EFFECTS OF WEARING THE ELEVATION TRAINING MASK™ ON ENDURANCE PERFORMANCE COMPARED WITH CHANGES FROM TRAINING AT INCREASED ENVIRONMENTAL ALTITUDE – PRELIMINARY RESULTS Bellovary, B. N. 1, King, K. E. 1, Nuñez, T. P. 1,2, McCormick, J. J.1, Wells, A. D. 1, Bourbeau, K. C. 1, Fennel, Z. J. 1, Li, Z.1, Johnson, K. E. 1,3, Moriarty, T.1, Mermier, C. M. 1 1Department of Health, Exercise, and Sports Sciences, University of New Mexico, Albuquerque, NM. 2Department of Human Performance and Sports, Metropolitan State University of Denver, Denver, CO. 3Department of Physical Therapy, University of Saint Mary, Leavenworth, KS. Discussion The main findings of this study were that the ETM and control groups improved their PPO (10.6% and 7.1%, respectively) and only the ETM group improved their PO at VT (8.9%) after six weeks of training. However, there were no significant differences between groups. These improvements in PPO and PO at VT were similar to those found by Porcari et al. (2016); however, results of the present study did not show improvements in VO2max or VT. This study also analyzed potential economy changes at submaximal workloads for potential improvements in aerobic fitness. Enhanced economy would indicate increased re-synthesis of adenosine triphosphate in skeletal muscle with a lower VO2 (Matheson et al., 2005). The control group had a lower VO2 at work rates of 100W, 125W, and 150W compared with the ETM group both pre- and post-training, though VO2max was not significantly different between groups for either time point. The lower VO2 at submaximal work rates and the lower VO2max indicates the control group was less fit compared with the ETM group. This is supported by normative values for relative VO2max values. For both groups, training did not result in aerobic adaptations in terms of improving maximal and submaximal oxygen consumption. Since groups lacked the VO2max performance improvements observed by Porcari et al. (2016), the present study does not fully support their findings. In order to assess Porcari’s et al. (2016) conclusion that training with the ETM is not a simulator of altitude training, further investigation is required to compare the present findings to increased hypobaric altitude. Abstract Purpose: To determine whether six weeks of high intensity interval training (HIIT) while wearing the Elevation Training Mask™ would improve endurance performance compared with a control. Methods: Eighteen participants completed the study who were randomized into a mask (n = 9) or control (n = 9) group. Pre- and post-testing included a VO2max cycle ergometer ramp protocol with economy measures at submaximal power outputs (PO). Participants trained on a cycle ergometer twice a week for 30 min each session for six weeks. Sessions included a 5-min warm-up and cool-down with 20 minutes of HIIT (30s exercise at 100% peak power output (PPO), 90s active recovery, 10 bouts). Independent t-tests and repeated measures ANOVA determined statistical significance (p < 0.05). Results: Prior to starting and after training, the mask group had a significantly higher (p < 0.05) VO2 at ventilatory threshold (VT), at 100W, 125W, and 150W (before: 36.5, 25.2, 27.6, & 31.4 mL∙kg-1∙min-1, respectively; after: 37.2, 23.6, 26.3, & 30.1 mL∙kg-1∙min-1 respectively) compared to the control (before: 28.8, 19.8, 22.9, & 24.5 mL∙kg-1∙min-1, respectively; after: 27.9, 18.5, 20.6, & 23.3 mL∙kg-1∙min-1, respectively). VO2max was not significantly different (p < 0.05) between groups (control: 31.75 & 32.48 mL∙kg-1∙min-1, mask: 40.59 & 41.39 mL∙kg-1∙min-1 respectively). There were significant improvements from pre- to post-training in PPO for the control (7.1%) and PPO and PO at VT in the mask group (10.6% and 8.9%, respectively). Conclusion: The mask group was less economical before and after training; however, no changes occurred from training. Only the mask group demonstrated a pre- to post-training increase in PO at VT; however, post-training values were not significantly different from the control. Both groups demonstrated similar training adaptations and further investigation is required to compare the present findings to increased altitude. Results A) B) Figure 1. A) Peak power output from pre- and post-training for the ETM (mask) and control groups. B) Power outputs at ventilatory threshold for the ETM and control groups. * denotes within-group significant difference between pre- and post-training (p < 0.05). What is to come? Where is the altitude? Unfortunately, due to mechanical issues with the hypobaric altitude chamber, the altitude group was delayed by two weeks. Only three participants completed the protocol in the chamber and this did not allow for enough power to run preliminary statistics with this group included. We are looking forward to this group completing the trial and analyzing the results.   