Robertson, E. Y., Saunders, P. U., Pyne, D. B., Aughey, R. J., Anson, J. M., & Gore, C.J. (2010). Reproducibility of performance changes to simulated live high/train low altitude. Medicine and Science in Sports and Exercise, 42, 394-401

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"Elite athletes often undertake multiple altitude exposures within and between training years in an attempt to improve sea level performance." This study quantified the reproducibility of responses to live high/train low (LHTL) altitude exposure in the same group of athletes. Highly trained male and female runners (N = 16) completed 2 x 3-week blocks of simulated LHTL (14 hours per day at ~3000 m) or resided near sea-level (600 m). Changes in a 4.5-km time-trial performance and physiological measures including VO2max , running economy, and hemoglobin mass (Hb(mass)) were assessed.

Time-trial performance showed small and variable changes after each 3-week altitude block in both the LHTL (-1.4% [+/-1.1%] and 0.7% [+/-1.3%]) and the control (0.5% [+/-1.5%] and -0.7% [+/-0.8%]) groups. The LHTL group demonstrated reproducible improvements in VO2max and hemoglobin mass after each 3-week block. Compared with those in the control group, the runners in the LHTL group were substantially faster after the first 3-week block and had substantially higher hemoglobin mass after the second 3-week block. There was no substantial difference in the change in mean VO2max between the groups after the first or second 3-week block.

Implication. Two three-week LHTL altitude exposures induced reproducible mean improvements in VO2max and hemoglobin mass in highly trained runners, but changes in time-trial performance were more variable and not different in a statistical sense. "Competitive performance is dependent not only on improvements in physiological capacities that underpin performance but also on a complex interaction of many factors including fitness, fatigue, and motivation."

[Editor's interpretation. While altitude produces physiological capacity changes, performances are more variable (i.e., unrelated to the physiological changes) and governed by many other factors than only measures of physiological capacity. That is in agreement with the authors' explanation. One cannot infer that altitude training will benefit performance in all athletes. What is intriguing is that performance changes in the altitude group when compared to a control group after the first three-week exposure were different to what was revealed after a second three-week exposure although the same Ss were used. After the second three-week camp, the sea-level control group performed as well as the altitude group. The reverse was reported for the first three-week block. No statistical significance for performance times was reported for between group comparisons for either camp. One must assume, that any differences that were revealed were no better than one would expect due to chance or a number of variable extraneous factors. From a statistical viewpoint, there were no performance differences between the altitude-trained and sea-level trained groups. So, how would one decide what is the best form of altitude exposure for those who did record positive benefits from either exposure?

That performance results varied a lot and often are not reproducible suggests that many published studies do not control extraneous variables that are performance-related to any admirable degree. It is possible that doing "altitude research" pays for researchers to travel to very intriguing and pleasant settings. Since physiological capacities did change in a reproducible manner, the relationships of those factors to performance is very weak to non-existent.

It is suspected that the government-funded institutions (e.g., AIS) and government supported sporting associations (e.g., SAL) have hoodwinked the government into supporting altitude training in the past over many years (~25 years). To turn around and say it was not effective is to admit that public monies were wasted - a dangerous thing to do in any political arena. Consequently, the charade continues with the main benefits being vacation-type respites and "feel-good" experiences at the still-programmed altitude experiences. By perpetuating this hoax (that is the inference from equivocal results) other projects also requiring public funding will not be threatened. If even one substantial training experience is admitted as wrong, would not that make funding more difficult on possibly more valid procedures? One could easily ask SAL to substantiate the measurable performance benefits that result from very occasional camps that make spurious claims and use performance-attribute names. It is possible that SAL is wasting a lot of public money on dubious (dogma validated) experiences. They are being perpetuated in the absence of scientific support.]

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