Background: Recent studies have indicated that people who live at altitude have a lower incidence of coronavirus disease (COVID-19) and lesser severity in infection cases. Hypothesis: Hypoxia exposure could lead to health benefits, and it could be used in the recovery process as an additional stimulus to physical training to improve cardiorespiratory fitness (CRF). Study Design: Randomized controlled clinical trial. Level of Evidence: Level 2. Methods: The 43 participants, aged 30 to 69 years, were divided into control group (CG, n = 18) and 2 training groups: normoxia (NG, n = 9) and hypoxia (HG, n = 16). Before and after the intervention were evaluated the lactate threshold 2 (L2), peak oxygen uptake (VO2peak), and a blood sample was collected at rest to evaluate hematological adaptation. Both groups performed an 8-week moderate-intensity physical training on a bike. The HG were trained under normobaric hypoxic conditions (fractional inspired oxygen [FiO2] = 13.5%). Results: The 8-week intervention promoted a similar improvement in CRF of people recovered from COVID-19 in the HG (L2 = 34.6%; VO2peak = 16.3%; VO2peak intensity = 24.6%) and NG (L2 = 42.6%; VO2peak = 16.7%; VO2peak intensity = 36.9%). Only the HG presented differences in hematological variables (erythropoietin = 191.7%; reticulocytes = -32.4%; off-score = 28.2%) in comparison with the baseline. Conclusion: The results of the present study provide evidence that moderate-intensity training in normoxia or hypoxia promoted similar benefits in CRF of people recovered from COVID-19. Furthermore, the hypoxia offered an additional stimulus to training promoting erythropoietin increase and hematological stimulation. Clinical Relevance: The present exercise protocol can be used for the rehabilitation of people recovered from COVID-19, with persistent low CRF. In addition, this is the first study demonstrating that physical training combined with hypoxia, as well as improving CRF, promotes greater hematological stimulation in people recovered from COVID-19.

The present study aimed to compare the MAODALT in situations of hypoxia and normoxia to confirm the method validity. Seventeen healthy and physically active men participated in this study, aged 25.2 ± 3.2 years. All participants underwent four days of evaluation. The first day was performed a body composition test, an incremental test to exhaustion to determine the maximum oxygen uptake, familiarizing the hypoxia (H) and normoxia (N) situation and the equipment used. On the second, third and fourth days, supramaximal efforts were performed until exhaustion at 110% of maximum oxygen uptake, in a situation of hypoxia (FIO2 = 14.0%) and normoxia (FIO2 = 20.9%). The anaerobic capacity was considered the sum of energy supply of the alactic and lactic systens. The absolute or relative anaerobic capacity values were not different (H = 3.9 ± 1.1 L, N= 3.8 ± 0.9 L, p = 0.69), similarly no differences were found for the alactic contribution (H=1.7 ± 0.5 L, N=1.5 ± 0.5 L, p = 0.30) and lactic contribution (H= 2.3 ± 0.9 L, N= 2.3 ± 0.7 L, p = 0.85). It can be concluded that the anaerobic capacity measured by a single exhaustive effort is not altered by hypoxia.

During the COVID-19 pandemic, several late-onset impairments have been observed, affecting the health and functionality of those involved. On the other hand, lower SARS-CoV-2 infection rates and severity of symptoms were observed in high-altitude cities. In this sense, the AEROBICOVID project was developed with the hypothesis that exercise would be an important opportunity for health improvement and that hypoxia would promote additional benefits in the recovery process. The cohort was about 84 participants with approximately 30 days since the COVID-19 symptoms recovery, 25 in the control group, and 59 divided into three moderate physical training groups. The project had good results in teaching, research, and extension, but also faced difficulties in operationalization. This experience is the basis for future proposals through an extension project at the University of São Paulo and in a Family Health Unit, besides a research project that will develop a new low-cost hypoxia technology.

Hypoxic exposure is safely associated with exercise for many pathological conditions, providing additional effects on health outcomes. COVID-19 is a new disease, so the physiological repercussions caused by exercise in affected patients and the safety of exposure to hypoxia in these conditions are still unknown. Due to the effects of the disease on the respiratory system and following the sequence of AEROBICOVID research work, this study aimed to evaluate the effectiveness, tolerance and acute safety of 24 bicycle training sessions performed under intermittent hypoxic conditions through analysis of peripheral oxyhemoglobin saturation (SpO2), heart rate (HR), rate of perceived exertion (RPE), blood lactate concentration ([La−]) and symptoms of acute mountain sickness in patients recovered from COVID-19. Participants were allocated to three training groups: the normoxia group (GN) remained in normoxia (inspired fraction of O2 (FiO2) of ∼20.9%, a city with 526 m altitude) for the entire session; the recovery hypoxia group (GHR) was exposed to hypoxia (FiO2 ∼13.5%, corresponding to 3,000 m altitude) all the time except during the effort; the hypoxia group (GH) trained in hypoxia (FiO2 ∼13.5%) throughout the session. The altitude simulation effectively reduced SpO2 mean with significant differences between groups GN, GHR, and GH, being 96.9(1.6), 95.1(3.1), and 87.7(6.5), respectively. Additionally, the proposed exercise and hypoxic stimulus was well-tolerated, since 93% of participants showed no or moderate acute mountain sickness symptoms; maintained nearly 80% of sets at target heart rate; and most frequently reporting session intensity as an RPE of “3” (moderate). The internal load calculation, analyzed through training impulse (TRIMP), calculated using HR [TRIMPHR = HR * training volume (min)] and RPE [TRIMPRPE = RPE * training volume (min)], showed no significant difference between groups. The current strategy effectively promoted the altitude simulation and monitoring variables, being well-tolerated and safely acute exposure, as the low Lake Louise scores and the stable HR, SpO2, and RPE values showed during the sessions.

Introdução: O Brasil é o terceiro colocado no ranking mundial em faturamento de serviços fitness, com 34.509 academias registradas. Entretanto, a pandemia da Covid-19 trouxe desafios e uma queda nesse faturamento. Com isto, as academias foram forçadas a adotar novas estratégias de gestão e marketing para se manterem no mercado diante deste novo contexto. Objetivo: Identificar as estratégias de marketing esportivo utilizadas por gestores de academias de Ribeirão Preto/SP para manter e captar novos clientes durante a pandemia da Covid-19. Métodos: Realizou-se um estudo qualitativo por meio de entrevista semiestruturada, realizada por meio da ferramenta Google Meet, gravadas para serem transcritas e analisadas posteriormente. Resultados: Dentre as estratégias utilizadas pelos seis gestores entrevistados, destacaram-se: segurança e limpeza da academia como marketing; priorização do relacionamento com o cliente como principal forma de retenção; uso recorrente do marketing de bonificações; pacotes e mensalidades mais atrativos para manter e ao mesmo tempo captar novos clientes; e, a utilização das redes sociais como principal forma de captação. Os problemas encontrados pelos gestores foram similares, com ao menos 1/3 apontando a falta de verba específica para o marketing, campanhas centralizadas em outras sedes ou franquias, lives ineficientes e marketing tradicional com custo muito alto. Considerações finais: Os gestores precisaram superar os obstáculos da pandemia para planejar e promover estratégias de marketing para academias com objetivos, público e porte diferentes. Ainda existem poucos estudos relacionando marketing e o mercado fitness no Brasil, destacando a importância de mais estudos que abordem esta temática.