Pathomechanics of lumbrical and flexor digitorum profundus muscle tears in climbers: A cadaveric model.

Lumbrical muscles originate on the flexor digitorum profundus (FDP) tendons and, during fist making, they move in the same direction when FDP muscle produces maximal proximal tendon gliding. Injuries of the bipennate lumbricals have been described when a shear force acts between the origins on adjacent tendons of the FDP, as they glide in opposite directions in asymmetric hand postures. Other structures of the deep flexors complex can be affected during this injury mechanism, due to the so-called quadriga effect, which can commonly occur during sport climbing practise. Biomechanical studies are needed to better understand the pathomechanism. A cadaveric study was designed to analyse the effects of load during the fourth lumbrical muscle injury mechanism. The amount of FDP tendon gliding and metacarpophalangeal (MCP) joint flexion of the 5th finger were calculated. Ten fresh-frozen cadaveric specimens (ten non-paired forearms and hands) were used. The specimens were placed on a custom-made loading apparatus. The FDP of the 5th finger was loaded, inducing isolated flexion of the 5th finger, until rupture. The rupture occurred in all specimens, under a load of 11 kg (SD 4.94), at 9.23 mm of proximal tendon gliding (SD 3.55) and at 21.4° (SD 28.91) of MCP joint flexion. Lumbrical muscle detachment from the 4th FDP was observed, from distal to proximal, and changes in FDP tendons at the distal forearm level too. The quadriga effect can lead to injury of the bipennate lumbrical muscles and the deep flexors complex in the hand and forearm.

Myoelectric manifestations of fatigue of the finger flexor muscles and endurance capacity in experienced versus intermediate climbers during suspension tasks.

Climbing is a physically demanding discipline, placing significant loads on the finger flexors. Notwithstanding the documented greater endurance capacity of experienced climbers, the mechanisms explaining these training-induced adaptations remain unknown. We therefore investigate whether two non-competing strategies - muscle adaptation and alternate muscle recruitment - may explain the disparity in endurance capacity in participants with different climbing experience. We analysed high-density surface electromyograms (EMGs) from 38 Advanced and Intermediate climbers, during suspension exercises over three different depths (15, 20, 30 mm) using a half-crimp grip position. From the spatial distribution of changes in MeDian Frequency and Root Mean Square values until failure, we assessed how much and how diffusely the myoelectric manifestations of fatigue took place. Advanced climbers exhibited greater endurance, as evidenced by significantly longer failure time (p < 0.009) and lower changes in MDF values (p < 0.013) for the three grip depths. These changes were confined to a small skin region (nearly 25% of the grid size), centred at variable locations across participants. Moreover, lower MDF changes were significantly associated with longer suspension times. Collectively, our results suggest that muscle adaptation rather than load sharing between and within muscles is more likely to explain the improved endurance in experienced climbers.

Cognitive-behavioural processes during route previewing in bouldering.

INTRODUCTION: In the Olympic climbing discipline of bouldering, climbers can preview boulders before actually climbing them. Whilst such pre-climbing route previewing is considered as central to subsequent climbing performance, research on cognitive-behavioural processes during the preparatory phase in the modality of bouldering is lacking. The present study aimed at extending existing findings on neural efficiency processes associated with advanced skill level during motor activity preparation by examining cognitive-behavioural processes during the previewing of boulders. METHODS: Intermediate (n = 20), advanced (n = 20), and elite (n = 20) climbers were asked to preview first, and then attempt two boulders of different difficulty levels (boulder 1: advanced difficulty; boulder 2: elite difficulty). During previewing, climbers' gaze behaviour was gathered using a portable eye-tracker. RESULTS: Linear regression revealed for both boulders a significant relation between participants' skill levels and both preview duration and number of scans during previewing. Elite climbers more commonly used a superficial scan path than advanced and intermediate climbers. In the more difficult boulder, both elite and advanced climbers showed longer preview durations, performed more scans, and applied less often a superficial scan path than in the easier boulder. CONCLUSION: Findings revealed that cognitive-behavioural processes during route previewing are associated with climbing expertise and boulder difficulty. Superior domain-specific cognitive proficiency seems to account for the expertise-processing-paradigm in boulder previewing, contributing to faster and more conscious acquisition of perceptual cues, more efficient visual search strategies, and better identification of representative patterns among experts.

