{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T18:39:32Z","timestamp":1792435172646,"version":"4.5.0"},"reference-count":66,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"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>Context:<\/jats:title>\n                    <jats:p>Altitude training is used widely by middle- and long-distance runners, yet its effects on performance and key physiological determinants remain inconsistently reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the effects of altitude or hypoxic exposure on endurance running performance and commonly reported physiological outcomes in middle- and long-distance runners.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources:<\/jats:title>\n                    <jats:p>Medline, Embase, SportDiscus, and Web of Science.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Selection:<\/jats:title>\n                    <jats:p>\n                      Experimental studies involving healthy adult middle- and long-distance runners were included if they examined altitude or hypoxic exposure, included a control group, and reported running time-trial performance, maximal oxygen uptake (V.O\n                      <jats:sub>2max<\/jats:sub>\n                      \u2009), aerobic endurance, running economy (RE), or hemoglobin-related outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis.<\/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>Data Extraction:<\/jats:title>\n                    <jats:p>Data on performance and physiological outcomes were extracted from eligible studies. Standardized mean differences (SMDs) with 95% CIs were calculated using random-effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 19 studies met the inclusion criteria. Altitude or hypoxic exposure was associated with a small but significant improvement in time-trial performance (SMD, 0.31 [95% CI, 0.02 to 0.60];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). Effects on V.O\n                      <jats:sub>2max<\/jats:sub>\n                      did not reach statistical significance (SMD, 0.32 [95% CI, \u20130.03 to 0.67];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.07). No meaningful effects were observed for aerobic endurance (SMD, 0.12 [95% CI, \u20130.20 to 0.44];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.47) or RE (SMD, \u20130.03 [95% CI, \u20130.20 to 0.13];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.70). Hemoglobin concentration increased significantly after altitude or hypoxic exposure (SMD, 0.77 [95% CI, 0.19 to 1.36];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Altitude or hypoxic exposure appears to confer small improvements in time-trial performance in middle- and long-distance runners, whereas physiological responses are less consistent across outcomes and protocols.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19417381261493394","type":"journal-article","created":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T11:41:22Z","timestamp":1792237282000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Altitude or Hypoxic Exposure on Endurance Running Performance: A Systematic Review and Meta-analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7917-2512","authenticated-orcid":false,"given":"Gerasimos V.","family":"Grivas","sequence":"first","affiliation":[{"name":"Physical Education and Sports, Division of Humanities and Political Sciences, Hellenic Naval Academy, Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4868-7986","authenticated-orcid":false,"given":"Nicolas","family":"Berryman","sequence":"additional","affiliation":[{"name":"D\u00e9partement des Sciences de l\u2019Activit\u00e9 Physique, Facult\u00e9 des Sciences, Universit\u00e9 du Qu\u00e9bec \u00e0 Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada"},{"name":"Institut national du sport du Qu\u00e9bec, Montr\u00e9al, Qu\u00e9bec, Canada"},{"name":"Centre de recherche de l\u2019Institut universitaire de g\u00e9riatrie de Montr\u00e9al (CRIUGM), Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8635-3151","authenticated-orcid":false,"given":"Adrien","family":"Vachon","sequence":"additional","affiliation":[{"name":"Laboratory MOVE (UR20296), Faculty of Sport Sciences (UFR STAPS), University of Poitiers, Poitiers, France"},{"name":"Stade Rochelais Rugby, La Rochelle, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2530-2676","authenticated-orcid":false,"given":"Laurent","family":"Bosquet","sequence":"additional","affiliation":[{"name":"Laboratory MOVE (UR20296), Faculty of Sport Sciences (UFR STAPS), University of Poitiers, Poitiers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8143-9132","authenticated-orcid":false,"given":"I\u00f1igo","family":"Mujika","sequence":"additional","affiliation":[{"name":"Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country, Leioa, Basque Country"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004210050432"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.14814\/phy2.14263"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-200939020-00002"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/9780470743386"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-200232110-00002"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1255067"},{"issue":"4","key":"e_1_3_3_8_2","first-page":"776","article-title":"Increased hypoxic dose after training at low altitude with 9h per night at 3000m normobaric hypoxia","volume":"14","author":"Carr AJ","year":"2015","unstructured":"Carr AJ, Saunders PU, Vallance BS, Garvican-Lewis LA, Gore CJ. 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