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Exhaustive Intermittent Cycling Preferentially Decreases Explosive Over Maximal Voluntary Torque in the Knee Extensors, With No Difference Between Normoxia and Moderate to Severe Hypoxia

Olivier Girard and Sébastien Racinais

Purpose: To compare the effects of graded hypoxia during exhaustive intermittent cycling on subsequent rapid and maximal torque-production capacity. Methods: Fifteen well-trained cyclists repeated intermittent cycling bouts (15 s at 30% of anaerobic power reserve; rest = 45 s) until exhaustion at sea level (FiO2 ∼0.21/end-exercise arterial oxygen saturation ∼96%), moderate hypoxia (FiO2 ∼0.16/∼90%), and severe hypoxia (FiO2 ∼0.12/∼79%). Rapid (rate of torque development [RTD]) and maximal isometric torque-production capacities of the knee extensors were assessed at baseline (visit 1) and exhaustion (visits 2–4). Results: Exercise capacity decreased with hypoxia severity (39 [30], 22 [13], and 13 [6] cycle efforts in sea level, moderate hypoxia, and severe hypoxia, respectively; P = .002). Changes in maximal-voluntary-contraction torque between baseline and postexercise in all conditions were not statistically significant (pooled values: −2.6% [5.7%]; P = .162). Peak RTD measured postexercise was reduced below baseline in all conditions (–21.5% [5.1%]; P ≤ .015). Compared with baseline, absolute RTD values were lower at 0- to 30-millisecond (–35.1% [5.3%], P ≤ .020), 0- to 50-millisecond (–40.0% [3.9%], P ≤ .002), 0- to 100-millisecond (–30.7% [3.7%], P ≤ .001), and 0- to 200-millisecond (–18.1% [2.4%], P ≤ .004) time intervals in all conditions. Conclusions: Exhaustive intermittent cycling induces substantial yet comparable impairments in RTD of knee extensors between normoxia and moderate to severe hypoxia.

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Combining Heat and Altitude Training to Enhance Temperate, Sea-Level Performance

Olivier Girard, Peter Peeling, Sébastien Racinais, and Julien D. Périard

Background: Repeated exposure to heat (ie, plasma volume expansion) or altitude (ie, increase in total hemoglobin mass), in conjunction with exercise, induces hematological adaptations that enhance endurance performance in each respective environment. Recently, combining heat and altitude training has become increasingly common for athletes preparing to compete in temperate, sea-level conditions. Purpose: To review the physiological adaptations to training interventions combining thermal and hypoxic stimuli and summarize the implications for temperate, sea-level performance. Current Evidence: To date, research on combining heat and hypoxia has employed 2 main approaches: simultaneously combining the stressors during training or concurrently training in the heat and sleeping at altitude, sometimes with additional training in hypoxia. When environmental stimuli are combined in a training session, improvements in aerobic fitness and time-trial performance in temperate, sea-level conditions are generally similar in magnitude to those observed with heat, or altitude, training alone. Similarly, training in the heat and sleeping at altitude does not appear to provide any additional hematological or nonhematological benefits for temperate; sea-level performance relative to training in hot, hypoxic, or control conditions. Conclusions: Current research regarding combined heat and altitude interventions does not seem to indicate that it enhances temperate, sea-level performance to a greater extent than “traditional” (heat or hypoxia alone) training approaches. A major challenge in implementing combined-stressor approaches lies in the uncertainty surrounding the prescription of dosing regimens (ie, exercise and environmental stress). The potential benefits of conducting heat and altitude exposure sequentially (ie, one after the other) warrants further investigation.

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Physiological and Performance Responses to a Training Camp in the Heat in Professional Australian Football Players

Sebastien Racinais, Martin Buchheit, Johann Bilsborough, Pitre C. Bourdon, Justin Cordy, and Aaron J. Coutts


To examine the physiological and performance responses to a heat-acclimatization camp in highly trained professional team-sport athletes.