Women at Altitude: Menstrual-Cycle Phase, Menopause, and Exogenous Progesterone Are Not Associated with Acute Mountain Sickness.

Gardner, Laurel, Linda E. Keyes, Caleb Phillips, Elan Small, Tejaswi Adhikari, Nathan Barott, Ken Zafren, Rony Maharjan, and James Marvel. Women at altitude: Menstrual-cycle phase, menopause, and exogenous progesterone are not associated with acute mountain sickness. High Alt Med Biol. 00:000-000, 2024. Background: Elevated progesterone levels in women may protect against acute mountain sickness (AMS). The impact of hormonal contraception (HC) on AMS is unknown. We examined the effect of natural and exogenous progesterone on the occurrence of AMS. Methods: We conducted a prospective observational convenience study of female trekkers in Lobuche (4,940 m) and Manang (3,519 m). We collected data on last menstrual period, use of exogenous hormones, and development of AMS. Results: There were 1,161 trekkers who met inclusion criteria, of whom 307 (26%) had AMS. There was no significant difference in occurrence of AMS between women in the follicular (28%) and the luteal (25%) phases of menstruation (p = 0.48). The proportion of premenopausal (25%) versus postmenopausal women (30%) with AMS did not differ (p = 0.33). The use of HC did not influence the occurrence of AMS (HC 23% vs. no HC 26%, p = 0.47), nor did hormonal replacement therapy (HRT) (HRT 11% vs. no HRT 31%, p = 0.13). Conclusion: We found no relationship between menstrual-cycle phase, menopausal status, or use of exogenous progesterone and the occurrence of AMS in trekkers and conclude that hormonal status is not a risk factor for AMS. Furthermore, women should not be excluded from future AMS studies based on hormonal status.

Nutritional physiology and body composition changes during a rapid ascent to high altitude.

Exposure to high altitude might cause the body to adapt with negative energy and fluid balance that compromise body composition and physical performance. In this field study involving 12 healthy adults, sex-balanced, and aged 29 ± 4 years with a body mass index of 21.6 ± 1.8 kg/m2, we investigated the effects of a 4-day trekking up to 4556 m a.s.l. on Monte Rosa (Alps, Italy). The food intake was recorded using food diaries and nutrient averages were calculated. The bio-impedance analysis was performed at low and high altitudes, and a wearable biosensor (Swemax) was used to track hydro-saline losses in two participants. Daily total energy intake was 3348 ± 386 kcal for males and 2804 ± 415 kcal for females (13%-14% protein, 35% fat, 44%-46% carbohydrates). Although there was a significant body weight loss (65.0 ± 9.3 vs. 64.2 ± 9.10 kg, p < 0.001, d = 1.398), no significant changes in body composition parameter were found but a trend in the increase of the bioelectrical phase angle in males (p = 0.059, d = -0.991). Body water percentage significantly changed (p = 0.026, η2 p = 0.440), but the absolute water did not, suggesting that the weight loss was not due to water loss. Salivary and urinary osmolality did not change. A reduction in sweat rate at higher altitudes was observed in both participants. Interestingly, salivary leptin increased (p = 0.014, η2 p = 0.510), and salivary ghrelin decreased (p = 0.036, η2 p  = 0.403). Therefore, the 4-day trekking at altitude of hypoxia exposure induced changes in satiety and appetite hormones. High altitude expeditions require more specific nutritional guidance, and using multiplex analysis could help in monitoring fluid balance and body composition.

