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1

Femoral neck stress fracture during sport climbing

100%

Küpper T., Rutten S., Morrison A., Schöffl V.

Health Promotion & Physical Activity

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2021

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vol. 17

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issue 4

1-5

EN

While the epiphyseal stress fracture of the finger’s middle phalanx is a known sport-specific injury occurring only in adolescent climbers, and in other locations it’s rare, no femoral neck stress fracture (FNSF) in sports climbing has yet been reported. An experienced female sport climber (37y, 160 cm, 45 kg, BMI 17.5) suffered from pain in the left inguinal region while climbing, and later, also required a stick to walk. Routine radiography missed the FNSF and it was many weeks before a MRI accurately provided that diagnosis. The time between the X-ray and MRI should have been minimized as it resulted in a delayed diagnosis, unnecessary pain and delayed healing. In this situation the initial clinical investigation, the patient’s history and the X-ray did not lead to a clear diagnosis, and the initial treatment was ineffective. Further investigation by MRI and / or CT scans should have taken place sooner and would have been essential.

2

Sportspecific performance diagnosis in ski mountaineering - comparison of a sportspecific cardiopulmonary exercise test on a treadmill versus outdoors and at altitude, a pilot study

100%

Schöffl I., Bliemsrieder B., Küpper T., Schöffl V.

Health Promotion & Physical Activity

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2021

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vol. 16

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issue 3

16-25

EN

Background: Ski mountaineering is a competitive sport that has gained popularity during the last years. As most competitions are held in altitudes between 1500 m and 3500 m, a considerable amount of training occurs at various hypobaric hypoxia degrees. It was establishing a sport-specific cardiopulmonary exercise protocol using standard ski mountaineering equipment on a treadmill. This study investigated altitude’s effects on a self-regulated incremental exercise field test at 3100 m with this protocol.Methods: Six athletes were tested (24.2 ± 4.2 years) from the German Ski Mountaineering National Team with a portable telemetric cardiopulmonary exercise test equipment. First, an incremental indoor step test with skis on a treadmill (altitude 310 m) and four days later outdoor on glacier snow (3085 m) after three days of acclimatization. All athletes were exposed to repetitive intermittent hypoxia during the weeks before the test. Standard cardiopulmonary exercise parameters were recorded while individual training zones were defined according to ventilatory thresholds.Results: In highly trained athletes, mean V̇O2peak (72/ml kg KG/min) was reduced by 25% or 9% per 1000 m altitude gain and by 18% and 23% at the first and second ventilatory thresholds, respectively. Mean maximum heart rate and the heart rate at the ventilatory thresholds were reduced at altitude compared to sea-level, as was the O2pulse.Conclusion: Due to distinctive individual reactions to hypoxia, cold, etc., an individual and sport-specific field performance analysis, representing the daily training environment, is highly useful in world-class athletes for precise training control. Our self-regulated cardiopulmonary field protocol could well prove to serve in such a way.

3

Portable hyperbaric chambers for the treatment of altitude disease

88%

Küpper T., Gieseler U., Milledge J., Morrison A., Schöffl V.

Health Promotion & Physical Activity

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2022

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vol. 20

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issue 3

36-40

EN

Portable hyperbaric chambers are a therapeutic option for altitude disease in the mountains. By an increase of the oxygen partial pressure the patient’s symptoms ameliorate significantly. Portable hyperbaric chambers may be used as ‘stand alone therapy’ as well as in combination with other therapeutic options. Here we present the recommendation how to use the device and how to avoid problems. The recommendation has been agreed by all members of the medical commission of the world umbrella organization Union Internationale des Associations d’Alpinisme (UIAA MedCom).

4

Risk Management and First Aid Knowledge of Trekkers in Nepal

76%

Lechner K., Scharfenberg C., Hettlich E. M., Giet S., Morrison A., Schöffl V., Küpper T.

