Hypoxic Resistance Training Research Articles

The Effects of Normobaric Hypoxia on the Acute Physiological Responses to Resistance Training: A Narrative Review.

Allsopp, GL, Britto, FA, Wright, CR, and Deldicque, L. The effects of normobaric hypoxia on the acute physiological responses to resistance training: a narrative review. J Strength Cond Res 38(11): 2001-2011, 2024-Athletes have used altitude training for many years as a strategy to improve endurance performance. The use of resistance training in simulated altitude (normobaric hypoxia) is a growing strategy that aims to improve the hypertrophy and strength adaptations to training. An increasing breadth of research has characterized the acute physiological responses to resistance training in hypoxia, often with the goal to elucidate the mechanisms by which hypoxia may improve the training adaptations. There is currently no consensus on the overall effectiveness of hypoxic resistance training for strength and hypertrophy adaptations, nor the underlying biochemical pathways involved. There are, however, numerous interesting physiological responses that are amplified by performing resistance training in hypoxia. These include potential changes to the energy system contribution to exercise and alterations to the level of metabolic stress, hormone and cytokine production, autonomic regulation, and other hypoxia-induced cellular pathways. This review describes the foundational exercise physiology underpinning the acute responses to resistance training in normobaric hypoxia, potential applications to clinical populations, including training considerations for athletic populations. The review also presents a summary of the ideal training parameters to promote metabolic stress and associated training adaptations. There are currently many gaps in our understanding of the physiological responses to hypoxic resistance training, partly caused by the infancy of the research field and diversity of hypoxic and training parameters.

Effects of resistance training on alleviating hypoxia-induced muscle atrophy: Focus on acetylation of FoxO1.

This study aims to explore the role of FoxO1 and its acetylation in the alleviation of hypoxia-induced muscle atrophy by resistance training. Forty male Sprague-Dawley rats were randomly divided into four groups: normoxic control group (C), normoxic resistance training group (R), hypoxic control group (H) and hypoxic resistance training group (HR). Rats in R and HR groups were trained on an incremental weight-bearing ladder every other day, while those in H and HR groups were kept in an environment containing 12.4% O2 . After 4 weeks, muscles were collected for analysis. Differentiated L6 myoblasts were analysed invitro after hypoxia exposure and plasmids transfection (alteration in FoxO1 acetylation). The lean body mass loss, wet weight and fibre cross-sectional area of extensor digitorum longus of rats were decreased after 4 weeks hypoxia, and the adverse reactions above was reversed by resistance training. At the same time, the increase in hypoxia-induced autophagy was suppressed, which was accompanied by a decrease in the expression of nuclear FoxO1 and cytoplasmic Ac-FoxO1 by resistance training. The L6 myotube diameter increased and the expression of autophagic proteins were inhibited under hypoxia via intervening by FoxO1 deacetylation. Overall, resistance training alleviates hypoxia-induced muscle atrophy by inhibiting nuclear FoxO1 and cytoplasmic Ac-FoxO1-mediated autophagy.

Does Normobaric Hypoxic Resistance Training Confer Benefit over Normoxic Training in Athletes? A Narrative Review

Does Normobaric Hypoxic Resistance Training Confer Benefit over Normoxic Training in Athletes? A Narrative Review

근 기능 개선 및 근 비대를 위한 저산소 환경에서의 저항성 트레이닝의 효용성 검증 - 문헌적 고찰

We are generally believed that optimal muscular function and hypertrophy gains are induced via moderate- or high-intensity resistance training, equivalent to at least 70% of an individual’s 1 repetition maximum. In recent years, systemic hypoxic stress has emerged as a stimulation condition that can induce more physiological and biochemical changes caused by resistance exercise. Hypoxic stress result in changes in neuromotor control, metabolic changes, hormonal changes, cellular swelling, and intracellular signaling pathways, similar to the effects of resistance exercise. The combination of hypoxic stress and resistance exercise is expected to have a greater effect on the improvement of muscular function and hypertrophy. Therefore, we examined the previous studies for understand the concept of intermittent hypoxic resistance training (IHRT) and its effectiveness, and to grasp the principle of IHRT to improve muscular function and hypertrophy. However, few investigations have examined the combination effects of hypoxic stress and resistance exercise, and as such it is difficult to make recommendations for implementing IHRT based on current understanding. It should also be acknowledged that a number of mechanisms proposed to facilitate the augmented response to IHRT remain poorly understood, particularly the systemic role of metabolic, hormonal, cellular swelling, and intracellular signaling pathways. Future research should examine the various physiological and biochemical mechanism and performance to resistance exercise in hypoxic condition and training in systemic hypoxic condition.

