title: MEDEX2015: Greater Sea-Level Fitness Is Associated with Lower Sense of Effort During Himalayan Trekking Without Worse Acute Mountain Sickness.
abstract: Rossetti, Gabriella M.K., Jamie H. Macdonald, Matthew Smith, Anna R. Jackson, Nigel Callender, Hannah K. Newcombe, Heather M. Storey, Sebastian Willis, Jojanneke van den Beukel, Jonathan Woodward, James Pollard, Benjamin Wood, Victoria Newton, Jana Virian, Owen Haswell, and Samuel J. Oliver. MEDEX2015: Greater sea-level fitness is associated with lower sense of effort during Himalayan trekking without worse acute mountain sickness. High Alt Med Biol. 18:152-162, 2017.-This study examined the complex relationships of fitness and hypoxic sensitivity with submaximal exercise responses and acute mountain sickness (AMS) at altitude. Determining these relationships is necessary before fitness or hypoxic sensitivity tests can be recommended to appraise individuals' readiness for altitude. Forty-four trekkers (26 men; 18 women; 20-67 years) completed a loaded walking test and a fitness questionnaire in normoxia to measure and estimate sea-level maximal aerobic capacity (maximum oxygen consumption [[Formula: see text]O2max]), respectively. Participants also completed a hypoxic exercise test to determine hypoxic sensitivity (cardiac, ventilatory, and arterial oxygen saturation responses to acute hypoxia, fraction of inspired oxygen [Fio2] = 0.112). One month later, all participants completed a 3-week trek to 5085 m with the same ascent profile. On ascent to 5085 m, ratings of perceived exertion (RPEascent), fatigue by Brunel Mood Scale, and AMS were recorded daily. At 5085 m, RPE during a fixed workload step test (RPEfixed) and step rate during perceptually regulated exercise (STEPRPE35) were recorded. Greater sea-level [Formula: see text]O2maxwas associated with, and predicted, lower sense of effort (RPEascent; r = -0.43; p < 0.001; RPEfixed; r = -0.69; p < 0.001) and higher step rate (STEPRPE35; r = 0.62; p < 0.01), but not worse AMS (r = 0.13; p = 0.4) or arterial oxygen desaturation (r = 0.07; p = 0.7). Lower RPEascentwas also associated with better mood, including less fatigue (r = 0.57; p < 0.001). Hypoxic sensitivity was not associated with, and did not add to the prediction of submaximal exercise responses or AMS. In conclusion, participants with greater sea-level fitness reported less effort during simulated and actual trekking activities, had better mood (less fatigue), and chose a higher step rate during perceptually regulated exercise, but did not suffer from worse AMS or arterial oxygen desaturation. Simple sea-level fitness tests may be used to aid preparation for high-altitude travel.
authors.affiliation: 1 Extremes Research Group, College of Health and Behavioral Sciences, Bangor University , Bangor, United Kingdom .|2 Medical Expeditions , Hyssington, United Kingdom .
authors.forename: Gabriella M K
authors.initials: GMK
authors.lastname: Rossetti
authors.affiliation: 1 Extremes Research Group, College of Health and Behavioral Sciences, Bangor University , Bangor, United Kingdom .|2 Medical Expeditions , Hyssington, United Kingdom .
authors.forename: Jamie H
authors.initials: JH
authors.lastname: Macdonald
authors.affiliation: 2 Medical Expeditions , Hyssington, United Kingdom .
authors.forename: Matthew
authors.initials: M
authors.lastname: Smith
authors.affiliation: 2 Medical Expeditions , Hyssington, United Kingdom .
authors.forename: Anna R
authors.initials: AR
authors.lastname: Jackson
authors.affiliation: 2 Medical Expeditions , Hyssington, United Kingdom .
authors.forename: Nigel
authors.initials: N
authors.lastname: Callender
authors.affiliation: 2 Medical Expeditions , Hyssington, United Kingdom .
authors.forename: Hannah K
authors.initials: HK
authors.lastname: Newcombe
authors.affiliation: 2 Medical Expeditions , Hyssington, United Kingdom .
authors.forename: Heather M
authors.initials: HM
authors.lastname: Storey
authors.affiliation: 2 Medical Expeditions , Hyssington, United Kingdom .
authors.forename: Sebastian
authors.initials: S
authors.lastname: Willis
authors.affiliation: 2 Medical Expeditions , Hyssington, United Kingdom .
authors.forename: Jojanneke
authors.initials: J
authors.lastname: van den Beukel
authors.affiliation: 2 Medical Expeditions , Hyssington, United Kingdom .
authors.forename: Jonathan
authors.initials: J
authors.lastname: Woodward
authors.affiliation: 1 Extremes Research Group, College of Health and Behavioral Sciences, Bangor University , Bangor, United Kingdom .|2 Medical Expeditions , Hyssington, United Kingdom .
authors.forename: James
authors.initials: J
authors.lastname: Pollard
authors.affiliation: 1 Extremes Research Group, College of Health and Behavioral Sciences, Bangor University , Bangor, United Kingdom .
authors.forename: Benjamin
authors.initials: B
authors.lastname: Wood
authors.affiliation: 1 Extremes Research Group, College of Health and Behavioral Sciences, Bangor University , Bangor, United Kingdom .
authors.forename: Victoria
authors.initials: V
authors.lastname: Newton
authors.affiliation: 1 Extremes Research Group, College of Health and Behavioral Sciences, Bangor University , Bangor, United Kingdom .
authors.forename: Jana
authors.initials: J
authors.lastname: Virian
authors.affiliation: 1 Extremes Research Group, College of Health and Behavioral Sciences, Bangor University , Bangor, United Kingdom .
authors.forename: Owen
authors.initials: O
authors.lastname: Haswell
authors.affiliation: 1 Extremes Research Group, College of Health and Behavioral Sciences, Bangor University , Bangor, United Kingdom .|2 Medical Expeditions , Hyssington, United Kingdom .
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Oliver
mesh_terms: D000328:Adult; D000368:Aged; D000531:Altitude; D000532:Altitude Sickness / Q000209:etiology / Q000503:physiopathology*; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009051:Mountaineering / Q000502:physiology*; D010101:Oxygen Consumption / Q000502:physiology; D010809:Physical Fitness / Q000502:physiology*; D012129:Respiratory Function Tests; D018609:Tibet; D055815:Young Adult
keywords: acute mountain sickness; arterial oxygen saturation; exercise; hypoxic ventilatory response; maximal oxygen uptake