Hormonal Contraception and Menstrual Cycle Control at High Altitude: A Scoping Review-UIAA Medical Commission Recommendations.

Horakova, Lenka , Susi Kriemler, Vladimír Student, Jacqueline Pichler Hefti, David Hillebrandt, Dominique Jean, Kaste Mateikaite-Pipiriene, Peter Paal, Alison Rosier, Marija Andjelkovic, Beth Beidlemann, Mia Derstine, and Linda E. Keyes. Hormonal contraception and menstrual cycle control at high altitude: a scoping review-UIAA Medical Commission recommendations. High Alt Med Biol. 00:00-00, 2024. Background: Women who use hormonal contraception (HC) may have questions about their use during travel to high altitude. This scoping review summarizes current evidence on the efficacy and safety of HC and cycle control during high-altitude travel. Methods: We performed a scoping review for the International Climbing and Mountaineering Federation (UIAA) Medical Commission series on Women's Health in the Mountains. Pertinent literature from PubMed and Cochrane was identified by keyword search combinations (including contraception) with additional publications found by hand search. Results: We identified 17 studies from 7,165 potentially eligible articles. No articles assessed the efficacy of contraception during a short-term high-altitude sojourn. Current data show no advantage or disadvantage in HC users for acclimatization or acute mountain sickness (AMS). Use of HC during high-altitude travel is common and safe for menses suppression. A potential concern of estrogen-containing HC is the increased thrombotic risk, which theoretically could be compounded in hypobaric hypoxia. Conclusions: Evidence is limited for the interaction of HC and high altitude on performance, thrombosis, and contraceptive efficacy. HC does not affect the risk of AMS. The most efficacious and safest method at high altitude is generally the one women are most familiar with and already using.

Exome sequencing in extreme altitude mountaineers identifies pathogenic variants in RTEL1 and COL6A1 previously associated with respiratory failure.

Adaptation of humans to challenging environmental conditions, such as extreme temperature, malnutrition, or hypoxia, is an interesting phenomenon for both basic and applied research. Identification of the genetic factors contributing to human adaptation to these conditions enhances our understanding of the underlying molecular and physiological mechanisms. In our study, we analyzed the exomes of 22 high altitude mountaineers to uncover genetic variants contributing to hypoxic adaptation. To our surprise, we identified two putative loss-of-function variants, rs1385101139 in RTEL1 and rs1002726737 in COL6A1 in two extremely high altitude (personal record of more than 8500 m) professional climbers. Both variants can be interpreted as pathogenic according to medical geneticists' guidelines, and are linked to inherited conditions involving respiratory failure (late-onset pulmonary fibrosis and severe Ullrich muscular dystrophy for rs1385101139 and rs1002726737, respectively). Our results suggest that a loss of gene function may act as an important factor of human adaptation, which is corroborated by previous reports in other human subjects.

Simulations of the human heat balance during Mount Everest summit attempts in spring and winter.

The majority of research dealing with the impacts of the Himalayan climate on human physiology focuses on low air temperature, high wind speed, and low air pressure and oxygen content, potentially leading to hypothermia and hypoxia. Only a few studies describe the influence of the weather conditions in the Himalayas on the body's ability to maintain thermal balance. The aim of the present research is to trace the heat exchange between humans and their surroundings during a typical, 6-day summit attempt of Mount Everest in the spring and winter seasons. Additionally, an emergency night outdoors without tent protection is considered. Daily variation of the heat balance components were calculated by the MENEX_HA model using meteorological data collected at automatic weather stations installed during a National Geographic expedition in 2019-2020. The data represent the hourly values of the measured meteorological parameters. The research shows that in spite of extreme environmental conditions in the sub-summit zone of Mount Everest during the spring weather window, it is possible to keep heat equilibrium of the climbers' body. This can be achieved by the use of appropriate clothing and by regulating activity level. In winter, extreme environmental conditions in the sub-summit zone make it impossible to maintain heat equilibrium and lead to hypothermia. The emergency night in the sub-peak zone leads to gradual cooling of the body which in winter can cause severe hypothermia of the climber's body. At altitudes < 7000 m, climbers should consider using clothing that allows variation of insulation and active regulation of their fit around the body.