Higher strength gain after hypoxic vs normoxic resistance training despite no changes in muscle thickness and fractional protein synthetic rate.

Acute hypoxia has previously been suggested to potentiate resistance training-induced hypertrophy by activating satellite cell-dependent myogenesis rather than an improvement in protein balance in human. Here, we tested this hypothesis after a 4-week hypoxic vs normoxic resistance training protocol. For that purpose, 19 physically active male subjects were recruited to perform 6 sets of 10 repetitions of a one-leg knee extension exercise at 80% 1-RM 3 times/week for 4weeks in normoxia (FiO2 : 0.21; n=9) or in hypoxia (FiO2 : 0.135, n=10). Blood and skeletal muscle samples were taken before and after the training period. Muscle fractional protein synthetic rate was measured over the whole period by deuterium incorporation into the protein pool and muscle thickness by ultrasound. At the end of the training protocol, the strength gain was higher in the hypoxic vs the normoxic group despite no changes in muscle thickness and in the fractional protein synthetic rate. Only early myogenesis, as assessed by higher MyoD and Myf5 mRNA levels, appeared to be enhanced by hypoxia compared to normoxia. No effects were found on myosin heavy chain expression, markers of oxidative metabolism and lactate transport in the skeletal muscle. Though the present study failed to unravel clearly the mechanisms by which hypoxic resistance training is particularly potent to increase muscle strength, it is important message to keep in mind that this training strategy could be effective for all athletes looking at developing and optimizing their maximal muscle strength.

Short-term hypoxic resistance training improves muscular performance in untrained males

We determined the effect of resistance training under the hypoxia on muscular strength, hypertrophy and performance in untrained males. Fourteen healthy male subjects were randomly assigned to either a normoxic (20.9%; oxygen, n = 7) or a hypoxic (12.7%; oxygen, n = 7) resistance training group. Subjects in both groups performed similar resistance training protocol included 4 weeks of back squat. Knee muscles isokinetic, one-repetition maximum, thigh fat percentage and cross-sectional area were measured before and after training. Extension peak torque, flexion and extension total work, extension angle and flexion peak torque, extension average power, agonist/antagonist strength ratio and thigh muscle cross-sectional were only significantly increased in hypoxic resistance training group ( P < 0.05). The increases in flexion peak torque and average power were significantly higher and thigh fat percentage was significantly lower in hypoxic resistance training group compared to the normoxic condition ( P < 0.05). Our results suggest that hypoxic resistance training reduces fat percentage and improves knee muscle performance efficiently without significant changes in strength and hypertrophy. Nous avons déterminé l’effet de l’entraînement en résistance sous hypoxie sur la force musculaire, l’hypertrophie et la performance chez des sujets de sexe masculin non entraînés. Quatorze sujets de sexe masculin en bonne santé ont été répartis au hasard dans un groupe d’entraînement en résistance normoxique (20,9 % ; oxygène, n = 7) ou hypoxique (12,7 % ; oxygène, n = 7). Les sujets dans les deux groupes ont effectué un protocole d’entraînement en résistance similaire comprenant 4 semaines de squat arrière. Les muscles isocinétiques du genou, le maximum d’une répétition, le pourcentage de graisse de la cuisse et la surface transversale ont été mesurés avant et après l’entraînement. Le couple maximal d’extension, le travail total de flexion et d’extension, l’angle d’extension et le couple maximal de flexion, la puissance moyenne d’extension, le rapport de force agoniste/antagoniste et la section transversale des muscles de la cuisse n’ont été significativement augmentés que dans le groupe d’entraînement à la résistance hypoxique ( p < 0,05). Les augmentations du couple de pointe en flexion et de la puissance moyenne étaient significativement plus élevées et le pourcentage de graisse de cuisse était significativement plus faible dans le groupe d’entraînement en résistance hypoxique par rapport à la condition normoxique ( p < 0,05). Nos résultats suggèrent que l’entraînement en résistance hypoxique réduit le pourcentage de masse grasse et améliore efficacement la performance musculaire du genou sans changements significatifs de force et d’hypertrophie.

