Altitude training has been integrated into athlete preparation and rehabilitation strategies comprehensively for the past five decades by elite endurance athletes, with the goal of improving performance (Gore, 2007). In general, the various systems of the human body - pulmonary, cardiovascular, endocrine, skeletal muscle - respond and adjust to normobaric (simulated) and hypobaric hypoxia (actual) altitude training in an effort to provide sufficient oxygen to survive in the hypoxic environment (Wilber 2004). Some mechanisms of physiological adaptation associated with simulated and actual altitude training have the potential to enhance athletic performance, particularly in endurance and repeated high intensity effort based sports and activities, including tactical and military environments. Figure 1 outlines the known physiological responses and subsequent performance benefits associated with simulated and real altitude training.
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