{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T14:44:21Z","timestamp":1792161861453,"version":"4.4.0"},"reference-count":51,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:00:00Z","timestamp":1791936000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sports Health: A Multidisciplinary Approach"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Physiological adaptations associated with chronic exposure to hypoxia have been suggested as potential factors contributing to reduced COVID-19 severity in high-altitude populations. Therefore, hypoxic exercise training has emerged as a potential strategy to enhance recovery following COVID-19 infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Hypothesis:<\/jats:title>\n                    <jats:p>Moderate-intensity training associated with continuous hypoxia (HYP) or intereffort recovery hypoxia (IEH) could induce additional stimulus to cardiorespiratory capacity in COVID-19 rehabilitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Randomized controlled clinical trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      Sixty-one adults recovered from COVID-19 (35.9 days after diagnosis, on average) were randomly assigned to a no-exercise control group (CON, n = 18) or moderate-intensity training groups under normoxia [NOR, n = 12; fraction of inspired oxygen (FiO\n                      <jats:sub>2<\/jats:sub>\n                      ) = 20.9%], HYP (n = 16; FiO\n                      <jats:sub>2<\/jats:sub>\n                      = 13.5%), or IEH (n = 15; efforts at 20.9% and the recovery periods at 13.5%). Ventilatory and lactate thresholds (VT and LT, respectively), peak power output (PPO) determined during a graded exercise cycling test to exhaustion, forced expiratory volume in 1 second (FEV1), and forced vital capacity (FVC) were accessed before and after an 8-week cycling training program (3-6 efforts of 5 min at 90% to 110% of LT interspersed with 2.5 min of recovery, 3 times per week). Group \u00d7 time effects were assessed using generalized mixed-effects models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      VT increased in all groups (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2264 0.013), with no group \u00d7 time interaction (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.15). VT ventilation increased only in the training groups (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2264 0.013), and there was a group \u00d7 time effect for IEH versus CON (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.036). PPO increased only in the training groups (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), with group \u00d7 time interactions for all training groups versus CON (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2264 0.002). Maximal ventilation increased in NOR (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.016) and HYP (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.012), both differing from CON (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.005). FEV1 decreased in NOR only (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), with group \u00d7 time interactions versus HYP (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) and IEH (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.035).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Moderate-intensity training promoted benefits in the indicators of aerobic capacity and PPO of COVID-19 convalescents. The additional exposure to hypoxia in the training sessions did not result in differences compared with NOR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance:<\/jats:title>\n                    <jats:p>This training protocol can be used in COVID-19 rehabilitation. In addition, HYP and IEH can achieve similar results compared to NOR, with probably lower intensity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19417381261490721","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T14:51:21Z","timestamp":1791989481000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Moderate-Intensity Cycling Training Combined With Intereffort Recovery Hypoxia for Lung Rehabilitation After COVID-19: A Double-Blinded, Randomized Controlled Trial"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3526-9344","authenticated-orcid":false,"given":"Carlos","family":"Dellavechia de Carvalho","sequence":"first","affiliation":[{"name":"School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo, Ribeir\u00e3o Preto, S\u00e3o Paulo, Brazil"},{"name":"Hypoxia, Sport and Health Team, School of Applied 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