The Effect of Normobaric Hypoxia on Resistance Training Adaptations in Older Adults.

Allsopp, GL, Hoffmann, SM, Feros, SA, Pasco, JA, Russell, AP, and Wright, CR. The effect of normobaric hypoxia on resistance training adaptations in older adults. J Strength Cond Res 36(8): 2306-2312, 2022-The effect of normobaric hypoxia on strength, body composition, and cardiovascular fitness was investigated after a resistance training intervention in older adults. A single-blinded, randomized control trial recruited 20 healthy adults aged 60-75 years for an 8-week resistance training intervention in normoxia ( n = 10) or normobaric hypoxia (14.4% O 2 ; n = 10). Subjects performed 2 sessions per week of upper-body and lower-body exercises at 70% of 1 repetition maximum (1RM). Pretraining and post-training, maximal oxygen uptake (V̇O 2 max), muscular endurance (30 maximal knee flexions/extensions), and 5RM were assessed, with 5RM used to calculate 1RM. Subjects underwent whole-body dual-energy x-ray absorptiometry (DXA) at pretraining and post-training for fat and lean mass quantification. Significance was set at p < 0.05. Subjects in both groups substantially improved their calculated 1RM strength for leg extension, pectoral fly, row, and squat (normoxia; 30, 38, 27, and 29%, hypoxia; 43, 50, 28, and 64%, respectively); however, hypoxia did not augment this response. Hypoxia did not enhance V̇O 2 max or muscular endurance responses after the training intervention, with no improvements seen in either group. Fat mass and lean mass remained unchanged in both groups after the intervention. In summary, 8 weeks of resistance training in hypoxia was well tolerated in healthy older adults and increased upper-body and lower-body strength. However, the magnitude of strength and lean muscle improvements in hypoxia was no greater than normoxia; therefore, there is currently no evidence to support the use of hypoxic resistance training in older adults.

Effect of 8-week resistance trainings in different environmental conditions on endothelial progenitor cells and some cardiovascular risk factors in overweight men

Background: Vascular endothelial dysfunction is pathological conditions that may be due to complications of obesity in various arteries. The purpose of this study was to investigate the effect of 8 weeks resistance training in different environmental conditions on endothelium progenitor cells (EPCS) (Marker of CD34), oxidized-LDL (oxLDL) and C-reactive protein (CRP) in overweight men. Methods: For this Purpose, 30 overweigh male students in Kermanshah city with the mean age of 19.8± 1.13 yr participated in this study, voluntarily. Subjects randomly assigned into 3 groups including hypoxic and normoxic resistance training, and hypoxic exposure. Participants performed the protocols 3 days per week for 8 weeks with 70% of 1RM. The oxLDL, CRP, and CD34 were measured before and after the intervention. T-test, one-Way ANOVA, Wilcoxon and Kruskal-Wallis tests were used to analyzing the data. Results: There was a significant decrease in CRP and oxLDL levels in the hypoxic resistance (P=0.001, P=0.005), normoxic resistance (P=0.003, P=0.013) and hypoxic exposure (P=0.003, P=0.005), respectively. However, no significant difference was observed between variations of the groups. The cells of CD34 was increased after the hypoxic resistance (P=0.005), normoxic resistance (P=0.005), and hypoxia exposure (P=0.004). No significant difference was observed between variations of the groups. Conclusion: Considering the similar effects of hypoxic exposure with other groups on study variables, it may be possible to use hypoxic exposure as a beneficial manner for some overweight individuals at the injury and special circumstances.

Short-Term Intermittent Hypoxic Resistance Training Does Not Impair Osteogenic Response in Sea Level Residents.