Eighteen male Australian Rules Football players trained for 2 wk in hot ambient conditions (31–33°C, humidity 34–50%). Players performed a laboratory-based heat-response test (24-min walk + 24 min seated; 44°C), a YoYo Intermittent Recovery Level 2 Test (YoYoIR2; indoor, temperate environment, 23°C) and standardized training drills (STD; outdoor, hot environment, 32°C) at the beginning and end of the camp.


The heat-response test showed partial heat acclimatization (eg, a decrease in skin temperature, heart rate, and sweat sodium concentration, P < .05). In addition, plasma volume (PV, CO rebreathing, +2.68 [0.83; 4.53] mL/kg) and distance covered during both the YoYoIR2 (+311 [260; 361] m) and the STD (+45.6 [13.9; 77.4] m) increased postcamp (P < .01). None of the performance changes showed clear correlations with PV changes (r < .24), but the improvements in running STD distance in hot environment were correlated with changes in hematocrit during the heat-response test (r = –.52, 90%CI [–.77; –.12]). There was no clear correlation between the performance improvements in temperate and hot ambient conditions (r < .26).


Running performance in both hot and temperate environments was improved after a football training camp in hot ambient conditions that stimulated heat acclimatization. However, physiological and performance responses were highly individual, and the absence of correlations between physical-performance improvements in hot and temperate environments suggests that their physiological basis might differ.

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Four Sessions of Repeated-Sprint Cycling Training With or Without Severe Hypoxia Do Not Modify Overground Running Sprint Force–Velocity Profile

Franck Brocherie, Sebastien Racinais, Anthony Couderc, Julien Piscione, and Olivier Girard

Purpose: To investigate the effect of cycling-based repeated-sprint training in hypoxia versus in normoxia on single overground running sprint performance and associated force–velocity (F–V) profile in world-class female rugby sevens players. Methods: Eighteen world-class female rugby sevens players were randomly assigned to repeated-sprint cycling training in normobaric hypoxia (n = 9) or normoxia (n = 9) groups. Training consisted of 4 sessions of repeated-sprint cycling training in normobaric hypoxia or in normoxia (4 × 5 × 5-s cycle sprints—25-s intersprint recovery performed in simulated altitude of ∼5000 m or in normoxia with 3-min interset rest in normoxia for both groups) in addition to rugby sevens training and strength and conditioning sessions within a 9-day intervention period before an international competition. Before and 1 day after the intervention, single 50-m overground running “all-out” sprint performance and associated F–V-related mechanical output were assessed. Results: No interaction (group × time; all P > .088), time effect (before vs 1 d after; all P > .296), or group effect (repeated-sprint cycling training in normobaric hypoxia vs in normoxia; all P > .325) was detected for 50-m overground running sprint performance and any derived F–V profiling variables. Conclusions: Four sessions of repeated-sprint training either in hypoxia or in normoxia performed over 9 days had no influence on single 50-m overground running sprint performance and associated F–V profile. In world-class female rugby sevens players, the intervention (training camp before an international competition) might have been too short to induce measurable changes. It is also plausible that implementing a similar program in players with likely different F–V profile may result in negligible mechanical effect.

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Effect of Cold on Proprioception and Cognitive Function in Elite Alpine Skiers

Sebastien Racinais, Nadia Gaoua, Khouloud Mtibaa, Rodney Whiteley, Christophe Hautier, and Marine Alhammoud


To determine the effect of cold ambient conditions on proprioception and cognitive function in elite alpine skiers.


22 high-level alpine skiers and 14 control participants performed a proprioceptive-acuity (active movement-extent discrimination) and a cognitive (planning task) test in cold (8°C) and temperate (24°C) ambient conditions.


All participants displayed an increase in thermal discomfort and the amount of negative affects in the cold environment (all P < .05). Average proprioceptive acuity was significantly better in the elite skiers (0.46° ± 0.12°) than in the control group (0.55° ± 0.12°) (P < .05) and was not affected by cold ambient conditions, except for a shift in the pattern of error (over- vs underestimation, P < .05). Cognitive performance was similar between elite skiers and control participants in temperate environments but decreased in the cold in the control group only (P < .05) becoming lower than in elite skiers (P < .05).


