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Grégoire P. Millet and Kilian Jornet

Purpose: To present the acclimatization strategy employed by an elite athlete prior to 2 successful ascents to Mount Everest (including a “fastest known time”) in 1 wk. Methods: Training volume, training content, and altitude exposure were recorded daily. Vertical velocity was recorded by GPS (global positioning system) heart-rate monitor. Results: The subject first used a live high–train low and high preacclimatization method in normobaric hypoxia (NH). Daily, he combined sleeping in a hypoxic tent (total hours: ∼260) and exercising “as usual” in normoxia but also in NH (altitude >6000 m: 30 h), including at high intensity. The hypoxic sessions were performed at the second threshold on treadmill in NH at 6000 m, and the pulse saturation increased from 70% to 85% over 1 mo. Then, the subject was progressively exposed to hypobaric hypoxia, first in the Alps and then in the Himalayas. On day 18, he reached for the second time an altitude >8000 m with the fastest vertical velocity (350 m/h) ever measured between 6300 and 8400 m. Afterward, he climbed twice in a week to the summit of Mount Everest (8848 m, including a “fastest known time” of 26.5 h from Rongbuk Monastery, 5100 m). Conclusion: Overall, this acclimatization was successful and in line with the most recent recommendations: first, using live high–train low and high, and second, using hypobaric hypoxia at increasing altitudes for a better translation of the NH benefits to hypobaric hypoxia. This case study reports the preparation for the most outstanding performance ever acheived at an extreme altitude.

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Grégoire P. Millet, Cyrille Tronche, and Frédéric Grappe

Purpose:

To use measurement by cycling power meters (Pmes) to evaluate the accuracy of commonly used models for estimating uphill cycling power (Pest). Experiments were designed to explore the influence of wind speed and steepness of climb on accuracy of Pest. The authors hypothesized that the random error in Pest would be largely influenced by the windy conditions, the bias would be diminished in steeper climbs, and windy conditions would induce larger bias in Pest.

Methods:

Sixteen well-trained cyclists performed 15 uphill-cycling trials (range: length 1.3–6.3 km, slope 4.4–10.7%) in a random order. Trials included different riding position in a group (lead or follow) and different wind speeds. Pmes was quantified using a power meter, and Pest was calculated with a methodology used by journalists reporting on the Tour de France.

Results:

Overall, the difference between Pmes and Pest was –0.95% (95%CI: –10.4%, +8.5%) for all trials and 0.24% (–6.1%, +6.6%) in conditions without wind (>2 m/s). The relationship between percent slope and the error between Pest and Pmes were considered trivial.

Conclusions:

Aerodynamic drag (affected by wind velocity and orientation, frontal area, drafting, and speed) is the most confounding factor. The mean estimated values are close to the power-output values measured by power meters, but the random error is between ±6% and ±10%. Moreover, at the power outputs (>400 W) produced by professional riders, this error is likely to be higher. This observation calls into question the validity of releasing individual values without reporting the range of random errors.

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Laurent Schmitt, Stéphane Bouthiaux, and Grégoire P. Millet

Purpose: To report the changes in the training characteristics, performance, and heart-rate variability (HRV) of the world’s most successful male biathlete of the last decade. Method: During the analyzed 11-year (2009–2019) period, the participant won 7 big crystal globes, corresponding to the winner of the International Biathlon Union World Cup. The training characteristics are reported as yearly volume (in hours) of low-intensity training (LIT), moderate- and high-intensity training, and speed and strength training. Performance was quantified by the number of World Cup top-3 positions per season. HRV was expressed as low- and high-frequency spectral power (in milliseconds squared), root-mean-square difference of successive R–R interval (in milliseconds), and heart rate (in beats per minute). Results: The training volume increased from 530 to ∼700 hours per year in 2009–2019, with a large polarization in training intensity distribution (ie, LIT 86.3% [2.9%]; moderate-intensity training 3.4% [1.5%]; high-intensity training 4.0% [0.7%]; strength 6.3% [1.6%]). The number of top-3 positions increased from 2 to 24–26 in 2009–2018 but decreased to 6 in 2019. The mean supine values in the root-mean-square difference of successive R–R interval and high-frequency spectral power divided by heart rate increased until 2015, which were stable over 2016–2018 but decreased in 2019. The number of top-3 positions was related to the total (r = .66, P = .02) and LIT (r = .92, P < .001) volume and to several markers of supine parasympathetic activity. Conclusion: The improvement in performance of the participant was mainly determined by the progressive increase in training volume, especially performed at low intensity, and was correlated to parasympathetic activity markers. This case study confirms the effectiveness of the training method, with a large amount of LIT in an elite endurance athlete, and of regular HRV monitoring.

