Journal of Sports Nursing, Medical, And Health

Vol. 2 No. 02 (2026): Journal of Sports Nursing, Medical, And Health
Original Research Articles

Climbing Speed and Acclimatization are determinants of Acute Mountain Sickness on Mount Sumbing, Indonesia

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  • M. Shoffiul Awal,
  • Moh. Ubaidillah Faqih,
  • Karyo,
  • Tiara Putri Ryandini
M. Shoffiul Awal
Department of Nursing, Faculty of Health Sciences, Institut Ilmu Kesehatan Nahdlatul Ulama Tuban, Indonesia
Moh. Ubaidillah Faqih
Department of Nursing, Faculty of Health Sciences, Institut Ilmu Kesehatan Nahdlatul Ulama Tuban, Indonesia
Karyo
Department of Nursing, Faculty of Health Sciences, Institut Ilmu Kesehatan Nahdlatul Ulama Tuban, Indonesia
Tiara Putri Ryandini
Department of Nursing, Faculty of Health Sciences, Institut Ilmu Kesehatan Nahdlatul Ulama Tuban, Indonesia
DOI: https://doi.org/10.69606/sportnursmedhealth.v2i02.506

Published 2026-07-30

Keywords

  • acute mountain sickness,
  • acclimatization,
  • climbing speed,
  • mountain climbers

How to Cite

Awal, M. S., Faqih, M. U., Karyo, & Ryandini, T. P. (2026). Climbing Speed and Acclimatization are determinants of Acute Mountain Sickness on Mount Sumbing, Indonesia. Journal of Sports Nursing, Medical, And Health, 2(02), 87–96. https://doi.org/10.69606/sportnursmedhealth.v2i02.506

Copyright (c) 2026 M. Shoffiul Awal, Moh. Ubaidillah Faqih, Karyo, Tiara Putri Ryandini

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Abstract

Background: Acute Mountain Sickness (AMS) commonly affects individuals ascending above 2,500 meters due to inadequate adaptation to hypobaric hypoxia. Climbing speed and acclimatization are important modifiable risk factors, although evidence regarding their contribution among Indonesian mountain climbers remains limited. Aims:  To investigate the relationships between climbing speed, acclimatization, and the incidence of acute mountain sickness among climbers of Mount Sumbing, Wonosobo Regency, Central Java. Methods: A quantitative study with a correlational cross-sectional design was conducted among 109 Mount Sumbing climbers recruited using a consecutive sampling technique. Climbing speed was assessed based on ascent performance, acclimatization status was evaluated using predefined acclimatization criteria, and acute mountain sickness was measured using the Lake Louise Acute Mountain Sickness Score (LLAMS). Spearman's rank correlation test was performed to examine the relationships between variables, with statistical significance set at α = 0.05. Results: Significant positive correlations were identified between both independent variables and the incidence of acute mountain sickness. Climbing speed demonstrated a moderate positive correlation with AMS (p < 0.001; r = 0.444), indicating that faster ascent was associated with a greater likelihood of developing AMS. Acclimatization also showed a statistically significant positive correlation with AMS (p < 0.001; r = 0.874), suggesting that inadequate acclimatization substantially increased the risk of acute mountain sickness. Among the two variables, acclimatization exhibited the strongest association with AMS. Conclusions: Climbing speed and acclimatization significantly influence acute mountain sickness among Mount Sumbing climbers. Appropriate ascent pacing and adequate acclimatization are essential to reduce AMS risk and support preventive guidelines and climber safety education.