Elite alpine skiers showed a significantly better proprioceptive acuity than a control population and were able to maintain their performance during a cognitive task in a cold environment.

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Risk Factors and Predictors of Hypothermia and Dropouts During Open-Water Swimming Competitions

Joffrey Drigny, Marine Rolland, Robin Pla, Christophe Chesneau, Tess Lebreton, Benjamin Marais, Pierre Outin, Sébastien Moussay, Sébastien Racinais, and Benoit Mauvieux

Purpose: To measure core temperature (T core) in open-water (OW) swimmers during a 25-km competition and identify the predictors of T core drop and hypothermia-related dropouts. Methods: Twenty-four national- and international-level OW swimmers participated in the study. Participants completed a personal questionnaire and a body fat/muscle mass assessment before the race. The average speed was calculated on each lap over a 2500-m course. T core was continuously recorded via an ingestible temperature sensor (e-Celsius, BodyCap). Hypothermia-related dropouts (H group) were compared with finishers (nH group). Results: Average prerace T core was 37.5°C (0.3°C) (N = 21). 7 participants dropped out due to hypothermia (H, n = 7) with a mean T core at dropout of 35.3°C (1.5°C). Multiple logistic regression analysis found that body fat percentage and initial T core were associated with hypothermia (G 2 = 17.26, P < .001). Early T core drop ≤37.1°C at 2500 m was associated with a greater rate of hypothermia-related dropouts (71.4% vs 14.3%, P = .017). Multiple linear regression found that body fat percentage and previous participation were associated with T core drop (F = 4.95, P = .019). There was a positive correlation between the decrease in speed and T core drop (r = .462, P < .001). Conclusions: During an OW 25-km competition at 20°C to 21°C, lower initial T core and lower body fat, as well as premature T core drop, were associated with an increased risk of hypothermia-related dropout. Lower body fat and no previous participation, as well as decrease in swimming speed, were associated with T core drop.

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Hematological Adaptations Following a Training Camp in Hot and/or Hypoxic Conditions in Elite Rugby Union Players

Julien D. Périard, Olivier Girard, Nathan Townsend, Pitre Bourdon, Scott Cocking, Mohammed Ihsan, Mathieu Lacome, David Nichols, Gavin Travers, Mathew G. Wilson, Julien Piscione, and Sebastien Racinais

Purpose: To investigate the effects of a training camp with heat and/or hypoxia sessions on hematological and thermoregulatory adaptations. Methods: Fifty-six elite male rugby players completed a 2-week training camp with 5 endurance and 5 repeated-sprint sessions, rugby practice, and resistance training. Players were separated into 4 groups: CAMP trained in temperate conditions at sea level, HEAT performed the endurance sessions in the heat, ALTI slept and performed the repeated sprints at altitude, and H + A was a combination of the heat and altitude groups. Results: Blood volume across all groups increased by 140 mL (95%CI, 42–237; P = .006) and plasma volume by 97 mL (95%CI 28–167; P = .007) following the training camp. Plasma volume was 6.3% (0.3% to 12.4%) higher in HEAT than ALTI (P = .034) and slightly higher in HEAT than H + A (5.6% [−0.3% to 11.7%]; P = .076). Changes in hemoglobin mass were not significant (P = .176), despite a ∼1.2% increase in ALTI and H + A and a ∼0.7% decrease in CAMP and HEAT. Peak rectal temperature was lower during a postcamp heat-response test in HEAT (0.3 °C [0.1–0.5]; P = .010) and H + A (0.3 °C [0.1–0.6]; P = .005). Oxygen saturation upon waking was lower in ALTI (3% [2% to 5%]; P < .001) and H + A (4% [3% to 6%]; P < .001) than CAMP and HEAT. Conclusion: Although blood and plasma volume increased following the camp, sleeping at altitude impeded the increase when training in the heat and only marginally increased hemoglobin mass. Heat training induced adaptations commensurate with partial heat acclimation; however, combining heat training and altitude training and confinement during a training camp did not confer concomitant hematological adaptations.

