Impact of Respiratory Muscle Training and Nitrate Therapy on Exercise Tolerance in Simulated Altitude
This study investigates whether respiratory muscle training (RMT) and dietary nitrate supplementation can improve exercise tolerance under simulated moderate altitude conditions. Exposure to reduced oxygen availability at altitude places additional strain on the cardiovascular and respiratory systems, which may limit endurance performance. By combining RMT-designed to strengthen the muscles involved in breathing-with nitrate therapy, which enhances nitric oxide availability and vascular function, this study aims to determine whether these interventions independently or synergistically improve oxygen delivery, reduce physiological strain, and enhance exercise performance. The findings will help identify non-pharmacological strategies to improve physical performance and tolerance to hypoxia in both clinical and operational environments.
• Healthy adults between 18 and 40 years old.
⁃ Recreationally active (performing ≥3 hours of structured physical activity per week).
⁃ Non-smokers for at least the past 6 months.
⁃ Free from any known cardiovascular, pulmonary, metabolic, or neuromuscular disease as determined by health screening questionnaire and medical history.
⁃ Able to perform cycle ergometer exercise to volitional fatigue.
⁃ Willing to abstain from high-nitrate foods and supplements (e.g., beets, spinach, arugula) for 48 hours prior to each testing session.
⁃ Able and willing to provide written informed consent and comply with all study procedures.