The Effects of Intermittent Hypoxic Training Strategies on Maximal Oxygen Uptake in Healthy Humans: A Meta-analysis with Meta-regression

@article{kohlbrenner2026effects,
  title = {{The Effects of Intermittent Hypoxic Training Strategies on Maximal Oxygen Uptake in Healthy Humans: A Meta-analysis with Meta-regression}},
  author = {Dario Kohlbrenner and Abdallah Ghaith and Joey Fournier and Charles Khouri and Antonin Bordas and Samarmar Chacaroun and Monique Mendelson and Patrice Flore and Mathieu Marillier and Julien Brugniaux and Jean-Louis Pépin and Renaud Tamisier and Samuel Verges},
  journal = {Sports Medicine},
  year = {2026},
  month = sep,
  doi = {10.1007/s40279-026-02482-9},
  url = {https://hal.science/hal-05768612v1},
  note = {CC BY 4.0},
}

TY  - JOUR
TI  - The Effects of Intermittent Hypoxic Training Strategies on Maximal Oxygen Uptake in Healthy Humans: A Meta-analysis with Meta-regression
AU  - Dario Kohlbrenner
AU  - Abdallah Ghaith
AU  - Joey Fournier
AU  - Charles Khouri
AU  - Antonin Bordas
AU  - Samarmar Chacaroun
AU  - Monique Mendelson
AU  - Patrice Flore
AU  - Mathieu Marillier
AU  - Julien Brugniaux
AU  - Jean-Louis Pépin
AU  - Renaud Tamisier
AU  - Samuel Verges
PY  - 2026
DA  - 2026/09/15
JO  - Sports Medicine
DO  - 10.1007/s40279-026-02482-9
UR  - https://hal.science/hal-05768612v1
AB  - Background Intermittent hypoxic training aims to enhance exercise performance and health, commonly assessed through maximal oxygen uptake (VO 2 max). Currently applied methods are live-high train-low (LHTL), live-low train-high (LLTH) and passive hypoxic conditioning (PHC). However, within these methods, numerous modes of application exist, and effectiveness is debated. Objective To determine the effect of LHTL, LLTH and PHC on VO 2 max in healthy participants, and identify factors associated with the amplitude of change in VO 2 max. Methods We conducted a systematic review with random-effects meta-analysis and meta-regression. Studies were identified through PubMed, EMBASE and Web of Science. We included controlled studies, calculating between-group standardised mean differences. Athlete and non-athlete populations were analysed separately. RoB2 was used to assess study quality and publication bias was investigated with funnel plots and the Egger's test. Results Of the 5244 identified studies, 62 were included for analysis, resulting in a sample size of 1332 participants (610 athletes, 722 non-athletes). LHTL increased VO 2 max significantly more than control in athletes (mean difference [MD] = 2.17; 95% CI = 0.77, 3.56) but not in non-athletes (MD = 3.1; 95% CI = -0.23, 6.43). LLTH did not increase VO 2 max significantly more than control in athletes (MD = 0.89; 95% CI = -0.27, 2.05) but it did in non-athletes (MD = 1.70; 95% CI = 0.85, 2.54). PHC did not increase VO 2 max significantly more than control in athletes (MD = -1.07; 95% CI = -3.51, 1.37) but it did in non-athletes (MD = 2.26; 95% CI = 1.00, 3.52). Multivariate meta-regressions identified the severity, duration, and frequency of hypoxic exposure to be significantly associated with the change in VO 2 max. Conclusions LHTL showed a significant effect on VO 2 max in athletic populations while LLTH and PHC showed a significant effect on VO 2 max in non-athletic populations only. Future studies should target investigating which characteristics (e.g. severity, duration) of the hypoxic exposure are most beneficial.  Key Points  Intermittent hypoxic training induces increases in VO2maxsuperior to control when applied as live-high train-low (i.e. training at low altitude while spending the rest of the day in hypoxia) in athletes.  Intermittent hypoxic training induces increases inVO2max superior to control when applied as live-low train-high (i.e. perform training in hypoxia) and passive hypoxic conditioning (i.e. hypoxia at rest during wakening hours) in non-athletes only.  The severity, duration and frequency of hypoxic exposure are independently driving the observed changes in VO2max.
SN  - 0112-1642
ER  -