for skating, it is on the order of 1.2 km where sa/ssl = 1.013. In running, the maximal aerobic speed at altitude declines very nearly in direct proportion with ¦O2max.
Key words: altitude, best performances, running, speed-skating, cycling
Read article »
Some metabolic responses to reduced breathing frequency during constant load exercise
Jernej Kapus, Anton Ušaj, Venceslav Kapus
Introduction: Hypoxia has not been detected only during altitude exercise but also during specific conditions during exercise at sea level, such exercise with reduced breathing frequency (RBF). Training with RBF is often referred to as “hypoxic training”. It was thought that, by limiting inspired air, the reduction of oxygen available for muscular work would result and therefore cause muscle hypoxia, similar to that experienced at altitude. Therefore, the aim of this study was to examine the possible effect of RBF on ventilatory parameters, blood gases, oxygen saturation and some metabolic responses during the constant load exercise to exhaustion.
Methods: Eight healthy male subjects performed an incremental cycling test with RBF at 10 breaths per minute. A constant load test with RBF (B10) was then performed to exhaustion at the peak power output obtained during the incremental test. Finally, the subjects repeated the constant load test with the spontaneous breathing (SB) using the same protocol as B10.
Results: RBF during the constant load exercise resulted in a profound reduction in VE, when compared to the spontaneous breathing, despite significantly increases in VT. Consequently, there were significantly lower SO2 and PO2 and higher PCO2 during B10 than during SB. However, there were no significant differences in VO2 and [LA-] between different breathing conditions.
Conclusions: Therefore, it may be concluded that RBF during the constant load exercise induced marked hypoventilation and consequently hypoxia and hypercapnia. However, it seemed that this degree of the breathing reduction did not influence on aerobic metabolism due to unchanged VO2 and [LA-].
Key words: constant load test, reduced breathing frequency, hypoxia, hypercapnia, blood lactate
Read article »
The influence of altitude training on selected blood parameters and lactate curves during swimming
Boro Štrumbelj, Anton Ušaj
Introduction: Moderate altitude training has become popular to improve competition performance in swimming both at altitude and sea level. The aim of the present study was to examine the influence of moderate altitude training on lactate curve during three weeks and after the exposure to altitude training at 1860 m and to examine the effects of altitude training on selected blood parameters before and after the training at altitude.
Methods: In the study participated four (1 men, 3 women) high competition-level swimmers (mean ± SD; age 21 ± 1.2 years). All swimmers performed 5 times standardized test 5x3x200m to obtain velocities and heart rates at lactate thresholds and OBLA thresholds (before, three times on altitude and after altitude exposure). Blood samples for selected blood parameters (Erci, Hb, Ht, ERC-ret and ferritin) were taken before and after exposure to altitude.
Results: There were no significant changes (P < 0.05) in heart rate and blood lactate at a lactate threshold and OBLA threshold during altitude camp and 21 days after return at sea level. Individual response at altitude camp were found above OBLA threshold. No significant differences were found in selected blood parameters before and after exposure to altitude training (Erci, Hb, Ht, ERC-ret and ferritin).
Conclusions: These data indicate that no significant changes in lactate threshold, OBLA threshold, and selected blood parameters were found at altitude and upon return to sea-level after three weeks of training at 1860 m.
Key words: swimming, moderate altitude, lactate threshold, OBLA threshold, blood
Read article »
Two deaths in two days: a case report of mountaineering fatalities on Mount Rainier
Travis W. Heggie, Jacob D. Jorgenson
Mountain climbing is a popular recreational activity that has experienced an increase in the number of fatalities as the popularity of mountaineering has increased. This case report presents the conditions surrounding two mountaineering fatalities on Mount Rainier, Washington, U.S.A. The fatalities occurred on subsequent days and in approximate locations. Environmental conditions and falls of 91 m and 250 m were identified as contributing mechanisms in both deaths. However, the role of climbing behavior is called into check as the climbers involved in both incidents repeatedly ignored warnings about poor climbing conditions and one victim ignored warnings of climbing solo.
