A systematic review and meta-analysis was conducted to determine the effects of resistance training under hypoxic conditions (RTH) on muscle hypertrophy and strength development. Searches of PubMed-Medline, Web of Science, Sport Discus and the Cochrane Library were conducted comparing the effect of RTH versus normoxia (RTN) on muscle hypertrophy (cross sectional area (CSA), lean mass and muscle thickness) and strength development [1-repetition maximum (1RM)]. An overall meta-analysis and subanalyses of training load (low, moderate or high), inter-set rest interval (short, moderate or long) and severity of hypoxia (moderate or high) were conducted to explore the effects on RTH outcomes. Seventeen studies met inclusion criteria. The overall analyses showed similar improvements in CSA (SMD [CIs] = 0.17 [− 0.07; 0.42]) and 1RM (SMD = 0.13 [0.0; 0.27]) between RTH and RTN. Subanalyses indicated a small effect on CSA for shorter inter-set rest intervals, moderate hypoxia and moderate loads favoring RTH. Moreover, a medium effect for longer inter-set rest intervals and a trivial to small effect for severe hypoxia and moderate loads favoring RTH was found on 1RM. Evidence suggests that RTH employed with moderate loads (60–80% 1RM) enhances both hypertrophy and strength. Hypertrophy appears to benefit from shorter (≤ 60 s) inter-set rest intervals during RTH while greater gains in strength are achieved with longer rest intervals (≥ 120 s). The use of moderate hypoxia (14.3–16% FiO₂) seems to be somewhat beneficial to hypertrophy but not strength. Further research is required with greater standardization of protocols to draw stronger conclusions on the topic.

This study investigated the effect of a traditional hypertrophy-oriented resistance training (R_T) session at acute terrestrial hypoxia on inflammatory, hormonal, and the expression of miR-378 responses associated with muscular gains. In a counterbalanced fashion, 13 resistance trained males completed a hypertrophic R_T session at both moderate-altitude (H; 2320 m asl) and under normoxic conditions (N; <700 m asl). Venous blood samples were taken before and throughout the 30 min post-exercise period for determination of cytokines (IL6, IL10, TNFα), hormones (growth hormone [GH], cortisol [C], testosterone), and miR-378. Both exercise conditions stimulated GH and C release, while miR-378, testosterone, and inflammatory responses remained near basal conditions. At H, the R_T session produced a moderate to large but nonsignificant increase in the absolute peak values of the studied cytokines. miR-378 revealed a moderate association with GH (r = 0.65; p = 0.026 and r = −0.59; p = 0.051 in N and H, respectively) and C (r = 0.61; p = 0.035 and r = 0.75; p = 0.005 in N and H, respectively). The results suggest that a R_T session at H does not differentially affect the hormonal, inflammatory, and miR-378 responses compared to N. However, the standardized mean difference detected values in the cytokines suggest an intensification of the inflammatory response in H that should be further investigated.

This study investigated the effect of a resistance training (R_T) period at terrestrial (HH) and normobaric hypoxia (NH) on both muscle hypertrophy and maximal strength development with respect to the same training in normoxia (N). Thirty-three strength-trained males were assigned to N (FiO₂ = 20.9%), HH (2,320 m asl) or NH (FiO₂ = 15.9%). The participants completed an 8-week R_T program (3 sessions/week) of a full body routine. Muscle thickness of the lower limb and 1RM in back squat were assessed before and after the training program. Blood markers of stress, inflammation (IL-6) and muscle growth (% active mTOR, myostatin and miRNA-206) were measured before and after the first and last session of the program. Findings revealed all groups improved 1RM, though this was most enhanced by R_T in NH (p = 0.026). According to the moderate to large excess of the exercise-induced stress response (lactate and Ca²⁺) in HH and N, results only displayed increases in muscle thickness in these two conditions over NH (ES > 1.22). Compared with the rest of the environmental conditions, small to large increments in % active mTOR were only found in HH, and IL-6, myostatin and miR-206 in NH throughout the training period. In conclusion, the results do not support the expected additional benefit of R_T under hypoxia compared to N on muscle growth, although it seems to favour gains in strength. The greater muscle growth achieved in HH over NH confirms the impact of the type of hypoxia on the outcomes.

