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Maksiutenko EM, Merkureva V, Barbitoff YA, Tsay VV, Aseev MV, Glotov AS, Glotov OS. Exome sequencing in extreme altitude mountaineers identifies pathogenic variants in RTEL1 and COL6A1 previously associated with respiratory failure. Physiol Rep 2024; 12:e16015. [PMID: 38653581 DOI: 10.14814/phy2.16015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 04/02/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
Adaptation of humans to challenging environmental conditions, such as extreme temperature, malnutrition, or hypoxia, is an interesting phenomenon for both basic and applied research. Identification of the genetic factors contributing to human adaptation to these conditions enhances our understanding of the underlying molecular and physiological mechanisms. In our study, we analyzed the exomes of 22 high altitude mountaineers to uncover genetic variants contributing to hypoxic adaptation. To our surprise, we identified two putative loss-of-function variants, rs1385101139 in RTEL1 and rs1002726737 in COL6A1 in two extremely high altitude (personal record of more than 8500 m) professional climbers. Both variants can be interpreted as pathogenic according to medical geneticists' guidelines, and are linked to inherited conditions involving respiratory failure (late-onset pulmonary fibrosis and severe Ullrich muscular dystrophy for rs1385101139 and rs1002726737, respectively). Our results suggest that a loss of gene function may act as an important factor of human adaptation, which is corroborated by previous reports in other human subjects.
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Affiliation(s)
- Evgeniia M Maksiutenko
- Department of Genomic Medicine, D.O. Ott Research Institute of Obstetrics, Gynaecology, and Reproductology, St. Petersburg, Russia
| | - Valeriia Merkureva
- Department of Genomic Medicine, D.O. Ott Research Institute of Obstetrics, Gynaecology, and Reproductology, St. Petersburg, Russia
- CerbaLab Ltd., St. Petersburg, Russia
| | - Yury A Barbitoff
- Department of Genomic Medicine, D.O. Ott Research Institute of Obstetrics, Gynaecology, and Reproductology, St. Petersburg, Russia
- Department of Genetics and Biotechnology, St. Petersburg State University, St. Petersburg, Russia
| | - Victoria V Tsay
- Department of Genomic Medicine, D.O. Ott Research Institute of Obstetrics, Gynaecology, and Reproductology, St. Petersburg, Russia
- CerbaLab Ltd., St. Petersburg, Russia
- Department of Experimental Medical Virology, Molecular Genetics and Biobanking of Pediatric Research and Clinical Center for Infectious Diseases, St. Petersburg, Russia
| | - Mikhail V Aseev
- Department of Genomic Medicine, D.O. Ott Research Institute of Obstetrics, Gynaecology, and Reproductology, St. Petersburg, Russia
- CerbaLab Ltd., St. Petersburg, Russia
| | - Andrey S Glotov
- Department of Genomic Medicine, D.O. Ott Research Institute of Obstetrics, Gynaecology, and Reproductology, St. Petersburg, Russia
- Department of Genetics and Biotechnology, St. Petersburg State University, St. Petersburg, Russia
| | - Oleg S Glotov
- Department of Genomic Medicine, D.O. Ott Research Institute of Obstetrics, Gynaecology, and Reproductology, St. Petersburg, Russia
- Department of Experimental Medical Virology, Molecular Genetics and Biobanking of Pediatric Research and Clinical Center for Infectious Diseases, St. Petersburg, Russia
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Söderqvist K, Identeg F, Zimmerman J, Senorski EH, Sansone M, Hedelin H. Validity and Reliability of Finger-Strength Testing in 6 Common Grip Techniques for the Assessment of Bouldering Ability in Men. Int J Sports Physiol Perform 2024; 19:290-298. [PMID: 38307010 DOI: 10.1123/ijspp.2023-0129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 11/11/2023] [Accepted: 11/15/2023] [Indexed: 02/04/2024]
Abstract
OBJECTIVE To determine the criterion validity and test-retest reliability of isometric finger-strength testing in 6 differentiated grip techniques for the assessment of bouldering ability among male climbers. METHODS We recruited participants at climbing gyms in Sweden and through online advertisements. We included climbers over 15 years of age with a minimum bouldering performance level of 17 International Rock Climbing and Research Association (IRCRA) for men and 15 IRCRA for women. We tested unilateral, maximal isometric peak finger strength in the front 3 drag, half crimp, closed crimp, 35 sloper, 45 × 90-mm, and 90 × 90-mm pinch through maximal force deloaded of a force plate. We analyzed criterion validity, test-retest reliability, and capacity to determine bouldering performance ability using a stepwise multivariable regression model. RESULTS Women were excluded from the analysis due to insufficient sample size (n = 16). Thirty-two male participants were included in the primary analysis. The median (interquartile range) age in the advanced and elite group was 27 (25; 35) and 23 (22; 32) years, respectively. The half crimp for the participants' weak and strong hand displayed the highest ability to determine bouldering grade performance, explaining 48% to 58% of the variance. In the stepwise regression, maximal strength in the half crimp and the front 3 drag collectively explained 66% of the variance for performance. CONCLUSION Strength in the half crimp proved the most important performance indicator. The results of this study provide a reliable and valid framework for maximal isometric peak finger-strength testing in advanced and elite male boulderers.
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Affiliation(s)
- Karl Söderqvist
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Fredrik Identeg
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jonas Zimmerman
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eric Hamrin Senorski
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mikael Sansone
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Henrik Hedelin
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Westwood J, Mayhook-Walker I, Simpkins C, Darby-Smith A, Morris D, Normando E. Retinal Vascular Changes in Response to Hypoxia: A High-Altitude Expedition Study. High Alt Med Biol 2024; 25:49-59. [PMID: 38011631 DOI: 10.1089/ham.2023.0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
Westwood, Jessica, India Mayhook-Walker, Ciaran Simpkins, Andrew Darby-Smith, Dan Morris, and Eduardo Normando. Retinal vascular changes in response to hypoxia: a high-altitude expedition study. High Alt Med Biol. 25:49-59, 2024. Background: Increased tortuosity and engorgement of retinal vasculature are recognized physiological responses to hypoxia. This can lead to high-altitude retinopathy (HAR), but incidence reports are highly variable, and our understanding of the etiological mechanisms remains incomplete. This study quantitatively evaluated retinal vascular changes during an expedition to 4,167 m. Methods: Ten healthy participants summited Mount Toubkal, Morocco. Fundus images were taken predeparture, daily throughout the expedition, and 1 month postreturn. Diameter and tortuosity of four vessels were assessed, in addition to vessel density and features of HAR. Results: Significant (p ≤ 0.05) increases in tortuosity and diameter were observed in several vessels on high-altitude exposure days. There was a strong correlation between altitude and supratemporal retinal artery diameter on days 2, 3, and 6 of the expedition (r = 0.7707, 0.7951, 0.7401, respectively; p < 0.05). There was a significant increase in median vessel density from 6.7% at baseline to 10.0% on summit day. Notably there were no incidences of HAR. Conclusion: Physiological but not pathological changes were seen in this cohort, which gives insight into the state of the cerebral vasculature throughout this expedition. These results are likely attributable to relatively low altitude exposure, a conservative ascent profile, and the cohort's demographic. Future study must include daily retinal images at higher altitudes and take steps to mitigate environmental confounders. This study is relevant to altitude tourists, patients with diabetic retinopathy or retinal vein occlusion, and critically ill patients.
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Affiliation(s)
- Jessica Westwood
- Imperial College London Ophthalmology Research Group, Western Eye Hospital, London, United Kingdom
| | - India Mayhook-Walker
- Imperial College London Ophthalmology Research Group, Western Eye Hospital, London, United Kingdom
| | - Ciaran Simpkins
- Imperial College London Ophthalmology Research Group, Western Eye Hospital, London, United Kingdom
| | - Andrew Darby-Smith
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Dan Morris
- Cardiff Eye Unit, University Hospital of Wales, Cardiff, United Kingdom
| | - Eduardo Normando
- Imperial College London Ophthalmology Research Group, Western Eye Hospital, London, United Kingdom
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Abstract
The aim of this study was to investigate the hold-by-hold climbing fluency dynamics by using an instrumented holds system that measured the contact time on each hold. Forty-four competitive climbers have been analysed in a regional lead climbing competition during a route composed of 41 instrumented holds on 11 m high artificial climbing wall and with a grade of difficulty 6b on the French scale (IRCRA reported scale: 13). After removing 10 climbers who fell before the top of the route, the 34 remaining climbers who completed the route were clustered according to their total contact time on each hold. The hierarchical cluster analysis distinguished four profiles of climbing fluency dynamics, on the basis of six 'crux' points, showing that the fastest climbers at the crux points were those with the shortest climbing time. This new instrumented-holds system appeared very innovative as it provides an instantaneous feedback to coaches regarding inter-limbs fluency and subsequent motor organisations.
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Affiliation(s)
- Ludovic Seifert
- Faculty of Sport Sciences, CETAPS EA3832, University of Rouen Normandy, Mont Saint Aignan, France
| | - Guillaume Hacques
- Faculty of Sport Sciences, CETAPS EA3832, University of Rouen Normandy, Mont Saint Aignan, France
| | - Rémi Rivet
- Inter-University Laboratory of Human Movement Biology, University of Lyon, University Claude Bernard Lyon, Villeurbanne, France
| | - Pierre Legreneur
- Inter-University Laboratory of Human Movement Biology, University of Lyon, University Claude Bernard Lyon, Villeurbanne, France
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Fornasiero A, Fornoni S, Callovini A, Todesco B, Savoldelli A, Schena F, Holmberg HC, Pellegrini B, Bortolan L. Analysis of Sprint Ski Mountaineering Performance. Int J Sports Physiol Perform 2024; 19:155-163. [PMID: 38086366 DOI: 10.1123/ijspp.2023-0075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 09/22/2023] [Accepted: 10/28/2023] [Indexed: 01/23/2024]
Abstract
Ski mountaineering sprint competitions are short individual races involving 3 uphill sections (U), 3 transitions (T), and a final descent. To date, relatively little is known about this novel Olympic discipline, and here we examined (1) the contribution of the time spent on U, T, and final descent to overall finishing time and (2) the potential relationships with final ranking. During the different rounds of 2 International Ski Mountaineering Federation World Cup sprint competitions, male and female ski mountaineers were video recorded. Correlation and multiple linear regression analyses were used to investigate the impact of U, T, and final descent on the best overall finishing time. Linear-mixed model analysis was applied to explore potential interactions between section times, rounds, and final ranking. Overall, U (r = .90-.97) and T (r = .57-.89) were closely correlated with the best overall finishing time (all P < .05). U explained approximately 80% to 90% of the variation in the best finishing time for both sexes, with U + T explaining approximately 95% to 98% of this variation. In each successive round, the ski mountaineers eliminated were all slower on U than the Top 3 (all P < .05). The fastest skiers increased their performance on U in the later rounds of the competitions, while those eliminated showed a tendency toward a decrease. Our findings reveal that world-class sprint ski mountaineers conduct transitions optimally and perform effectively uphill. Training for such competitions should aim to improve short supramaximal uphill performance (∼1.5-2.5 min), ensuring that this does not decline with multiple efforts. These insights into ski mountaineering sprint performance are of considerable value in connection with training for the 2026 Winter Olympics.
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Affiliation(s)
- Alessandro Fornasiero
- CeRiSM, Sport Mountain and Health Research Center, University of Verona, Rovereto, Italy
- Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
| | - Simone Fornoni
- Faculty of Sports and Exercise Sciences, University of Verona, Verona, Italy
| | - Alexa Callovini
- CeRiSM, Sport Mountain and Health Research Center, University of Verona, Rovereto, Italy
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Beatrice Todesco
- CeRiSM, Sport Mountain and Health Research Center, University of Verona, Rovereto, Italy
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Aldo Savoldelli
- CeRiSM, Sport Mountain and Health Research Center, University of Verona, Rovereto, Italy
- Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy
| | - Federico Schena
- CeRiSM, Sport Mountain and Health Research Center, University of Verona, Rovereto, Italy
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Hans-Christer Holmberg
- Department of Health Sciences, Luleå University of Technology, Luleå, Sweden
- Department of Physiology and Pharmacology, Biomedicum C5, Karolinska Institutet, Stockholm, Sweden
| | - Barbara Pellegrini
- CeRiSM, Sport Mountain and Health Research Center, University of Verona, Rovereto, Italy
- Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
| | - Lorenzo Bortolan
- CeRiSM, Sport Mountain and Health Research Center, University of Verona, Rovereto, Italy
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Earth is warming but Mount Everest is getting chillier. Nature 2023; 624:477-477. [PMID: 38082129 DOI: 10.1038/d41586-023-03805-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
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Sjöman AE, Grønhaug G, Julin MV. A Finger in the Game: Sport-Specific Finger Strength Training and Onset of Injury. Wilderness Environ Med 2023; 34:435-441. [PMID: 37550103 DOI: 10.1016/j.wem.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 06/11/2023] [Accepted: 06/20/2023] [Indexed: 08/09/2023]
Abstract
INTRODUCTION Strength training has proved to be an effective way to prevent injuries, but the evidence of the impact of strength training on finger injuries is lacking. A fingerboard is a sport-specific tool used by climbers for strength training of fingers. In this study, we searched for associations between fingerboard training and finger injuries in climbers with different lengths of climbing experience and levels of performance. METHODS A web-based survey was used to collect information on self-perceived pain or injury in fingers (SPIIF) and regular fingerboard training (RFT). The survey was administered to the Finnish climbing community. Data were analyzed using contingency tables; chi-square was used to evaluate statistical significance. RESULTS No significant correlations between SPIIF and RFT were found when analyzing all the participants (n=434) together. In climbers with 6 y or more in the sport, SPIIF was not common and RFT was negatively associated with SPIIF (χ2 [1, n=200]=4.57; P=0.03). In contrast to this, in male climbers who had been climbing for less than 6 y and had advanced to 7a level or higher (French lead/Font bouldering), SPIIF was common and RFT was positively associated with SPIIF (χ2 [1, n=75]=4.61; P=0.03). CONCLUSIONS We suggest that doing RFT may prevent SPIIF in climbers with a long background in the sport as fingerboard training can help build stronger fingers and thereby stronger tendons and ligaments. Climbers with fewer years in the sport and less adaptation to the fingers should be cautious with their training loads and RFT to avoid finger injuries and pain.
