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This randomized controlled trial aims to investigate the effects of balneotherapy (hot spring bathing) on cardiac autonomic nervous system function and exercise performance in healthy athletes undergoing high-altitude training. Participants will be randomly assigned to the intervention group (receiving hot spring baths three times per week (38°C, 20 minutes) combined with high-altitude training), the control group (receiving routine recovery protocols combined with high-altitude training), or the hot water immersion group (receiving hot water baths three times per week (38°C, 20 minutes) combined with high-altitude training). Primary outcome measures include heart rate variability (HRV) indices and exercise performance indicators. Secondary outcomes include blood lactate, peripheral oxygen saturation (SpO2), and subjective fatigue. These findings may provide evidence for non-pharmacological interventions to enhance high-altitude training adaptation and exercise recovery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Natural Recovery Group | Active Comparator | Control group participants will undergo the same altitude training protocol (altitude 1600 meters) for 4 weeks. After each training session, participants will receive standard recovery procedures, including 20 minutes of passive rest in a thermoneutral environment (room temperature 24°C), supplemented with mild hydration and self-selected stretching. No hydrothermal intervention will be provided. |
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| Hot water immersion group | Active Comparator | The hot water immersion group will undergo a 4-week altitude training at 1600 meters above sea level. Subjects will receive a 20-minute hot water immersion (daily tap water, 38°C±1°C) in a standardized indoor hot spring facility. The immersion protocol involves soaking the body below the chest for 20 minutes, followed by a 10-minute rest before leaving the facility. Three times per week. |
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| Hot Spring Immersion Group | Experimental | The hot spring immersion group will undergo a 4-week high-altitude training at an altitude of 1600 meters. Subjects will receive a 20-minute hot spring therapy (natural hot spring water, 38°C ± 1°C) in a standardized indoor hot spring facility. The immersion protocol involves soaking the body below the chest for 20 minutes, followed by a 10-minute rest before leaving the facility. Three times per week. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Control Group：Natural Recovery | Behavioral | Control group participants will undergo the same altitude training protocol (altitude 1600 meters) for 4 weeks. After each training session, participants will receive standard recovery procedures, including 20 minutes of passive rest in a thermoneutral environment (room temperature 24°C), supplemented with mild hydration and self-selected stretching. No hydrothermal intervention will be provided. |
| Measure | Description | Time Frame |
|---|---|---|
| Heart Rate Variability (HRV) - RMSSD | Root mean square of successive differences (RMSSD) between normal heartbeats, measured from a 5-minute seated ECG recording in a quiet, temperature-controlled (22-24°C) room after 15 minutes of rest. A higher RMSSD value indicates stronger parasympathetic activity. Unit: milliseconds (ms). Baseline, Week 2, Week 3 (post-intervention). | Baselines were measured at the formal start of the experiment, at night during the 2nd, 3rd, and 4th weeks (post-intervention) after ascending the plateau, and post-tests were conducted one week after descending the plateau. |
| Measure | Description | Time Frame |
|---|---|---|
| HRV - SDNN | Standard deviation of NN intervals (normal-to-normal R-R intervals), reflecting overall autonomic modulation. Unit: milliseconds (ms). Baseline, Week 2, Week 3, Week4, post-tests | Baselines were measured at the formal start of the experiment, at night during the 2nd, 3rd, and 4th weeks (post-intervention) after ascending the plateau, and post-tests were conducted one week after descending the plateau. |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Macao Polytechnic University | Macao | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22752345 | Background | Stanley J, Peake JM, Buchheit M. Consecutive days of cold water immersion: effects on cycling performance and heart rate variability. Eur J Appl Physiol. 2013 Feb;113(2):371-84. doi: 10.1007/s00421-012-2445-2. Epub 2012 Jul 3. | |
| 38663342 | Background | Jdidi H, Dugue B, de Bisschop C, Dupuy O, Douzi W. The effects of cold exposure (cold water immersion, whole- and partial- body cryostimulation) on cardiovascular and cardiac autonomic control responses in healthy individuals: A systematic review, meta-analysis and meta-regression. J Therm Biol. 2024 Apr;121:103857. doi: 10.1016/j.jtherbio.2024.103857. Epub 2024 Apr 18. |
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The current research project has not yet been completed, and the data have not been publicly released. After publication, sharing will be decided on a case-by-case basis.
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| Hot water immersion group | Behavioral | The hot water immersion group will undergo a 4-week altitude training at 1600 meters above sea level. Subjects will receive a 20-minute hot water immersion (daily tap water, 38°C±1°C) in a standardized indoor hot spring facility. The immersion protocol involves soaking the body below the chest for 20 minutes, followed by a 10-minute rest before leaving the facility. Three times per week. |
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| hot spring immersion group | Behavioral | The hot spring immersion group will undergo a 4-week high-altitude training at an altitude of 1600 meters. Subjects will receive a 20-minute hot spring therapy (natural hot spring water, 38°C ± 1°C) in a standardized indoor hot spring facility. The immersion protocol involves soaking the body below the chest for 20 minutes, followed by a 10-minute rest before leaving the facility. Three times per week. |
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| Peripheral Oxygen Saturation (SpO2) | Resting peripheral oxygen saturation measured via fingertip pulse oximeter after 10 minutes of seated rest. Unit: percentage (%) | one month. |
| Rating of Perceived Exertion (RPE) | Borg 6-20 scale rating of perceived exertion recorded immediately after each training session. Higher scores indicate greater subjective effort. Unit: score (6-20). Daily during intervention | one month. |
| Maximum oxygen uptake | Testing maximum oxygen uptake on a rowing ergometer combined with a cardiopulmonary function tester. Protocol: Using a graded incremental protocol to test maximal oxygen uptake (VO2max). Units: mL·kg-1 ·min-1. Baseline, Week 5. | The baseline measurement was taken before the official start of the experiment, and the post-test was conducted one week after descending from the plateau. |
| 30-second anaerobic power. | Perform a 30-s all-out test on a rowing ergometer. Protocol: sprint at maximum effort to measure the 30-second average power. Record power. Units: watt. Baseline, Week 4，1 week after altitude training. | The tests are scheduled before entering the plateau (baseline), during the 4th week of plateau training, and 1 week after leaving the plateau. |
| 25705824 | Background | Laukkanen T, Khan H, Zaccardi F, Laukkanen JA. Association between sauna bathing and fatal cardiovascular and all-cause mortality events. JAMA Intern Med. 2015 Apr;175(4):542-8. doi: 10.1001/jamainternmed.2014.8187. |
| 14564334 | Background | Michalsen A, Ludtke R, Buhring M, Spahn G, Langhorst J, Dobos GJ. Thermal hydrotherapy improves quality of life and hemodynamic function in patients with chronic heart failure. Am Heart J. 2003 Oct;146(4):728-33. doi: 10.1016/S0002-8703(03)00314-4. |
| 24282195 | Background | Buchheit M, Simpson BM, Garvican-Lewis LA, Hammond K, Kley M, Schmidt WF, Aughey RJ, Soria R, Sargent C, Roach GD, Claros JC, Wachsmuth N, Gore CJ, Bourdon PC. Wellness, fatigue and physical performance acclimatisation to a 2-week soccer camp at 3600 m (ISA3600). Br J Sports Med. 2013 Dec;47 Suppl 1(Suppl 1):i100-6. doi: 10.1136/bjsports-2013-092749. |
| ID | Term |
|---|---|
| D000532 | Altitude Sickness |
| ID | Term |
|---|---|
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
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