RESUMEN
Objective: To describe the characteristics of athletes with solid-organ transplants (TxA) attending the British and World Transplant Games. Methods: 220 TxA completed an online survey to explore transplant history, medications, training advice and support and limitations to training. Results: TxA were predominantly caucasian, male, kidney recipients in their mid-forties and approximately 11 years post-transplant. The majority of TxA took some form of medication (immunosuppressants 88%, steroids 47%, antihypertensives 47%, statins 28%, antiplatelets 26%, antibiotics/antivirals/antifungals 20%). Stem cell recipients were least likely to require medication. Post-transplant complications were experienced by 40% of TxA, with 53% of these being rejection. Although over half the participants (57%) initially received exercise or training advice post-transplant, only 34% of these received this from their consultants or immediate medical team. Only 1% had been specifically directed towards transplant sport. Half of the TxA (53%) perceived there were limitations preventing them from performing at their potential, 45% considered they did not recover from training as well as non-TxA while 29% felt they trained equally to non-Tx's. Only 6% considered medication impaired training. TxA competed for a range of reasons from social and health benefits to winning medals. Conclusions: TxA compete at the British and World Transplant Games for a diverse range of reasons. Athletes manage a range of medications with a range of exercise and health experiences pre-transplant. TxA face a lack of both general and specific exercise training and recovery guidance. The individuality of each TxA's background should be considered and is likely reflected in their exercise capacity and goals.
RESUMEN
CONTEXT: Anecdotal reports suggest elite sports clubs combine lower-body positive-pressure rehabilitation with a hypoxic stimulus to maintain or increase physiological and metabolic strain, which are reduced during lower-body positive pressure. However, the effects of hypoxia on cardiovascular and metabolic response during lower-body positive-pressure rehabilitation are unknown. OBJECTIVE: Evaluate the use of normobaric hypoxia as a means to increase physiological strain during body-weight-supported (BWS) running. DESIGN: Crossover study. SETTING: Controlled laboratory. PARTICIPANTS: Seven familiarized males (mean (SD): age, 20 (1) y; height, 1.77 (0.05) m; mass, 69.4 (5.1) kg; hemoglobin, 15.2 (0.8) g·dL-1) completed a normoxic and hypoxic (fraction of inspired oxygen [O2] = 0.14) trial, during which they ran at 8 km·h-1 on an AlterG™ treadmill with 0%, 30%, and 60% BWS in a randomized order for 10 minutes interspersed with 5 minutes of recovery. MAIN OUTCOME MEASURES: Arterial O2 saturation, heart rate, O2 delivery, and measurements of metabolic strain via indirect calorimetry. RESULTS: Hypoxic exercise reduced hemoglobin O2 saturation and elevated heart rate at each level of BWS compared with normoxia. However, the reduction in hemoglobin O2 saturation was attenuated at 60% BWS compared with 0% and 30%, and consequently, O2 delivery was better maintained at 60% BWS. CONCLUSION: Hypoxia is a practically useful means of increasing physiological strain during BWS rehabilitation. In light of the maintenance of hemoglobin O2 saturation and O2 delivery at increasing levels of BWS, fixed hemoglobin saturations rather than a fixed altitude are recommended to maintain an aerobic stimulus.