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Grégoire P. Millet, Eric Hermand, and Rémy Hurdiel

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Franck Brocherie, Grégoire P. Millet, and Olivier Girard

Purpose:

To compare psychophysiological responses to 6 repeated-sprint sessions in normobaric hypoxia (RSH) and normoxia (RSN) in team-sport athletes during a 2-wk “live high–train low” training camp.

Methods:

While residing under normobaric hypoxia (≥14 h/d, FiO2 14.5–14.2%), 23 lowland elite field hockey players performed, in addition to their usual training, 6 sessions (4 × 5 × 5-s maximal sprints, 25-s passive recovery, 5 min rest) under either RSH (FiO2 ~14.5%) or RSN (FiO2 21%). Sprint 1 and 5 times, physiological strain (heart rate [HR], arterial oxyhemoglobin saturation [SpO2]), and perceptual responses (overall peripheral discomfort, difficulty breathing, and lower-limb discomfort) were monitored.

Results:

During the 1st session, HR increased across sets (P < .001) independently of the conditions, while SpO2 was globally lower (P < .001) for RSH (averaged value: 91.9% ± 1.2%) vs RSN (96.9% ± 0.6%). Thereafter, SpO2 and HR remained similar across sessions for each condition. While 1st-sprint time remained similar, last-sprint time and fatigue index significantly decreased across sets (P < .01) and sessions (P < .05) but not between conditions. Ratings of overall perceived discomfort, difficulty breathing, and lower-limb discomfort were higher (P < .05) in RSH vs RSN at the 1st session. During subsequent sessions, values for overall perceived discomfort (time [P < .001] and condition [P < .05] effects), difficulty breathing (time effect; P < .001), and lower-limb discomfort (condition [P < .001] and interaction [P < .05] effects) decreased to a larger extent in RSH vs RSN.

Conclusion:

Despite higher hypoxia-induced physiological and perceptual strain during the 1st session, perceptual responses improved thereafter in RSH so as not to differ from RSN. This indicates an effective acclimation and tolerance to this innovative training.

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Laurent Trincat, Xavier Woorons, and Grégoire P. Millet

Purpose:

Repeated-sprint training in hypoxia (RSH) has been shown as an efficient method for improving repeated-sprint ability (RSA) in team-sport players but has not been investigated in swimming. We assessed whether RSH with arterial desaturation induced by voluntary hypoventilation at low lung volume (VHL) could improve RSA to a greater extent than the same training performed under normal breathing (NB) conditions.

Methods:

Sixteen competitive swimmers completed 6 sessions of repeated sprints (2 sets of 16 × 15 m with 30 s send-off) either with VHL (RSH-VHL, n = 8) or with NB (RSN, n = 8). Before and after training, performance was evaluated through an RSA test (25-m all-out sprints with 35 s send-off) until exhaustion.

Results:

From before to after training, the number of sprints was significantly increased in RSH-VHL (7.1 ± 2.1 vs 9.6 ± 2.5; P < .01) but not in RSN (8.0 ± 3.1 vs 8.7 ± 3.7; P = .38). Maximal blood lactate concentration ([La]max) was higher after than before in RSH-VHL (11.5 ± 3.9 vs 7.9 ± 3.7 mmol/L; P = .04) but was unchanged in RSN (10.2 ± 2.0 vs 9.0 ± 3.5 mmol/L; P = .34). There was a strong correlation between the increases in the number of sprints and in [La]max in RSH-VHL only (R = .93, P < .01).

Conclusions:

RSH-VHL improved RSA in swimming, probably through enhanced anaerobic glycolysis. This innovative method allows inducing benefits normally associated with hypoxia during swim training in normoxia.

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Kenny Guex, Francois Fourchet, Heiko Loepelt, and Gregoire P. Millet

Context:

A passive knee-extension test has been shown to be a reliable method of assessing hamstring tightness, but this method does not take into account the potential effect of gravity on the tested leg.

Objective:

To compare an original passive knee-extension test with 2 adapted methods including gravity’s effect on the lower leg.

Design:

Repeated measures.

Setting:

Laboratory.

Participants:

20 young track and field athletes (16.6 ± 1.6 y, 177.6 ± 9.2 cm, 75.9 ± 24.8 kg).

Intervention:

Each subject was tested in a randomized order with 3 different methods: In the original one (M1), passive knee angle was measured with a standard force of 68.7 N (7 kg) applied proximal to the lateral malleolus. The second (M2) and third (M3) methods took into account the relative lower-leg weight (measured respectively by handheld dynamometer and anthropometrical table) to individualize the force applied to assess passive knee angle.

Main Outcome Measures:

Passive knee angles measured with video-analysis software.

Results:

No difference in mean individualized applied force was found between M2 and M3, so the authors assessed passive knee angle only with M2. The mean knee angle was different between M1 and M2 (68.8 ± 12.4 vs 73.1 ± 10.6, P < .001). Knee angles in M1 and M2 were correlated (r = .93, P < .001).

