Valorization of Natural Cardio Trekking Trails Through Open Innovation for the Promotion of Sustainable Cross-generational Health-Oriented Tourism in the Connect2Move Project: Protocol for a Cross-sectional Study

Abstract

Background Hiking is one of the most popular forms of exercise in the alpine region. However, besides its health benefits, hiking is the alpine activity with the highest incidence of cardiac events. Most incidents occur due to overexertion or underestimation of the physiological strain of hiking. Objective This project will establish a standardized cardio trekking test trail to evaluate the exercise capacity of tourists within hiking areas and deliver a tool for the prevention of hiking-associated cardiac incidents. Further, individual exercise intensity for a hiking tour will be predicted and visualized in digital maps. Methods This cooperation study between Austria and Germany will first validate a 1-km outdoor cardio trekking test trail at 2 different study sites. Then, exercise intensity measures on 8-km hiking trails will be evaluated during hiking to estimate overall hiking intensity. A total of 144 healthy adults (aged >45 years) will perform a treadmill test in the laboratory and a 1-km hiking test outdoors. They will wear a portable spirometry device that measures gas exchange, as well as heart rate, walking speed, ventilation, GPS location, and altitude throughout the tests. Estimation models for exercise capacity based on measured parameters will be calculated. Results The project “Connect2Move” was funded in December 2019 by the European Regional Development Fund (INTERREG V-A Programme Austria-Bavaria – 2014-2020; Project Number AB296). “Connect2Move” started in January 2020 and runs until the end of June 2022. By the end of April 2022, 162 participants were tested in the laboratory, and of these, 144 were tested outdoors. The data analysis will be completed by the end of June 2022, and results are expected to be published by the end of 2022. Conclusions Individual prediction of exercise capacity in healthy individuals with interest in hiking aims at the prevention of hiking-associated cardiovascular events caused by overexertion. Integration of a mathematical equation into existing hiking apps will allow individual hiking route recommendations derived from individual performance on a standardized cardio trekking test trail. Trial Registration ClinicalTrails.gov NCT05226806; https://clinicaltrials.gov/ct2/show/NCT05226806 International Registered Report Identifier (IRRID) DERR1-10.2196/39038

Development and validation of a 1-km cardio-trekking test to estimate cardiorespiratory fitness in healthy adults

“…The study was funded by the European Regional Development Fund, INTERREG V-A Program Austria-Bavaria 2014–2020. The methods of this cross-sectional cross-border study have been published previously ( Mayr et al, 2022 ).…”

“…The investigators obtained the participants’ medical history and collected fasting venous blood samples. After completing the cardiac examinations ( Mayr et al, 2022 ), the participants underwent a maximal exercise test on the treadmill to evaluate their aerobic capacity. Each participant was fitted with the portable spirometry device K5 (COSMED Deutschland GmbH, Fridolfing, Germany) to measure the respiratory gas exchange throughout the exercise testing; the K5 dynamic mixing chamber mode was used for the gas analysis ( Winkert et al, 2021 ).…”

“…The participants were instructed to reach a submaximal effort with a maximum value of 15 (hard) perceived on the scale throughout the whole test. A more detailed description of the 1-km CTT is provided in the previously published study ( Mayr et al, 2022 ).

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Assessment of Exercise Intensity for Uphill Walking in Healthy Adults Performed Indoors and Outdoors

“…We included 134 healthy adults [median age: 56 years (IQR 52–63)], 58 men [median age: 56 years (IQR 52–62)], and 76 women [median age: 57 years (IQR 51–63)] in the Connect2Move project [ 44 , 45 ]. The European cross-border study aimed to highlight natural and safe cardio-trekking trails for the sustainable promotion of cross-generational and health-oriented tourism.…”

“…The Technical University of Munich (Germany) and the Ludwig Boltzmann Institute for Digital Health and Prevention in Salzburg (Austria) conducted the laboratory and field testing. A detailed description of the study design, the inclusion criteria, and the recruitment process is provided elsewhere [ 44 ].…”