Abstract
High altitude missions pose significant challenges to Warfighter medical readiness and performance. Decreased circulating oxygen levels cause a decrease in exercise performance and can cause debilitating symptoms associated with acute mountain sickness, especially with rapid ascent. Acetazolamide (AZ) is known to minimize symptoms of acute mountain sickness, but it is unknown whether this medication alters hand strength and manual dexterity during altitude exposure. Ten male volunteers (22±4yr, 75.9±13.7kg, 174.9±9.3cm) participated in two separate 30h simulated altitude exposures (496mmHg, equivalent to 3,500m, 20°C, 20% RH) in a hypobaric chamber. Participants were given either a placebo or 250mg of AZ twice daily for 3.5d (2 sea-level [SL] days + the 30h altitude exposure) in a randomized, single-blind, crossover design. During SL and both altitude (ALT) exposures, hand function tests were performed, including hand grip and finger pinch strength tests, as well as the Purdue Pegboard (PP) and magazine loading tests to assess manual dexterity. Paired T tests and two-way repeated measure analysis of variance were used as appropriate to evaluate the effects of AZ and ALT. The value of p<0.05 was accepted for statistical significance. There were no influences of acute ALT exposure or AZ treatment on hand strength (eg, grip strength; SL: 39.2±5.5kg vs. ALT: 41.5±6.9kg, p>0.05) or dexterity (eg, PPassembly; placebo: 35.5±5.3 vs. AZ: 34.3±4.6, p>0.05) in our volunteers. Two dexterity tests (PPsum and magazine loading) showed improvements over time at ALT, regardless of treatment, where scores were improved after 10h of exposure compared to at 1h (eg, magazine loading: 56±12 vs. 48±10, p<0.001). This pattern was not seen in the PPassembly test or any strength measurements. Our results suggest that 500mg/d of AZ does not influence hand strength or manual dexterity during a 30h exposure to 3,500m simulated ALT. Acute ALT exposure (1h) did not influence dexterity or strength, although some measures of dexterity showed improvements as exposure time increased. We conclude that use of AZ to optimize medical readiness at ALT is unlikely to impair the Warfighter's ability to complete mission tasks that depend on hand function.
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