Acute Mountain Sickness and High Altitude Cerebral Edema in Women: A Scoping Review-UIAA Medical Commission Recommendations.

Derstine, Mia, Dominique Jean, Beth A. Beidleman, Jacqueline Pichler Hefti, David Hillebrandt, Lenka Horakova, Susi Kriemler, Kasté Mateikaité-Pipiriené, Peter Paal, Alison Rosier, Marija Andjelkovic, and Linda E. Keyes. Acute mountain sickness and high altitude cerebral edema in women: A scoping review-UIAA Medical Commission recommendations. High Alt Med Biol. 24:259-267, 2023. Background: Acute mountain sickness (AMS) and high-altitude cerebral edema (HACE) are illnesses associated with rapid ascent to altitudes over 2,500 m in unacclimatized lowlanders. The aim of this scoping review is to summarize the current knowledge on sex differences in the epidemiology, pathophysiology, symptomatology, and treatment of AMS and HACE, especially in women. Methods and Results: The UIAA Medical Commission convened an international author team to review women's health issues at high altitude and to publish updated recommendations. Pertinent literature from PubMed and Cochrane was identified by keyword search combinations (including AMS, HACE, and high altitude), with additional publications found by hand search. The primary search focus was for articles assessing lowland women sojourning at high altitude. Results: The literature search yielded 7,165 articles, 37 of which were ultimately included. The majority of publications included did not find women at increased risk for AMS or HACE. There was extremely limited sex-specific data on risk factors or treatment. Conclusions: There is a limited amount of data on female-specific findings regarding AMS and HACE, with most publications addressing only prevalence or incidence with regard to sex. As such, general prevention and treatment strategies for AMS and HACE should be used regardless of sex.

Diet, Supplementation and Nutritional Habits of Climbers in High Mountain Conditions.

Appropriate nutritional preparation for a high-mountain expedition can contribute to the prevention of nutritional deficiencies affecting the deterioration of health and performance. The aim of the study was to analyze the dietary habits, supplementation and nutritional value of diets of high mountain climbers. The study group consisted of 28 men (average age 33.12 ± 5.96 years), taking part in summer mountaineering expeditions at an altitude above 3000 m above sea level, lasting at least 3 weeks. Food groups consumed with low frequency during the expedition include vegetables, fruits, eggs, milk and milk products, butter and cream, fish and meat. The energy demand of the study participants was 4559.5 ± 425 kcal, and the energy supply was 2776.8 ± 878 kcal. The participants provided 79.6 ± 18.5 g of protein (1.1 ± 0.3 g protein/kg bw), 374.0 ± 164.5 g of carbohydrates (5.3 ± 2.5 g/kg bw) and 110.7 ± 31.7 g of fat (1.6 ± 0.5 g/kg bw) in the diet. The climbers' diet was low in calories, the protein supply was too low, and the fat supply was too high. There is a need to develop nutritional and supplementation recommendations that would serve as guidelines for climbers, improving their well-being and exercise capacity in severe high-mountain conditions, which would take their individual taste preferences into account.

Color Vision in the Mountains.

This Lessons from History article uses science, aviation, medicine, and mountaineering sources to describe some of the effects of hypoxia, illumination, and other environmental conditions on the eye, the central nervous system, and light and color perception. The historical perspective is augmented by an analysis of an informal observation of the altered perception of red color on a deck of playing cards while climbing Mera Peak in the Himalaya. The appearance of a grayer red color on the cards was initially attributed to the effects of hypoxia alone. Instead, analysis of cards in combination with the low incidence of protan color vision defects at altitude indicated that glare and contrast effects in the extremely bright lighting environment combined with hypoxia likely caused the perception of a grayer red. The incident provides an educational opportunity for review, analysis, and commentary about some of the complex elements that impact color vision.