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Affiliation(s)
- Anna E Sjöman
- LAUREA University of Applied Science, Espoo, Finland.
| | - Gudmund Grønhaug
- Department of Sport, Food and Natural Sciences, Faculty of Education, Western Norway University of Applied Sciences, Campus Sogndal, Norway Arts and Sports, Sogndal, Norway
| | - Mikko V Julin
- LAUREA University of Applied Science, Espoo, Finland
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Hartley C, Taylor N, Chidley J, Baláš J, Giles D. Handedness, Bilateral, and Interdigit Strength Asymmetries in Male Climbers. Int J Sports Physiol Perform 2023; 18:1390-1397. [PMID: 37678830 DOI: 10.1123/ijspp.2023-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 05/23/2023] [Accepted: 08/07/2023] [Indexed: 09/09/2023]
Abstract
PURPOSE To determine whether there are bilateral and interdigit differences in the maximal force production of experienced climbers and whether these differences are mediated by ability level or preferred style of climbing. METHODS Thirty-six male climbers (age 30 [9.4] y) took part in a single-session trial to test their maximal force production on both hands. The tests included a one-arm maximal isometric finger flexor strength test (MIFS) and a one-arm individual MIFS. Bilateral differences were analyzed by strongest hand (defined as the hand that produced the highest MIFS value) and dominance (defined as the writing hand). RESULTS A pairwise t test found that MIFS was significantly greater for the strongest hand (mean difference = 4.1%, 95% CI, -0.052 to 0.029, P < .001), with handedness explaining 89% of the variation. A 2-way mixed-model analysis of variance determined that there were no interactions between preferred style (bouldering or sport climbing) and MIFS or between ability level (advanced or elite) and MIFS. CONCLUSIONS Climbers have significant finger flexor strength bilateral asymmetries between their strongest and weakest hand. Moreover, when dominance is controlled, this difference in strength is present, with the dominant hand producing more force. Neither preferred style of climbing nor the ability level of the climbers could explain these asymmetries. As such, practitioners should consider regularly monitoring unilateral strength, aiming to minimize the likelihood of large bilateral asymmetry occurring.
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Affiliation(s)
- Cameron Hartley
- Clinical Exercise and Rehabilitation Research Center, University of Derby, Derby, United Kingdom
- Lattice Training Ltd., Chesterfield, United Kingdom
| | - Nicola Taylor
- Clinical Exercise and Rehabilitation Research Center, University of Derby, Derby, United Kingdom
| | - Joel Chidley
- Clinical Exercise and Rehabilitation Research Center, University of Derby, Derby, United Kingdom
| | - Jiří Baláš
- Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic
| | - Dave Giles
- Lattice Training Ltd., Chesterfield, United Kingdom
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Lugnet V, McDonough M, Gordon L, Galindez M, Mena Reyes N, Sheets A, Zafren K, Paal P. Termination of Cardiopulmonary Resuscitation in Mountain Rescue: A Scoping Review and ICAR MedCom 2023 Recommendations. High Alt Med Biol 2023; 24:274-286. [PMID: 37733297 DOI: 10.1089/ham.2023.0068] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
Lugnet, Viktor, Miles McDonough, Les Gordon, Mercedes Galindez, Nicolas Mena Reyes, Alison Sheets, Ken Zafren, and Peter Paal. Termination of cardiopulmonary resuscitation in mountain rescue: a scoping review and ICAR MedCom 2023 recommendations. High Alt Med Biol. 24:274-286, 2023. Background: In 2012, the International Commission for Mountain Emergency Medicine (ICAR MedCom) published recommendations for termination of cardiopulmonary resuscitation (CPR) in mountain rescue. New developments have necessitated an update. This is the 2023 update for termination of CPR in mountain rescue. Methods: For this scoping review, we searched the PubMed and Cochrane libraries, updated the recommendations, and obtained consensus approval within the writing group and the ICAR MedCom. Results: We screened a total of 9,102 articles, of which 120 articles met the inclusion criteria. We developed 17 recommendations graded according to the strength of recommendation and level of evidence. Conclusions: Most of the recommendations from 2012 are still valid. We made minor changes regarding the safety of rescuers and responses to primary or traumatic cardiac arrest. The criteria for termination of CPR remain unchanged. The principal changes include updated recommendations for mechanical chest compression, point of care ultrasound (POCUS), extracorporeal life support (ECLS) for hypothermia, the effects of water temperature in drowning, and the use of burial times in avalanche rescue.
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Affiliation(s)
- Viktor Lugnet
- International Commission for Mountain Emergency Medicine (ICAR MedCom), Kloten, Switzerland
- Department of Anesthesiology and Intensive Care, Östersund Hospital, Östersund, Sweden
- Swedish Mountain Guides Association (SBO), Gällivare, Sweden
| | - Miles McDonough
- International Commission for Mountain Emergency Medicine (ICAR MedCom), Kloten, Switzerland
- Department of Emergency Medicine, UCSF Fresno, Fresno, California, USA
| | - Les Gordon
- International Commission for Mountain Emergency Medicine (ICAR MedCom), Kloten, Switzerland
- Langdale Ambleside Mountain Rescue Team, Ambleside, United Kingdom
- Department of Anaesthesia, University Hospitals of Morecambe Bay Trust, Lancaster, United Kingdom
| | - Mercedes Galindez
- International Commission for Mountain Emergency Medicine (ICAR MedCom), Kloten, Switzerland
- Department of Internal Medicine, Hospital Zonal Ramón Carrillo, San Carlos de Bariloche, Argentina
- Comisión de Auxilio Club Andino Bariloche, San Carlos de Bariloche, Argentina
| | - Nicolas Mena Reyes
- International Commission for Mountain Emergency Medicine (ICAR MedCom), Kloten, Switzerland
- Department of Emergency Medicine, Sótero del Río Hospital, Santiago de Chile, Chile
- Grupo de Rescate Médico en Montaña (GREMM), Santiago, Chile
- Emegency Medicine Section, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Alison Sheets
- International Commission for Mountain Emergency Medicine (ICAR MedCom), Kloten, Switzerland
- Emergency Medicine, Boulder Community Health, Boulder, Colorado, USA
- Wilderness Medicine Section, University of Colorado Health Sciences Center, Aurora, Colorado, USA
| | - Ken Zafren
- International Commission for Mountain Emergency Medicine (ICAR MedCom), Kloten, Switzerland
- Himalayan Rescue Association, Kathmandu, Nepal
- Department of Emergency Medicine, Stanford University Medical Center, Stanford, California, USA
- Alaska Native Medical Center, Anchorage, Alaska, USA
| | - Peter Paal
- International Commission for Mountain Emergency Medicine (ICAR MedCom), Kloten, Switzerland
- Department of Anaesthesiology and Intensive Care Medicine, St. John of God Hospital, Paracelsus Medical University, Salzburg, Austria
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Küpper T, Gieseler U, Morrison A, Schöffl V. Occupational Aspects of Alpine Helicopter Rescue Operations: Recommendation of the Medical Commission of the Union Internationale des Associations d'Alpinisme. Wilderness Environ Med 2023; 34:517-523. [PMID: 37778976 DOI: 10.1016/j.wem.2023.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 05/23/2023] [Accepted: 07/11/2023] [Indexed: 10/03/2023]
Abstract
Helicopter rescue operations in the mountains or at high altitude are well-known as strenuous tasks often associated with some risk. However, there is no standardized procedure for preventive checkups of rescue personnel by occupational care professionals. Therefore, the Medical Commission of the International Climbing and Mountaineering Federation (UIAA MedCom) suggests the procedure presented in this study. This comprehensive recommendation is based on more than 2 decades of research of MedCom members and extensive literature search. A total of 248 references were selected by the committee as relevant for the topic. To keep the recommendation handy, the complete list is available as supplemental material (see online Supplemental Material). This article recommends standardized procedures for occupational screening and better health of search and rescue personnel.
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Affiliation(s)
- Thomas Küpper
- Medical Commission of the International Mountaineering and Climbing Federation (Union Internationale des Associations d'Alpinisme (UIAA MedCom), Bern, Switzerland; Institute for Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, Aachen, Germany.
| | - Ulf Gieseler
- Medical Commission of the International Mountaineering and Climbing Federation (Union Internationale des Associations d'Alpinisme (UIAA MedCom), Bern, Switzerland
| | - Audry Morrison
- Medical Commission of the International Mountaineering and Climbing Federation (Union Internationale des Associations d'Alpinisme (UIAA MedCom), Bern, Switzerland; Royal Free London NHS Foundation Trust, London, UK
| | - Volker Schöffl
- Medical Commission of the International Mountaineering and Climbing Federation (Union Internationale des Associations d'Alpinisme (UIAA MedCom), Bern, Switzerland; Department of Trauma and Orthopedic Surgery, Klinikum Bamberg, Bamberg, Germany; Department of Trauma Surgery, Friedrich Alexander University Erlangen-Nuremberg, Nuremberg, Germany
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Garrido E, Hüfner K. An Episode of "Third Person" Phenomenon Involving Somesthetic and Visual Hallucinations in a World-Class Extreme Altitude Climber. Wilderness Environ Med 2023; 34:549-552. [PMID: 37620238 DOI: 10.1016/j.wem.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 07/14/2023] [Accepted: 07/14/2023] [Indexed: 08/26/2023]
Abstract
Psychotic symptoms can occur at high altitude. However, most reports are in the mountaineering literature and lack a clear medical assessment and interpretation. Here we report an episode of isolated high-altitude psychosis. It consisted of a "third person" phenomenon involving 2 sensory modalities: somesthetic (felt presence) and visual (the light of 2 flashlights) hallucinations. This episode occurred in a highly experienced climber when he was at an altitude of approximately 7500 m while descending at dusk from the summit of Gasherbrum I (8068 m). The symptoms lasted approximately 3 h and had fully resolved on reaching high camp (7150 m). No other physical or mental symptoms were reported. In addition to hypoxia, a number of other risk factors could have contributed to the occurrence of psychosis in this climber. These included sleep deprivation, exhaustion, dehydration, electrolyte disturbance, reduced visibility, feeling of isolation, and perceived danger. The climber has participated in many extreme altitude expeditions, and neither before nor since this episode has the climber experienced psychotic symptoms.
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Affiliation(s)
- Eduardo Garrido
- Hypobaria and Biomedical Physiology Service, Department of Physiological Sciences II, University of Barcelona-Bellvitge University Campus, Barcelona, Spain.
| | - Katharina Hüfner
- Department for Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, University Clinic for Psychiatry II (Psychosomatic Medicine), Medical University Innsbruck, Innsbruck, Austria
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Dorji T, Giri S, Tshering U, LeVine S, Tshering U, Chhetri S, Dhakal N, Gaikwad SN, Flaherty GT, Lucero-Prisno DE, McIntosh S. Challenges in the management of high-altitude illnesses and emergencies in Bhutan and Nepal. Travel Med Infect Dis 2023; 56:102660. [PMID: 37926372 DOI: 10.1016/j.tmaid.2023.102660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 10/04/2023] [Accepted: 10/30/2023] [Indexed: 11/07/2023]
Abstract
Many popular tourist attractions and trekking routes in Bhutan and Nepal are situated between 3000 and 6000 m in elevation. High-altitude emergencies are becoming more common and medical providers must be aware of the practical and medical issues in managing these disorders. We reflect on the challenges in providing high-altitude emergency medical services in Bhutan and Nepal.
