SYSTEMATIC REVIEW article
Front. Sports Act. Living
Sec. Exercise Physiology
Volume 7 - 2025 | doi: 10.3389/fspor.2025.1641379
A multilevel meta-analysis of the effects of repeated sprint training in hypoxia on athletic performance
Provisionally accepted
Meng Han1*
Binglin Liu2- 1Department of Physical Education, Tianjin University of Sport, Tianjin, China
- 2School of Athletic Training, Tianjin University of Sport, Tianjin, China
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Background Repeated-sprint training in hypoxia (RSH) has emerged as a novel strategy to optimize repeated-sprint ability (RSA), aerobic capacity, and anaerobic performance in athletes. Although numerous studies have explored its efficacy compared with repeated-sprint training in normoxia (RSN), inconsistencies remain regarding overall benefits and modulating factors.This study aimed to quantify the overall effect of RSH versus RSN on athletic performance through a systematic review and multilevel meta-analysis and to identify categorical and continuous moderators influencing intervention efficacy.Methods A comprehensive literature search was conducted across PubMed, Embase, Web of Science, and Cochrane Library up to January 31, 2025. Randomized controlled trials comparing RSH and RSN were included. Two reviewers independently screened, extracted, and assessed study quality. Random-effects multilevel models were used to calculate Hedges' g for overall and domain-specific outcomes (RSA, aerobic and anaerobic performance). Categorical (e.g., outcome types, intervention format, sex) and continuous moderators (e.g., inspired oxygen fraction (FiO2), intervention duration, frequency, and exercise-to-rest ratio) were tested via meta-regression.Publication bias was assessed through funnel plots and regression-based Egger tests.Eighteen studies (N = 378 participants) were included, yielding 55 independent effect sizes.RSH significantly improved performance outcomes compared with RSN (g = 0.50, 95% CI: 0.34-0.67, p < 0.001). Subgroup analyses revealed stronger effects for RSA (g = 0.61) than for aerobic (g = 0.42) or anaerobic (g = 0.39) outcomes. Moderator analyses indicated that outcome type, exercise format, and FiO2) significantly moderated the effect size, with lower FiO2 (~13-14%) and longer training duration (weeks) associated with greater gains. No sex differences were found.Funnel plot symmetry suggested low risk of publication bias.This meta-analysis confirms that RSH provides a moderate performance advantage over RSN, particularly for repeated-sprint ability. Specific implementation parameters such as moderate hypoxia intensity and sufficient training duration enhance efficacy. These findings offer evidence-based guidance for optimizing high-intensity interval training protocols under hypoxic conditions.
Keywords: repeated-sprint training, hypoxia, Athletic Performance, Meta-analysis, Repeated-sprint ability, aerobic capacity, Anaerobic power, training adaptation
Received: 18 Jun 2025; Accepted: 15 Jul 2025.
Copyright: © 2025 Han and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Meng Han, Department of Physical Education, Tianjin University of Sport, Tianjin, China
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