Key words: mountaineering, Mount Rainier, fatality, falls, behavior
Read article »
"CO2PING": Acute Mountain Sickness, stress and the role of the right cerebral hemisphere
Robb Waanders
Introduction: The concept of stress has been introduced in psychology and psychosomatic medicine in order to describe the response of biological systems to different types of strain and pressure. Mild oxygen deprivation (hypoxemia) is a vital physical stressor which triggers an alarm reaction. The adrenal hypothalamus-medulla system is being activated along the fight-or-flight stress axis. Research has shown that the right cerebral hemisphere is predominant in orchestrating the primary alarm reaction.
Aim of the study: This study aimed to evaluate the effect of the personality dimension trait-anxiety (ANXT-factor) on processing the stressor hypoxemia under field conditions.
Methods: Prior to the expeditions to Imja Tse (n=14) and Chulu West Peak (n=14) an extensive anamnesis of each participant was written and the individual ANXT-factor was determined using the STAI. After having crossed the thresholdaltitude (2500 m), the Lake Louise Score was applied (evening and morning protocol) to quantify symptoms of AMS. A sum score ≥3 was considered symptomatic. Additionally heart rate (HR) and peripheral oxygen saturation (SpO2) were daily measured by pulse oximetry.
Results: In the Chulu-group ANXT-percentile and LL-AMS-sum score were highly related (r=0.82, t=5 which exceeds 4.318, the critical value of t for P<.001). In the Imja-team r=0.74 (P<.01; evening protocol). HR and likewise SpO2 had insignificant relations with ANXT and AMS-scores.
Conclusions: The study indicates a direct link between AMS and the personality dimension trait-anxiety. The symptoms of acute mountain sickness are to be considered as the neuro-psycho-somatic stress response to mild oxygen deprivation orchestrated by the right cerebral hemisphere. This article presents a stress-model based on those findings.
Key words: hypoxemia, mild AMS, vegetative nervous system, neurotic trait, stress model
Read article »
Occupational aspects of work in hypoxic conditions – the new recommendation of the Medical Commission of the Union Internationale des Associations d’Alpinisme (UIAA MedCom)
Thomas Küpper, Jim S. Milledge, David Hillebrandt, Jana Kubalova, Urs Hefti, Buddha Basnayt, Ulf Gieseler, Suzanne Arnold, Volker Schoffl
More and more persons are exposed to hypoxia while working at altitude, e.g. when working for cable cars or ski areas in the Alps, for business in South America or Asia, as airline crews, or in rooms with reduced oxygen pressure for hypoxia training or fire protection. Unfortunately, the different countries have a multitude of regulations for occupational health and safety concerning hypoxia – most of them with major deficiencies and a significant lack of knowledge about hypoxia and possible specific risks. So far, no national regulation differentiates the different types of hypoxia and the environment, both having significant influence on the specific risk profile of employees and consequences for occupational health and safety. As the world’s umbrella body for preventive medicine at altitude / hypoxia, the Medical Commission of the Union Internationale des Associations d’Alpinisme (UIAA MedCom) recently established a recommendation to enable the national bodies to establish knowledge-based pragmatic procedures for occupational health and safety [1]. The most important message is as follows: Any environment with oxygen concentration of 14.0% or more or an altitude of 3,000 m or less is safe for any non-acclimatized person without severe cardiopulmonary disease (10 g/dl) and an exposure limited to a few hours (one work shift). These environments include most alpine cable cars, ski areas, aircrafts flying on long-range distances, most towns or villages where businessmen might go to, and rooms for fire protection. For longer exposure (sleep at high altitude) or higher environments the persons should be acclimatized or exposed for a short time only. Details how to manage health and safety in such environments are given.