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Affiliation(s)
- Thinley Dorji
- Department of Internal Medicine, Central Regional Referral Hospital, Gelephu, Bhutan.
| | - Sweta Giri
- Faculty of Postgraduate Medicine, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan; Department of Emergency Medicine, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan; Bhutan Emergency Aeromedical Retrieval, Ministry of Health, Thimphu, Bhutan.
| | - Ugyen Tshering
- Faculty of Postgraduate Medicine, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan; Department of Emergency Medicine, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan; Bhutan Emergency Aeromedical Retrieval, Ministry of Health, Thimphu, Bhutan.
| | - Shankar LeVine
- Faculty of Postgraduate Medicine, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan; Department of Emergency Medicine at Dartmouth, Geisel School of Medicine at Dartmouth, NH, USA.
| | - Ugyen Tshering
- Department of Health Services, Ministry of Health, Thimphu, Bhutan.
| | - Sunit Chhetri
- Department of Internal Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
| | - Narayan Dhakal
- Department of Internal Medicine, Shree Birendra Hospital, Kathmandu, Nepal.
| | | | | | - Don Eliseo Lucero-Prisno
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom.
| | - Scott McIntosh
- Department of Emergency Medicine, University of Utah Health, Salt Lake City, UT, USA.
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13
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Medernach JP, Henz J, Memmert D. Mechanisms underlying superior memory of skilled climbers in indoor bouldering. J Sports Sci 2023; 41:1837-1844. [PMID: 38166602 DOI: 10.1080/02640414.2023.2300569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION Bouldering is an Olympic climbing discipline that encompasses short climbing sequences, referred to as boulders, set up on low-height bouldering walls. Memory plays a critical role in bouldering, as it allows climbers to develop climbing strategies, to mentally rehearse climbing movements, and to recall climbing holds of boulders. This study extends previous research on memory in climbing and bouldering with the purpose to elucidate potential mechanisms underlying superior memory abilities of skilled climbers. METHODS Sixty climbers with intermediate (n = 20), advanced (n = 20), or elite (n = 20) skill levels were tasked to memorise the climbing holds and movements of a boulder, set up on a spray wall and demonstrated by a bouldering expert. RESULTS Findings revealed a positive relation between the participants' bouldering skills and sport-specific movement knowledge and both, the number of climbing holds and movements they were able to memorise following a two-minute rehearsal period. CONCLUSION Consistent with previous research, bouldering expertise is positively associated with the ability to memorise domain-specific information. Superior memory abilities among skilled climbers appear to be associated with climbing-specific movement knowledge, coupled with better mental visualisation and increased attentional focus towards functional aspects of boulders.
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Affiliation(s)
- Jerry Prosper Medernach
- Institute of Exercise Training and Sport Informatics, German Sport University Cologne, Cologne, Germany
- Institut National de l´Activité Physique et des Sports, Ministry of Sport, Luxembourg
| | - Julian Henz
- Institute of Exercise Training and Sport Informatics, German Sport University Cologne, Cologne, Germany
| | - Daniel Memmert
- Institute of Exercise Training and Sport Informatics, German Sport University Cologne, Cologne, Germany
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14
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Wagner TD, Paul ME, Youngson LR, Levin DR. Lessons Learned on a High-Altitude Expedition to Mount Kilimanjaro. Wilderness Environ Med 2023; 34:354-360. [PMID: 37147268 DOI: 10.1016/j.wem.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 03/03/2023] [Accepted: 03/03/2023] [Indexed: 05/07/2023]
Abstract
High-altitude expeditions expose teams to particular medical, environmental, and social challenges that can have unintended and severe consequences for crew members. In June 2017, the 9-d Equal Playing Field (EPF) expedition to Mount Kilimanjaro to set a world record for the highest-altitude soccer match ever played demonstrated the variety of challenges that may arise during these types of trips. This trip included a full-length soccer match at 5714 m (18,746 ft), leading to additional challenges for expedition members participating in the athletic event. The EPF medical team identified the challenges that occurred during the expedition and documented the methods used to resolve these challenges in real time. From the challenges faced during the expedition, we describe the lessons learned for future expeditions to Mount Kilimanjaro and other high-altitude environments. Challenges arose with medical tent visibility, medical disqualification, underreporting of medical events, and acute pain management, while anticipated challenges with interpersonal conflict did not occur. The rigorous preparation and anticipation by the EPF medical team prior to expedition departure may have helped mitigate this conflict as well as prevented unintended severe medical events from occurring.
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Affiliation(s)
- Thomas D Wagner
- Columbia University Vagelos College of Physicians & Surgeons, New York, NY.
| | - Megan E Paul
- Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Dana R Levin
- Department of Emergency Medicine, Weill Cornell Medical Center, New York, NY; Department of Aerospace Medicine, University of Texas Medical Branch, Galveston, TX; Department of Emergency Medicine, University of Colorado Anschutz School of Medicine, Aurora, CO
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15
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Miyatake H, Onishi T, Kaneda Y, Ozaki A, Tanimoto T, Beniya H. Possibility for Children with Medical Complexities to Reach a 3000-m Peak: A Report of 2 Cases. Wilderness Environ Med 2023; 34:383-387. [PMID: 37438154 DOI: 10.1016/j.wem.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 05/13/2023] [Accepted: 05/16/2023] [Indexed: 07/14/2023]
Abstract
With the recent development of neonatal medicine, the number of children with medical complexities (CMCs) is increasing. Outdoor activities are important for their psychosocial development, and the principles of accessibility should be addressed. We report the experience of 2 CMCs' high-altitude mountaineering with the necessary support. The participants were a 3-y-old girl with cerebral palsy, symptomatic epilepsy, and a ventriculoperitoneal shunt (Child A) and a 6-y-old girl who underwent bilateral Glenn operations at 11 mo for hypoplastic left heart syndrome (Child B). The support staff consisted of 4 doctors, 1 nurse, 5 nonmedical staff , 3 members from a mountaineering association, and 2 people from an oxygen company. The climbing schedule was 2 days. On the first day, we took a bus to a hut at an altitude of 2450 m and stayed overnight to acclimatize to the altitude. On the second day, we took the beginner's route, which took 3 h to climb 500 m, and our team made an attempt on the summit. During the attempt, Child B panicked. Although her lung sounds did not raise suspicions of pulmonary edema, we decided to leave the mountain with her because her transcutaneous oxygen saturation decreased. Child A had no apparent health problems and made it to the summit. Although CMCs' alpine climbing requires careful planning and staffing considering the risk of high-altitude sickness, our case suggests the feasibility of such activities with CMCs as part of accessibility.
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Affiliation(s)
| | - Toya Onishi
- School of Medicine, Shiga University of Medical Science, Otsu City, Shiga Prefecture, Japan
| | - Yudai Kaneda
- School of Medicine, Hokkaido University, Sapporo City, Hokkaido, Japan
| | - Akihiko Ozaki
- Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki City, Fukushima Prefecture, Japan
| | - Tetsuya Tanimoto
- Medical Governance Research Institute, Minato City, Tokyo, Japan
| | - Hiroyuki Beniya
- Orange Home-Care Clinic, Fukui City, Fukui Prefecture, Japan
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16
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van Bergen NG, Soekarjo K, Van der Kamp J, Orth D. Reliability and Validity of Functional Grip Strength Measures Across Holds and Body Positions in Climbers: Associations With Skill and Climbing Performance. Res Q Exerc Sport 2023; 94:627-637. [PMID: 35452375 PMCID: PMC10503502 DOI: 10.1080/02701367.2022.2035662] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
Purpose: In climbing, exceptional levels of fingertip strength across different holds and body positions are considered essential for performance. There is no commonly agreed upon way to measure such "grip strength variability." Furthermore, the accurate and reliable monitoring of strength is necessary to achieve safe, progressive improvement in strength. Therefore, this study aimed to develop reliability and criterion validity for assessment of grip strength across multiple holds and body positions. Methods: Twenty-two advanced toelite climbers (age = 28.5 ± 8.6 years) performed maximal voluntary isometric contractions on two occasions (for test-retest reliability). Conditions included two hold types (edge and sloper) tested in two postures (elbow flexion [90°] and self-preferred). Climbing performance was determined on two "difficulty" routes (difficulty increases with each hold): one route composed of only edges and another only of slopers. Results: Test-retest reliability was high (ICC between 0.94-0.99). Significant positive correlations were observed for the forces produced on the sloper test and climbing distance on the sloper route (r = 0.512,p < .05), and for the forces produced on the edge test and climbing distance on the edge route (ρ = 0.579, p < .01). Conclusion: These findings support reliability and validity of the method used to measure grip strength variability with different holds and body positions and suggest that improving strength across different grasping types supports adaptive climbing performance.
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Affiliation(s)
| | | | | | - Dominic Orth
- Vrije Universiteit Amsterdam
- Swinburne University of Technology
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17
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Looareesuwan P, Sim PE, Matsee W. Bilateral macular edema associated with high altitude: an unusual clinical presentation. J Travel Med 2023; 30:taad070. [PMID: 37166376 DOI: 10.1093/jtm/taad070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/02/2023] [Accepted: 05/08/2023] [Indexed: 05/12/2023]
Affiliation(s)
- Panita Looareesuwan
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
| | - Pek E Sim
- Gleneagles Hospital Kota Kinabalu, 88100 Kota Kinabalu, Sabah, Malaysia
| | - Wasin Matsee
- Thai Travel Clinic, Hospital for Tropical Diseases, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
- Travel Medicine Research Unit, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok 10400, Thailand
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18
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Szymczak RK, Sawicka M. Can intranasal delivery of dexamethasone facilitate the management of severe altitude disease? J Travel Med 2023; 30:taad026. [PMID: 36811647 PMCID: PMC10289519 DOI: 10.1093/jtm/taad026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/24/2023]
Affiliation(s)
- Robert K Szymczak
- Department of Emergency Medicine, Faculty of Health Sciences, Medical University of Gdańsk, Mariana Smoluchowskiego 17, Gdańsk 80-214, Poland
| | - Magdalena Sawicka
- Department of Neurology, Faculty of Medicine, Medical University of Gdańsk, Mariana Smoluchowskiego 17, Gdańsk 80-214, Poland
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19
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Hillebrandt D, Gurtoo A, Kupper T, Richards P, Schöffl V, Shah P, van der Spek R, Wallis N, Milledge J. UIAA Medical Commission Recommendations for Mountaineers, Hillwalkers, Trekkers, and Rock and Ice Climbers with Diabetes. High Alt Med Biol 2023; 24:110-126. [PMID: 30335516 PMCID: PMC10282971 DOI: 10.1089/ham.2018.0043] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 08/20/2018] [Indexed: 01/01/2023] Open
Abstract
Hillebrandt, David, Anil Gurtoo, Thomas Kupper, Paul Richards, Volker Schöffl, Pankaj Shah, Rianne van der Spek, Nikki Wallis, and Jim Milledge. UIAA Medical Commission recommendations for mountaineers, hillwalkers, trekkers, and rock and ice climbers with diabetes. High Alt Med Biol. 24: 110-126.-The object of this advice article is not only to give the diabetic mountaineer general guidance but also to inform his or her medical team of practical aspects of care that may not be standard for nonmountaineers. The guidelines are produced in seven sections. The first is an introduction to the guidelines, and the second is an introduction to this medical problem and is designed to be read and understood by diabetic patients and their companions. The third section is for use in an emergency in mountains. The fourth is for rock, ice, and competition climbers operating in a less remote environment. These initial sections are deliberately written in simple language. The fifth and sixth sections are written for clinicians and those with skills to read more technical information, and the seventh looks at modern technology and its pros and cons in diabetes management in a remote area. Sections One and Two could be laminated and carried when in the mountains, giving practical advice.
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Affiliation(s)
- David Hillebrandt
- Union Internationale des Associations d'Alpinisme Medical Commission (UIAA MedCom), Bern, Switzerland
- Derriton House, Holsworthy, England
| | - Anil Gurtoo
- Union Internationale des Associations d'Alpinisme Medical Commission (UIAA MedCom), Bern, Switzerland
- Department of Medicine, Lady Hardinge Medical College and Associated SSK Hospital, New Delhi, India
| | - Thomas Kupper
- Union Internationale des Associations d'Alpinisme Medical Commission (UIAA MedCom), Bern, Switzerland
- Institute of Occupational and Social Medicine, RWTH Aachen University, Aachen, Germany
| | - Paul Richards
- Faculty of PreHospital Care, Basildon and Brentwood CCG, Essex, England
| | - Volker Schöffl
- Union Internationale des Associations d'Alpinisme Medical Commission (UIAA MedCom), Bern, Switzerland
- Section Sportsmedicine, Department of Trauma and Orthopedic Surgery, Klinikum Bamberg, Bamberg, Germany
- Department of Trauma Surgery, University of Erlangen-Nuermebrg, Germany
- Section of Wilderness Medicine, Department of Emergency Medicine, University of Colorado School of Medicine, Denver, Colorado
| | - Pankaj Shah
- Division of Endocrinology, Mayo Clinic, Rochester, Minnesota
| | - Rianne van der Spek
- Union Internationale des Associations d'Alpinisme Medical Commission (UIAA MedCom), Bern, Switzerland
- Department of Endocrinology and Metabolism, University of Amsterdam, Academic Medical Center, Amsterdam, The Netherlands
| | - Nikki Wallis
- Emergency Department, Ysbyty Gwynedd, Bangor, Wales
| | - Jim Milledge
- Union Internationale des Associations d'Alpinisme Medical Commission (UIAA MedCom), Bern, Switzerland
- Northwick Park Hospital, Harrow, United Kingdom
- Department of Medicine, Medical Research Council, United Kingdom
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20
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Winkler M, Künzell S, Augste C. Competitive performance predictors in speed climbing, bouldering, and lead climbing. J Sports Sci 2023; 41:736-746. [PMID: 37486001 DOI: 10.1080/02640414.2023.2239598] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/14/2023] [Indexed: 07/25/2023]
Abstract
The study modelled the influence of anthropometric components, climbing-specific power, strength and endurance parameters, flexibility, coordination, and motor planning skills on competitive climbing performance in speed, bouldering, and lead climbing. Sixty-one competitive climbers (26 women [18.1 ± 1.9y], 35 men [21.4 ± 6.1y]) participated. PCA and MRA were used for statistical analyses. Significant predictors for speed climbing performance (R2 = 44% and 35%) were lower (ß = .43 and .47) and upper body power and strength (ß = .40 and .37) for women and men, respectively. For women's bouldering performance (R2 = 39%), they were hip flexibility (ß = .42) and upper body power and strength (ß = .37), for the men's (R2 = 53%) lower (ß = .41) and upper body power (ß = .41) and body fat (ß = .37). For women's lead climbing (R2 = 58%) upper body power and strength (ß = .59) and finger endurance (ß = .48) predict performance, for the men's (R2 = 58%) lower (ß = .36) and upper body power (ß = .28), body fat (ß = .27) and motor planning skills (ß = .27). The multivariate models provide a framework for scientifically grounded climbing training by emphasizing the role of specific performance components.