An Episode of "Third Person" Phenomenon Involving Somesthetic and Visual Hallucinations in a World-Class Extreme Altitude Climber.

Psychotic symptoms can occur at high altitude. However, most reports are in the mountaineering literature and lack a clear medical assessment and interpretation. Here we report an episode of isolated high-altitude psychosis. It consisted of a "third person" phenomenon involving 2 sensory modalities: somesthetic (felt presence) and visual (the light of 2 flashlights) hallucinations. This episode occurred in a highly experienced climber when he was at an altitude of approximately 7500 m while descending at dusk from the summit of Gasherbrum I (8068 m). The symptoms lasted approximately 3 h and had fully resolved on reaching high camp (7150 m). No other physical or mental symptoms were reported. In addition to hypoxia, a number of other risk factors could have contributed to the occurrence of psychosis in this climber. These included sleep deprivation, exhaustion, dehydration, electrolyte disturbance, reduced visibility, feeling of isolation, and perceived danger. The climber has participated in many extreme altitude expeditions, and neither before nor since this episode has the climber experienced psychotic symptoms.

Possibility for Children with Medical Complexities to Reach a 3000-m Peak: A Report of 2 Cases.

With the recent development of neonatal medicine, the number of children with medical complexities (CMCs) is increasing. Outdoor activities are important for their psychosocial development, and the principles of accessibility should be addressed. We report the experience of 2 CMCs' high-altitude mountaineering with the necessary support. The participants were a 3-y-old girl with cerebral palsy, symptomatic epilepsy, and a ventriculoperitoneal shunt (Child A) and a 6-y-old girl who underwent bilateral Glenn operations at 11 mo for hypoplastic left heart syndrome (Child B). The support staff consisted of 4 doctors, 1 nurse, 5 nonmedical staff , 3 members from a mountaineering association, and 2 people from an oxygen company. The climbing schedule was 2 days. On the first day, we took a bus to a hut at an altitude of 2450 m and stayed overnight to acclimatize to the altitude. On the second day, we took the beginner's route, which took 3 h to climb 500 m, and our team made an attempt on the summit. During the attempt, Child B panicked. Although her lung sounds did not raise suspicions of pulmonary edema, we decided to leave the mountain with her because her transcutaneous oxygen saturation decreased. Child A had no apparent health problems and made it to the summit. Although CMCs' alpine climbing requires careful planning and staffing considering the risk of high-altitude sickness, our case suggests the feasibility of such activities with CMCs as part of accessibility.

Comparison of personality differences of Polish mountaineers.

A noticeably increased interest in mountain climbing, both as the form of extreme sport and a form of tourism, has been observed in Poland recently. The assumption of this study is that practicing different varieties of mountaineering influences the personality of Polish climbers in a different manner. The aim of the research was to compare the personality differences of Polish mountaineers. To this aim, the population of Polish high-performance mountaineers was studied (N = 81; including 39 women and 42 men). Due to the type of mountaineering practiced, the respondents were divided into Alpine climbers (n = 48) and Himalayan climbers (n = 33). The average age of the surveyed climbers is 33.85 years. The Big Five model was used including the NEO-FFI Personality Questionnaire and the analyzes were performed using the IBM SPSS Statistics statistical method package, version 27.0. Statistically significant differences were noted only for agreeableness F(1.77) = 5.05, p = 0.027. The Alpine climbers showed a higher level of agreeableness than the Himalayan climbers. After taking into account the Sidak amendment, significant differences in the level of agreeableness were found only among women. Comparisons between other personality traits were not statistically significant. There is a significant difference between the personalities of Polish Alpine climbers and Polish Himalayan climbers in the dimension of agreeableness only among women: female Alpine mountaineers are more agreeable than Himalayan mountaineers. It was presumed that in terms of ethics in the high mountains, the social competences of Alpine mountaineers are much more developed than that of Himalayan mountaineers.