Background: Osteogenic responses induced by training under hypoxia remain unclear. We aimed to investigate whether intermittent hypoxic resistance training affects osteogenic responses. Materials and Methods: Sixteen male participants underwent resistance training under normoxia (NRT; n = 7) or hypoxia (HRT; O2 = 14.4%, n = 9), twice a week for 8 weeks. The HRT group exercised and rested for 30 minutes under hypoxia, with total hypoxic exposure time in one session of ∼60 minutes. At pre- and postexperiment, bone mineral density (BMD) of the whole body and right proximal femur was measured. At the first and last training sessions, bone alkaline phosphatase (BAP), osteocalcin (OC), cross-linked N-telopeptide of type I collagen (NTx), type I collagen cross-linked C-telopeptide (ICTP), interleukin-6 (IL-6), and blood lactate (La) concentration were analyzed at rest and postexercise. Results: BMD did not change with training and hypoxia. Although BAP, OC, and ICTP levels at rest significantly increased with training (p < 0.01, 0.05, and 0.05, respectively), they did not change with hypoxia. NTx and IL-6 did not change. Additionally, changing patterns of bone markers and La induced by a single bout of exercise were similar among groups in both training sessions. Conclusions: Short-term resistance training enhanced overall bone metabolism, regardless of the oxygen level. Hypoxia has no effects on osteogenic responses.

PO-306 The effect of four weeks hypoxic resistance training on myostatin and follistatin expression in skeletal muscle of rats

Objective Loss of skeletal muscle weight is a common phenomenon in hypoxic environment. It has been recognized that resistance training can reduce hypoxia-induced skeletal muscle atrophy, but its molecular mechanism is still unclear. Myostatin is a major factor that inhibits muscle growth and differentiation, and Follistatin can inhibit Myostatin. Therefore, this study is to clarify the effect of 4-week hypoxic resistance exercise on Myostatin and Follistatin gene expression in skeletal muscle of rats.&#x0D; Methods Twenty four 8-week-old male SD rats were randomly divided into normoxic control group (group C: 6 rats), normoxic exercise group (group R: 6 rats), hypoxic control group (group H: 6 rats) and hypoxic exercise group (group HR: 6 rats). Rats in each hypoxic group were fed in a hypoxic chamber (atmospheric hypoxia) with oxygen concentration of 12.7% (simulated 4000m altitude). Rats in each exercise group were trained according to the rat's resistance training program developed in our laboratory. After all the intervention, DEXA was used to analyze the body composition. The soleus, extensor digitorum longus and biceps brachii muscles of rats were taken and the wet weight of individual muscles was measured. The data were processed by SPSS17.0 statistical software. The expression level of skeletal muscle mRNA was expressed as "median (25-75%)" and the data of body composition and muscle wet weight were expressed as"mean±standard deviation". The differences between the groups were evaluated using a one-way analysis of variance (ANOVA) test. The significance level for the study was less than 0.05.&#x0D; Results Body composition analysis after 4 weeks of hypoxic intervention showed that the body weight of rats in group H decreased significantly (p=0.012), and the muscle mass decreased more significantly (p&lt;0.001). But resistance exercises obviously reduced the muscle atrophy (p&lt;0.01) caused by hypoxia. After analyzing the changes of the wet weight of individual muscles, it was found that the wet weight of biceps brachii in HR group was significantly higher than that in H group (p=0.048). After 4 weeks of hypoxic intervention and hypoxic resistance exercise, the expression of Myostatin mRNA in individual muscles of each group changed differently. The expression of Myostatin mRNA in soleus muscle of H group was significantly higher than that of C group (371.2%) after 4 weeks of hypoxia intervention. Myostatin mRNA expression in soleus and biceps brachii of HR group was significantly lower than that of H group (591.1% and 478.4% respectively). However, there was no significant difference in the expression level of Myostatin mRNA in the extensor digitorum longus between each group (p=0.259). The change of Follistatin mRNA expression in different groups also showed a different trend. The expression of Follistatin mRNA in soleus muscle and biceps brachii muscle was significantly different among groups (p=0.003, p=0.004, respectively). However, there was no significant difference in the expression level of Follistatin mRNA in the extensor digitorum longus between each group (p=0.734). Myostatin mRNA/Follistatin mRNA ratio (M/F) showed a more significant difference. The M/F ratio of soleus muscle in group H was significantly lower than that in group C (p&lt;0.001), but the M/F ratio in group HR was significantly higher than that in group H (p&lt;0.001). The M/F ratio of biceps brachii in group H was significantly lower than that in group C (p&lt;0.001), but the M/F ratio in group HR showed a higher trend than that in group H (p=0.051).&#x0D; Conclusions Hypoxic exposure results in an increase in Myostatin mRNA expression in skeletal muscle, but hypoxic resistance exercise reduces such an increase. On the contrary, the level of Follistatin mRNA expression in skeletal muscle decreased after hypoxic exposure, and hypoxic resistance exercise could slow down the decline. As a result, rat resistance exercise significantly slowed down hypoxia-induced muscle atrophy. In conclusion, the mutual restriction between Myostatin and Follistatin is one of the main links of resistance exercise to reduce hypoxia-induced skeletal muscle atrophy. However, the process of resistance training to reduce the hypoxia-induced skeletal muscle atrophy is very complex. There are many molecular signaling pathways involved, which need further study.