Conclusions:

Differences in knee angle were found between the original passive knee-extension test and a method with gravity correction. M2 is an improved version of the original method (M1) since it minimizes the effect of gravity. Therefore, we recommend using it rather than M1.

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Grégoire P. Millet, Rosalie Trigueira, Frédéric Meyer, and Marcel Lemire

Aims: It has been hypothesized that altitude training may alter running mechanics due to several factors such as the slower training velocity with associated alteration in muscle activation and coordination. This would lead to an altered running mechanics attested by an increase in mechanical work for a given intensity and to the need to “re-establish” the neuromuscular coordination and running biomechanics postaltitude. Therefore, the present study aimed to test the hypothesis that “live high—train high” would induce alteration in the running biomechanics (ie, longer contact time, higher vertical oscillations, decreased stiffness, higher external work). Methods: Before and 2 to 3 days after 3 weeks of altitude training (1850–2200 m), 9 national-level middle-distance (800–5000 m) male runners performed 2 successive 5-minute bouts of running at moderate intensity on an instrumented treadmill with measured ground reaction forces and gas exchanges. Immediately after the running trials, peak knee extensor torque was assessed during isometric maximal voluntary contraction. Results: Except for a slight (−3.0%; P = .04) decrease in vertical stiffness, no mechanical parameters (stride frequency and length, contact and flight times, ground reaction forces, and kinetic and potential work) were modified from prealtitude to postaltitude camp. Running oxygen cost was also unchanged. Discussion: The present study is the first one to report that “live high—train high” did not change the main running mechanical parameters, even when measured immediately after the altitude camp. This result has an important practical implication: there is no need for a corrective period at sea level for “normalizing” the running mechanics after an altitude camp.

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Thibault Lussiana, Kim Hébert-Losier, Grégoire P. Millet, and Laurent Mourot

The effects of footwear and inclination on running biomechanics over short intervals are well documented. Although recognized that exercise duration can impact running biomechanics, it remains unclear how biomechanics change over time when running in minimalist shoes and on slopes. Our aims were to describe these biomechanical changes during a 50-minute run and compare them to those observed in standard shoes. Thirteen trained recreational male runners ran 50 minutes at 65% of their maximal aerobic velocity on a treadmill, once in minimalist shoes and once in standard shoes, 1 week apart in a random order. The 50-minute trial was divided into 5-minute segments of running at 0%, +5%, and –5% of treadmill incline sequentially. Data were collected using photocells, high-speed video cameras, and plantar-pressure insoles. At 0% incline, runners exhibited reduced leg stiffness and plantar flexion angles at foot strike and lower plantar pressure at the forefoot and toes in minimalist shoes from minute 34 of the protocol onward. However, only reduced plantar pressure at the toes was observed in standard shoes. Overall, similar biomechanical changes with increased exercise time were observed on the uphill and downhill inclines. The results might be due to the unfamiliarity of subjects to running in minimalist shoes.

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Sarah J. Willis, Grégoire P. Millet, and Fabio Borrani

Purpose: To assess tissue oxygenation, along with metabolic and physiological responses during blood flow restriction (BFR, bilateral vascular occlusion) and systemic hypoxia conditions during submaximal leg- versus arm-cycling exercise. Methods: In both legs and arms, 4 randomized sessions were performed (normoxia 400 m, fraction of inspired oxygen [FIO2] 20.9% and normobaric hypoxia 3800 m, FIO2 13.1% [0.1%]; combined with BFR at 0% and 45% of resting pulse elimination pressure). During each session, a single 6-minute steady-state submaximal exercise was performed to measure physiological changes and oxygenation (near-infrared spectroscopy) of the muscle tissue in both the vastus lateralis (legs) and biceps brachii (arms). Results: Total hemoglobin concentration ([tHb]) was 65% higher (P < .001) in arms versus legs, suggesting that arms had a greater blood perfusion capacity than legs. Furthermore, there were greater changes in tissue blood volume [tHb] during BFR compared with control conditions (P = .017, F = 5.45). The arms elicited 7% lower tissue saturation (P < .001) and were thus more sensitive to the hypoxia-induced reduction in oxygen supply than legs, no matter the condition. This indicates that legs and arms may elicit different regulatory hemodynamic mechanisms (ie, greater blood flow in arms) for limiting the decreased oxygen delivery during exercise with altered arterial oxygen content. Conclusions: The combination of BFR and/or hypoxia led to increased [tHb] in both limbs likely due to greater vascular resistance; further, arms were more responsive than legs. This possibly influences the maintenance of oxygen delivery and enhances perfusion pressure, suggesting greater vascular reactivity in arms than in legs.