Comparison of finger flexion strength and muscular recovery of male lead sport climbers across climbing classes.

BACKGROUND/OBJECTIVE: The purpose of this study was to compare finger flexor strength (FS), finger flexor muscle recovery (FR), and forearm circumference (FC) across three different climbing classes in male lead sport climbers. METHODS: A total of 37 male lead sport climbers were classified into low (LC), intermediate (IC), and advanced classes (AC) categories according to the International Rock Climbing Research Association (IRCRA) Scale. All participants measured FS three times for both open grip (OG) and crimp grip (CG). Following FS measurement, the FR was observed immediately after the all-out training. The FC was measured twice using an inelastic tape. RESULTS: The FS differed significantly across climbing classes for both grip styles and hands, regardless of dominant hand, with the higher classes showing greater FS (all, p ≤ 0.001). FR was significantly higher in AC compared to IC and LC at 5 min (all, p ≤ 0.001), 10 min (all, p ≤ 0.005) and 15 min (all, p ≤ 0.005). The FC showed significant differences with climbing classes for both forearms. CONCLUSION: Climbing classes are associated with differences in FS, with higher class corresponding to greater FS. Similarly, climbing classes are linked to FR and FC, with higher classes being associated with faster recovery and larger FC.

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.

Assessing climbers' pull-up capabilities by differentiating the parameters involved in power production.

This study explored the capabilities of sport climbers to pull up with arms. The methodology aimed at assessing (i) concentric capabilities of arm muscles, (ii) body coordination skills (iii) characteristics of energy storage and (iv) capabilities to resist fatigue. Twenty-eight climbers were tested and the force exerted was recorded during three pull-up exercises: jump tests (with or without coordination, or preceded by an eccentric phase), incrementally weighted pull-ups and maximum number of pull-ups. Force, velocity, muscle power and muscle work were analysed using ANOVA with post-hoc tests and principal component analysis. Correlations with climbing level were also studied. Overall, jump test results showed that body coordination and stretch-shortening cycle phenomena contributed significantly to performance but only the body coordination was related to the climber's grade level. Muscle work and maximum number of pull-ups are correlated with climbing level which showed that the capacity to resist fatigue is another crucial capability of climbers arms. The development of force capacities appeared crucial for performing whereas the velocity capabilities seemed to originate from the climber's own characteristics/style without correlating with climbing performance. Our study provides the basis for evaluating these parameters in order to help trainers in the diagnosis process and training follow-up.

Wearable and Non-Invasive Sensors for Rock Climbing Applications: Science-Based Training and Performance Optimization.

Rock climbing has evolved from a method for alpine mountaineering into a popular recreational activity and competitive sport. Advances in safety equipment and the rapid growth of indoor climbing facilities has enabled climbers to focus on the physical and technical movements needed to elevate performance. Through improved training methods, climbers can now achieve ascents of extreme difficulty. A critical aspect to further improve performance is the ability to continuously measure body movement and physiologic responses while ascending the climbing wall. However, traditional measurement devices (e.g., dynamometer) limit data collection during climbing. Advances in wearable and non-invasive sensor technologies have enabled new applications for climbing. This paper presents an overview and critical analysis of the scientific literature on sensors used during climbing. We focus on the several highlighted sensors with the ability to provide continuous measurements during climbing. These selected sensors consist of five main types (body movement, respiration, heart activity, eye gazing, skeletal muscle characterization) that demonstrate their capabilities and potential climbing applications. This review will facilitate the selection of these types of sensors in support of climbing training and strategies.

Forearm muscle oxygenation and blood volume parameters during sustained contraction performance in youth sport climbers.