Bench press performance during an intermittent hypoxic resistance training to muscle failure.

Resistance training performed under hypoxia conditions has been shown to cause major metabolic and hormonal responses. However, the influence of hypoxia on an acute session has been barely studied. The aim of this study was to evaluate the acute effects of an intermittent hypoxic resistance training (IHRT) to muscle failure on bench press performance. A randomized crossover design was performed, and 25 untrained men performed a resistance training under two different conditions: normoxia (FIO2=21%) and high-level hypoxia (FIO2=13%). Resistance training consisted of 3 sets of 75% 1RM to muscle failure, with a 2-minute rest between sets. Physical performance was assessed by quantifying total repetitions, concentric velocity and power variable during all sets. Arterial oxygen saturation, heart rate, rating of perceived exertion (RPE), capillary blood lactate and muscle soreness were also assessed after training. Physical performance during bench press did not differ under hypoxic conditions (P>0.05). However, there were significant increases (P<0.05) of RPE (from 7.5±0.8 to 7.9±0.8) and blood lactate concentrations (from 5.5±1.2 to 6.2±1.5 mmol/L) in the hypoxia group. These findings suggest that hypoxic resistance exercise does not affect exercise performance during bench press exercise. However, influence to perceived exercise intensity and blood lactate concentrations, suggesting that hypoxic resistance training may add substantially to the training dose experienced.

PL-012 Effect of hypoxic resistance training on the regulation of muscle mass and phenotype

Objective Hypoxia is a state of lowered oxygen tension in tissue that can be created by environmental or pathological conditions. Whatever the origin of hypoxia, different tissues will adapt acutely and/or chronically to deal with this reduction in oxygen availability. Hypoxia has recently emerged as a particularly efficient stimulus to stimulate muscle cell proliferation and accretion of muscle mass and hypoxic resistance training has become popular amongst athletes as it is thought to favor muscle accretion. However, the molecular mechanisms are largely unknown. &#x0D; Methods To determine those molecular mechanisms, 19 volunteers participated to 12 sessions of resistance training spread over 4 weeks whether in normoxia (n=9) or in hypoxia (n=10, FiO213.5% corresponding to 3500m altitude). Each session consisted in 6 sets of 10 repetitions of a one-leg extension exercise at 80% of one repetition maximum (1-RM). Blood and muscle samples in each leg were taken before and after the 4-week training period. Fiber types were determined by immunohistochemistry based on myosin heavy chain isotypes. Blood saturation (SpO2, pulsoximetry) and tissue saturation index (TSI, near-infrared spectroscopy) were monitored during the exercise sessions. &#x0D; Results Muscle thickness determined by ultrasound was increased by 7% in normoxia only (p=0.04). The 1-RM was increased in both groups but the increase was higher in hypoxia (+34%) than in normoxia (+24%) (p=0.02). In average, SpO2stayed around 98-99% in normoxia and around 93-94% in hypoxia during each set of contractions. No difference in TSI between normoxia and hypoxia was measured, which averaged 60% before starting muscle contractions and 40% during muscle contractions. A trend towards a shift in fiber type from type I to type IIa was observed in normoxia (p&lt;0.09) but not in hypoxia. Fiber area was not modified by any condition. &#x0D; Conclusions In summary, 4 weeks of hypoxic resistance training induced a larger increase in 1-RM compared to normoxic resistance training, independently of muscle hypertrophy or any change in fiber type. Further investigation should determine whether metabolic or molecular changes may explain this potentiation of maximal muscle force by hypoxia.