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Affiliation(s)
- Marvin Winkler
- Institute of Sports Science, Augsburg University, Augsburg, Germany
| | - Stefan Künzell
- Institute of Sports Science, Augsburg University, Augsburg, Germany
| | - Claudia Augste
- Institute of Sports Science, Augsburg University, Augsburg, Germany
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21
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Vijayaraghavan N, Lee J. Atypical Presentation of Left Knee Swelling in a Recreational Rock-Climbing Athlete. Curr Sports Med Rep 2023; 22:115-116. [PMID: 37036458 DOI: 10.1249/jsr.0000000000001053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Affiliation(s)
| | - Justin Lee
- Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
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22
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Li L, Zhou Y, Zou S, Wang Y. The Effects of High-Altitude Mountaineering on Cognitive Function in Mountaineers: A Meta-Analysis. Int J Environ Res Public Health 2023; 20:5101. [PMID: 36982007 PMCID: PMC10049572 DOI: 10.3390/ijerph20065101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/04/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Nowadays, with the convenience of international traveling and driven by many individuals' fond dreams of challenging high-altitude exercises, high-altitude mountaineering is becoming increasingly popular worldwide. Therefore, we performed a meta-analysis to determine the effects of high-altitude mountaineering on cognitive functions in mountaineers before and after climbing. METHODS After a thorough electronic literature search and selection, eight studies were included in this meta-analysis, and the conducted test cycles ranged from 8 to 140 days. Eight variables were included in this meta-analysis: the Trail-Making Test (TMB), Digit Span-Forward (DSF), Digit Span-Backward (DSB), Finger Tapping Test-Right (FTR) Finger Tapping Test-Left (FTL), Wechsler Memory Scale Visual (WMSV), the Aphasia Screening Test (Verbal Items) (AST-Ver), and the Aphasia Screening Test (Visual Motor Errors) (AST-Vis). The effect sizes (ES) and forest plots of these eight variables were generated. RESULTS Five variables (TMB, ES = 0.39; DSF, ES = 0.57; FTR, ES = 0.50; FTL, ES = 0.16; WMSV, ES = 0.63) out of eight were significantly improved after high-altitude mountaineering, whereas the ES values of DSB, AST-Ver, and AST-Vis did not show significant improvement after climbing. CONCLUSION Despite two limitations, namely, methodological issues inherent in the meta-analysis and the inability to explain high heterogeneity between studies, this study is the first meta-analysis that has attempted to specify and compare the cognitive functions of mountaineers before and after high-altitude mountaineering. Furthermore, as a short-term plateau exercise, high-altitude mountaineering has no significant negative impacts on the cognitive functions of climbers. Future research is needed for a long period of high-altitude mountaineering.
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Affiliation(s)
- Lun Li
- College of Physical Education, China University of Geosciences (Wuhan), Wuhan 430074, China; (L.L.)
| | - Yun Zhou
- College of Physical Education, China University of Geosciences (Wuhan), Wuhan 430074, China; (L.L.)
| | - Shisi Zou
- College of Physical Education, China University of Geosciences (Wuhan), Wuhan 430074, China; (L.L.)
| | - Yongtai Wang
- College of Health Sciences and Technology, Rochester Institute of Technology, Rochester, NY 14623, USA
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23
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Schöffl VR, Zimmermann P, Küpper T, Lutter C. Ski Mountaineering-Scientific Knowledge of This New Olympic Sport: A Narrative Review. Curr Sports Med Rep 2023; 22:61-66. [PMID: 36757125 DOI: 10.1249/jsr.0000000000001038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
ABSTRACT Ski mountaineering (skimo) has been accepted as a new sport for the 2026 Milan-Cortina Olympics. The equipment used in this competitive ski mountaineering varies from leisure ski mountaineering equipment mainly in one point: the minimal weight. At the elite athlete level, skimo demands both maximal endurance performance and a high-intensity anaerobic capacity for the sprint and vertical races. Race time significantly correlates to V˙O2max, body mass index and racing gear mass. Available literature only rarely comments on competitive skimo injuries. Injuries are not only due to falls in downhill skiing but also can result from external hazards, such as avalanches and cold. The high training load of athletes in combination with a low body weight, low body fat, and exposure to cold cause high rates of respiratory infections in athletes. The inclusion of skimo into the Olympic program is expected to result in certain changes, such as higher training loads for the athletes and increased scientific interest into training methods.
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Affiliation(s)
| | | | - Thomas Küpper
- Institute of Occupational & Social Medicine, RWTH Aachen Technical University, Aachen, FRG, GERMANY
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24
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Pastor T, Schweizer A, Andronic O, Dietrich LG, Berk T, Gueorguiev B, Pastor T. A Life Dedicated to Climbing and Its Sequelae in the Fingers-A Review of the Literature. Int J Environ Res Public Health 2022; 19:17050. [PMID: 36554928 PMCID: PMC9778768 DOI: 10.3390/ijerph192417050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/07/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
Fingers of sport climbers are exposed to high mechanical loads. This work focuses on the fingers of a 52-year-old active elite climber who was the first in mankind to master 8B (V13), 8B+ (V14) and 8C (V15) graded boulders, bringing lifelong high-intensity loads to his hands. It is therefore hypothesized that he belongs to a small group of people with the highest accumulative loads to their fingers in the climbing scene. Fingers were analyzed by means of ultrasonography, X-rays and physical examination. Soft tissue and bone adaptations, as well as the onset of osteoarthritis and finger stiffness, were found, especially in digit III, the longest and therefore most loaded digit. Finally, this article aims to provide an overview of the current literature in this field. In conclusion, elite sport climbing results in soft tissue and bone adaptations in the fingers, and the literature provides evidence that these adaptations increase over one's career. However, at later stages, radiographic and clinical signs of osteoarthritis, especially in the middle finger, seem to occur, although they may not be symptomatic.
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Affiliation(s)
- Tatjana Pastor
- Department of Plastic and Hand Surgery, Inselspital University Hospital Bern, University of Bern, 3012 Bern, Switzerland
- AO Research Institute Davos, 7270 Davos, Switzerland
| | - Andreas Schweizer
- Division of Hand Surgery, Department of Orthopaedics and Trauma Surgery, Balgrist University Hospital, University of Zurich, 8006 Zurich, Switzerland
| | - Octavian Andronic
- Division of Hand Surgery, Department of Orthopaedics and Trauma Surgery, Balgrist University Hospital, University of Zurich, 8006 Zurich, Switzerland
| | - Léna G. Dietrich
- Department of Plastic and Hand Surgery, Inselspital University Hospital Bern, University of Bern, 3012 Bern, Switzerland
| | - Till Berk
- AO Research Institute Davos, 7270 Davos, Switzerland
- Department of Trauma, University Hospital Zurich, 8091 Zurich, Switzerland
| | | | - Torsten Pastor
- Division of Hand Surgery, Department of Orthopaedics and Trauma Surgery, Balgrist University Hospital, University of Zurich, 8006 Zurich, Switzerland
- Department of Orthopaedic and Trauma Surgery, Cantonal Hospital Lucerne, 6002 Lucerne, Switzerland
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25
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Haunolder M, Apel C, Bertsch D, Cerfontaine C, van der Giet M, van der Giet S, Grass M, Heussen NM, Hundt N, Jäger J, Kühn C, Musiol S, Timmermann L, Wernitz K, Gieseler U, Morrison A, Schöffl V, Küpper T. Cardiovascular Risk Profiles and Pre-Existing Health Conditions of Trekkers in the Solu-Khumbu Region, Nepal. Int J Environ Res Public Health 2022; 19:16388. [PMID: 36554269 PMCID: PMC9779219 DOI: 10.3390/ijerph192416388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/27/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND High-altitude tourist trekking continues to grow in popularity on the Everest Trek in Nepal. We examined which pre-existing cardiovascular and health conditions these global trekkers had and what health issues they encountered during the trek, be it exacerbations of pre-existing conditions, or new acute ones. METHOD Trekkers (n = 350) were recruited from guesthouses along the Everest Trek, mostly at Tengboche (3860 m). After completing a questionnaire on their health and travel preparation, they underwent a basic physical examination with an interview. RESULTS Almost half (45%) had pre-existing conditions, mostly orthopaedic and cardiovascular diseases. The average age was 42.7 years (range 18-76). The average BMI was 23.4 kg/m2, but 21% were overweight. A third were smokers (30%), and 86% had at least one major cardiovascular risk factor. A quarter (25%) were suffering from manifest acute mountain sickness (AMS), and 72% had at least one symptom of AMS. Adequate pre-travel examination, consultation, and sufficient personal preparation were rarely found. In some cases, a distinct cardiovascular risk profile was assessed. Hypertensive patients showed moderately elevated blood pressure, and cholesterol levels were favourable in most cases. No cardiovascular emergencies were found, which was fortunate as timely, sufficient care was not available during the trek. CONCLUSION The results of earlier studies in the Annapurna region should be revalidated. Every trekker to the Himalayas should consult a physician prior to departure, ideally a travel medicine specialist. Preventative measures and education on AMS warrant special attention. Travellers with heart disease or with a pronounced cardiovascular risk profile should be presented to an internal medicine professional. Travel plans must be adjusted individually, especially with respect to adequate acclimatisation time and no physical overloading. With these and other precautions, trekking at high altitudes is generally safe and possible, even with significant pre-existing health conditions. Trekking can lead to invaluable personal experiences. Since organized groups are limited in their flexibility to change their itinerary, individual trekking or guided tours in small groups should be preferred.
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Affiliation(s)
- Miriam Haunolder
- Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
- Medical Department, St. Antonius Hospital, 52249 Eschweiler, Germany
| | - Christian Apel
- Department of Dental Preservation, Parodontology & Preventive Dentistry, RWTH Aachen Technical University, 52074 Aachen, Germany
- Institute of Applied Medical Engineering, RWTH Aachen University, 52074 Aachen, Germany
| | - Daniela Bertsch
- Department of Internal Medicine & Cardiology, Ilmtalklinik, 85276 Pfaffenhofen, Germany
| | - Carina Cerfontaine
- Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Michael van der Giet
- Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Simone van der Giet
- Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Maren Grass
- Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Nicole Maria Heussen
- Department of Medical Statistics, RWTH Aachen Technical University, 52074 Aachen, Germany
- Medical School, Sigmund Freud Private University, 1020 Vienna, Austria
| | - Nina Hundt
- Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Julia Jäger
- Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Christian Kühn
- Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Sonja Musiol
- Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Lisa Timmermann
- Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Knut Wernitz
- Department of Dental Preservation, Parodontology & Preventive Dentistry, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Ulf Gieseler
- Medical Commission of the Union Internationale des Associations d’Alpinisme (UIAA MedCom), 3007 Bern, Switzerland
| | - Audry Morrison
- Medical Commission of the Union Internationale des Associations d’Alpinisme (UIAA MedCom), 3007 Bern, Switzerland
- Royal Free London NHS Foundation Trust, London NW3 2QG, UK
| | - Volker Schöffl
- Department of Sport Orthopaedics, Klinikum Bamberg, 96049 Bamberg, Germany
- Department of Trauma Surgery, University Hospital Erlangen-Nuremberg, 91054 Erlangen, Germany
- School of Applied and Clinical Sciences, Leeds Becket University, Leeds LS2 9JT, UK
- Section of Wilderness Medicine, Department of Emergency Medicine, University of Colorado School of Medicine, Denver, CO 80045, USA
| | - Thomas Küpper
- Institute of Occupational, Social & Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
- Medical Commission of the Union Internationale des Associations d’Alpinisme (UIAA MedCom), 3007 Bern, Switzerland
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Cerfontaine C, Apel C, Bertsch D, Grass M, Haunolder M, Hundt N, Jäger J, Kühn C, Museol S, Timmermann L, van der Giet M, van der Giet S, Wernitz K, Schöffl V, Morrison A, Küpper T. Companion Rescue and Risk Management of Trekkers on the Everest Trek, Solo Khumbu Region, Nepal. Int J Environ Res Public Health 2022; 19:16288. [PMID: 36498360 PMCID: PMC9739670 DOI: 10.3390/ijerph192316288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Trekking to high-altitude locations presents inherent health-related hazards, many of which can managed with specific first aid (FA) training. This study evaluates the trip preparation, FA knowledge, and FA self-assessment of trekkers (organized by tour operators vs. individually planned tours). Data obtained shall be used for specific FA trip preparation and management of emergencies en route for this population. METHODS A total of 366 trekkers on the Everest Base Camp Trek, Nepal, were interviewed using a questionnaire specifically designed to evaluate their FA knowledge and management of emergencies. Data evaluation was performed using descriptive statistics. RESULTS A total of 40.5% of trekkers experienced at least one medical incident during their trip, of which almost 50% were due to acute mountain sickness (AMS). There was more AMS in commercially organized groups than in individually planned ones (55% vs. 40%). For more than 50%, no medical care was available during their trip. A total of 80% could answer only 3/21 FA questions completely correctly. Only 1% showed adequate knowledge concerning FA strategies. A total of 70% were willing to enroll in an FA class specialized towards the needs of trekkers. CONCLUSIONS The importance of high-altitude FA knowledge and trip preparation is widely underestimated. There is an unmet demand amongst trekkers for specific wilderness FA classes.