The Effects of High-Altitude Mountaineering on Cognitive Function in Mountaineers: A Meta-Analysis.

BACKGROUND: Nowadays, with the convenience of international traveling and driven by many individuals' fond dreams of challenging high-altitude exercises, high-altitude mountaineering is becoming increasingly popular worldwide. Therefore, we performed a meta-analysis to determine the effects of high-altitude mountaineering on cognitive functions in mountaineers before and after climbing. METHODS: After a thorough electronic literature search and selection, eight studies were included in this meta-analysis, and the conducted test cycles ranged from 8 to 140 days. Eight variables were included in this meta-analysis: the Trail-Making Test (TMB), Digit Span-Forward (DSF), Digit Span-Backward (DSB), Finger Tapping Test-Right (FTR) Finger Tapping Test-Left (FTL), Wechsler Memory Scale Visual (WMSV), the Aphasia Screening Test (Verbal Items) (AST-Ver), and the Aphasia Screening Test (Visual Motor Errors) (AST-Vis). The effect sizes (ES) and forest plots of these eight variables were generated. RESULTS: Five variables (TMB, ES = 0.39; DSF, ES = 0.57; FTR, ES = 0.50; FTL, ES = 0.16; WMSV, ES = 0.63) out of eight were significantly improved after high-altitude mountaineering, whereas the ES values of DSB, AST-Ver, and AST-Vis did not show significant improvement after climbing. CONCLUSION: Despite two limitations, namely, methodological issues inherent in the meta-analysis and the inability to explain high heterogeneity between studies, this study is the first meta-analysis that has attempted to specify and compare the cognitive functions of mountaineers before and after high-altitude mountaineering. Furthermore, as a short-term plateau exercise, high-altitude mountaineering has no significant negative impacts on the cognitive functions of climbers. Future research is needed for a long period of high-altitude mountaineering.

Nutrition and Hydration for High-Altitude Alpinism: A Narrative Review.

This report aims to summarise the scientific knowledge around hydration, nutrition, and metabolism at high altitudes and to transfer it into the practical context of extreme altitude alpinism, which, as far as we know, has never been considered before in the literature. Maintaining energy balance during alpine expeditions is difficult for several reasons and requires a deep understanding of human physiology and the biological basis for altitude acclimation. However, in these harsh conditions it is difficult to reconcile our current scientific knowledge in sports nutrition or even for mountaineering to high-altitude alpinism: extreme hypoxia, cold, and the logistical difficulties intrinsic to these kinds of expeditions are not considered in the current literature. Requirements for the different stages of an expedition vary dramatically with increasing altitude, so recommendations must differentiate whether the alpinist is at base camp, at high-altitude camps, or attempting the summit. This paper highlights nutritional recommendations regarding prioritising carbohydrates as a source of energy and trying to maintain a protein balance with a practical contextualisation in the extreme altitude environment in the different stages of an alpine expedition. More research is needed regarding specific macro and micronutrient requirements as well as the adequacy of nutritional supplementations at high altitudes.

Sudden Cardiac Arrests in the Polish Tatra Mountains: A Retrospective Study.

INTRODUCTION: Achieving the optimal survival rate for sudden cardiac arrest in mountains is challenging. The odds of surviving are influenced mainly by distance, response time, and organization of the emergency medical system. The aim of this study was to analyze the epidemiology and outcomes of patients with out-of-hospital cardiac arrest in whom cardiopulmonary resuscitation was performed in the Polish Tatra Mountains. METHODS: This was a retrospective analysis of data on sudden cardiac arrest collected from the database of the Tatra Mountain Rescue Service and local emergency medical system from 2001 to 2021. RESULTS: A total of 74 cases of sudden cardiac arrest were recorded. The mortality rate was 88% (65/74). Return of spontaneous circulation was achieved in 22 (30%) patients. A group of survivors was characterized by more frequent use of an automated external defibrillator (AED) (56% vs 14%, P=0.011), a shorter interval between cardiac arrest and emergency team arrival (12 vs 20 min, P=0.005), and a shorter time to initiation of advanced life support (ALS) (12 vs 22 min, P=0.004). All survivors had a shockable initial rhythm. The majority of survivors (8/9, 89%) had a good or moderate neurological outcome. CONCLUSIONS: This study confirms poor survival rate after sudden cardiac arrest in the mountain area. The use of AED, shockable initial rhythm, and shorter time interval to emergency team arrival and ALS initiation are associated with better outcomes.