BACKGROUND: Forearm muscle strength and endurance are essential determinants of sports climbing success. This study aimed to investigate whether delayed rates of muscle oxygen saturation and total hemoglobin correlate to sustained contraction performance of youth climbers. METHODS: Twelve recreational and competitive youth sport climbers (six females, six males) participated in the study. Variables included finger flexors muscle maximal voluntary contraction, sustained contraction test (SCT), muscle oxygen dynamics (SmO2), and blood volume (tHb) parameters. Pearson's correlation coefficients were calculated to determine the correlation between physiological and performance variables. RESULTS: SCT had a significant positive relationship to SmO2 delayed rate (r=0.728, P=0.007), and a significant negative relationship to tHb delayed rate (r=-0.690, P=0.013). SmO2 delayed rate and tHb delayed rate also had a significant negative correlation (r=-0.760, P=0.004). CONCLUSIONS: According to the results of this study, it can be suggested that delayed rates of SmO2 and tHb could be used in determining and predicting sustainable finger flexors performance in youth climbers. However, future studies investigating delayed rates of SmO2 and tHb in climbers of different ability levels are warranted to investigate this issue in more detail.

Body Composition, Anthropometric Parameters, and Strength-Endurance Characteristics of Sport Climbers: A Systematic Review.

ABSTRACT: Ginszt, M, Saito, M, Zieba, E, Majcher, P, and Kikuchi, N. Body composition, anthropometric parameters, and strength-endurance characteristics of sport climbers: a systematic review. J Strength Cond Res 37(6): 1339-1348, 2023-Sport climbing was selected to be part of the Summer Olympic Games in Tokyo 2021 with 3 subdisciplines: lead climbing, speed climbing, and bouldering. The nature of physical effort while speed climbing, lead climbing, and bouldering performance is different. This literature review aimed to describe differences between body composition, anthropometric parameters, and upper-limb strength-endurance variables between sport climbers with different ability levels and nonclimbers. The following databases were searched: PubMed and Scopus. The following keywords were used: "sport climbing," "rock climbing," "lead climbing," and "bouldering." Articles were considered from January 2000 to October 2021 if they concerned at least one of the following parameters: body composition (mass, body mass index, body fat, lean muscle mass, bone mineral density), anthropometric parameters (height, ape index), muscle strength (MVC finger strength in half-crimp grip, MVC finger strength to body mass, handgrip strength), and muscle endurance (force time integral, pull-ups). A review shows that body mass and body fat content were lower in the sport climbers compared with controls and in elite sport climbers compared with those less advanced. Sport climbers presented higher values of MVC finger strength in half-crimp grip, MVC finger strength to body mass, handgrip strength, and force time integral parameter than control subjects. Significantly higher MVC values in half-crimp grip were observed in elite sport climbers than in advanced athletes. None of the analyzed work showed differences between sport climber groups in the ape index. The abovementioned parameters may be a key factor in elite sport climbing performance.

Differences in the effects of a startle stimulus on rate of force development between resistance-trained rock climbers and untrained individuals: Evidence for reticulospinal adaptations?

The aim of the present cross-sectional study was to determine if chronic rock climbing and climbing-specific resistance training (RT) would modify the reticulospinal tract (RST) efficacy. Sixteen healthy, elite level climbers (CL; n = 16, 5 F; 29.8 ± 6.7 years) with 12 ± 7 years of climbing and climbing-specific RT experience and 15 healthy recreationally active participants (CON; n = 15, 4 F; 24.6 ± 5.9 years), volunteered for the study. We quantified RST efficacy by comparing the effects of a startle stimulus over reaction time (Rtime ) and measured rate of force development (RFD) and surface electromyography (sEMG) in representative muscles during powerful hand grip contractions. Both groups performed two Rtime tasks while performing rapid, powerful gripping with the right hand (Task 1) or during 3-s-long maximal voluntary right hand grip contractions in response to an imperative visual signal alone (V), or combined with a auditory-non startle stimulus (A) or/and startling auditory stimulus (S). We also tested the reproducibility of these responses on two separate days in CON. Intersession reliability ranged from 0.34 to 0.96 for all variables. The CL versus CON was 37% stronger (p = 0.003). The S stimulus decreased Rtime and increased RFD and sEMG in both groups during both tasks (all p < 0.001). Rtime was similar between groups in all conditions. However, CL had a greater RFD from 50 to 100 ms compared with CON only after the S stimulus in both tasks (p < 0.05, d = 0.85-0.96). The data tentatively suggest that chronic rock climbing and climbing-specific RT might improve RST efficacy, by increasing RST input to the α-motoneurons.