Key words: hypoxia, occupational medicine, occupational safety, workload
Read article »
Indexed in: SportDiscus; EBSCO; Index Copernicus
Editorial
Medicina Sportiva 2010 vol. 14, Issue 1
Copyright ® 2010 Medicina Sportiva
Read article »
Testing of alpinists in normoxic and hypoxic conditions, before and after high-altitude expeditions
Anton Ušaj
Read article »
Altitude and best performances in human locomotion
Pietro Enrico di Prampero
Read article »
Some metabolic responses to reduced breathing frequency during constant load exercise
Jernej Kapus, Anton Ušaj, Venceslav Kapus
Read article »
The influence of altitude training on selected blood parameters and lactate curves during swimming
Boro Štrumbelj, Anton Ušaj
Read article »
Two deaths in two days: a case report of mountaineering fatalities on Mount Rainier
Travis W. Heggie, Jacob D. Jorgenson
Read article »
"CO2PING": Acute Mountain Sickness, stress and the role of the right cerebral hemisphere
Robb Waanders
Read article »
Occupational aspects of work in hypoxic conditions – the new recommendation of the Medical Commission of the Union Internationale des Associations d’Alpinisme (UIAA MedCom)
Thomas Küpper, Jim S. Milledge, David Hillebrandt, Jana Kubalova, Urs Hefti, Buddha Basnayt, Ulf Gieseler, Suzanne Arnold, Volker Schoffl
Read article »
Letters to the Editor
Read article »
Testing of alpinists in normoxic and hypoxic conditions, before and after high-altitude expeditions
Anton Ušaj
The aim of the review was to present experimental results performed in the past 3 years in the Laboratory of Biodynamics. These results have brought to a novel point of view on alpinist adaptations influenced by climbing to (acclimatization) and descent from (deacclimatization) high-altitude expedition. Alpinists were tested before and after expeditions in normoxic and hypoxic conditions. The reduction of body weight, which accompanied alpinists during high-altitude expedition, affects some other parameters because of the increased relative energetic expenditure for the same absolute work. Heart rate (HR) increased its values. However, because of possible simultaneous influence of training, which influences HR in opposite direction (decrease), values not show adaptation, probably due to masking of the phenomenon. Ventilation is parameter, which was affected by high-altitude hypoxia and reduced body weight in the same direction. Why increased VE observed during testing in normoxic conditions after high-altitude expedition was not observed also during testing in hypoxic conditions is not known. Arterial oxygen saturation is still elevated after a month of deacclimatization during testing in hypoxia. This was effect of acclimatization. Better oxygenation of arterial blood and brain was not found after a three weeks of deacclimatization from high-altitude expedition. However, it seems that a certain level of enhanced oxygenation persisted in exercising leg muscles. Local muscle oxygenation seems to be important during climbing at all. We observed forearm muscles oxygenation and found that muscles have been more oxygenated in trained alpinists and less in untrained.
Key words: acclimatization, deacclimatization, reacclimatization, training
Read article »
Altitude and best performances in human locomotion
Pietro Enrico di Prampero
During locomotion on land, on flat terrain in the absence of wind, metabolic power (E) increases with speed (s): E = C·s = α·s + β·s3, where α and β are constant, α·s the power utilised against non aerodynamic forces, and β·s3 (= Eair) that dissipated against air resistance. At maximal aerobic speed, Eair is about 97 % of the total in track cycling and about 8 % in running. At altitude, Eair is reduced in direct proportion with the air density, and hence with the barometric pressure (for a given temperature). Hence the metabolic power at a given speed is less, and conversely, the speed for a given power is larger. However, altitude leads also to a fall of maximal O2 consumption (¦O2max), so its net results on performance are set by the balance between these two conflicting effects, as discussed below. The maximal endurance speed depends on ¦O2max: E = ¦O2max = α·ssl + β·ssl3, where sl denotes sea level. At altitude: A ¦O2max = α·sa + k·β·sa3 , where A and k are the fractional decreases of ¦O2max and of β, and the subscript a denotes altitude. Therefore the optimum altitude for aerobic performances can be calculated, provided that α and β are known: for cycling it amounts to about 3.8 km, where sa/ssl = 1.046, whereas for skating, it is on the order of 1.2 km where sa/ssl = 1.013. In running, the maximal aerobic speed at altitude declines very nearly in direct proportion with ¦O2max.