UIAA Medical Commission Recommendations for Mountaineers, Hillwalkers, Trekkers, and Rock and Ice Climbers with Diabetes.

Hillebrandt, David, Anil Gurtoo, Thomas Kupper, Paul Richards, Volker Schöffl, Pankaj Shah, Rianne van der Spek, Nikki Wallis, and Jim Milledge. UIAA Medical Commission recommendations for mountaineers, hillwalkers, trekkers, and rock and ice climbers with diabetes. High Alt Med Biol. 24: 110-126.-The object of this advice article is not only to give the diabetic mountaineer general guidance but also to inform his or her medical team of practical aspects of care that may not be standard for nonmountaineers. The guidelines are produced in seven sections. The first is an introduction to the guidelines, and the second is an introduction to this medical problem and is designed to be read and understood by diabetic patients and their companions. The third section is for use in an emergency in mountains. The fourth is for rock, ice, and competition climbers operating in a less remote environment. These initial sections are deliberately written in simple language. The fifth and sixth sections are written for clinicians and those with skills to read more technical information, and the seventh looks at modern technology and its pros and cons in diabetes management in a remote area. Sections One and Two could be laminated and carried when in the mountains, giving practical advice.

Why do we climb mountains? An exploration of features of behavioural addiction in mountaineering and the association with stress-related psychiatric disorders.

Common knowledge implies that individuals engaging in outdoor sports and especially in regular and extreme mountaineering are exceptionally healthy and hardened. Physical activity in outdoor environments has a positive effect on physical and mental health. However, regular and/or extreme mountaineering might share similarities with behavioural addictions and could thus also have a negative impact on health. In this cross-sectional web-based questionnaire study, we collected data on exercise and mountaineering addiction (Exercise Addiction Inventory; original and adapted version for mountaineering; Exercise Dependence Scale adapted version for mountaineering). Further surveyed parameters included mountaineering habits, Risk-Taking Inventory, Sensation-Seeking/Emotion Regulation/Agency Scale (SEAS), resilience, self-perceived stress, physical activity in metabolic units and mental health. Comparisons were performed between individuals with symptoms of addiction to mountaineering (MA) and individuals without symptoms of addiction to mountaineering or sports in general (CO) using non-parametric analyses. We analysed data from 335 participants, n = 88 thereof with addiction to mountaineering (MA) and n = 247 control participants (CO). The MA group scored significantly higher with regards to self-perceived stress (p < 0.001) and included a significantly higher number of individuals affected by symptoms of depression (p < 0.001), symptoms of anxiety (p < 0.001), symptoms of eating disorders (p < 0.001), alcohol abuse or dependence (p < 0.001), illicit drug abuse (p = 0.050), or current and history of psychiatric disorders (p < 0.001). Individuals with MA showed higher values in all SEAS subscales as well as increased risk-taking (p < 0.001). Regular and extreme mountaineering can display features of a behavioural addiction and is associated with psychiatric disorders. Behavioural addiction in mountaineering is associated with higher levels of sensation-seeking, emotion regulation, and agency, as well as increased risk-taking.

