{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:45:12Z","timestamp":1777934712536,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T00:00:00Z","timestamp":1726444800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Burns Family Foundation"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Wilderness &amp; Environmental Medicine"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The sharpened Romberg test (SRT) is a physical maneuver that has been used to identify ataxia in individuals in resource-limited settings. Previous research has suggested that performance on balance testing may be affected by hypocapnia. In this study, we sought to determine whether acute hyperventilation-induced hypocapnia affects performance on the SRT at 501 meters above sea level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We recruited 22 healthy subjects. Each subject performed a baseline SRT. Subjects were then asked to hyperventilate to the point of hypocapnia, confirmed by measurement with a capnometer. Subjects were then asked to re-perform SRT. The primary endpoint was time to loss of balance, measured as time-to-stepout.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Time-to-stepout (TTS) on SRT at baseline had a mean\u2009\u00b1\u2009standard deviation of 101\u2009\u00b1\u2009117\u2005s. In the hypocapnic condition, TTS was reduced to 48\u2009\u00b1\u200968\u2005s. TTS normalized to 121\u2009\u00b1\u2009132\u2005s after recovery to normal capnic levels. Time-to-stepout was found to be significantly shorter in the hypocapnic measurement compared to the baseline measurement ( P\u2009=\u2009.0128). Statistical analysis was conducted using one-tailed, paired sample T-tests using a P-value of\u2009&lt;\u2009.05.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study found a statistically and clinically significant reduction in performance on a balance test (SRT) when exposed to acute hyperventilation-induced hypocapnia compared to a eucapnic control. Our results suggest that acute hypocapnia may contribute to neurological dysfunction independently of hypobaric hypoxia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10806032241282320","type":"journal-article","created":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T03:06:11Z","timestamp":1726455971000},"page":"417-421","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of Acute Hypocapnia on Postural Standing Balance Measured by Sharpened Romberg Testing (SRT) in Healthy Subjects"],"prefix":"10.1177","volume":"35","author":[{"given":"Ryan","family":"Dunn","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Mayo Clinic, Scottsdale, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Stepanek","sequence":"additional","affiliation":[{"name":"Aerospace Medicine Program, Aerospace Medicine and Vestibular Research Laboratory, Mayo Clinic, Scottsdale, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Eboka","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gaurav N.","family":"Pradhan","sequence":"additional","affiliation":[{"name":"Aerospace Medicine Program, Aerospace Medicine and Vestibular Research Laboratory, Mayo Clinic, Scottsdale, AZ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,9,16]]},"reference":[{"key":"bibr1-10806032241282320","doi-asserted-by":"publisher","DOI":"10.1016\/j.wem.2011.02.001"},{"key":"bibr2-10806032241282320","doi-asserted-by":"publisher","DOI":"10.1089\/ham.2017.0164"},{"key":"bibr3-10806032241282320","doi-asserted-by":"publisher","DOI":"10.1089\/1527029041352054"},{"issue":"3","key":"bibr4-10806032241282320","first-page":"142","volume":"26","author":"Fitzgerald B","year":"1996","journal-title":"SPUMS J"},{"key":"bibr5-10806032241282320","doi-asserted-by":"publisher","DOI":"10.1580\/PR02-04.1"},{"issue":"3","key":"bibr6-10806032241282320","first-page":"602","volume":"56","author":"Huang SY","year":"1984","journal-title":"J Appl Physiol Respir Environ Exerc Physiol"},{"key":"bibr7-10806032241282320","doi-asserted-by":"publisher","DOI":"10.1113\/EP087602"},{"key":"bibr8-10806032241282320","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198912213212505"},{"key":"bibr9-10806032241282320","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00637.2013"},{"key":"bibr10-10806032241282320","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-011-1954-8"},{"key":"bibr11-10806032241282320","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2010.02.003"},{"key":"bibr12-10806032241282320","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra012457"},{"key":"bibr13-10806032241282320","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0204419"},{"key":"bibr14-10806032241282320","doi-asserted-by":"publisher","DOI":"10.1016\/j.wem.2014.10.001"},{"key":"bibr15-10806032241282320","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181d8cf2b"},{"key":"bibr16-10806032241282320","doi-asserted-by":"publisher","DOI":"10.1113\/JP271914"},{"key":"bibr17-10806032241282320","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)13591-X"}],"container-title":["Wilderness &amp; Environmental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10806032241282320","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10806032241282320","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10806032241282320","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T02:31:54Z","timestamp":1777689114000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10806032241282320"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,16]]},"references-count":17,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1177\/10806032241282320"],"URL":"https:\/\/doi.org\/10.1177\/10806032241282320","relation":{},"ISSN":["1080-6032","1545-1534"],"issn-type":[{"value":"1080-6032","type":"print"},{"value":"1545-1534","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,16]]}}}