Breathing less to win Paris 2024 gold: A case study using voluntary hypoventilation at low lung volume-based training in a para-badminton athlete

Purpose To examine the feasibility of implementing voluntary hypoventilation at low lung volume (VHL) training during the 2024 Paralympic Games’ preparation of an elite SH6 (short-stature) para-badminton athlete and characterize associated arterial oxygen saturation (SpO 2 ) and heart rate (HR) responses. Methods During a 5-week intervention, 9 VHL-based training sessions were added, consisting of either repeated running-shuttle sprints or badminton-specific exercises performed with maximal end-expiratory breath holding (EEBH). SpO 2 and HR were monitored, rating of perceived exertion (RPE) was recorded, and hypoxic dose was quantified. Within-participant variability and response patterns across training conditions were characterized using visual inspection of the complete time-series data and summary descriptive metrics. Results In both training types, a marked decrease in SpO 2 occurred from the first to the last repetition of each set. Mean nadir SpO 2 was higher during repeated running-shuttle sprint sessions vs . badminton-specific exercise sessions (81.8 ± 2% vs . 76.3 ± 3%) due to a shorter EEBH duration (7.2 ± 0.7 s vs . 9.8 ± 0.9 s). Mean session SpO 2 , HR, and RPE did not differ between training types, but RPE decreased significantly across sessions, indicating improved tolerance to the VHL-induced hypoxic stimulus. Conclusions This case report demonstrates that VHL-based training with maximal EEBH is feasible, well tolerated, and capable of eliciting robust hypoxemic stimuli in an elite SH6 para-badminton athlete.