This study examined the acute effects of exposure to moderate altitude on factors associated with muscular adaptations following whole‐body hypertrophy‐oriented resistance training (R _T) sessions. Thirteen resistance‐trained males completed both counterbalanced standard hypertrophic R _T sessions (3 sets × 10RM, 2 min rest) at moderate‐altitude (H; 2320 m asl) and under normoxic conditions (N; <700 m asl). Participants rested 72 h between training sessions. Before and after the exercise session, blood samples were obtained for determination of metabolites and ions (lactate, inorganic phosphate, liquid carbon dioxide and calcium) and hormones (testosterone and growth hormone). Session‐related performance and perception of effort (s‐RPE) were also monitored. Results showed no meaningful differences in performance or s‐RPE (8.5 ± 1.4 vs 8.6 ± 0.8 respectively for N and H; p = 0.603). All blood variables displayed statistically significant changes throughout the recovery period compared to basal levels (p < 0.05), except for the testosterone. However, no altitude effect was observed in maximal blood lactate, calcium or anabolic hormones (p > 0.05). The reduction observed in the liquid carbon dioxide concentration in H (21.11 ± 1.46 vs 16.19 ± 1.61 mmol·l⁻¹) seems compatible with an increase in buffering capacity. Compared to N, inorganic phosphate displayed lower recovery values after the R _T in H (2.89 ± 0.64 vs 2.23 ± 0.60 mg dl⁻¹; p = 0.007). The results of this study do not support an accentuated effect of acute moderate terrestrial hypoxia on metabolic and hormonal factors linked to muscle growth during hypertrophic resistance training.

Hypobaric hypoxia (HH) seems to lead to different responses compared to normobaric hypoxia (NH) during physical conditioning. The aim of the study was to analyze the hormonal and circulating ion responses after performing high-intensity resistance training with different inter-set rest under HH and NH condition. Sixteen male volunteers were randomly divided into two training groups. Each group completed two counterbalanced resistance training sessions (three sets × ten repetitions, remaining two repetitions in reserve), with both one- and two-minute inter-set rest, under HH and NH. Blood samples were obtained to determine hormones and circulating ions (Ca²⁺, Pi, and HCO₃⁻) at baseline and after training sessions (5, 10, and 30 min). Resistance training with one-minute rest caused greater hormonal stress than with two-minute rest in cortisol and growth hormone, although the hypoxic environmental condition did not cause any significant alterations in these hormones. The short inter-set rest also caused greater alterations in HCO₃⁻ and Pi than the longer rest. Additionally, higher levels of Ca²⁺ and Pi, and lower levels of HCO₃⁻, were observed after training in HH compared to NH. Metabolic and physiological responses after resistance training are mediated by inter-set rest intervals and hypoxic environmental condition. According to the alterations observed in the circulating ions, HH could cause greater muscular fatigue and metabolic stress than NH.

Hypobaric hypoxia (HH) limits oxygen supply to tissues and increases metabolic demands, especially during exercise. We studied the influence of HH exposure on the subcutaneous adipose tissue (SAT) thickness and circulating metabolic-related cytokines levels after a resistance training (R_T) program. Twenty trained men participated in a traditional hypertrophy R_T for 8 weeks (three sessions/week) under intermittent terrestrial HH (2320 m) or normoxia (N, 690 m) conditions. Before, at week 6, and after the R_T, SAT, and vastus lateralis (VL) muscle thickness were measured by ultrasound. Blood samples were taken to analyse serum cytokines (IL-6, IL-15, irisin, and myostatin) by multiplex immunoassay. Our findings revealed a moderate reduction in IL-6 and irisin in HH following the R_T (ES < −0.64; p < 0.05). Additionally, R_T in HH promoted serum IL-15 release (ES = 0.890; p = 0.062), which exhibited a trivial inverse association with the reductions observed on SAT (−17.69%; p < 0.001) compared with N. R_T in HH explained ~50% of SAT variance (p < 0.001). These results highlight the benefit of stressor factors linked to R_T in HH on SAT through the modulation of serum metabolic cytokine profiles, suggesting a potential effect on overall body composition.