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Intensified Training Supersedes the Impact of Heat and/or Altitude for Increasing Performance in Elite Rugby Union Players

Sebastien Racinais, Julien D. Périard, Julien Piscione, Pitre C. Bourdon, Scott Cocking, Mohammed Ihsan, Mathieu Lacome, David Nichols, Nathan Townsend, Gavin Travers, Mathew G. Wilson, and Olivier Girard

Purpose: To investigate whether including heat and altitude exposures during an elite team-sport training camp induces similar or greater performance benefits. Methods: The study assessed 56 elite male rugby players for maximal oxygen uptake, repeated-sprint cycling, and Yo-Yo intermittent recovery level 2 (Yo-Yo) before and after a 2-week training camp, which included 5 endurance and 5 repeated-sprint cycling sessions in addition to daily rugby training. Players were separated into 4 groups: (1) control (all sessions in temperate conditions at sea level), (2) heat training (endurance sessions in the heat), (3) altitude (repeated-sprint sessions and sleeping in hypoxia), and (4) combined heat and altitude (endurance in the heat, repeated sprints, and sleeping in hypoxia). Results: Training increased maximal oxygen uptake (4% [10%], P = .017), maximal aerobic power (9% [8%], P < .001), and repeated-sprint peak (5% [10%], P = .004) and average power (12% [14%], P < .001) independent of training conditions. Yo-Yo distance increased (16% [17%], P < .001) but not in the altitude group (P = .562). Training in heat lowered core temperature and increased sweat rate during a heat-response test (P < .05). Conclusion: A 2-week intensified training camp improved maximal oxygen uptake, repeated-sprint ability, and aerobic performance in elite rugby players. Adding heat and/or altitude did not further enhance physical performance, and altitude appears to have been detrimental to improving Yo-Yo.

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Heat Adaptation and Nutrition Practices: Athlete and Practitioner Knowledge and Use

Salma Alabdulwahed, Natalia Galán-López, Tom Hill, Lewis J. James, Bryna Catherine Rose Chrismas, Sebastien Racinais, Trent Stellingwerff, Diogo V. Leal, Matheus Hausen, Karim Chamari, Hugh H.K. Fullagar, Christopher Esh, and Lee Taylor

Purpose: To survey elite athletes and practitioners to identify (1) knowledge and application of heat acclimation/acclimatization (HA) interventions, (2) barriers to HA application, and (3) nutritional practices supporting HA. Methods: Elite athletes (n = 55) and practitioners (n = 99) completed an online survey. Mann–Whitney U tests (effect size [ES; r]) assessed differences between ROLE (athletes vs practitioners) and CLIMATE (hot vs temperate). Logistic regression and Pearson chi-square (ES Phi [ϕ]) assessed relationships. Results: Practitioners were more likely to report measuring athletes’ core temperature (training: practitioners 40% [athletes 15%]; P = .001, odds ratio = 4.0, 95% CI, 2%–9%; competition: practitioners 25% [athletes 9%]; P = .020, odds ratio = 3.4, 95% CI, 1%–10%). Practitioners (55% [15% athletes]) were more likely to perceive rectal as the gold standard core temperature measurement site (P = .013, ϕ = .49, medium ES). Temperate (57% [22% hot]) CLIMATE dwellers ranked active HA effectiveness higher (P < .001, r = .30, medium ES). Practitioners commonly identified athletes’ preference (48%), accessibility, and cost (both 47%) as barriers to HA. Increasing carbohydrate intake when training in the heat was more likely recommended by practitioners (49%) than adopted by athletes (26%; P = .006, 95% CI, 0.1%–1%). Practitioners (56% [28% athletes]) were more likely to plan athletes’ daily fluid strategies, adopting a preplanned approach (P = .001; 95% CI, 0.1%–1%). Conclusions: Practitioners, and to a greater extent athletes, lacked self-reported key HA knowledge (eg, core temperature assessment/monitoring methods) yet demonstrated comparatively more appropriate nutritional practices (eg, hydration).