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Affiliation(s)
- Carina Cerfontaine
- Department of Occupational, Social and Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Christian Apel
- Department of Biohybrid and Medical Textiles, Institute of Applied Medical Engineering, Helmholtz Institute of Biomedical Engineering, RWTH Aachen University, 52074 Aachen, Germany
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University Hospital, 52074 Aachen, Germany
| | - Daniela Bertsch
- Department of Internal Medicine, Ilmtalklinik, 85276 Pfaffenhofen, Germany
| | - Maren Grass
- Department of Occupational, Social and Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Miriam Haunolder
- Department of Occupational, Social and Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Nina Hundt
- Department of Occupational, Social and Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Julia Jäger
- Department of Occupational, Social and Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Christian Kühn
- Department of Occupational, Social and Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Sonja Museol
- Department of Occupational, Social and Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Lisa Timmermann
- Department of Occupational, Social and Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Michael van der Giet
- Department of Occupational, Social and Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Simone van der Giet
- Department of Occupational, Social and Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
| | - Knut Wernitz
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen University Hospital, 52074 Aachen, Germany
| | - Volker Schöffl
- Department of Orthopedic and Trauma Surgery, Sportsorthopedics and Sportsmedicine, Klinikum Bamberg, 96049 Bamberg, Germany
- Department of Trauma Surgery, Friedrich Alexander University Erlangen-Nuremberg, 91054 Erlangen, Germany
- School of Applied and Clinical Sciences, Leeds Becket University, Leeds LS1 3HE, UK
- Section of Wilderness Medicine, Department of Emergency Medicine, University of Colorado School of Medicine, Denver, CO 80045, USA
| | - Audry Morrison
- Royal Free London NHS Foundation Trust, London NW3 2QG, UK
| | - Thomas Küpper
- Department of Occupational, Social and Environmental Medicine, RWTH Aachen Technical University, 52074 Aachen, Germany
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Zimmermann P, Eckstein ML, Moser O, Schöffl I, Zimmermann L, Schöffl V. Left Ventricular, Left Atrial and Right Ventricular Strain Modifications after Maximal Exercise in Elite Ski- Mountaineering Athletes: A Feasibility Speckle Tracking Study. Int J Environ Res Public Health 2022; 19:13153. [PMID: 36293734 PMCID: PMC9603167 DOI: 10.3390/ijerph192013153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
Eleven world elite ski-mountaineering (Ski-Mo) athletes were evaluated for pronounced echocardiographic physiological remodeling as the primary aim of our feasibility speckle tracking study. In this context, sports-related cardiac remodeling was analyzed by performing two-dimensional echocardiography, including speckle tracking analysis of the left atrium (LA), right ventricle (RV) and left ventricular (LV) global longitudinal strain (LV-GLS) at rest and post-peak performance. The feasibility echocardiographic speckle tracking analysis was performed on eleven elite Ski-Mo athletes, which were obtained in 2022 during the annual medical examination. The obtained data of the professional Ski-Mo athletes (11 athletes, age: 18-26 years) were compared for different echocardiographic parameters at rest and post-exercise. Significant differences were found for LV-GLS mean (p = 0.0036) and phasic LA conduit strain pattern at rest and post-exercise (p = 0.0033). Furthermore, negative correlation between LV mass and LV-GLS (p = 0.0195, r = -0.69) and LV mass Index and LV-GLS (p = 0.0253, r = -0.66) at rest were elucidated. This descriptive reporting provided, for the first time, a sport-specific dynamic remodeling of an entire elite national team of the Ski-Mo athlete's left heart and elucidated differences in the dynamic deformation pattern of the left heart.
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Affiliation(s)
- Paul Zimmermann
- Department of Cardiology, Klinikum Bamberg, 96049 Bamberg, Germany
- Interdisciplinary Center of Sportsmedicine Bamberg, Klinikum Bamberg, 96049 Bamberg, Germany
- Division of Exercise Physiology and Metabolism, BaySpo-Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany
| | - Max L. Eckstein
- Division of Exercise Physiology and Metabolism, BaySpo-Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany
| | - Othmar Moser
- Division of Exercise Physiology and Metabolism, BaySpo-Bayreuth Center of Sport Science, University of Bayreuth, 95440 Bayreuth, Germany
| | - Isabelle Schöffl
- Interdisciplinary Center of Sportsmedicine Bamberg, Klinikum Bamberg, 96049 Bamberg, Germany
- Department of Pediatric Cardiology, Friedrich-Alexander-University Erlangen-Nurnberg, 91054 Erlangen, Germany
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds LS1 3HE, UK
| | - Lukas Zimmermann
- Interdisciplinary Center of Sportsmedicine Bamberg, Klinikum Bamberg, 96049 Bamberg, Germany
| | - Volker Schöffl
- Interdisciplinary Center of Sportsmedicine Bamberg, Klinikum Bamberg, 96049 Bamberg, Germany
- School of Clinical and Applied Sciences, Leeds Beckett University, Leeds LS1 3HE, UK
- Department of Orthopedic and Trauma Surgery, Friedrich-Alexander-University Erlangen-Nurnberg, 91054 Erlangen, Germany
- Department of Orthopedic and Trauma Surgery, Klinikum Bamberg, 96049 Bamberg, Germany
- Section of Wilderness Medicine, Department of Emergency Medicine at the University of Colorado School of Medicine, Denver, CO 80045, USA
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Gasser B. Deathly Accidents While High-Altitude Mountaineering in the Swiss Alps-An Observational Analysis from 2009 to 2021. Int J Environ Res Public Health 2022; 19:12498. [PMID: 36231795 PMCID: PMC9566316 DOI: 10.3390/ijerph191912498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/22/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND High-altitude mountaineering has become more and more popular. While many enjoy the beauty of the highest parts of Switzerland, there are considerable risks, which can even result in death. This study analyzed fatal events while high-altitude mountaineering in the Swiss Alps. MATERIALS AND METHODS In this study, cases of emergencies while high-altitude mountaineering in the Swiss Alps were analyzed in the period from 2009 to 2021 from the Swiss Alpine Club (SAC) emergency registry. Fatal emergencies were identified and analyzed in detail. RESULTS In total, 5020 emergency cases were analyzed, and among them 303 deathly events where detected. Of the fatal emergencies, 261 cases (86.1%) were male and 42 (13.9%) were female. The average age was 53.2 ± 19.1 years. More than half of the emergencies were on a route to a classic four-thousander. Fatal events were most common on the Matterhorn, with 40 cases (13.2%); on the Mönch, with 18 cases (5.9%); and on the Piz Bernina, with 10 cases (3.3%). In 245 of the fatal emergencies (80.9%), a fall was the cause. The second most prominent cause was rockfalls, with 16 cases (5.3%), followed by stranding, with 10 cases (3.3%), and avalanches, with 9 cases (3%). Illnesses and crevasse accidents counted together for less than 5% of the fatal cases. Almost two-thirds of fatal falls occurred while descending. Concerning nationality, 30% were from Switzerland and more than three-fourths of victims were from the countries of the Alps. DISCUSSION We found that falls were the most common cause of fatal emergencies in the Swiss Alps. Concerning the fact that most of these emergencies occurred during descents, fatigue and inadequate focus (forgetting the risks of the descent after successfully reaching the peak) are potential reasons for the fatal events. This potentially resulted from a lack of acclimatization, insufficient physical fitness, and inadequate tour planning. Since most victims were from the countries of the Alps, training tours may be possible as a recommended preparation for more difficult four-thousander peaks.
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Affiliation(s)
- Benedikt Gasser
- Departement für Sport, Bewegung und Gesundheit-Abteilung Rehabilitative und Regenerative Sportmedizin-Universität Basel-Grosse Allee 6, CH-4052 Basel, Switzerland
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Simen F, Hohmann A, Siener M. Balancing the Bar-Influence of Social Behaviour on Sport Climbing Performance. Int J Environ Res Public Health 2022; 19:9703. [PMID: 35955059 PMCID: PMC9368498 DOI: 10.3390/ijerph19159703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 07/29/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
Background: For high performance in sport climbing, various factors must be taken into account, however, social interactions during climbing sessions have not yet been considered. Methods: For this study, four assumptions were made: (1) elite climbers share similar patterns of behaviour; (2) these behaviour patterns influence the climbing performance in a positive way; (3) the behaviour patterns had to be formed over time, and the process of changing behaviour was catalysed by formative experiences; and, (4) the social behaviour of elite climbers shows a tendency to be on their own rather than in the centre of social events, while their behavioural roots date back to their school life. Six male higher-elite-level climbers participated in semi-structured in-depth interviews. Results: In school, all participants perceived themselves as not being at the centre of social interactions. Moreover, all participants described a development from egoistic behaviour towards more supportive behaviour. Two participants were able to outline specific, formative experiences (crucibles), that drastically shaped their behaviour. Conclusion: All participants performed best in the absence of social tensions and when the atmosphere between the climbing partners was positive. Positive atmosphere was achieved by finding the optimal personal balance between supportive and egoistic behaviour.
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Gasser B, Schwendinger F. 4000ers of the Alps–So beautiful, so dangerous: An analysis of falls in the Swiss Alps between 2009–2020. PLoS One 2022; 17:e0266032. [PMID: 35385546 PMCID: PMC8985987 DOI: 10.1371/journal.pone.0266032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 02/20/2022] [Indexed: 11/22/2022] Open
Abstract
Background This study aimed to analyze falls regarding their demographic characteristics, severity, frequency over time, and the localization of injuries while high-altitude mountaineering in the Swiss Alps. Methods Data on fall-related emergencies during mountaineering between 2009 to 2020 from the Swiss Alpine Club central registry were analyzed retrospectively. The variables age, sex, time of occurrence, severity of an event quantified by NACA-Score (National Advisory Committee for Aeronautics Score), and injury localization were examined descriptively. Changes in injury severity, number of total emergencies, and fatal emergencies over time were analyzed using linear regression models. Results Out of 1347 (28.7%) victims of fall-related emergencies, 1027 were men (76.2%) and 320 (23.8%) women. Around 70% of the cases happened during summer in July and August. The mean age was 49.9 ± 14.9 years for men and 51.3 ± 14.4 years for women with no between-sex difference. Higher NACA-Scores were found in men than women (3.6 ± 2.2 vs. 3.1 ± 1.6; p < 0.01). Approximately 80% of all victims originated from the countries close to the Alps (Switzerland, Germany, Italy, France, and Austria). There was a slight decrease of total cases (R2 = 0.104) and fatal cases over time (R2 = 0.183). NACA-Scores decreased over time (R2 = 0.168). Likewise, risk aversion decreased over time as the severity of emergencies decreased. Injuries occurred predominantly at the extremities (90%). Out of all cases, 228 fatal emergencies (16.9%) could be identified of which 82 occurred while climbing one of the classic 4000ers. Conclusions The decrease of the number and severity implies that security standards of the average alpinist have in tendency increased. Nevertheless, the high number of emergencies on classic 4000ers implies that despite the potentially improved security standards, many tours on famous mountains still have high requirements in terms of alpine skills.
