Among the different altitude training methods, intermittent hypoxic training (IHT); i.e., a method where athletes live at or near sea level but train under hypoxic conditions, has gained unprecedented popularity. A thorough analysis of studies including IHT, however, leads to strikingly poor benefits for sea-level performance improvement, compared to the same training method performed in normoxia. Despite positive molecular adaptations observed after various IHT modalities, the characteristics of optimal training stimulus in hypoxia are still unclear and their functional translation in term of whole-body performance enhancement is minimal. To overcome some of the inherent limitations of IHT (lower workload due to hypoxia), recent studies have successfully investigated a new training method based on the repetition of short sprints with incomplete recoveries in hypoxia; named RSH. Additionally, the growing scientific interest on the practical application of hypoxic training legitimizes the development of innovative technologies serving athletes in a sport-specific setting. The aims of the present review are therefore threefold. First, to critically analyze the results of the studies involving high-intensity exercises performed in hypoxia for sea-level performance enhancement by differentiating IHT and RSH. Second, to discuss the potential mechanisms underpinning their effectiveness and their inherent limitations. Third, to present the potentials benefits of using new technological innovation (i.e., the mobile inflatable simulated hypoxic system) which will undoubtedly contribute to the understanding advancement of hypoxia-induced physiological adaptations by conducting relevant research in the most sport-specific ecological test setting.
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