Muscle strength coordination training for athletes in mountaineering sports / Treinamento de coordenação da força muscular dos atletas em esportes de montanhismo / Entrenamiento de la coordinación de la fuerza muscular de los atletas de deportes de montaña

ABSTRACT Introduction Rock climbing is a physical activity that requires excellent physical conditioning. In addition to improving physical fitness and motor coordination, rock climbing requires constant improvements in muscle coordination skill training to enhance its modern tactics. Objective Explore the muscular coordination skill training of rock climbers. Methods A random sample of 8 athletes were assigned to the experiment involving the measurement of athletes' body composition, serum creatine kinase and blood urea levels, and other biomarkers collected before and after the trial. Results There was a significant negative correlation between dynamic balance and motor coordination ability after training in extreme rock climbing sports. On the second day after the rock climbing exercise, the volunteers' body weight and fat content significantly reduced, and the concentration of creatine kinase (CK) and blood urea (BU) increased significantly. Conclusion The exploration of extreme sports' effect on improving athletes' muscle coordination ability showed that strength and coordination should be enhanced in rock climbing. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução A escalada em rocha é uma atividade física que exige excelente condicionamento físico. Além de melhorar a aptidão física e a coordenação motora, a escalada requer aperfeiçoamentos constantes no treinamento de habilidade em coordenação muscular para aprimoramento de suas táticas modernas. Objetivo Explorar o treinamento da capacidade de coordenação muscular de escaladores em rocha. Métodos Uma amostragem aleatória composta de 8 atletas foi designada para o experimento envolvendo a mensuração da composição corporal dos atletas, níveis séricos de creatina quinase e ureia sanguínea além de outros biomarcadores coletados antes e após o ensaio. Resultados Houve uma correlação negativa significativa entre o equilíbrio dinâmico e a capacidade de coordenação motora após o treinamento em esportes radicais de escalada em rocha. No segundo dia após o exercício de escalada em rocha, o peso corporal e o conteúdo de gordura dos voluntários mostrou uma redução significativa, e a concentração de creatina quinase (CK) e ureia sanguínea (BU) aumentaram significativamente. Conclusão A exploração do efeito dos esportes radicais na melhoria da capacidade de coordenação muscular dos atletas evidenciou que a força e a coordenação devem ser reforçadas no processo de escalada em rocha. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción La escalada en roca es una actividad física que exige una excelente condición física. Además de mejorar la forma física y la coordinación motriz, la escalada requiere una mejora constante en el entrenamiento de las habilidades de coordinación muscular para optimizar su táctica moderna. Objetivo Explorar el entrenamiento de las habilidades de coordinación muscular de los escaladores de roca. Métodos Se asignó una muestra aleatoria compuesta por 8 atletas al experimento que incluía la medición de la composición corporal de los atletas, los niveles de creatina quinasa sérica y de urea en sangre, además de otros biomarcadores recogidos antes y después de la prueba. Resultados Se observó una correlación negativa significativa entre el equilibrio dinámico y la capacidad de coordinación motriz tras el entrenamiento en deportes extremos de escalada. El segundo día después del ejercicio de escalada en roca, el peso corporal y el contenido de grasa de los voluntarios mostraron una reducción significativa, y la concentración de creatina quinasa (CK) y de urea en sangre (BU) aumentó significativamente. Conclusión La exploración del efecto de los deportes extremos en la mejora de la capacidad de coordinación muscular de los atletas puso de manifiesto que la fuerza y la coordinación deben mejorarse en el proceso de escalada en roca. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Relationship of Training Factors and Resilience with Injuries in Ski Mountaineers.

Ski mountaineering is an increasingly popular sport with a relatively high risk of injury. Therefore, several studies have analyzed factors related to the likelihood of injury, including athlete characteristics, training, resilience and equipment. Thus, the aim of this study was to identify factors that may influence injury risk. A 15-minute online survey was sent to various ski mountaineering groups of different ages and levels. Both the Mann-Whitney U test and odds ratio analysis were performed in order to analyze the data. Results from 104 skiers showed that most injuries occurred in the lower extremities, especially in the knee (29.6%). The findings indicated that skiers who had suffered an injury performed in more competitions per year (p = 0.046), more ski mountaineering sessions per week (p = 0.022) and fewer core training sessions per week (0.029), although core training and competition were not statistically significant factors. Likewise, non-injured athletes had fewer pairs of skis (p = 0.019), which were also wider (p = 0.04). However, no difference was found for warm up and resilience between both groups (p = 0.275). In conclusion, it is important to implement preventive measures based on these factors, even if more research is needed.