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Affiliation(s)
- Benedikt Gasser
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
- * E-mail:
| | - Fabian Schwendinger
- Department for Sport, Exercise and Health, University of Basel, Basel, Switzerland
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Marcolin G, Faggian S, Muschietti M, Matteraglia L, Paoli A. Determinants of Climbing Performance: When Finger Flexor Strength and Endurance Count. J Strength Cond Res 2022; 36:1099-1104. [PMID: 32149885 DOI: 10.1519/jsc.0000000000003545] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Giuseppe Marcolin
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Sara Faggian
- School of Human Movement Sciences, University of Padova, Padua, Italy ; and
| | | | | | - Antonio Paoli
- Department of Biomedical Sciences, University of Padova, Padova, Italy
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Oshiro K, Murakami T. Causes of death and characteristics of non-survivors rescued during recreational mountain activities in Japan between 2011 and 2015: a retrospective analysis. BMJ Open 2022; 12:e053935. [PMID: 35115353 PMCID: PMC8814748 DOI: 10.1136/bmjopen-2021-053935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES This study aimed to describe the cause of death and characteristics at the prehospital setting associated with care and rescue processes of non-survivors rescued in the mountain of Japan. DESIGN Retrospective analysis. SETTING Prehospital setting of mountain searches and rescues in Japan. A total of 10 prefectural police headquarters with >10 cases of mountain death from 2011 to 2015. PARTICIPANTS Data were generated from the existing records. Of the total 6159 rescued subjects, 548 mountain deaths were caused by recreational activities. RESULTS Among the 548 mountain deaths, 83% were men, and major causes of death were trauma (49.1%), hypothermia (14.8%), cardiac death (13.1%) and avalanche-related death (6.6%). The alive rate at rescue team arrival in all non-survivors was 3.5%, with 1, 4 and 14 cases of cardiac, hypothermia and trauma, respectively. Cardiac deaths occurred in 93.1% (67/72) of men and individuals aged >41 years, and 88.7% (63/71) were found on mountain trails. In hypothermia, callouts were made between 17:00 and 6:00 at 49% (40/81) and by persons not on-site in 59.7% (46/77). People with >6 hours in trauma or >1 hour in cardiac death already died on rescue team arrival, but some with hypothermia after 6 hours were alive. CONCLUSION This study is one of the first large-scale retrospective analyses of prehospital non-survivors in mountain emergencies. The alive rate at rescue arrival in all mountain deaths was only 3.5%. These data showed that the circumstances related to onset and the process until the rescue team arrives have different characteristics, depending on the cause of death. Survival may be enhanced by targeting better use of the time before rescue team arrival and by providing further education, particularly mountain rescue-related medical problems to rescuers including bystanders.
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Affiliation(s)
- Kazue Oshiro
- Department of Cardiovascular Medicine and Director of Mountain Medicine, Research, and Survey Division, Hokkaido Ono Memorial Hospital, Sapporo, Hokkaido, Japan
- Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan
- Director, Association for Mountain Medical Rescue Japan, Hokkaido, Japan
| | - Tomikazu Murakami
- Director, Association for Mountain Medical Rescue Japan, Hokkaido, Japan
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Abstract
A fit and healthy 44-year-old woman took a single dose of oral acetazolamide (125 mg) in preparation for a hiking trip to Everest base camp. She awoke the next morning with profoundly blurred distance vision. She presented to eye casualty later that morning, approximately 18 hours postingestion: examination demonstrated myopia and bilateral choroidal effusions. Acetazolamide is used to minimise symptoms of altitude sickness. Rarely, its use can be linked with ophthalmic side effects, such as myopia. A handful of case reports also describe choroidal effusions secondary to its use as part of ophthalmic treatment (eg, postoperatively). This is the first reported case in which choroidal effusions have been demonstrated as a side effect of its prophylactic use against altitude sickness.
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Affiliation(s)
- Alice Rothwell
- Ophthalmology, University Hospitals Dorset NHS Foundation Trust, Bournemouth, UK
| | - Owen Anderson
- Ophthalmology, University Hospitals Dorset NHS Foundation Trust, Bournemouth, UK
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Gasser B, Stouder J. Rescue Emergencies Due to High-Altitude Illnesses Are Rare in Switzerland. Int J Environ Res Public Health 2022; 19:ijerph19020865. [PMID: 35055685 PMCID: PMC8776185 DOI: 10.3390/ijerph19020865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 12/31/2021] [Accepted: 01/10/2022] [Indexed: 02/04/2023]
Abstract
Background: Despite a potential high risk of acute mountain sickness (AMS) in the Swiss Alps, there is a lack of analyses concerning its relevance over longer periods. In consequence, the aim of this study is to analyze the prevalence of AMS in comparison to other causes of mountain emergencies in recent years in Switzerland. Material and Methods: Based on the central registry of mountain emergencies of the Swiss Alpine Club (SAC), all cases in the period between 2009 and 2020 were analyzed for AMS including the most severe forms of high-altitude pulmonary edema (HAPE) and high-altitude cerebral edema (HACE). Emergencies were assessed for the severity of the event with a National Advisory Committee for Aeronautics (NACA) score. Results: From a total of 4596 high-altitude mountaineering emergencies identified in the observational period, a total number of 352 cases of illnesses were detected. Detailed analysis revealed 85 cases of AMS, 5 cases of HAPE, and 1 case of HACE. The average altitude was 3845 ± 540 m. Most cases were in the canton of Valais, especially in the Monte Rosa region and the mountains of the Mischabel group (Täschhorn, Dom, Südlenz, Nadelhorn, Hohberghorn). There were only three deaths related to high-altitude illnesses; all the other events could be identified as moderate to severe but not life-threatening. Discussion: An emergency due to AMS that requires rescue is unlikely in the Swiss Alps. This does not imply that AMS is not a concern. However, the facts that the maximal altitude is relatively low and that fast self-descents often seem possible probably minimize the likelihood that mountaineers with symptoms contact emergency services.
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Burtscher M, Viscor G. How important is V̇O 2max when climbing Mt. Everest (8,849 m)? Respir Physiol Neurobiol 2021; 297:103833. [PMID: 34952230 DOI: 10.1016/j.resp.2021.103833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 12/12/2021] [Accepted: 12/20/2021] [Indexed: 11/18/2022]
Abstract
The maximal rate of oxygen uptake (V̇O2max) of humans declines with increasing altitude, but represents the upper limit of aerobic endurance performance at low and high altitude as well. Before Reinhold Messner and Peter Habeler climbed Mt. Everest first (1978) without supplemental oxygen, physiologists have doubted whether this would be possible due to insufficient V̇O2max remaining when approaching the summit (8849 m). Subsequently, several studies evaluated the decline in the V̇O2max levels at real and simulated extreme altitudes. However, the potential influence of the preexisting individual sea level V̇O2max remained largely unconsidered. Based on available studies and case observations, here we discuss the observed and expected decline of V̇O2max up to 8849 m dependent on the individual sea level V̇O2max. It is concluded that a high sea level V̇O2max and an only moderate decline of arterial oxygen saturation and associated V̇O2max with increasing altitude, due to appropriate acclimatization and ascent strategies, enable certain mountaineers to climb 8,000er summits and even the Everest without supplemental oxygen.
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Affiliation(s)
- Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria.
| | - Ginés Viscor
- Physiology Section, Department of Cell Biology, Physiology and Immunology, Faculty of Biology, University of Barcelona, Barcelona, Spain
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Kottmann A, Pasquier M, Strapazzon G, Zafren K, Ellerton J, Paal P. Quality Indicators for Avalanche Victim Management and Rescue. Int J Environ Res Public Health 2021; 18:ijerph18189570. [PMID: 34574495 PMCID: PMC8464975 DOI: 10.3390/ijerph18189570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/05/2021] [Accepted: 09/07/2021] [Indexed: 12/29/2022]
Abstract
Decisions in the management and rescue of avalanche victims are complex and must be made in difficult, sometimes dangerous, environments. Our goal was to identify indicators for quality measurement in the management and rescue of avalanche victims. The International Commission for Mountain Emergency Medicine (ICAR MedCom) convened a group of internal and external experts. We used brainstorming and a five-round modified nominal group technique to identify the most relevant quality indicators (QIs) according to the National Quality Forum Measure Evaluation Criteria. Using a consensus process, we identified a set of 23 QIs to measure the quality of the management and rescue of avalanche victims. These QIs may be a valuable tool for continuous quality improvement. They allow objective feedback to rescuers regarding clinical performance and identify areas that should be the foci of further quality improvement efforts in avalanche rescue.
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Affiliation(s)
- Alexandre Kottmann
- Rega—Swiss Air Ambulance, Zürich Airport, 8058 Zürich, Switzerland
- Emergency Department, Lausanne University Hospital, 1011 Lausanne, Switzerland;
- International Commission for Mountain Emergency Medicine (ICAR MedCom), 8058 Zürich, Switzerland; (G.S.); (K.Z.); (J.E.); (P.P.)
- Correspondence:
| | - Mathieu Pasquier
- Emergency Department, Lausanne University Hospital, 1011 Lausanne, Switzerland;
- International Commission for Mountain Emergency Medicine (ICAR MedCom), 8058 Zürich, Switzerland; (G.S.); (K.Z.); (J.E.); (P.P.)
| | - Giacomo Strapazzon
- International Commission for Mountain Emergency Medicine (ICAR MedCom), 8058 Zürich, Switzerland; (G.S.); (K.Z.); (J.E.); (P.P.)
- Institute of Mountain Emergency Medicine, Eurac Research, 39100 Bolzano, Italy
- CNSAS—Corpo Nazionale Soccorso Alpino e Speleologico, National Medical School, 20124 Milano, Italy
| | - Ken Zafren
- International Commission for Mountain Emergency Medicine (ICAR MedCom), 8058 Zürich, Switzerland; (G.S.); (K.Z.); (J.E.); (P.P.)
- Alaska Native Medical Center, Department of Emergency Medicine, 4300 Diplomacy Drive, Anchorage, AK 99508, USA
- Stanford University Medical Center, Department of Emergency Medicine, 900 Welch Road, Palo Alto, CA 94304, USA
| | - John Ellerton
- International Commission for Mountain Emergency Medicine (ICAR MedCom), 8058 Zürich, Switzerland; (G.S.); (K.Z.); (J.E.); (P.P.)
| | - Peter Paal
- International Commission for Mountain Emergency Medicine (ICAR MedCom), 8058 Zürich, Switzerland; (G.S.); (K.Z.); (J.E.); (P.P.)
- Department of Anaesthesiology and Intensive Care Medicine, St. John of God Hospital, Paracelsus Medical University, Kajetanerplatz 1, 5020 Salzburg, Austria
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Medernach JP, Memmert D. Effects of decision-making on indoor bouldering performances: A multi-experimental study approach. PLoS One 2021; 16:e0250701. [PMID: 33983977 PMCID: PMC8118292 DOI: 10.1371/journal.pone.0250701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 04/13/2021] [Indexed: 11/23/2022] Open
Abstract
The purpose of this study was to investigate whether novice, intermediate, and advanced bouldering athletes would differ in their decision-making abilities and to what extent distinct problem-solving tactics would affect the athletes’ bouldering performances. Seventy-seven male bouldering athletes participated in a multi-experimental study with the conceptual replication of three bouldering tasks. Participants were allocated according to their ability levels to the novice group (NOV with n = 18), the intermediate group (INT with n = 18), or the advanced group (ADV with n = 41). The data collected for movement analysis via video consisted of the pre-ascent decision-making times, the number of movement deviations from the best solution, the number of movement mistakes, the average gripping times, the bouldering times to the top, the number of successful ascents, and the number of attempts to complete the tasks. Results among all three experiments revealed shorter decision-making times, fewer movement mistakes, and shorter average gripping and bouldering times to the top in the ADV group than in the NOV group and the INT group. Furthermore, participants from the ADV group demonstrated fewer movement deviations than participants from the NOV group (in all three experiments) and the INT group (Experiment 1 and Experiment 2). Moreover, participants from the ADV group and the INT group were characterized, in all three experiments, by a higher number of successful ascents and a lower number of attempts to complete the tasks than participants from the NOV group. In total, these findings emphasize that accomplished decision-making abilities consist of a key determinant in successful indoor bouldering performances.
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Affiliation(s)
- Jerry Prosper Medernach
- Institute of Exercise Training and Sports Informatics, German Sport University Cologne, Cologne, Germany
- * E-mail:
| | - Daniel Memmert
- Institute of Exercise Training and Sports Informatics, German Sport University Cologne, Cologne, Germany
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McMullen CW, Mugleston BJ, Booker LN. Coaches' Attitudes Toward Campus Board Training in Adolescent Climbers in the United States. Wilderness Environ Med 2021; 32:168-175. [PMID: 33972161 DOI: 10.1016/j.wem.2021.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 01/09/2021] [Accepted: 02/03/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Campus board training in adolescent climbers is controversial. Evidence, albeit limited, suggests this type of training may lead to the development of finger epiphyseal stress fractures. The purpose of the present study was to investigate coaches' attitudes toward campus board training in the United States. METHODS Surveys were sent to 116 coaches at gyms across the United States with affiliated adolescent climbing teams. Outcomes collected included demographic information, training time, campus board use prevalence, coaches' attitudes toward campus board use, and willingness to participate in future research. RESULTS Seventy-three coaches representing 3090 adolescent climbers completed the survey. Forty-six coaches (63%) reported using full weight (no foot contact) campus board training in some or all of their climbers. A variety of factors were cited by coaches when deciding which climbers should or should not use the campus board, including physical maturity, climbing ability, and age, among others. CONCLUSIONS Climbing coaches in the United States disagree on the use of campus board training in adolescent climbers. Some coaches avoid using this training modality entirely, whereas others believe certain climbers can use it safely. There is lack of consensus in determining who those certain climbers are.