Why compare the ETM to altitude? Previous literature determined certain aerobic performance variables improved while wearing the ETM (Granados et al., 2016; Porcari et al., 2016) and that the ETM is not a simulator of altitude, but rather a respiratory muscle device (Porcari et al., 2016). However, exercising while wearing the ETM has not been compared with exercising in hypobaric environment. Therefore, this study will look to examine similar cycling performance variables as Porcari et al. (2016) comparing individuals wearing the ETM with those in a hypobaric altitude chamber and to a control (no ETM and no increased altitude). The hypobaric altitude chamber will be used to match the increase in simulated elevations claimed by the company who manufactures the ETM. Introduction The Elevation Training Mask 2.0™ (ETM) (Training Mask LLC, Cadillac, MI) aims to increase endurance, maximal oxygen consumption (VO2 max), and lung function (“Elevation Training Mask ® | Performance Breathing Device,” 2016) while increasing the resistance of respiration (Granados et al., 2016; Porcari et al., 2016). Training Mask LLC suggests this resistance system purportedly results in similar aerobic performance benefits as added elevations ranging from 3000 – 18000 ft (“Elevation Training Mask ® | Performance Breathing Device,” 2016). However, these altitude simulations have not been verified and the ETM has not been compared to training at hypobaric environmental altitude. Recently, researchers examined the ETM’s influence on lung function variables, psychological variables, and endurance performance variables compared to control groups who did not wear the ETM (Granados et al., 2016; Porcari et al., 2016). Previous researchers concluded the ETM is well tolerated during submaximal exercise as ratings of perceived exertion and Beck Anxiety Inventory scores were modest from three bouts of 20 minutes of steady-state treadmill running (Granados et al., 2016). Granados et al. (2016) and Porcari et al. (2017) concluded that inspiration and expiration were impeded by the resistance caps leading to decreased ventilation while wearing the ETM (Granados et al., 2016). In addition, there was a reduction in respiratory rate, and increased maximal oxygen consumption (VO2max), ventilatory threshold (VT), and power output (PO) at ventilatory threshold (VT) while wearing the ETM (Granados et al., 2016; Porcari et al., 2016). The only significant difference post-six weeks of high intensity cycling training between the ETM group and the control was respiratory compensation threshold (RCT) and PO at RCT which was higher for the ETM compared with the control group (Porcari et al., 2016). Finally, since hematocrit, hemoglobin, and blood oxygen saturation did not differ between groups, Porcari et al. (2016) concluded the ETM worked like a respiratory muscle training device rather than a simulator of altitude. They suggested that research is still needed to study the capabilities of the ETM. The current literature regarding the ETM has yet to compare wearing the ETM to a group exercising at increased environmental altitude. Figure 2. Oxygen consumption at ventilatory threshold (VT), 100W, 125W, and 150W for the ETM (mask) and control (groups) pre- and post-training. * denotes significant difference between the ETM and control groups for both pre-training and post-training (p < 0.05). Table 2. Pre- and post-training maximal oxygen consumption (VO2max) and heart rate (HR) for the ETM (mask) and control groups. Methods Participants performed pre- and post-training VO2max tests using a metabolic cart (TrueOne 2400, Parvomedics, Sandy, UT) on a cycle ergometer (Excalibur Sport, Lode Medical Technology, Groningen, Netherlands). Males performed a 25 watt ramp protocol and females performed a 20 watt ramp protocol to volitional fatigue. To determine cycling economy changes pre- to post-training, VO2 was measured at 100W, 125W, and 150W. Training consisted of cycling twice a week, 30-min each session, for six weeks. Sessions included a 5-min warm-up and cool-down with 20-min of HIIT (30s exercise at peak power output (PPO), 90-sec active recovery at 25W for 10 bouts) (Porcari et al., 2016). Heart rate (HR) was recorded after each interval. Rating of perceived exertion during training were used to progressively overload each participant. For the ETM group, if participants rated the session as ≤ 7 for two consecutive sessions, then the resistance was increased 0.5 kg. The same occurred for the control group when sessions were rated ≤ 5 (Porcari et al., 2016). Independent t-tests and repeated measures ANOVA were used to determine within and between group differences (p < 0.05) using statistical package SPSS (version 19).   Pre-VO2max (mL∙kg-1∙min-1) Post-VO2max (mL∙kg-1∙min-1) Pre-HRmax (bpm) Post-HRmax (bpm) ETM (n = 9) 40.6 ± 9.6 41.4 ± 9.5 185 ± 8 184 ± 10 Control (n = 9) 31.7 ± 8.5 32.5 ± 9.5 185 ± 12 188 ± 12 References Elevation Training Mask ® | Performance Breathing Device. (2016). Retrieved September 23, 2016, from https://www.trainingmask.com/ Granados, J., Gillum, T. L., Castillo, W., Christmas, K. M., & Kuennen, M. R. (2016). “Functional” Respiratory Muscle Training During Endurance Exercise Causes Modest Hypoxemia but Overall is Well Tolerated: Journal of Strength and Conditioning Research, 30(3), 755–762. https://doi.org/10.1519/JSC.0000000000001151 Matheson, G. O., Allen, P. S., Ellinger, D. C., Hanstock, C. C., Gheorghiu, D., McKenzie, D. C., Stanley, C., Parkhouse, W. S., and Hochachka, P. W. (1991). Skeletal muscle metabolism and work capacity: a 31P-NMR study of Andean natives and lowlanders. Journal of Applied Physiology 70, 1963-1976. Porcari, J. P., Probst, L., Forrester, K., Doberstein, S., Foster, C., Cress, M. L., & Schmidt, K. (2016). Effect of Wearing the Elevation Training Mask on Aerobic Capacity, Lung Function, and Hematological Variables. Journal of Sports Science & Medicine, 15(2), 379–386. Results were not significantly different between pre- and post-training nor significantly different between groups (p > 0.05). Table 1. Participant descriptions: 18 participants (males = 7; females = 11) randomized into the ETM or control group.   Age (years) Height (meters) Weight (kilograms) ETM group (n = 9) 22.9 ± 3.0 1.67 ± 0.09 69.6 ± 19.8 Control group (n = 9) 24.6 ± 5.4 1.67 ± 0.07 88.7 ± 19.2 2017 Southwest American College of Sports Medicine Conference, Long Beach, CA, October 19th – 20th