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2020

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vol. 13

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issue 4

21-24

EN

Background: Trekking in Nepal is popular and generally safe. However preventable trekking injuries and deaths are often the result of poor risk managementand lack of skills – i.e. acute mountain sickness (AMS) and specific First Aid (FA). Shlim and Gallie’s reviews in 1992 and 2004 of trekking deaths here found a fivefold higher risk for fatal outcomes in organized trekking tours (OT) compared to independently organised trekkers (IT), including preventable deaths (i.e. AMS). Our survey sought to identify the AMS, FA and risk management knowledge/skills of OT and IT whilst trekking in Nepal. Methods: Based on previous pilot studies at the Khumbu region in Nepal, and on risk management information provided by leading German trekking operators, a survey was conducted using two questionnaires: one each for OT and IT.The study site was Manang (3,500m) in Annapurna region, Nepal. All trekkers passing through this site who volunteered their participation were included. For evaluation descriptive statistical methods and non-parametric tests were used. Results: 442 questionnaires were completed (155 OT; 287 IT). Mean agewas 36.4 +/– 12.0y and 61% were male. Mountaineering experience was low and FA training was scarce in both groups. IT (92.7%) followed acclimatization recommendations and 59.2% carried AMS medication, compared respectively to OT at 63.2% and 25.2%. Only 27.1% of OT had repatriation plans for a medical emergency. Conclusions: Most of OT and IT were inexperienced in mountaineering and in mountain emergencies. The preparedness of OT overall was inadequate and over-reliant on the organisers whose skills may also be inadequate when responding to an emergency. Responsible trekking should require that more than one person in a group have adequate, up-to-date riskassessment/management and FA skills specific to the trek, and in particular an understanding of altitude profile, AMS, and individual abilities.

5

Cardiopulmonary exercise tests of adolescent elite sport climbers – a comparison of the German junior national team in sport climbing and Nordic skiing

76%

Schöffl I., Wüstenfeld J., Jones G., Dittrich S., Lutter C., Schöffl V.

Health Promotion & Physical Activity

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2021

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vol. 14

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issue 1

1-8

EN

Introduction: All the research investigating the cardiopulmonary capacity in climbers is focused on predictors for climbing performance. The effects of climbing on the cardiovascular system in adolescents climbing at an elite level (national team) have not been evaluated.Material and methods: Retrospective analysis of the cardiopulmonary exercise test (CPET) performed on a cycle ergometer during the annual medical examination of the entire German Junior National climbing team on one occasion and for a selected subgroup on two occasions spaced two years apart. The data from the subgroup was compared to an age- and gender-matched control of Nordic skiers from the German Junior National Nordic skiing team.Results: 47 climbers (20 girls, 27 boys) were examined once. The VO2peak achieved by the athletes was 41.3 mL kg−1 min−1 (boys) and 39.8 mL kg−1 min−1 (girls). 8 boys and 6 girls were tested twice over a period of 27.5 months. The parameters of the exercise test measured on both occasions were significantly lower than those of the 8 male and 6 female Nordic skiers. There was no change with respect to any variables (e.g. VO2peak, peak work load, peak heart rate, peak lactate or O2 pulse) over the examined period.Conclusions: The elite climbers investigated in this study showed comparable VO2peak values to athletes from team and combat sports. The Nordic skiers to which they were compared showed significantly higher values consistant with the fact that this is an endurance sport. Even though the cardiopulmonary measurements of the Nordic skiers still improved after two years of training, no adaptations could be observed in the elite climbers.

6

The Borg Scale at high altitude

64%

Küpper T., Heussen N., Morrison A., Schöffl V., Basnyat B., Hillebrandt D., Milledge J., Steffgen J., Meier B.

Health Promotion & Physical Activity

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2021

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vol. 15

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issue 2

1-8

EN

Introduction: The Borg Scale for perceived exertion is well established in science and sport to keep an appropriate level of workload or to rate physical strain. Although it is also often used at moderate and high altitude, it was never validated for hypoxic conditions. Since pulse rate and minute breathing volume at rest are increased at altitude it may be expected that the rating of the same workload is higher at altitude compared to sea level.Material and methods: 16 mountaineers were included in a prospective randomized design trial. Standardized workload (ergometry) and rating of the perceived exertion (RPE) were performed at sea level, at 3,000 m, and at 4,560 m. For validation of the scale Maloney-Rastogi-test and Bland-Altmann-Plots were used to compare the Borg ratings at each intensity level at the three altitudes; p < 0.05 was defined as significant.Results: In Bland-Altmann-Plots more than 95% of all Borg ratings were within the interval of 1.96 x standard deviation. There was no significant deviation of the ratings at moderate or high altitude. The correlation between RPE and workload or oxygen uptake was weak.Conclusion: The Borg Scale for perceived exertion gives valid results at moderate and high altitude – at least up to about 5,000 m. Therefore it may be used at altitude without any modification. The weak correlation of RPE and workload or oxygen uptake indicates that there should be other factors indicating strain to the body. What is really measured by Borg’s Scale should be investigated by a specific study.

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Femoral neck stress fracture during sport climbing

Sportspecific performance diagnosis in ski mountaineering - comparison of a sportspecific cardiopulmonary exercise test on a treadmill versus outdoors and at altitude, a pilot study

Portable hyperbaric chambers for the treatment of altitude disease

Risk Management and First Aid Knowledge of Trekkers in Nepal

Cardiopulmonary exercise tests of adolescent elite sport climbers – a comparison of the German junior national team in sport climbing and Nordic skiing

The Borg Scale at high altitude