The effect of hypoxia on muscle strength and mass responses of older adults to resistance training

Introduction: As we age, complex mechanisms cause skeletal muscle atrophy. Older adults often experience low muscle mass and strength, that are associated with increased morbidity and mortality. Resistance training is an effective tool to prevent age-related muscle atrophy and declining strength, and novel training parameters are valuable for improving program efficacy. The use of hypoxia (low O2) during resistance training elicits superior muscle hypertrophy and strength gains in young men. This study therefore aimed to determine the responses of older adults to hypoxic resistance training, and hypothesised that muscle hypertrophy and strength gains would be greater in hypoxia compared to normoxia. Enhancing muscle mass and strength gains in older adults could lessen the burden of muscle atrophy-related morbidities and mortalities.

Hypoxia During Resistance Exercise Does Not Affect Physical Performance, Perceptual Responses, or Neuromuscular Recovery.

Scott, BR, Slattery, KM, Sculley, DV, and Dascombe, BJ. Hypoxia during resistance exercise does not affect physical performance, perceptual responses, or neuromuscular recovery. J Strength Cond Res 32(8): 2174-2182, 2018-This study aimed to determine whether performing resistance exercise in hypoxia affects markers of physical performance, perceptual responses, and neuromuscular function. Fourteen male subjects (age: 24.6 ± 2.7 years; height: 179.7 ± 5.9 cm; body mass: 84.6 ± 11.6 kg) with >2 years resistance training experience performed moderate-load resistance exercise in 2 conditions: normoxia (FIO2 = 0.21) and hypoxia (FIO2 = 0.16). Resistance exercise comprised 3 sets of 10 repetitions of back squats and deadlifts at 60% of 1 repetition maximum (1RM), with 60 seconds inter-set rest. Physical performance was assessed by quantifying velocity and power variables during all repetitions. Perceptual ratings of perceived exertion, physical fatigue, muscle soreness, and overall well-being were obtained during and after exercise. Neuromuscular performance was assessed by vertical jump and isometric mid-thigh pull (IMTP) tasks for up to 48 hours after exercise. Although physical performance declined across sets, there were no differences between conditions. Similarly, perceived exertion and fatigue scores were not different between conditions. Muscle soreness increased from baseline at 24 and 48 hours after exercise in both conditions (p ≤ 0.001). Jump height and IMTP peak force were decreased from baseline immediately after exercise (p ≤ 0.026), but returned to preexercise values after 24 hours. These findings suggest that hypoxic resistance exercise does not affect exercise performance or perceived exercise intensity. In addition, neuromuscular recovery and perceptual markers of training stress were not affected by hypoxia, suggesting that hypoxic resistance training may not add substantially to the training dose experienced.

Intermittent Resistance Training at Moderate Altitude: Effects on the Force-Velocity Relationship, Isometric Strength and Muscle Architecture.

Intermittent hypoxic resistance training (IHRT) may help to maximize the adaptations following resistance training, although conflicting evidence is available. The aim of this study was to explore the influence of moderate altitude on the functional, neural and muscle architecture responses of the quadriceps muscles following a power-oriented IHRT intervention. Twenty-four active males completed two 4-week consecutive training blocks comprising general strengthening exercises (weeks 1–4) and power-oriented resistance training (weeks 5–8). Training sessions were conducted twice a week at moderate altitude (2320 m; IHRT, n = 13) or normoxia (690 m; NT, n = 11). Training intensity during the second training block was set to the individual load corresponding to a barbell mean propulsive velocity of 1 m·s−1. Pre-post assessments, performed under normoxic conditions, comprised quadriceps muscle architecture (thickness, pennation angle and fascicle length), isometric maximal (MVF) and explosive strength, and voluntary muscle activation. Dynamic strength performance was assessed through the force-velocity relationship (F0, V0, P0) and a repeated CMJ test (CMJ15MP). Region-specific muscle thickness changes were observed in both training groups (p < 0.001, = 0.02). A small opposite trend in pennation angle changes was observed (ES [90% CI]: −0.33 [−0.65, −0.01] vs. 0.11 [−0.44, 0.6], in the IHRT and NT group, respectively; p = 0.094, = 0.02). Both training groups showed similar improvements in MVF (ES: 0.38 [0.20, 0.56] vs. 0.55 [0.29, 0.80], in the IHRT and NT group, respectively; p = 0.645, < 0.01), F0 (ES: 0.41 [−0.03, 0.85] vs. 0.52 [0.04, 0.99], in the IHRT and NT group, respectively; p = 0.569, < 0.01) and P0 (ES: 0.53 [0.07, 0.98] vs. 0.19 [−0.06, 0.44], in the IHRT and NT group, respectively; p = 0.320, < 0.01). No meaningful changes in explosive strength performance were observed. In conclusion, contrary to earlier adverse associations between altitude and resistance-training muscle adaptations, similar anatomical and functional muscle strength responses can be achieved in both environmental conditions. The observed region-specific muscle thickness changes may encourage further research on the potential influence of IHRT on muscle morphological changes.