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.

Mission Himalaya: Exploring the Impact of a Supported High-Altitude Mountaineering Expedition on the Well-Being and Personal Development of UK Military Veterans.

Meaningful, positive, emotional and challenging adventurous activities may generate personal growth or recovery from ill health or injury. In this study, we used a distinctive longitudinal and immersive research approach to explore the psychological impact of a high-altitude expedition to the Nepalese Himalaya on 10 (9 males) UK military veterans with longstanding well-being concerns. In the 12 months prior to the expedition, participants took part in three training weekends in the UK mountains. During the expedition, instructors-who were all experienced health coaches-facilitated reflective practices with the beneficiaries throughout, focusing on experiential transfer to day-to-day lives after the expedition. Follow-up interviews, conducted up to 18-months post-expedition, identified that the most desirable changes aligned with the three innate psychological needs of self-determination theory: autonomy, competence and relatedness. The routines established during the preparation stage and during the expedition itself activated a renewed energy for personal improvement. At 18 months post-expedition, the key changes reflected altered perspective, employment skills and work-life balance, increased physical activity and enhanced personal awareness and mindfulness. Importantly, supported by regular health coaching and focused on the transfer of learning, expeditions can activate meaningful long-term changes to the well-being and personal development of military veterans.

Heart Rate Response, Duration, Grip Strength, and Anthropometric Characteristics in Recreational Indoor Rock Climbers.

ABSTRACT: Smetanka, RG, Armenta, RF, Nessler, JA, and Newcomer, SC. Heart rate response, duration, grip strength, and anthropometric characteristics in recreational indoor rock climbers. J Strength Cond Res 36(3): 832-837, 2022-Despite the growing popularity of recreational indoor rock climbing, there is a lack of research on cardiovascular responses to rock climbing. In addition, although the importance of body composition and grip strength has been established in elite climbers, their effect on recreational climbing is unknown. Therefore, the purpose of this study was to characterize the physiological and anthropometric characteristics of indoor climbers engaging in climbing at a recreational or noncompetitive setting. We hypothesized that heart rates and climbing durations would meet the standards set by the American College of Sports Medicine (ACSM) and Center for Disease Control and Prevention (CDC) for eliciting health benefits and that grip strength would decrease over the course of a typical climbing session. One hundred twenty-one male and female adult recreational climbers participated in this study. Following informed consent, subjects were instrumented with a heart rate monitor (Polar V800) which recorded heart rate and duration. Preclimb and postclimb grip strength were evaluated using a hand grip dynamometer and used to calculate fatigue. Subjects were 30.9 ± 8.3 years old and had participated in climbing for 5.6 ± 6.5 years. The average heart rate during climbing sessions was 122.3 ± 14.5 b·min-1, and session duration was 90.6 ± 31.3 minutes. Mean grip strength was 49.9 ± 11.2 kg, whereas the strength to mass ratio was 0.71 ± 0.14, and fatigue was 13.1 ± 11.6%. Results from the current study suggest that recreational indoor climbing elicits exercise heart rates and durations that are consistent with the CDC and ACSM's recommendations for cardiovascular health. Grip strength data suggested that forearm muscle fatigue may limit climbing durations.

Effect of a speed ascent to the top of Europe on cognitive function in elite climbers.