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Affiliation(s)
- Christopher W McMullen
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington.
| | - Brian J Mugleston
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Lyndsey N Booker
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington
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Auer J, Schöffl VR, Achenbach L, Meffert RH, Fehske K. Indoor Bouldering-A Prospective Injury Evaluation. Wilderness Environ Med 2021; 32:160-167. [PMID: 33966976 DOI: 10.1016/j.wem.2021.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 02/01/2021] [Accepted: 02/03/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Bouldering has become a sport of growing interest, but little prospective evidence exists about injury proportions and patterns. The purpose of this study was to prospectively evaluate the cause of injuries sustained during indoor bouldering, proportion of affected body location, and injury severity. METHODS Proportions and patterns of injury among German-speaking indoor boulderers were evaluated prospectively in an explorative cohort study. Participants completed a baseline questionnaire assessing anthropometric data and sport-specific potential preventive and risk factors, followed by monthly injury questionnaires including injury location and injury severity over a period of 12 mo. RESULTS Out of 507 boulderers, 222 (44%) sustained 305 injuries. Of those, 78% (n=238) were classified as Union Internationale de Associations d'Alpinisme (UIAA) 1, 19% (n=57) as UIAA 2, and 3% (n=10) as UIAA 3. Injuries of the upper extremities accounted for 63% (n=191) of all injuries. Injuries of the lower extremities accounted for 23% (n=71) but were more often classified as UIAA≥2 (P=0.0071; odds ratio [OR] 2.23; 95% CI 1.23-4.04) and were more often caused by falling (P=0.0005; OR 2.92; 95% CI 1.57-5.42) and jumping off the wall (P<0.0001; OR 4.39; 95% CI 2.25-8.56) than injuries of other body locations. There was no statistically significant protective effect of the evaluated potential preventive measures. Participants who used heavily downturned climbing shoes had a higher risk of sustaining a UIAA ≥2 injury (P=0.0034; OR 2.58; 95% CI 1.34-4.95). CONCLUSIONS Injuries in indoor bouldering are common. Lower extremity injuries are associated with higher injury severity. Preventive measures need to be established to reduce bouldering injuries, especially during falls and landings.
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Affiliation(s)
- Jonas Auer
- Department of Trauma, Hand, Plastics and Reconstructive Surgery, University Clinics Würzburg, Würzburg, Germany
| | - Volker R Schöffl
- Department of Sports Medicine-Sports Orthopedics, Klinikum Bamberg, Bamberg, Germany
| | - Leonard Achenbach
- Department of Trauma, Hand, Plastics and Reconstructive Surgery, University Clinics Würzburg, Würzburg, Germany
| | - Rainer H Meffert
- Department of Trauma, Hand, Plastics and Reconstructive Surgery, University Clinics Würzburg, Würzburg, Germany
| | - Kai Fehske
- Department of Trauma, Hand, Plastics and Reconstructive Surgery, University Clinics Würzburg, Würzburg, Germany.
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Stien N, Vereide VA, Saeterbakken AH, Hermans E, Shaw MP, Andersen V. Upper body rate of force development and maximal strength discriminates performance levels in sport climbing. PLoS One 2021; 16:e0249353. [PMID: 33770128 PMCID: PMC7997018 DOI: 10.1371/journal.pone.0249353] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/16/2021] [Indexed: 11/30/2022] Open
Abstract
The aim of this study was to assess and compare the maximal force and rate of force development (RFD) between intermediate, advanced and elite climbers using several different methods for calculating RFD. Fifty-seven male climbers (17 intermediate, 25 advanced, and 15 elite) performed isometric pull-ups on a climbing-specific hold while the RFD was calculated using several absolute (50, 100, 150, 200, and 250 ms from onset of force) and relative time periods (25, 50, 75, 95, and 100% of time to peak force). The maximal force was higher among elite climbers compared to advanced (ES = 1.78, p < 0.001) and intermediate climbers (ES = 1.77, p < 0.001), while no difference was observed between intermediate and advanced climbers (P = 0.898). The elite group also showed higher RFD than the other two groups at all relative time periods (ES = 1.02–1.58, p < 0.001–0.002), whereas the absolute time periods only revealed differences between the elite vs. the other groups at 50, 100 and 150 ms from the onset of force (ES = 0.72–0.84, p = 0.032–0.040). No differences in RFD were observed between the intermediate and advanced groups at any time period (p = 0.942–1.000). Maximal force and RFD, especially calculated using the longer periods of the force curve, may be used to distinguish elite climbers from advanced and intermediate climbers. The authors suggest using relative rather than absolute time periods when analyzing the RFD of climbers.
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Affiliation(s)
- Nicolay Stien
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Bergen, Norway
- * E-mail:
| | - Vegard Albert Vereide
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Bergen, Norway
| | - Atle Hole Saeterbakken
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Bergen, Norway
| | - Espen Hermans
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Bergen, Norway
| | - Matthew Peter Shaw
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Bergen, Norway
| | - Vidar Andersen
- Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Bergen, Norway
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Szymczak RK, Pyka MK, Grzywacz T, Marosz M, Naczyk M, Sawicka M. Comparison of Environmental Conditions on Summits of Mount Everest and K2 in Climbing and Midwinter Seasons. Int J Environ Res Public Health 2021; 18:ijerph18063040. [PMID: 33809531 PMCID: PMC8000062 DOI: 10.3390/ijerph18063040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/09/2021] [Accepted: 03/09/2021] [Indexed: 12/02/2022]
Abstract
(1) Background: Today’s elite alpinists target K2 and Everest in midwinter. This study aimed to asses and compare weather at the summits of both peaks in the climbing season (Everest, May; K2, July) and the midwinter season (January and February). (2) Methods: We assessed environmental conditions using the ERA5 dataset (1979–2019). Analyses examined barometric pressure (BP), temperature (Temp), wind speed (Wind), perceived altitude (Alt), maximal oxygen uptake (VO2max), vertical climbing speed (Speed), wind chill equivalent temperature (WCT), and facial frostbite time (FFT). (3) Results: Most climbing-season parameters were found to be more severe (p < 0.05) on Everest than on K2: BP (333 ± 1 vs. 347 ± 1 hPa), Alt (8925 ± 20 vs. 8640 ± 20 m), VO2max (16.2 ± 0.1 vs. 17.8 ± 0.1 ml·kg−1·min−1), Speed (190 ± 2 vs. 223 ± 2 m·h−1), Temp (−26 ± 1 vs. −21 ± 1°C), WCT (−45 ± 2 vs. −37 ± 2 °C), and FFT (6 ± 1 vs. 11 ± 2 min). Wind was found to be similar (16 ± 3 vs. 15 ± 3 m·s−1). Most midwinter parameters were found to be worse (p < 0.05) on Everest vs. K2: BP (324 ± 2 vs. 326 ± 2 hPa), Alt (9134 ± 40 vs. 9095 ± 48 m), VO2max (15.1 ± 0.2 vs. 15.3 ± 0.3 ml·kg−1·min−1), Speed (165 ± 5 vs. 170 ± 6 m·h−1), Wind (41 ± 6 vs. 27 ± 4 m·s−1), and FFT (<1 min vs. 1 min). Everest’s Temp of −36 ± 2 °C and WCT −66 ± 3 °C were found to be less extreme than K2’s Temp of −45 ± 1 °C and WCT −76 ± 2 °C. (4) Conclusions: Everest presents more extreme conditions in the climbing and midwinter seasons than K2. K2’s 8° higher latitude makes its midwinter BP similar and Temp lower than Everest’s. K2’s midwinter conditions are more severe than Everest’s in the climbing season.
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Affiliation(s)
- Robert K. Szymczak
- Department of Emergency Medicine, Faculty of Health Sciences, Medical University of Gdansk, Debinki 1, 80-211 Gdansk, Poland
- Polish Mountaineering Association, Polish National K2 Winter Expedition 2018 Support Team, Mokotowska 24, 00-561 Warszawa, Poland;
- Correspondence: ; Tel.: +48-667-674141
| | - Michał K. Pyka
- Polish Mountaineering Association, Polish National K2 Winter Expedition 2018 Support Team, Mokotowska 24, 00-561 Warszawa, Poland;
| | - Tomasz Grzywacz
- Institute of Physical Culture, Kazimierz Wielki University in Bydgoszcz, Chodkiewicza 30, 85-064 Bydgoszcz, Poland;
| | - Michał Marosz
- Institute of Meteorology and Water Management—National Research Institute, Waszyngtona 42, 81-342 Gdynia, Poland;
| | - Marta Naczyk
- Polish Mountaineering Association, Polish National K2 Winter Expedition 2018 Support Team, Mokotowska 24, 00-561 Warszawa, Poland;
- Department of Nutritional Biochemistry, Faculty of Health Sciences, Medical University of Gdansk, Debinki 1, 80-211 Gdansk, Poland
| | - Magdalena Sawicka
- Department of Neurology, Faculty of Medicine, Medical University of Gdansk, Debinki 1, 80-211 Gdansk, Poland;
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Kocur P, Piwińska I, Goliwąs M, Adamczewska K. Assessment of myofascial stiffness of flexor digitorum superficialis muscles in rock climbers. Acta Bioeng Biomech 2021; 23:23-31. [PMID: 34846042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE Myofascial stiffness is the biomechanical property that can be considered as a modifiable risk factor injury of athletes. Moreover, the level of muscle stiffness can be crucial to assessment muscle adaptation to exercise. However, stiffness of flexor muscles in rock climbers has never been investigated. The purpose of this study was to evaluate the myofascial stiffness of the flexor digitorum superficialis (FDS) in the rock climbers. METHODS The group of rock climbers (n = 16) has been compared to the non-climbers group (n = 16), matched in terms of anthropometric measures and an average level of physical fitness. Moreover, the impact of the one-time rock climbing training on FDS stiffness was assessed in the rock climbers group. The measurement of myotonometric myofascial stiffness of FDS muscles was performed, when the elbow was flexed and fully extended. In both positions, the measurements were taken with the hand open and closed. RESULTS It has been shown that rock climber's FDS muscle stiffness before training was significantly higher (from 15 to 20%) compared to non-climbers group. Moreover, after climbing myofascial stiffness of FDS muscles increased significantly from 25 to 40%. CONCLUSIONS Rock climbers have significantly higher stiffness of FDS muscles after rock climbing training. Moreover, the increased stiffness in the FDS differentiates rock climbers from the active and healthy control group. Results may indicate that decrease of muscle stiffness of FDS can be an important factor for the improvement of the climbing effectiveness and prevention of overload in the forearm flexor muscles and their recovery.
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Affiliation(s)
- Piotr Kocur
- Department of Musculoskeletal Rehabilitation, Poznan University of Physical Education, Poznań, Poland
| | - Iga Piwińska
- Faculty of Physiotherapy, Poznan University of Physical Education, Poznań, Poland
| | - Magdalena Goliwąs
- Department of Musculoskeletal Rehabilitation, Poznan University of Physical Education, Poznań, Poland
| | - Katarzyna Adamczewska
- Department of Musculoskeletal Rehabilitation, Poznan University of Physical Education, Poznań, Poland
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Assmann M, Steinmetz G, Schilling AF, Saul D. Comparison of Grip Strength in Recreational Climbers and Non-Climbing Athletes-A Cross-Sectional Study. Int J Environ Res Public Health 2020; 18:ijerph18010129. [PMID: 33375452 PMCID: PMC7796164 DOI: 10.3390/ijerph18010129] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/23/2020] [Accepted: 12/24/2020] [Indexed: 01/17/2023]
Abstract
In recent years, climbing sports is on the rise making its Olympic debut in 2021. Physiological traits of professional rock climbers have been intensively studied, while recreational indoor climbers are less investigated, especially regarding grip strength and upper extremity proportions. In this cross-sectional study, we aimed to understand what discerns the recreational climber from disparate recreational athletes. Therefore, we analyzed 50 recreational climbing (30.3 ± 12.7 years, 1.76 ± 0.09 m and 67.0 ± 14.0 kg) and 50 non-climbing athletes (26.4 ± 9.1 years, 1.78 ± 0.09 m and 73.2 ± 12.6 kg) to detect differences in their finger grip strength of seven different pinches. In addition, the upper extremity proportions were measured. Even in recreational climbers, almost all analyzed grips were stronger compared to other athletes (p < 0.05 in all but non-dominant fist, small to moderate effect sizes). Only the grip strength of the whole non-dominant hand was not significantly different (p = 0.17). Interestingly, differences between the dominant and non-dominant hand appeared to be larger in the non-climbing (all p < 0.05, all but one with small effect size) compared to the climbing cohort (pinch I/IV and pinch I/II+III+IV not different and mostly trivial). Circumference measurements showed that 10 cm below the lateral epicondyle, climbers exhibited significantly greater perimeter compared to non-climbing athletes (p < 0.05, small effect size). Our results show that recreational climbers have higher measured grip strength, but less profound differences between the dominant and non-dominant hand.