High-Intensity Exercise in Hypoxia: Is Increased Reliance on Anaerobic Metabolism Important?

Hypoxic training strategies to optimize physiological exercise responses have been extensively investigated, although often with limited performance benefits over the equivalent normoxic training (Roels et al., 2007). Recently, novel methods including intermittent hypoxic resistance training (IHRT) and repeat sprint training in hypoxia (RSH) have begun to receive research attention. Early results indicate that IHRT can augment muscle hypertrophy and strength compared to normoxic training (Nishimura et al., 2010; Manimmanakorn et al., 2013a,b), while RSH improves fatigue resistance, resulting in an increased capacity for repeated maximal efforts (Galvin et al., 2013; Faiss et al., 2013b). Although performing these high-intensity activities in hypoxia appears to provide some benefits for training adaptations, the mechanisms underpinning these responses are not fully understood. The beneficial responses to high-intensity exercise in hypoxia may result from a greater reliance on anaerobic metabolism, suggesting that increased metabolic stress may drive (or at least contribute to) these adaptations (Faiss et al., 2013b; Scott et al., 2015a). Considering the likely importance of metabolic stress on adaptation to IHRT and RSH strategies, the purpose of this paper is to briefly discuss the potential benefits of high-intensity training in hypoxia with reference to the role of anaerobic processes.

Neuroendocrine Responses and Body Composition Changes Following Resistance Training Under Normobaric Hypoxia.

The aim of the present study was to evaluate the effects of a 6 week resistance training protocol under hypoxic conditions (FiO2 = 12.9%, 4000 m) on muscle hypertrophy. The project included 12 resistance trained male subjects, randomly divided into two experimental groups. Group 1 (n = 6; age 21 ± 2.4 years; body height [BH] 178.8 ± 7.3 cm; body mass [BM] 80.6 ± 12.3 kg) and group 2 (n = 6; age 22 ± 1.5 years; BH 177.8 ± 3.7cm; BM 81.1 ± 7.5 kg). Each group performed resistance exercises alternately under normoxic and hypoxic conditions (4000 m) for 6 weeks. All subjects followed a training protocol that comprised two training sessions per week at an exercise intensity of 70% of 1RM; each training session consisted of eight sets of 10 repetitions of the bench press and barbell squat, with 3 min rest periods. The results indicated that strength training in normobaric hypoxia caused a significant increase in BM (p < 0.01) and fat free mass (FFM) (p < 0.05) in both groups. Additionally, a significant increase (p < 0.05) was observed in IGF-1 concentrations at rest after 6 weeks of hypoxic resistance training in both groups. The results of this study allow to conclude that resistance training (6 weeks) under normobaric hypoxic conditions induces greater muscle hypertrophy compared to training in normoxic conditions.

Intermittent hypoxic resistance training: Is metabolic stress the key moderator?

