An Updated Panorama of “Living Low-Training High” Altitude/Hypoxic Methods

Abstract

With minimal costs and travel constraints for athletes, the “living low-training high” (LLTH) approach is becoming an important intervention for modern sport. The popularity of the LLTH model of altitude training is also associated with the fact that it only causes a slight disturbance to athletes' usual daily routine, allowing them to maintain their regular lifestyle in their home environment. In this perspective article, we discuss the evolving boundaries of the LLTH paradigm and its practical applications for athletes. Passive modalities include intermittent hypoxic exposure at rest (IHE) and Ischemic preconditioning (IPC). Active modalities use either local [blood flow restricted (BFR) exercise] and/or systemic hypoxia [continuous low-intensity training in hypoxia (CHT), interval hypoxic training (IHT), repeated-sprint training in hypoxia (RSH), sprint interval training in hypoxia (SIH) and resistance training in hypoxia (RTH)]. A combination of hypoxic methods targeting different attributes also represents an attractive solution. In conclusion, a growing number of LLTH altitude training methods exists that include the application of systemic and local hypoxia stimuli, or a combination of both, for performance enhancement in many disciplines.

The Effects of Intermittent Hypoxic–Hyperoxic Exposures on Lipid Profile and Inflammation in Patients With Metabolic Syndrome

“…The beneficial effects of different passive hypoxic conditioning protocols are well-reported in many studies. The effectiveness of various hypoxic training models has been investigated in the programs of complex treatment and rehabilitation of patients with obesity (16,17), systemic hypertension (18), and type 2 diabetes (9). The use of hypoxic-hyperoxic training was shown to cause a significant decrease in body weight (mainly due to fat mass reduction) and in blood lipids, lower blood pressure, and improve hypoxia and exercise tolerance.…”

The Use of the SpO2 to FiO2 Ratio to Individualize the Hypoxic Dose in Sport Science, Exercise, and Health Settings

“…With the widespread availability of hypoxic chambers and portable hypoxicators, the LLTH paradigm has gained significant popularity over the last decade. This model involves exposure to hypoxia at rest or combined with exercise, while residing near sea level (Wilber, 2007;Girard et al, 2020). Altitude simulation (normobaric hypoxia) with the LLTH method is typically achieved by reducing the inspired oxygen fraction (FiO 2 ), while atmospheric pressure remains unchanged.…”

Aerobic Continuous and Interval Training under Hypoxia Enhances Endurance Exercise Performance with Hemodynamic and Autonomic Nervous System Function in Amateur Male Swimmers

“…LLTH for exercise performance consists of various types of training methods such as continuous hypoxic training (CHT), interval hypoxic training (IHT), sprint interval training under hypoxia (SIH), repeated sprint training under hypoxia (RSH), resistance training under hypoxia (RTH), and voluntary hypoventilation at a low lung volume (VHL) [ 11 ]. Among these various LLTH methods (e.g., CHT, IHT, SIH, RSH, RTH, and VHL), CHT and IHT are most commonly used to enhance endurance exercise performance [ 1 , 4 , 5 , 10 ].…”