Key words: altitude, best performances, running, speed-skating, cycling
Read article »
Some metabolic responses to reduced breathing frequency during constant load exercise
Jernej Kapus, Anton Ušaj, Venceslav Kapus
Introduction: Hypoxia has not been detected only during altitude exercise but also during specific conditions during exercise at sea level, such exercise with reduced breathing frequency (RBF). Training with RBF is often referred to as “hypoxic training”. It was thought that, by limiting inspired air, the reduction of oxygen available for muscular work would result and therefore cause muscle hypoxia, similar to that experienced at altitude. Therefore, the aim of this study was to examine the possible effect of RBF on ventilatory parameters, blood gases, oxygen saturation and some metabolic responses during the constant load exercise to exhaustion.
Methods: Eight healthy male subjects performed an incremental cycling test with RBF at 10 breaths per minute. A constant load test with RBF (B10) was then performed to exhaustion at the peak power output obtained during the incremental test. Finally, the subjects repeated the constant load test with the spontaneous breathing (SB) using the same protocol as B10.
Results: RBF during the constant load exercise resulted in a profound reduction in VE, when compared to the spontaneous breathing, despite significantly increases in VT. Consequently, there were significantly lower SO2 and PO2 and higher PCO2 during B10 than during SB. However, there were no significant differences in VO2 and [LA-] between different breathing conditions.
Conclusions: Therefore, it may be concluded that RBF during the constant load exercise induced marked hypoventilation and consequently hypoxia and hypercapnia. However, it seemed that this degree of the breathing reduction did not influence on aerobic metabolism due to unchanged VO2 and [LA-].
Key words: constant load test, reduced breathing frequency, hypoxia, hypercapnia, blood lactate
Read article »
The influence of altitude training on selected blood parameters and lactate curves during swimming
Boro Štrumbelj, Anton Ušaj
Introduction: Moderate altitude training has become popular to improve competition performance in swimming both at altitude and sea level. The aim of the present study was to examine the influence of moderate altitude training on lactate curve during three weeks and after the exposure to altitude training at 1860 m and to examine the effects of altitude training on selected blood parameters before and after the training at altitude.
Methods: In the study participated four (1 men, 3 women) high competition-level swimmers (mean ± SD; age 21 ± 1.2 years). All swimmers performed 5 times standardized test 5x3x200m to obtain velocities and heart rates at lactate thresholds and OBLA thresholds (before, three times on altitude and after altitude exposure). Blood samples for selected blood parameters (Erci, Hb, Ht, ERC-ret and ferritin) were taken before and after exposure to altitude.
Results: There were no significant changes (P < 0.05) in heart rate and blood lactate at a lactate threshold and OBLA threshold during altitude camp and 21 days after return at sea level. Individual response at altitude camp were found above OBLA threshold. No significant differences were found in selected blood parameters before and after exposure to altitude training (Erci, Hb, Ht, ERC-ret and ferritin).
Conclusions: These data indicate that no significant changes in lactate threshold, OBLA threshold, and selected blood parameters were found at altitude and upon return to sea-level after three weeks of training at 1860 m.
