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The APC was funded by Rey Juan Carlos University.

Analysis of institutional authors

Deasis-Fernandez, FranciscoAuthor

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February 8, 2025
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Effects of Hook Maneuver on Oxygen Saturation Recovery After -40 m Apnea Dive-A Randomized Crossover Trial

Publicated to:Sports (Basel). 13 (1): 24- - 2025-01-01 13(1), DOI: 10.3390/sports13010024

Authors: DeAsis-Fernandez, Francisco; Reina-Varona, Alvaro; Papotsidakis, Evangelos; Lafuente, Juan; Fierro-Marrero, Jose

Affiliations

Ctr Med Mapfre, Barcelona 08009, Spain - Author
Hosp Moisses Brogges, Dept Oxigenoterapia Hiperbar, CRIS UTH, Barcelona 08970, Spain - Author
Rey Juan Carlos Univ, Dept Phys Therapy Occupat Therapy Rehabil & Phys M, Madrid 28922, Spain - Author
Univ Autonoma Madrid, Ctr Super Estudios, Mot Brains Res Grp, Univ La Salle, Madrid 28023, Spain - Author

Abstract

To reduce the risk of syncope, trained breath-hold divers (BHDs) use a specialized breathing technique after surfacing called "hook breathing" (HB). It consists of a full inspiration followed by a Valsalva-like maneuver and with subsequent exhalation performed against resistance to generate continuous positive airway pressure during exhalation. This study analyzed the influence of HB on oxygen saturation recovery after a -40 m depth apnea dive in trained BHDs. Thirteen BHDs performed two dives to -40 m at different days, one followed by HB after a dive and the other using usual breathing (UB). To detect signs of lung edema, ultrasound B-line measurements were conducted before, 10 min after the dive, and within 1 h after the dive. To detect oxygen saturation recovery, pulse oximetry was recorded before and immediately after surfacing. Both groups exhibited significant increases in SpO(2) over time (UB: F (2.25, 24.7) = 22.1, p < 0.001, eta g2 = 0.612; HB: F (2.11, 23.2) = 29.0, p < 0.001, eta g2 = 0.688). Significant differences in SpO(2) were observed between the HB and UB groups at 30-45 s post-apnea, with higher SpO(2) values in the HB group; between 1.64 and 5.08% of SpO(2) in favor of the HB intervention. Four participants showed ultrasound B-lines within ten minutes post-dive. After a 40 m apnea dive, the results revealed significant SpO(2) recovery from 30 s to 45 s, with the HB recovering more rapidly. No differences were found at earlier (10-25 s) or later time points (50-60 s).

Keywords

Breath-hold diveDrowninDrowningHypoxiaHypoxic syncopeLung squeezeSigUltrasoundUltrasound lung comets

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Sports (Basel) due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2025, it was in position 31/133, thus managing to position itself as a Q1 (Primer Cuartil), in the category Sport Sciences.

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-08-08:

  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 5 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

    It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

    • The work has been submitted to a journal whose editorial policy allows open Open Access publication.

    Leadership analysis of institutional authors

    There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (Fernández Martínez, Francisco de Asís) .