The Altitude Centre Ireland

• Leading Altitude specialist company in the UK and Ireland

• Clients include: UK Athletics, English FA, English RFU, Liverpool FC, Manchester City FC, Tottenham Hotspur FC, The Brownlee brothers

• An innovator in the world of simulated altitude training for both acclimatisation, performance and rehab purposes.

What is altitude & Where does it start?

• Low altitude:1250m (4,000ft)

• Moderate altitude : 1250-3000m (4,000-10,000ft)

• High altitude: 3000-6000m (10,000-20,000ft)

• Severe altitude: 6000m+ (20,000ft+)

Altitude & Hypoxia

Altitude & Hypoxia At Altitude:

• Less oxygen is taken up by the body

• The body has to work harder

• The body is under greater STRESS

• Over time the body adapts to withstand the stress

What is hypoxia:

Inadequate supply of oxygen to respiring tissue (Kent 1998)

Altitude & Hypoxia The result:

• Increases in haemoglobin (Hb) and thus in the blood’s

ability to carry oxygen

• Higher efficiency in the respiratory gas transfer in the

lungs

• Increases in peripheral use of oxygen in the muscles.

How do we simulate altitude?

Simulated altitude technology

Sleep System Exercise mask system Intermittent Hypoxic Exposure (IHE)

Simulated altitude technology

• Create a hypoxic environment in a room, chamber

• Suitable for gyms, house, universities, hospitals

Our Products • Manufactured by Hypoxico Altitude Training Systems

• Patented technology (European Patent EP0959862 )

• Full Product liability and 3 year warranty

• Sole Distributer of Hypoxico manufactured products in the

UK and Ireland

Patented technology

2 key altitude projects in Ireland

The Altitude House - Residential altitude training facility at the University of Limerick

The Altitude Gym – Simulated altitude training facility at Delta Sports Dome in Limerick

The Altitude House at University of Limerick

Just a normal house inside

The Altitude House

• Research Facility – UL Education & Health Science Faculty (Professor Phil Jakeman)

The Altitude Gym

The Altitude Gym

• Irelands first and only simulated altitude training facility

• 9m x 4m chamber

• Capacity for 15 users

• Spin, Crossfit, Boxfit classes

• Personal Training

• Injury Rehabilitation

• Pre-acclimatization sessions

The Altitude Gym

The Altitude Centre Ireland Team

• Richard Pullan – Director

• Colin Griffin - Director (Ireland)

• Rachel Turner – Altitude Performance Specialist & Altitude House Co-ordinator (University of Limerick)

• Andrew O’Neill – Sports Scientist, S&C Coach (Delta Sports Dome)

Mountaineering

Sport

Health

Mountaineering Acute Mountain Sickness (AMS) is the effect of high altitude on humans caused

by acute exposure to altitude. Commonly occurring above 2,400 metres

Mild AMS

• Headaches//fatigue//stomach upset//nausea//pins &

needles

Moderate AMS

• Severe headaches//vomiting//decreased coordination

(ataxia)

Severe AMS

• Shortness of breath at rest//inability to walk//decreasing

mental status//fluid build up in the lungs//Impaired cognitive

function

Mountaineering • AMS susceptibility consultation

• Pre-acclimatize

• IHE (Intermittent hypoxic exposure)

• IHT (Intermittent hypoxic training)

• Sleep system

• Provide advice and resources for successful summit

Sport

• Endurance

• Speed/Power

• Rehabilitation

Approaches to Altitude training

Live High Train Low (LHTL)

Sleeping at simulated altitude

Live High Train Low (LHTL)

• Provides the benefits of altitude (cardiovascular and

metabolic)

• Avoid the need for decreased training intensity associated

with LHTH strategies

• Avoid the negative effects of chronic exposure

• Low is typically <1250m and high is moderate altitude

(1250-3000m)

Simulated v Natural Altitude

• Moving from high to low altitude places

stress on athletes and can cause fatigue

• Technical developments in altitude simulation

equipment (oxygen extraction; altitude tents)

avoids the above problem

LHTL – Haematological benefits • Increased levels of EPO • Increased levels of Hb

Levine et al (1991) Stray-Gunderson et al (1998) Both studies were 27 days in length. Training at 1250 and living at 2500

• Research into this form of training has suggested that an optimum hypoxic dose is required to achieve benefits

12hrs/day at 2500m for 3 weeks (Clark et al 2009) Can be achieved by sleeping in an altitude tent or chamber. Adaptations have been reported to last for 2 weeks after LHTL (Burgniaux et

al 2006)

LHTL – Non-Haematological benefits

Exercise economy

Decreased oxygen cost of ventilation

Increased CHO oxidation

Improved lactate exchange and removal

Improved muscle buffering capacity

LHTL – Performance benefits • Improvements of 1-1.5% in events between 45s-17min (Hahn

et al 2001; Gore et al 2007)

• 1.1% increase in 3000m time & 3% increase in VO2max in those living at 2500m and training at 1250m (Levine at al 1991)

• Improved sea level performance (velocity at VO2max and at ventilatory threshold) in those training 1250m and living at 2500m for 4 weeks compared to those training and living at sea level (Levine & Stray-Gunderson 1997)

• Also, improved 5 km performance time lasted for 3weeks post LHTL

LHTL – My own experience • A good responder to altitude

April 22nd 2012 Hb 14.5 Hct 43% May 10th 2012 Hb 16.4 Hct 47.5%

21 days at 2500m-3600m in the Altitude house

15 hours exposure per day

4.30 per km 1.2 mmol 4.20 per km 1.1 mmol

May 13th IAAF World Cup: 3.52.55- second fastest time ever (32 degs heat) and Olympic qualification

Use pre and post altitude training camp and right up until 48 hours before competition

• As a coach?

