Effect of Hot Spring Therapy on Autonomic Nervous System and Exercise Performance During Altitude Training
A Randomized Controlled Trial Investigating the Effects of Balneotherapy on Cardiac Autonomic Modulation and Athletic Performance in Healthy Adults Undergoing Simulated Altitude Training Undergoing Simulated Athlete Training
Macao Polytechnic University
27 participants
May 25, 2026
INTERVENTIONAL
Conditions
Summary
This randomized controlled trial aims to investigate the effects of balneotherapy (hot spring bathing) on cardiac autonomic nervous system function and exercise performance in healthy athletes undergoing high-altitude training. Participants will be randomly assigned to the intervention group (receiving hot spring baths three times per week (38°C, 20 minutes) combined with high-altitude training), the control group (receiving routine recovery protocols combined with high-altitude training), or the hot water immersion group (receiving hot water baths three times per week (38°C, 20 minutes) combined with high-altitude training). Primary outcome measures include heart rate variability (HRV) indices and exercise performance indicators. Secondary outcomes include blood lactate, peripheral oxygen saturation (SpO2), and subjective fatigue. These findings may provide evidence for non-pharmacological interventions to enhance high-altitude training adaptation and exercise recovery.
Eligibility
Inclusion Criteria5
- Male or female aged 11-17years
- Regular endurance training (≥3 sessions/week) for ≥2 years
- No history of altitude exposure >2000m in the past 3 months
- No contraindications to hot water immersion (e.g., uncontrolled hypertension, severe cardiovascular disease, open wounds, pregnancy)
- Ability to provide written informed consent- Willingness to abstain from other recovery modalities (e.g., massage, cryotherapy, compression garments) during the study period
Exclusion Criteria5
- History of cardiovascular, respiratory, renal, or endocrine disorders
- Current use of medications affecting autonomic function (e.g., beta-blockers, anticholinergics)- History of syncope or heat intolerance
- Acute musculoskeletal injury within the past 6 months- Regular use of sauna, hot tub, or spa within the past month
- Pregnancy or breastfeeding (for female participants)- Shift work or trans-meridian travel within 2 weeks prior to baseline assessment
- Alcohol consumption >14 units/week or smoking
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Interventions
Control group participants will undergo the same altitude training protocol (altitude 1600 meters) for 4 weeks. After each training session, participants will receive standard recovery procedures, including 20 minutes of passive rest in a thermoneutral environment (room temperature 24°C), supplemented with mild hydration and self-selected stretching. No hydrothermal intervention will be provided.
The hot water immersion group will undergo a 4-week altitude training at 1600 meters above sea level. Subjects will receive a 20-minute hot water immersion (daily tap water, 38°C±1°C) in a standardized indoor hot spring facility. The immersion protocol includes whole-body immersion up to the neck for 20 minutes, followed by a 10-minute rest before leaving the facility. Three times per week.
The hot spring immersion group will undergo a 4-week high-altitude training at an altitude of 1600 meters. Subjects will receive a 20-minute hot spring therapy (natural hot spring water, 38°C ± 1°C) in a standardized indoor hot spring facility. The immersion protocol includes whole-body immersion to the neck for 20 minutes, followed by a 10-minute rest before leaving the facility. Three times per week.
Locations(1)
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NCT07608887