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Quantifying the effects of acute hypoxic exposure on exercise performance and capacity: a systematic review and meta-regression.

Deb, Sanjoy K.; Brown, Daniel R.; Gough, Lewis A.; Mclellan, Christopher P.; Swinton, Paul A.; Sparks, S. Andy; Mcnaughton, Lars R.


Sanjoy K. Deb

Daniel R. Brown

Lewis A. Gough

Christopher P. Mclellan

S. Andy Sparks

Lars R. Mcnaughton


The aim of this study was to quantify the effects of acute hypoxic exposure on exercise capacity and performance, which includes continuous and intermittent forms of exercise. A systematic review was conducted with a three-level mixed effects meta-regression. The ratio of means method was used to evaluate main effects and moderators providing practical interpretations with percentage change. A systemic search was performed using 3 databases (Google scholar, PubMed and SPORTDiscus). Inclusion was restricted to investigations that assessed exercise performance (time trials, sprint, and intermittent exercise tests) and capacity (time to exhaustion test (TTE)) with acute hypoxic ( < 24 hrs) exposure and a normoxic comparator. Eighty-two outcomes from 53 studies (N = 798) were included in this review. The results show an overall reduction in exercise performance/capacity -17.8 ± 3.9% (95% CI -22.8% to -11.0%), which was significantly moderated by -6.5 ± 0.9% per 1000 m altitude elevation (95% CI -8.2% to -4.8%) and oxygen saturation (-2.0 ± 0.4%; 95% CI -2.9% to -1.2%). Time trial (-16.2 ± 4.3%; 95% CI -22.9% to -9%) and TTE (-44.5 ± 6.9%; 95% CI -51.3% to -36.7%) elicited a negative effect, whilst indicating a quadratic relationship between hypoxic magnitude and both TTE and TT performance. Furthermore, exercise < 2-min exhibited no ergolytic effect from acute hypoxia. This review highlights the ergolytic effect of acute hypoxic exposure, which is curvilinear for TTE and TT performance with increasing hypoxic levels, but short-duration intermittent and sprint exercise seem to be unaffected.


DEB, S.K., BROWN, D.R., GOUGH, L.A., MCLELLAN, C.P., SWINTON, P.A., SPARKS, S.A. and MCNAUGHTON, L.R. 2018. Quantifying the effects of acute hypoxic exposure on exercise performance and capacity: a systematic review and meta-regression. European journal of sport science [online], 18(2), pages 243-256. Available from:

Journal Article Type Review
Acceptance Date Nov 22, 2017
Online Publication Date Dec 8, 2017
Publication Date Feb 7, 2018
Deposit Date Nov 23, 2017
Publicly Available Date Jun 9, 2019
Journal European journal of sport science
Print ISSN 1746-1391
Electronic ISSN 1536-7290
Publisher Taylor and Francis
Peer Reviewed Peer Reviewed
Volume 18
Issue 2
Pages 243-256
Keywords Altitude; Intermittent hypoxic training; Extreme environments; Environmental physiology
Public URL


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