Muscular endurance in mountaineers under different load training observation / Observação da resistência muscular em montanhistas sob diferentes treinamentos de carga / Observación de la resistencia muscular en montañistas bajo diferentes entrenamientos de carga

ABSTRACT Introduction Mountaineering is a very healthy reasoning sport event that focuses on intelligence and physical strength, climbing rock walls with the hands. Objective Observe the specific indicators of upper limb strength in mountaineering. Methods Athletes from a rock-climbing training team were selected as the research subjects (N=12, M=6). Before the formal experimental test, the subjects performed 30-minute warm-up exercises, including stretching and jogging. Results The negative correlation between sports performance and maximum heart rate after a 15-meter speed climb indicates that the higher the heart rate mobilized in sport, the better the exercise performance. Similarly, was observed the positive correlation between athletic performance and blood lactate at 3 minutes after a 15-meter climb, i.e., the higher the blood lactate during exercise, the worse the athletic performance. Conclusions The higher the climbing speed and the lower the blood lactate, the better the athletic performance. Thus, athletes with high training levels and solid athletic ability can achieve a higher maximum heart rate level during exercise. Evidence Level II; Therapeutic Studies - Investigating the result.

RESUMO Introdução O montanhismo é um evento esportivo de raciocínio muito saudável que se concentra tanto na inteligência quanto na força física, consistindo em escalar paredes de rocha com as mãos. Objetivo Observar os indicadores específicos de força dos membros superiores do montanhismo. Métodos Os atletas de uma equipe de treinamento em escalada em rocha foram selecionados como os sujeitos de pesquisa (N=12, M=6). Antes do teste experimental formal, os sujeitos fizeram exercícios de aquecimento de 30 minutos, incluindo essencialmente exercícios de alongamento e manobras de montanhismo. Resultados A correlação negativa entre o desempenho esportivo e a frequência cardíaca máxima após uma escalada de 15 metros de velocidade indica que quanto maior a frequência cardíaca mobilizada no esporte, melhor o desempenho do exercício. Da mesma forma, houve a correlação positiva entre o desempenho atlético e o lactato de sangue aos 3 minutos após uma escalada de 15 metros, ou seja, quanto maior o lactato sanguíneo durante o exercício, pior o desempenho atlético. Conclusão Quanto mais alta a velocidade de escalada e mais baixo o lactato sanguíneo, melhor o desempenho atlético. Assim, atletas com alto nível de treinamento e forte capacidade atlética podem alcançar um nível máximo de frequência cardíaca maior durante o exercício. Nível de evidência II; Estudos Terapêuticos - Investigação de Resultados.

RESUMEN Introducción El alpinismo es una prueba deportiva de razonamiento muy saludable que se centra tanto en la inteligencia como en la fuerza física, consistiendo en escalar paredes de roca con las manos. Objetivo Observar los indicadores específicos de la fuerza de los miembros superiores en el alpinismo. Métodos Se seleccionaron atletas de un equipo de entrenamiento de escalada en roca como sujetos de la investigación (N=12, M=6). Antes de la prueba experimental formal, los sujetos realizaron ejercicios de calentamiento de 30 minutos, que incluían esencialmente ejercicios de estiramiento y maniobras de montañismo. Resultados La correlación negativa entre el rendimiento deportivo y la frecuencia cardíaca máxima tras una subida de velocidad de 15 metros indica que cuanto mayor sea la frecuencia cardíaca movilizada en el deporte, mejor será el rendimiento del ejercicio. Asimismo, se observa la correlación positiva entre el rendimiento atlético y el lactato en sangre a los 3 minutos después de una subida de 15 metros, es decir, cuanto más alto sea el lactato en sangre durante el ejercicio, peor será el rendimiento atlético. Conclusión Cuanto mayor sea la velocidad de ascenso y menor el lactato en sangre, mejor será el rendimiento deportivo. Así, los atletas con un alto nivel de entrenamiento y una fuerte capacidad atlética pueden alcanzar un nivel de frecuencia cardíaca más alto durante el ejercicio. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.