Traditionally, researchers and practitioners have manipulated acute resistance exercise variables to elicit the desired responses to training. However, recent research indicates that altering the muscular environment during resistance training, namely by implementing a hypoxic stimulus, can augment muscle hypertrophy and strength. Intermittent hypoxic resistance training (IHRT), whereby participants inspire hypoxic air during resistance training, has been previously demonstrated to increase muscle cross-sectional area and maximum strength by significantly greater amounts than the equivalent training in normoxia. However, some recent evidence has provided conflicting results, reporting that the use of systemic hypoxia during resistance training provided no added benefit. While the definitive mechanisms that may augment muscular responses to IHRT are not yet fully understood, an increased metabolic stress is thought to be important for moderating many downstream processes related to hypertrophy. It is likely that methodological differences between conflicting IHRT studies have resulted in different degrees of metabolic stress during training, particularly when considering the inter-set recovery intervals used. Given that the most fundamental physiological stresses resulting from hypoxia are disturbances to oxidative metabolism, it becomes apparent that resistance training may only benefit from additional hypoxia if the exercise is structured to elicit a strong metabolic response. We hypothesize that for IHRT to be more effective in producing muscular hypertrophy and increasing strength than the equivalent normoxic training, exercise should be performed with relatively brief inter-set recovery periods, with the aim of providing a potent metabolic stimulus to enhance anabolic responses.

Intermittent hypoxic resistance training: does it provide added benefit?

Methods to enhance the adaptive responses to resistance training are of great interest to clinical and athletic populations alike. Altering the muscular environment by restricting oxygen availability during resistance exercise has been shown to induce favorable physiological adaptations. An acute hypoxic stimulus during exercise essentially increases reliance on anaerobic pathways, augmenting metabolic stress responses, and subsequent hypertrophic processes (Scott et al., 2014). Hypoxic strategies during resistance exercise were originally investigated using blood flow restriction (BFR) methods (Takarada et al., 2000), whereby a cuff is applied proximally to a limb to partially limit arterial inflow while occluding venous outflow from the working muscles. Another method that has been investigated more recently is performing resistance exercise in systemic hypoxia, by means of participants breathing a hypoxic air mixture. The addition of systemic hypoxia to resistance training has previously resulted in significantly enhanced hypertrophic and strength responses to both low-load (20% 1-repetition maximum; 1RM) (Manimmanakorn et al., 2013a,b) and moderate-load (70% 1RM) (Nishimura et al., 2010) resistance training. While research into intermittent hypoxic resistance training (IHRT) is in its infancy, some studies have reported conflicting results, which is likely due to differing research methodologies. In a recent review, it has been suggested that many of the potential mechanisms underpinning muscle adaptations to BFR training and IHRT are linked to the muscular oxygenation status and degree of metabolic stress associated with exercise (Scott et al., 2014). The purpose of this paper is to briefly summarize the adaptive responses that have been reported following both low- and moderate-load IHRT and to highlight key areas of concern for IHRT methodology, including the level of hypoxia used and the degree of metabolic stress imposed during exercise.

Effects of systemic hypoxia on human muscular adaptations to resistance exercise training.

Hypoxia is an important modulator of endurance exercise‐induced oxidative adaptations in skeletal muscle. However, whether hypoxia affects resistance exercise‐induced muscle adaptations remains unknown. Here, we determined the effect of resistance exercise training under systemic hypoxia on muscular adaptations known to occur following both resistance and endurance exercise training, including muscle cross‐sectional area (CSA), one‐repetition maximum (1RM), muscular endurance, and makers of mitochondrial biogenesis and angiogenesis, such as peroxisome proliferator‐activated receptor‐γ coactivator‐1α (PGC‐1α), citrate synthase (CS) activity, nitric oxide synthase (NOS), vascular endothelial growth factor (VEGF), hypoxia‐inducible factor‐1 (HIF‐1), and capillary‐to‐fiber ratio. Sixteen healthy male subjects were randomly assigned to either a normoxic resistance training group (NRT, n =7) or a hypoxic (14.4% oxygen) resistance training group (HRT, n =9) and performed 8 weeks of resistance training. Blood and muscle biopsy samples were obtained before and after training. After training muscle CSA of the femoral region, 1RM for bench‐press and leg‐press, muscular endurance, and skeletal muscle VEGF protein levels significantly increased in both groups. The increase in muscular endurance was significantly higher in the HRT group. Plasma VEGF concentration and skeletal muscle capillary‐to‐fiber ratio were significantly higher in the HRT group than the NRT group following training. Our results suggest that, in addition to increases in muscle size and strength, HRT may also lead to increased muscular endurance and the promotion of angiogenesis in skeletal muscle.