The Impact of Altitude on Exercise Tolerance of Various Patients

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Sports Medicine and Sports Traumatology".

Deadline for manuscript submissions: closed (31 May 2025) | Viewed by 1302

Special Issue Editors


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Guest Editor
Sport and Exercise Medicine Division, Department of Medicine, University of Padova, 35122 Padova, Italy
Interests: cardiopulmonary exercise testing; functional evaluation in health and disease; physical exercise training in chronic disease; effectiveness of different exercise modalities; sports and exercise medicine; exercise physiology; high-altitude medicine

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Guest Editor
Director Clinic of Pulmonology, Head of Pulmonary Vascular Unit, University and University Hospital of Zurich, Rämisstrasse 100, 8091 Zürich, Switzerland
Interests: pulmonary hypertension; pulmonary diseases; high altitude; exercise; physiology

Special Issue Information

Dear Colleagues,

More than 500 million humans live at or above the altitude of 1500 m, and many more people transiently sojourn at such altitudes for recreation, athletic training, or work. A considerable proportion, in particular of elderly people, may suffer from chronic diseases, e.g., cardiovascular, respiratory, and/or metabolic disorders. Barometric and related oxygen partial pressure continuously decrease with increasing altitude (hypobaric hypoxia), thereby negatively affecting aerobic exercise capacity and the associated activities of daily living and quality of life. The negative impact of the low-oxygen environment at altitude largely depends on the type and severity of diseases.

While the general effects of hypobaric hypoxia on aerobic exercise capacity in healthy individuals are well known, information on the differential impact of high altitudes on exercise tolerance in patients suffering from various diseases is rather scarce. Thus, this Special Issue is primarily aimed to uncover disease-dependent pathophysiological mechanisms affecting exercise capacity at high altitudes and provide helpful management strategies.

Gas exchange in the lungs, oxygen delivery to exercising muscles, and the use of oxygen in the mitochondria of these muscles are the main determinants of an individual’s aerobic exercise capacity. Any impairment of these mechanisms and/or their control by the autonomous nervous system, e.g., ventilation/perfusion mismatching, heart failure, myo- and/or mitochondriopathies, and disturbed chemo- and/or/baro-reflexes, will negatively impact on exercise tolerance, which is especially pronounced when ambient oxygen availability is reduced, i.e., at high altitude. The impact of different diseases on an individual’s exercise tolerance when acutely or chronically exposed to high altitudes and, even less, the underlying pathophysiological mechanisms, have not yet been sufficiently investigated. However, such knowledge would be of utmost importance to developing appropriate preventive and therapeutic measures.

Research articles and review articles, as well as short communications, are welcome.

Prof. Dr. Martin Burtscher
Dr. Daniel Neunhaeuserer
Prof. Dr. Silvia Ulrich
Guest Editors

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Keywords

  • high altitude
  • hypoxia
  • exercise
  • exercise limitation
  • chronic diseases
  • chronic lung disease
  • chronic heart disease
  • sleep apnea
  • arterial hypertension
  • pulmonary hypertension

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Published Papers (1 paper)

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Research

13 pages, 1731 KiB  
Article
Are Suggested Hiking Times Accurate? A Validation of Hiking Time Estimations for Preventive Measures in Mountains
by Marco Vecchiato, Nicola Borasio, Emiliano Scettri, Vanessa Franzoi, Federica Duregon, Sandro Savino, Andrea Ermolao and Daniel Neunhaeuserer
Medicina 2025, 61(1), 115; https://doi.org/10.3390/medicina61010115 - 14 Jan 2025
Cited by 1 | Viewed by 809
Abstract
Background and Objectives: Accurate hiking time estimate is crucial for outdoor activity planning, especially in mountainous terrains. Traditional mountain signage and online platforms provide generalized hiking time recommendations, often lacking personalization. This study aims to evaluate the variability in hiking time estimates [...] Read more.
Background and Objectives: Accurate hiking time estimate is crucial for outdoor activity planning, especially in mountainous terrains. Traditional mountain signage and online platforms provide generalized hiking time recommendations, often lacking personalization. This study aims to evaluate the variability in hiking time estimates from different methods and assess the potential of a novel algorithm, MOVE, to enhance accuracy and safety. Materials and Methods: A cross-sectional analysis was conducted using data from 25 Italian loop trails selected via the Wikiloc platform, considering user-uploaded GPS data from at least 20 users per trail. Real-world hiking times were compared with estimations from Komoot, Outdooractive, mountain signage, and the MOVE algorithm, which incorporates individualized biological and trail characteristics. Results: Significant discrepancies were observed between actual hiking times and estimates from Komoot (ΔWK: −48.92 ± 57.16 min), Outdooractive (ΔWO: −69.13 ± 58.23 min), and mountain signage (ΔWS: −29.59 ± 59.90 min; all p < 0.001). In contrast, MOVE showed no statistically significant difference (ΔWM: −0.27 ± 65.72 min; p = 0.278), providing the most accurate predictions. Conclusions: Current hiking time estimation methods show substantial variability and inaccuracy, which may pose safety risks. MOVE demonstrated superior accuracy, offering personalized hiking time predictions based on user-specific data and trail characteristics. Integrating such advanced tools into outdoor activity planning could enhance safety and accessibility, particularly for individuals with chronic conditions. Further studies should explore integrating real-time health data to refine these tools. Full article
(This article belongs to the Special Issue The Impact of Altitude on Exercise Tolerance of Various Patients)
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