Key words: swimming, moderate altitude, lactate threshold, OBLA threshold, blood
Read article »
Two deaths in two days: a case report of mountaineering fatalities on Mount Rainier
Travis W. Heggie, Jacob D. Jorgenson
Mountain climbing is a popular recreational activity that has experienced an increase in the number of fatalities as the popularity of mountaineering has increased. This case report presents the conditions surrounding two mountaineering fatalities on Mount Rainier, Washington, U.S.A. The fatalities occurred on subsequent days and in approximate locations. Environmental conditions and falls of 91 m and 250 m were identified as contributing mechanisms in both deaths. However, the role of climbing behavior is called into check as the climbers involved in both incidents repeatedly ignored warnings about poor climbing conditions and one victim ignored warnings of climbing solo.
Key words: mountaineering, Mount Rainier, fatality, falls, behavior
Read article »
"CO2PING": Acute Mountain Sickness, stress and the role of the right cerebral hemisphere
Robb Waanders
Introduction: The concept of stress has been introduced in psychology and psychosomatic medicine in order to describe the response of biological systems to different types of strain and pressure. Mild oxygen deprivation (hypoxemia) is a vital physical stressor which triggers an alarm reaction. The adrenal hypothalamus-medulla system is being activated along the fight-or-flight stress axis. Research has shown that the right cerebral hemisphere is predominant in orchestrating the primary alarm reaction.
Aim of the study: This study aimed to evaluate the effect of the personality dimension trait-anxiety (ANXT-factor) on processing the stressor hypoxemia under field conditions.
Methods: Prior to the expeditions to Imja Tse (n=14) and Chulu West Peak (n=14) an extensive anamnesis of each participant was written and the individual ANXT-factor was determined using the STAI. After having crossed the thresholdaltitude (2500 m), the Lake Louise Score was applied (evening and morning protocol) to quantify symptoms of AMS. A sum score ≥3 was considered symptomatic. Additionally heart rate (HR) and peripheral oxygen saturation (SpO2) were daily measured by pulse oximetry.
Results: In the Chulu-group ANXT-percentile and LL-AMS-sum score were highly related (r=0.82, t=5 which exceeds 4.318, the critical value of t for P<.001). In the Imja-team r=0.74 (P<.01; evening protocol). HR and likewise SpO2 had insignificant relations with ANXT and AMS-scores.
Conclusions: The study indicates a direct link between AMS and the personality dimension trait-anxiety. The symptoms of acute mountain sickness are to be considered as the neuro-psycho-somatic stress response to mild oxygen deprivation orchestrated by the right cerebral hemisphere. This article presents a stress-model based on those findings.
Key words: hypoxemia, mild AMS, vegetative nervous system, neurotic trait, stress model
Read article »
Occupational aspects of work in hypoxic conditions – the new recommendation of the Medical Commission of the Union Internationale des Associations d’Alpinisme (UIAA MedCom)
Thomas Küpper, Jim S. Milledge, David Hillebrandt, Jana Kubalova, Urs Hefti, Buddha Basnayt, Ulf Gieseler, Suzanne Arnold, Volker Schoffl
More and more persons are exposed to hypoxia while working at altitude, e.g. when working for cable cars or ski areas in the Alps, for business in South America or Asia, as airline crews, or in rooms with reduced oxygen pressure for hypoxia training or fire protection. Unfortunately, the different countries have a multitude of regulations for occupational health and safety concerning hypoxia – most of them with major deficiencies and a significant lack of knowledge about hypoxia and possible specific risks. So far, no national regulation differentiates the different types of hypoxia and the environment, both having significant influence on the specific risk profile of employees and consequences for occupational health and safety. As the world’s umbrella body for preventive medicine at altitude / hypoxia, the Medical Commission of the Union Internationale des Associations d’Alpinisme (UIAA MedCom) recently established a recommendation to enable the national bodies to establish knowledge-based pragmatic procedures for occupational health and safety [1]. The most important message is as follows: Any environment with oxygen concentration of 14.0% or more or an altitude of 3,000 m or less is safe for any non-acclimatized person without severe cardiopulmonary disease (
Key words: hypoxia, occupational medicine, occupational safety, workload
Read article »