INTRODUCTION: The "Live High-Train Low" protocol, as an altitude training protocol used to enhance endurance sports performance, including cycling, aims to increase red cell mass and hemoglobin mass, crucial for aerobic performance. This study sought to review and meta-analyze cycling studies applying LHTL, focusing on hematological and performance variables. EVIDENCE ACQUISITION: The search of studies was conducted in PubMed/MEDLINE and SPORTDiscus databases and 34 studies were identified, with six meeting the inclusion criteria. EVIDENCE SYNTHESIS: Results revealed improvements in red cell mass, hemoglobin concentration, hemoglobin mass, reticulocyte count, performance variables of maximum oxygen consumption and time trial performance. However, studies with lower PEDro scores reported non-significant or modest enhancements. Meta-analysis on hemoglobin concentration] and hemoglobin mass indicated a significant positive effect (0.82%) with confidence limits of 0.62% to 1.03%. CONCLUSIONS: Influence and bias analyses underscored individual study impacts, urging caution in interpretation. A positive effect of Live High-Train Low on hematological variables in cycling was found, emphasizing the need for further research which amplifies studies available on Live High-Train Low in cycling.
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