Perceptions Among Backcountry Skiers During the COVID-19 Pandemic: Avalanche Safety and Backcountry Habits of New and Established Skiers.

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic impacted the ski industry worldwide by closing or limiting access to ski resorts. Subsequently, anecdotal reports of increased backcountry use emerged in the press, with concerns of inexperienced skiers causing or having problems in the backcountry. This study attempted to quantify this and identify motivations for new backcountry skiers. METHODS: Self-identified backcountry skiers and snowboarders (aged ≥18 y) in the United States and Canada completed an anonymous 29-question online survey distributed by regional avalanche centers, education providers, and skiing organizations (n=4792). Respondents were stratified by backcountry experience, defining "newcomers" who began backcountry skiing from 2019 to 2021, coincident with the COVID-19 pandemic. Percentages of ski days spent in the backcountry were compared before and during the COVID-19 pandemic using paired t-tests and across cohorts using repeated-measures analysis of variance. Avalanche education was compared using unpaired χ2 tests. RESULTS: Of established skiers, 81% noticed more people in the backcountry and 27% reported increasing their own use. Participants reported spending 17% (95% CI, 15.8-17.9) more of their days in the backcountry during the COVID-19 pandemic, with newcomers increasing their time spent by 36% and established skiers increasing their time spent by 13% (P<0.0001). Of newcomers, 27% cited the COVID-19 pandemic as motivation to enter the backcountry and 24% lacked formal avalanche education, which is significantly higher than the 14% of established skiers (P<0.0001). CONCLUSIONS: Influenced by factors related to COVID-19, reported backcountry use increased during the pandemic. Newcomers had a lower level of avalanche education and less confidence in evaluating terrain. Because 80% of participants were recruited from avalanche safety or education websites, this likely underestimates skiers lacking avalanche awareness or education and is further limited by the nature of online surveys.

Left Ventricular, Left Atrial and Right Ventricular Strain Modifications after Maximal Exercise in Elite Ski-Mountaineering Athletes: A Feasibility Speckle Tracking Study.

Eleven world elite ski-mountaineering (Ski-Mo) athletes were evaluated for pronounced echocardiographic physiological remodeling as the primary aim of our feasibility speckle tracking study. In this context, sports-related cardiac remodeling was analyzed by performing two-dimensional echocardiography, including speckle tracking analysis of the left atrium (LA), right ventricle (RV) and left ventricular (LV) global longitudinal strain (LV-GLS) at rest and post-peak performance. The feasibility echocardiographic speckle tracking analysis was performed on eleven elite Ski-Mo athletes, which were obtained in 2022 during the annual medical examination. The obtained data of the professional Ski-Mo athletes (11 athletes, age: 18-26 years) were compared for different echocardiographic parameters at rest and post-exercise. Significant differences were found for LV-GLS mean (p = 0.0036) and phasic LA conduit strain pattern at rest and post-exercise (p = 0.0033). Furthermore, negative correlation between LV mass and LV-GLS (p = 0.0195, r = -0.69) and LV mass Index and LV-GLS (p = 0.0253, r = -0.66) at rest were elucidated. This descriptive reporting provided, for the first time, a sport-specific dynamic remodeling of an entire elite national team of the Ski-Mo athlete's left heart and elucidated differences in the dynamic deformation pattern of the left heart.