LHTL Summary

Proposals for LHTL (Hahn 2001)

• Optimal altitude for erythropoetic effect – 2200-2500m

• Optimal altitude for non-haematological parameters – 3100m

• Optimal duration 4 weeks for erythropoesis

• Less than 3 weeks for beneficial peripheral adaptations

• Minimum dose for simulated erythropoesis – 12h/day

• For peripheral adaptations much shorter exposure seems possible.

Live Low Train High

LLTH

• At sea-level (normoxia) the body is close to 100% saturated (SpO2) with oxygen

• In order to receive a benefit from simulated altitude training, the SpO2 must drop bellow 92%

Triggers physiological and muscular adaptations which can enhance athletes conditioning

LLTH - Conditioning • Increase in run time to exhaustion of up to 35% over

6 week period (Dufour et al. 2006)

• 2 hours a day IHT at 2500m for 10 days had up to 7% greater increase in VO2 max and mean maximal power output compared to those doing same training at sea-level (Meeuwsen et al. 2001)

• Up to 21% increase number of sprints to exhaustion in RSA test. Subjects did 7 x 10 sec sprints x 3 sets for 4 weeks at 3000m. (Faiss 2012)

LLTH - Strength • Resistance training under hypoxic conditions

improves muscle strength and induces muscle hypertrophy faster than under normoxic conditions (Nishimura et al. 2010)

• Muscle de-oxygenation that occurs in hypoxia increases rate of metabolite/growth hormone anabolic accumulation which in turn increases motor neuron recruitment(Kon al. 2010)

• Rate of phosphocreatine (Pcr) hydrolysis is faster in hypoxia than in normoxia (Katayma et al. 2011)

Hypoxia for Rehabilitation

Hypoxia for Rehabilitation

• Hypoxia increases capillarization and blood flow (Rowell et. al, 1996) • Many reports of increased Osteoblast (Warren et. al, 2001) and

testosterone (Guey-Shyang Hwang, 2009) activity

• Anecdotal reports by Sports Doctors indicate quicker bone healing time utilising hypoxic training during rehabilitation. • There is a requirement for further research in this area.

• LLTH for injury rehabilitation:

• Reduce muscoskeletal load while achieving fitness stimulus

• Maintain optimal body weight whilst injured

• Minimise fitness and time lost to injury

Hypoxic training for Team Sports

Emerging evidence that hypoxic training can provide benefits in

the following areas:

1. Speed endurance

2. Strength development

3. Concurrent training gains

4. Injury Rehabilitation

Hypoxic training for Team sports

• Mid field players regularly cover distances in

excess of 10 km in a game

• The endurance required to cope with this will

require a large aerobic capacity

• Players still need to be explosive to compete for

aerial balls and make important tackles

Hypoxic Training for Team Sports

• British Premier League and UEFA competitions result in high frequency of matches

• Large squads to rotate players in order to manage fitness, fatigue and injuries but key players will be required more often

• Support staff strive to find ways to minimise fatigue and injuries while maximising fitness and readiness

Health

Potential benefits/uses of simulated altitude in medicine:

• Treatment of spinal cord injuries

Altitude shown to stimulate nerve growth

• Treatment of EI asthma

• Treatment of heart failure

• Treatment of diabetes

Glucose metabolism

Health & Safety • Risk Assessment:

• Pre-Altitude Activity Readiness Questionnaire (PAARQ) prior to use

of facility

• Further examination by qualified physician if required

• Physiological Monitoring

• Heart rate

• Oxygen Saturation Percentage (SpO2)

• Rate of Perceived Exertion (RPE)

Day Training Course in Hypoxia and hypoxic training Day Training Course

REPs Level 2 Accreditation

8.30 - 9.00 am Registration

09.00 - 09.10 am Welcome and Introduction

09.10 - 10.30 am Lecture 1 : The scientific basis for hypoxic training

10.30 - 10.45 am Tea - Coffee Break

10.45 - 12.00 pm Lecture 2 : The physiological response to hypoxic

training

12.00 - 12.45 pm Lunch (Provided)

12.45 – 14.30 pm Technical session 1: The practical application of

hypoxic training

14.30 - 15.30 pm Technical session 2: Design and Implementation of

a hypoxic training programme

15.30 – 15.45 pm Feedback/ Q&A / Closing Remarks

15.45pm Close and Certificates

Summary • Simulated altitude provides a safe cost and time effective substitute for a

natural altitude training camp

• Can help prolong or enhance benefits of altitude for several weeks upon

return from a training camp or in between competition

• Used to pre-acclimatize for a trip to high altitude

• Mountaineering

• Altitude training camp

• Competition at altitude venue

• Benefits not just limited to endurance sports – team sports, S&C, Speed

oriented sports/events

• Useful tool for injury rehabilitation

• Uses in Health and Medical fields

Acknowledgements

Rachel Turner, Harvey Galvin