PURPOSE: The combined effects of acute hypoxia and exercise on cognition remain to be clarified. We investigated the effect of speed climbing to high altitude on reactivity and inhibitory control in elite climbers. METHODS: Eleven elite climbers performed a speed ascent of the Mont-Blanc (4810 m) and were evaluated pre- (at 1000 m) and immediately post-ascent (at 3835 m). In both conditions, a Simon task was done at rest (single-task session, ST) and during a low-intensity exercise (dual-task session, DT). Prefrontal cortex (PFC) oxygenation and middle cerebral artery velocity (MCAv) were monitored using near-infrared spectroscopy and transcranial Doppler, respectively, during the cognitive task. Self-perceived mental fatigue and difficulty to perform the cognitive tests were estimated using a visual analog scale. Heart rate and pulse oxygenation (SpO2) were monitored during the speed ascent. RESULTS: Elite climbers performed an intense (~ 50% of the time ≥ 80% of maximal heart rate) and prolonged (8h58 ± 6 min) exercise in hypoxia (minimal SpO2 at 4810 m: 78 ± 4%). Reaction time and accuracy during the Simon task were similar pre- and post-ascent (374 ± 28 ms vs. 385 ± 39 ms and 6 ± 4% vs. 5 ± 4%, respectively; p > 0.05), despite a reported higher mental fatigue and difficulty to perform the Simon task post-ascent (all p < 0.05). The magnitude of the Simon effect was unaltered (p > 0.05), suggesting a preserved cognitive control post-ascent. Pattern of PFC oxygenation and MCAv differed between pre- and post-ascent as well as between ST and DT conditions. CONCLUSIONS: Cognitive control is not altered in elite climbers after a speed ascent to high-altitude despite substantial cerebral deoxygenation and fatigue perception.

Effects of Two vs. Four Weekly Campus Board Training Sessions on Bouldering Performance and Climbing-Specific Tests in Advanced and Elite Climbers.

This study examined the effects of two or four weekly campus board training sessions among highly accomplished lead climbers. Sixteen advanced-to-elite climbers were randomly allocated to two (TG2), or four weekly campus board training sessions (TG4), or a control group (CG). All groups continued their normal climbing routines. Pre- and post-intervention measures included bouldering performance, maximal isometric pull-up strength using a shallow rung and a large hold (jug), and maximal reach and moves to failure. Rate of force development (RFD; absolute and 100ms) was calculated in the rung condition. TG4 improved maximal force in the jug condition (effect size (ES) = 0.40, p = 0.043), and absolute RFD more than CG (ES = 2.92, p = 0.025), whereas TG2 improved bouldering performance (ES = 2.59, p = 0.016) and maximal moves to failure on the campus board more than CG (ES = 1.65, p = 0.008). No differences between the training groups were found (p = 0.107-1.000). When merging the training groups, the training improved strength in the rung condition (ES = 0.87, p = 0.002), bouldering performance (ES = 2.37, p = 0.006), maximal reach (ES = 1.66, p = 0.006) and moves to failure (ES = 1.43, p = 0.040) more than CG. In conclusion, a five-week campus board training-block is sufficient for improving climbing-specific attributes among advanced-to-elite climbers. Sessions should be divided over four days to improve RFD or divided over two days to improve bouldering performance, compared to regular climbing training.

Physiological Responses and Predictors of Performance in a Simulated Competitive Ski Mountaineering Race.

