Endurance Training in Normobaric Hypoxia Imposes Less Physical Stress for Geriatric Rehabilitation

Abstract

Rationale: Evidence suggests that training in hypoxia can be very effective even while requiring less physical effort. We therefore aimed to measure the effect of endurance training under hypoxic conditions on pulmonary and cardiovascular parameters in an elderly population undergoing inpatient rehabilitation.Methods: Forty patients over age 65 years with multiple co-morbid conditions were recruited during a 3-week stay in a geriatric rehabilitation center. Using a randomized, single-blinded, placebo-controlled design, patients were assigned to a hypoxic (HG) or normoxic (NG) group. HG patients completed seven training sessions of 30 min duration on a treadmill in a normobaric chamber with inspired oxygen fraction (FiO2) of 15.27%, with 10–30 min active training. Training was conducted with target heart rate at 80% of peak oxygen consumption (VO2-peak). NG group performed similar training in sham hypoxia (room air or FiO2 = 20.94%). At pre- and post-test completion, measures included: (1) cycle ergometry with ECG monitoring and measurement of VO2-peak, and (2) echocardiography for ejection fraction.Results: The physical effort required of patients to reach target heart rate was reduced significantly (−28%, p = 0.043) in the HG compared to NG. Cardiopulmonary parameters showed no differences between groups.Conclusion: Endurance training at 3,000 meters elevation imposes less stress on the locomotor systems while resulting in a similar physiological strain (i.e., heart rate). Hypoxic training holds promise for successful geriatric rehabilitation by being more accommodating to physical limitations in geriatric patients.Trial registration: Registration at DRKS. (Approval No. 359/12, Trial No. DRKS00005241).

Twelve weeks of exercise modality in hypoxia enhances health‐related function in obese older Korean men: A randomized controlled trial

“…Only a few studies have examined the effects of long‐term hypoxic training on body composition and health‐related factors in older adults. Pramsohler et al measured the effect of endurance training under hypoxia (F i O 2 = 15.3%) versus normoxia (F i O 2 = 20.9%) for 10–30 min at 80% peak oxygen consumption during a 3‐week period on pulmonary and cardiovascular parameters in an older adult population . They reported that the physical effort required of participants to reach target heart rate reduced significantly (−28%) in HTG compared with NTG, whereas no differences were found in cardiopulmonary function between the groups.…”

“…Various mechanisms for the beneficial effects of hypoxic therapy have been shown, such as appetite suppression, enhanced ability to transport oxygen to working muscle and improvement of fat oxidation . In addition, exercise in hypoxia imposes less stress on the locomotor systems, while resulting in similar physiological stress . Therefore, hypoxic therapy is a promising modality for successful health promotion in the older obese population.…”

“…12,13 In addition, exercise in hypoxia imposes less stress on the locomotor systems, while resulting in similar physiological stress. 14 Therefore, hypoxic therapy is a promising modality for successful health promotion in the older obese population.…”

“…However, the majority of studies on obesity and aging have mainly been carried out in Western society, and studies using hypoxic therapy for health promotion of the older adult population are very limited. 3,[14][15][16][17][18] Until now, the majority of obese and aging studies have focused on abdominal or central obesity, hypertension, insulin resistance, high triglyceride and low high-density lipoprotein cholesterol levels, which are associated with metabolic syndrome. 6 The numerous changes in health-related factors that occur during the process of obesity and aging need to be investigated.…”

Cardiac Autonomic and Physiological Responses to Moderate- intensity Exercise in Hypoxia

“…Hypoxic exercise (i. e. exercise under reduced oxygen availability) has been shown to represent a valid alternative to normoxic exercise to provide an adequate training stimulus, promoting beneficial physiological training adaptations as well as positive healthrelated outcomes [5][6][7]. Nowadays, hypoxic exercise is implemented within training programs of different populations [5,[7][8][9]. For instance, hypoxic exercise is adopted to increase the physiological load while reducing the mechanical load both in obese patients [10] and in older adults [8].…”