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Affiliation(s)
- Mara Assmann
- Department of Trauma, Orthopedics and Reconstructive Surgery, Georg-August-University of Goettingen, 37075 Goettingen, Germany; (M.A.); (G.S.); (A.F.S.)
| | - Gino Steinmetz
- Department of Trauma, Orthopedics and Reconstructive Surgery, Georg-August-University of Goettingen, 37075 Goettingen, Germany; (M.A.); (G.S.); (A.F.S.)
| | - Arndt Friedrich Schilling
- Department of Trauma, Orthopedics and Reconstructive Surgery, Georg-August-University of Goettingen, 37075 Goettingen, Germany; (M.A.); (G.S.); (A.F.S.)
| | - Dominik Saul
- Department of Trauma, Orthopedics and Reconstructive Surgery, Georg-August-University of Goettingen, 37075 Goettingen, Germany; (M.A.); (G.S.); (A.F.S.)
- Kogod Center on Aging and Division of Endocrinology, Mayo Clinic, Rochester, MN 55905, USA
- Correspondence:
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Jäger H, Schirpke U, Tappeiner U. Assessing conflicts between winter recreational activities and grouse species. J Environ Manage 2020; 276:111194. [PMID: 32891036 DOI: 10.1016/j.jenvman.2020.111194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 07/30/2020] [Accepted: 08/02/2020] [Indexed: 06/11/2023]
Abstract
Mountain environments provide habitats for many wild animal species and are of great importance to recreational activities. In the European Alps, winter recreation activities such as ski mountaineering are becoming increasingly popular, which may lead more often to disturbance of Alpine wildlife. Assessment of ski mountaineering activities and related potential conflict zones is needed to implement protection measures and to guide skiers towards nature-friendly behaviour in sensitive locations. Yet basic data regarding frequencies of ski mountaineers is still missing at regional scale. For the Region of the Tyrol (Austria), this study therefore aimed to advance methods of assessing ski mountaineering activities for use in the spatial analysis of conflict zones with grouse species. We overlaid high-resolution information on the spatial and temporal distribution of ski mountaineers from crowd-sourced data (Strava) with distribution maps of capercaillie (Tetrao urogallus L.) and black grouse (Tetrao tetrix L.). Our results indicate that ski mountaineering activities affected 10.3% of the distribution area of black grouse and 8.6% of the distribution area of capercaillie. The raw crowd-sourced data was pre-processed with local information on skiing resorts, cross-country trails and infrastructure and use of the tested method was validated, with good spatial resolution (0.076 km2 per minimum mapping unit) for large study areas. We identified four intensity classes of ski mountaineering activity, which were randomly distributed in the study area. The spatial distribution of ski mountaineering activities showed an accumulation of activities in the south of the Inn valley. Our results could provide a valuable basis for developing mitigation measures and strategies in order to reduce the disturbance of Alpine wildlife by ski mountaineering.
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Affiliation(s)
- Hieronymus Jäger
- Department of Ecology, University of Innsbruck, Sternwartestrasse 15, 6020, Innsbruck, Austria; ifuplan - Institute for Environmental Planning and Spatial Development, Amalienstrasse 79, 80799, München, Germany.
| | - Uta Schirpke
- Department of Ecology, University of Innsbruck, Sternwartestrasse 15, 6020, Innsbruck, Austria; Institute for Alpine Environment, Eurac Research, Viale Druso 1, 39100, Bozen/Bolzano, Italy
| | - Ulrike Tappeiner
- Department of Ecology, University of Innsbruck, Sternwartestrasse 15, 6020, Innsbruck, Austria; Institute for Alpine Environment, Eurac Research, Viale Druso 1, 39100, Bozen/Bolzano, Italy
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Draga P, Ozimek M, Krawczyk M, Rokowski R, Nowakowska M, Ochwat P, Jurczak A, Stanula A. Importance and Diagnosis of Flexibility Preparation of Male Sport Climbers. Int J Environ Res Public Health 2020; 17:ijerph17072512. [PMID: 32272571 PMCID: PMC7178254 DOI: 10.3390/ijerph17072512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/01/2020] [Accepted: 04/04/2020] [Indexed: 11/24/2022]
Abstract
The objective of the study was to verify the relationships between sport skill levels and to identify the tests that accurately diagnose flexibility of sport climbers. This study examined 60 competitive advanced–higher elite male 7b–9a redpoint (RP) climbers. The athletes performed commonly used flexibility tests (stand-and-reach, straddle sit, straddle stand) and climbing-specific flexibility tests. Significant correlations were found between sport skill levels for the straddle stand test (r = −0.48) and the straddle sit test (r = −0.41). No significant correlations were observed between climbing-specific flexibility tests and sports skill level of climbers. Hip abduction evaluated using the straddle sit and straddle stand tests were significantly correlated with sports skill level and thus can be approached as a tool to diagnose flexibility of climbers. Flexibility is very specific and difficult to diagnose in climbing, but it should be developed.
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Affiliation(s)
- Paweł Draga
- Kletterverband Österreich, 6020 Innsbruck, Austria;
| | - Mariusz Ozimek
- Institute of Sport, Department of Track and Field’s Sports, University of Physical Education, 31-571 Krakow, Poland;
| | - Marcin Krawczyk
- Faculty of Health Sciences, University of Applied Sciences, 33-100 Tarnow, Poland;
| | - Robert Rokowski
- Department of Tourism and Leisure, Section of Mountaineering and Qualified Tourism, University of Physical Education, 31-571 Krakow, Poland;
| | | | - Paweł Ochwat
- Department of Theory and Methodology of Physical Education, University of Physical Education, 31-571 Krakow, Poland; (P.O.); (A.J.)
| | - Adam Jurczak
- Department of Theory and Methodology of Physical Education, University of Physical Education, 31-571 Krakow, Poland; (P.O.); (A.J.)
| | - Arkadiusz Stanula
- Institute of Sport Science, Department of Exercise and Sport Performance, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland
- Correspondence: ; Tel.: +48-32-207-5105
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Egger A, Niederer M, Tscherny K, Burger J, Fuhrmann V, Kienbacher C, Roth D, Schreiber W, Herkner H. Influence of physical strain at high altitude on the quality of cardiopulmonary resuscitation. Scand J Trauma Resusc Emerg Med 2020; 28:19. [PMID: 32143653 PMCID: PMC7060596 DOI: 10.1186/s13049-020-0717-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 03/02/2020] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND High quality cardiopulmonary resuscitation is a key factor in survival with good overall quality of life after out-of-hospital cardiac arrest. Current evidence is predominantly based on studies conducted at low altitude, and do not take into account the special circumstances of alpine rescue missions. We therefore aimed to investigate the influence of physical strain at high altitude on the quality of cardiopulmonary resuscitation. METHODS Alpine field study. Twenty experienced mountaineers of the Austrian Mountain Rescue Service trained in Basic Life Support (BLS) performed BLS on a manikin in groups of two for 16 min. The scenario was executed at baseline altitude and immediately after a quick ascent over an altitude difference of 1200 m at 3454 m above sea level. The sequence of scenarios was randomised for a cross over analysis. Quality of CPR and exhaustion of participants (vital signs, Borg-Scale, Nine hole peg test) were measured and compared between high altitude and baseline using random-effects linear regression models. RESULTS The primary outcome of chest compression depth significantly decreased at high altitude compared to baseline by 1 cm (95% CI 0.5 to 1.3 cm, p < 0.01). There was a significant reduction in the proportion of chest compressions in the target depth (at least 5 cm pressure depth) by 55% (95% CI 29 to 82%, p < 0.01) and in the duration of the release phase by 75 ms (95% CI 48 to 101 ms, p < 0.01). No significant difference was found regarding hands-off times, compression frequency or exhaustion. CONCLUSION Physical strain during a realistic alpine rescue mission scenario at high altitude led to a significant reduction in quality of resuscitation. Resuscitation guidelines developed at sea level are not directly applicable in the mountain terrain.
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Affiliation(s)
- Alexander Egger
- Mountain Rescue Service Austria, Schelleingasse 26/2/2, 1040, Wien, Austria
- Department of Anaesthesiology and Intensive Care Medicine, Hospital Scheibbs, Eisenwurzenstraße 26, 3270, Scheibbs, Austria
| | - Maximilian Niederer
- Mountain Rescue Service Austria, Schelleingasse 26/2/2, 1040, Wien, Austria
- Department of Emergency Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Wien, Austria
| | - Katharina Tscherny
- Department of Emergency Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Wien, Austria
| | - Josef Burger
- Mountain Rescue Service Austria, Schelleingasse 26/2/2, 1040, Wien, Austria
- Department of Paediatrics, Hospital Lienz, Emanuel von Hibler-Straße 5 A, 9900, Lienz, Austria
| | - Verena Fuhrmann
- Department of Emergency Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Wien, Austria
| | - Calvin Kienbacher
- Department of Emergency Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Wien, Austria
| | - Dominik Roth
- Department of Emergency Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Wien, Austria.
| | - Wolfgang Schreiber
- Department of Emergency Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Wien, Austria
| | - Harald Herkner
- Department of Emergency Medicine, Medical University of Vienna, Spitalgasse 23, 1090, Wien, Austria
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Stuppner S, Ruiu A, Stirpe E, Bonazza L. Ein Fall aus der Höhenmedizin. Radiologe 2020; 60:269-272. [PMID: 32052113 PMCID: PMC7080129 DOI: 10.1007/s00117-020-00650-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- S Stuppner
- Abteilung für Diagnostische und Interventionelle Radiologie, Regionalkrankenhaus Bozen, 39100, Bozen, Südtirol, Italien.
| | - A Ruiu
- Abteilung für Diagnostische und Interventionelle Radiologie, Regionalkrankenhaus Bozen, 39100, Bozen, Südtirol, Italien
| | - E Stirpe
- Abteilung für Pneumologie, Regionalkrankenhaus Bozen, Bozen, Südtirol, Italien
| | - L Bonazza
- Abteilung für Pneumologie, Regionalkrankenhaus Bozen, Bozen, Südtirol, Italien
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Abstract
As a model of extreme conditions, eight healthy women, part of a 40-member Nepal mountain-climbing expedition, were monitored for dynamic endocrine adaptations. Endocrine measurements were made at frequent intervals over a 6-10-h period at four altitudes: 450 m, 4,800 m (base camp), 6,050 m, and again at 4,800 m (on descent) after an acclimatization (A) period (4,800 mA). Quantified hormones were growth hormone (GH), prolactin (PROL), cortisol (Cort), thyroid-stimulating hormone (TSH), and free thyroxine. These hormones are important to the anabolic/catabolic balance of the body, and are vital to growth, homeostasis, hypothalamic inhibition, regulation of stress, and metabolism. A key secondary question was the degree to which acclimatization can stabilize hormonal disruption. On the basis of statistical false discovery rates, the present analyses unveil marked adaptive changes in the thyroid axis at the level of pulsatile secretion of the pituitary hormone TSH and its downstream product, free thyroxine; strong effects on the mass of GH, TSH, Cort, and PROL secretion per burst; and prominent pulsatile frequency disruption and recovery for PROL and Cort. Because pulsatility changes reflect de facto perturbations in hypothalamo-pituitary control mechanisms, the present data introduce the concept of both frequency- and amplitude-dependent adaptive control of brain-pituitary neuroendocrine signals under conditions of extreme altitude exertion and exposure.
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Affiliation(s)
- Daniel M Keenan
- Department of Statistics, University of Virginia, Charlottesville, Virginia
| | - Jacqueline Pichler Hefti
- Department of Pulmonary Medicine, University Hospital and University of Berne, Inselspital, Berne, Switzerland
| | - Johannes D Veldhuis
- Department of Medicine, Endocrine Research Unit, Mayo Clinic, Rochester, Minnesota
| | - Michael Von Wolff
- Women's University Hospital, Department of Gynecological endocrinology and Reproductive Medicine, Berne, Switzerland
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Soteras I, Paal P, Ayala M, Carmona F, Subirats E, Strapazzon G. In Response to Cardiac Events in Mountain Rescues in Aragón by Martínez-Caballero et al. Wilderness Environ Med 2020; 31:118-119. [PMID: 31982349 DOI: 10.1016/j.wem.2019.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/13/2019] [Accepted: 08/30/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Iñigo Soteras
- Cerdanya Hospital. University of Girona, Faculty of Medicine, Girona, Spain
| | - Peter Paal
- Hospitallers Brothers Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Marc Ayala
- Unidad de rescate de Montaña, Huesca, Spain
| | | | - Enric Subirats
- University of Girona, Faculty of Medicine, Girona, Spain
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Zhang W, Zhou C, Huang Z, Yang S, Chen J, Ma C, Zhu Y, Ni C. Effect of Continuous Monitoring of Oxygen Saturation to Counter Acute Mountain Sickness in Physician Climbers: A Pilot Study. High Alt Med Biol 2019; 20:204-205. [PMID: 31180237 DOI: 10.1089/ham.2019.0048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Weidai Zhang
- 1 Department of Cardiology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Chunbin Zhou
- 2 Department of Orthopedics, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Zhuangcheng Huang
- 3 Department of surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Senyuan Yang
- 3 Department of surgery, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Junheng Chen
- 4 Department of Anesthesiology, Shantou Central Hospital, Shantou, Guangdong, China
| | - Chuangxin Ma
- 5 Department of Intervention, Shantou Central Hospital, Shantou, Guangdong, China
| | - Yilin Zhu
- 2 Department of Orthopedics, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Chumin Ni
- 1 Department of Cardiology, Shantou Central Hospital, Shantou, Guangdong, China
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