Competitive ski mountaineering (SKIMO) has achieved great popularity within the past years. However, knowledge about the predictors of performance and physiological response to SKIMO racing is limited. Therefore, 21 male SKIMO athletes split into two performance groups (elite: VO2max 71.2 ± 6.8 ml· min-1· kg-1 vs. sub-elite: 62.5 ± 4.7 ml· min-1· kg-1) were tested and analysed during a vertical SKIMO race simulation (523 m elevation gain) and in a laboratory SKIMO specific ramp test. In both cases, oxygen consumption (VO2), heart rate (HR), blood lactate and cycle characteristics were measured. During the race simulation, the elite athletes were approximately 5 min faster compared with the sub-elite (27:15 ± 1:16 min; 32:31 ± 2:13 min; p < 0.001). VO2 was higher for elite athletes during the race simulation (p = 0.046) and in the laboratory test at ventilatory threshold 2 (p = 0.005) and at maximum VO2 (p = 0.003). Laboratory maximum power output is displayed as treadmill speed and was higher for elite than sub-elite athletes (7.4 ± 0.3 km h-1; 6.6 ± 0.3 km h-1; p < 0.001). Lactate values were higher in the laboratory maximum ramp test than in the race simulation (p < 0.001). Pearson's correlation coefficient between race time and performance parameters was highest for velocity and VO2 related parameters during the laboratory test (r > 0.6). Elite athletes showed their superiority in the race simulation as well as during the maximum ramp test. While HR analysis revealed a similar strain to both cohorts in both tests, the superiority can be explainable by higher VO2 and power output. To further push the performance of SKIMO athletes, the development of named factors like power output at maximum and ventilatory threshold 2 seems crucial.

Cardiopulmonary response to high-altitude mountaineering in lung transplant recipients-The Jebel Toubkal experience.

OBJECTIVES: Only a small proportion of lung transplant recipients achieve a physical status comparable to healthy individuals in the long term. It is reasonable to hypothesize that the necessary cardiopulmonary adaptation required for strenuous physical exercise may be impaired. Exposure to high altitude provides an optimal platform to study the physiological cardiopulmonary adaptation in lung transplant recipients under aerobic conditions. To gain a deeper understanding, 14 healthy lung transplant recipients and healthcare professionals climbed the highest peak in North Africa (Mount Jebel Toubkal; 4167 m) in September 2019. METHODS: Monitoring included daily assessment of vital signs, repeated transthoracic echocardiography, pulmonary function tests, and capillary blood sampling throughout the expedition. RESULTS: Eleven out of fourteen lung transplant recipients reached the summit. All recipients showed a stable lung function and vital parameters and physiological adaptation of blood gases. Similar results were found in healthy controls. Lung transplant recipients showed worse results in the 6-minute walk test at low and high altitude compared to controls (day 1: 662 m vs. 725 m, p < 0.001, day 5: 656 m vs. 700 m, p = 0.033) and a lack of contractile adaptation of right ventricular function with increasing altitude as measured by tricuspid plane systolic excursion on echocardiography (day 2: 22 mm vs. 24 mm, p = 0.202, day 5: 23 mm vs. 26 mm, p = 0.035). CONCLUSIONS: Strenuous exercise in healthy lung transplant recipients is safe. However, the poorer cardiopulmonary performance in the 6-minute walk test and the lack of right ventricular cardiac adaptation may indicate underlying autonomic dysregulation.

Hangboard training in advanced climbers: A randomized controlled trial.

Improving climbing performance strongly depends upon effective training methods. Hangboard training is one of the most popular approaches to increase finger and forearm strength. Training protocols are based on maximizing weight or minimizing edges. We aimed to evaluate which of these protocols was superior. We prospectively analyzed 30 intermediate to advanced climbing athletes [Union Internationale des Associations d'Alpinisme (UIAA) VI-VIII] and randomized them into three groups: control group C (Control, normal climbing training), hangboard group HE (Hang endurance, grips to hold for a determined time decreased every week), and hangboard group HW (Hang weight, + 1.25 kg weight were added each week to hold for a determined time). As endpoints, we measured the grip strength before and after an 8-week training protocol in seven different pinches. Over the 8-week training period, HW hangboard training significantly improved the climbers' grip strength compared to C [p = 0.032, effect size (ES) 0.36]. Maximizing weight improved the strength in I/II + III, I/II + III + IV and fist significantly. HW was superior compared to C in terms of grip strength improvement in three out of seven pinches and overall grip strength. The overall changes in the HE group did not differ significantly from the C group. An 8-week training protocol with increasing weights (HW) significantly improved overall grip strength more than a regular climbing training without the use of a hangboard.