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References

  1. Bärtsch, P., & Swenson, E. R. (2013). Clinical practice: Acute high-altitude illnesses. The New England Journal of Medicine, 368(24), 2294–2302. https://doi.org/10.1056/NEJMcp1214870
  2. Beidleman, B. A., Figueiredo, P., Landspurg, S., Femling, J., Williams, J., Staab, J. E., Buller, M. J., Karl, J. P., Reilly, A. J., Mayschak, T. J., Atkinson, E. Y., Mesite, T. J., & Hoyt, R. W. (2023). Active ascent accelerates the time course but not the overall incidence and severity of acute mountain sickness at 3600 m. Journal of Applied Physiology. https://doi.org/10.1152/japplphysiol.00216.2023
  3. Berger, M. M., & Luks, A. M. (2023). High altitude. Seminars in Respiratory and Critical Care Medicine, 44, 681–695. https://doi.org/10.1055/s-0043-1770063
  4. Berger, M. M., Sareban, M., & Bärtsch, P. (2020). Acute mountain sickness: Do different time courses point to different pathophysiological mechanisms? Journal of Applied Physiology, 128(4), 952–959. https://doi.org/10.1152/japplphysiol.00305.2019
  5. Byrd, M., Wheatley-Guy, C. M., Grill, D. E., Shea, M. G., Herman, N. M., & Johnson, B. E. (2022). Gene expression changes associated with acute mountain sickness after rapid altitude exposure at the South Pole. The FASEB Journal, 36(S1). https://doi.org/10.1096/fasebj.2022.36.s1.r4043
  6. Cai, C., Ni, G., Chen, L., Deng, C., Chai, S., Zhang, R., Luo, F., & Ge, R.-L. (2026). Altitude hypoxia and hypoxemia: Pathogenesis and management. Signal Transduction and Targeted Therapy, 11. https://doi.org/10.1038/s41392-025-02531-1
  7. Centers for Disease Control and Prevention. (2019). High-altitude travel & altitude illness. U.S. Department of Health & Human Services.
  8. Ebihara, T., Shimizu, K., Mitsuyama, Y., & Ogura, H. (2023). Association between high cardiac output at altitude and acute mountain sickness: Preliminary study on Mt. Fuji. Journal of Physiological Anthropology, 42(1). https://doi.org/10.1186/s40101-023-00322-7
  9. Gao, C., Qi, G.-D., Wang, D., Zhang, Z., Liu, Z., Ge, R., Yong, Z., & Yan, L. (2024). Incidence and risk factors of severe acute high-altitude illness in healthy adults first entering the northern Tibetan Plateau of over 5,000 m. Frontiers in Public Health, 12. https://doi.org/10.3389/fpubh.2024.1400236
  10. Gonzalez Garay, A. G., Molano Franco, D., Nieto Estrada, V. H., Martí-Carvajal, A. J., & Arevalo-Rodriguez, I. (2018). Interventions for preventing high altitude illness: Part 2. Less commonly used drugs. Cochrane Database of Systematic Reviews, 3(3). https://doi.org/10.1002/14651858.CD012983
  11. Hackett, P. H., & Roach, R. C. (2001). High-altitude illness. The New England Journal of Medicine, 345(2), 107–114. https://doi.org/10.1056/NEJM200107123450206
  12. Honigman, B., Theis, M. K., Koziol-McLain, J., Roach, R., Yip, R., Houston, C., & Moore, L. G. (1993). Acute mountain sickness in a general tourist population at moderate altitudes. Annals of Internal Medicine, 118(8), 587–592. https://doi.org/10.7326/0003-4819-118-8-199304150-00003
  13. Jia, N., Chen, C., Chen, Q., Liu, J., Liu, Y., Pei, C., Wang, Y., Huang, D., Wang, F., He, Y., & Wang, Z. (2026). Acute high-altitude illness: Risk factors, susceptibility prediction, and personalized prevention and treatment. Frontiers in Medicine. https://doi.org/10.3389/fmed.2025.1735083
  14. Li, W., Zhang, M., Hu, Y., Shen, P., Bai, Z., Huangfu, C., Ni, Z., Wang, N., Zhang, P., Tong, L., Gao, Y., & Zhou, W. (2025). Acute mountain sickness prediction: A concerto of multidimensional phenotypic data and machine learning strategies in the framework of predictive, preventive, and personalized medicine. The EPMA Journal. https://doi.org/10.1007/s13167-025-00404-9
  15. Luks, A. M., Auerbach, P. S., Freer, L., Grissom, C. K., Keyes, L. E., McIntosh, S. E., Rodway, G. W., Schoene, R. B., Zafren, K., & Hackett, P. H. (2019). Wilderness Medical Society clinical practice guidelines for the prevention and treatment of acute altitude illness: 2019 update. Wilderness & Environmental Medicine, 30(4S), S3–S18. https://doi.org/10.1016/j.wem.2019.04.006
  16. Luks, A. M., Swenson, E. R., & Bärtsch, P. (2017). Acute high-altitude sickness. European Respiratory Review, 26(143), 160096. https://doi.org/10.1183/16000617.0096-2016
  17. Meier, D., Collet, T. H., Locatelli, I., Cornuz, J., Kayser, B., Simel, D. L., & Sartori, C. (2017). Does this patient have acute mountain sickness? The Rational Clinical Examination systematic review. JAMA, 318(18), 1810–1819. https://doi.org/10.1001/jama.2017.16192
  18. Molano Franco, D., Nieto Estrada, V. H., Gonzalez Garay, A. G., Martí-Carvajal, A. J., & Arevalo-Rodriguez, I. (2019). Interventions for preventing high altitude illness: Part 3. Miscellaneous and non-pharmacological interventions. Cochrane Database of Systematic Reviews, 4(4). https://doi.org/10.1002/14651858.CD013315
  19. Netzer, N., Strohl, K., Faulhaber, M., Gatterer, H., & Burtscher, M. (2013). Hypoxia-related altitude illnesses. Journal of Travel Medicine, 20(4), 247–255. https://doi.org/10.1111/jtm.12017
  20. Poudel, K. M., Poudel, T. R., Shah, N., Bhandari, S., Sharma, R., Timilsina, A., & Prakash, M. (2022). Ascent rate and the Lake Louise scoring system: An analysis of one year of emergency ward entries for high-altitude sickness at the Mustang District Hospital, Nepal. PLOS ONE, 17(10), e0276901. https://doi.org/10.1371/journal.pone.0276901
  21. Richalet, J.-P., Larmignat, P., Poitrine, E., Letournel, M., & Canouï-Poitrine, F. (2012). Physiological risk factors for severe high-altitude illness: A prospective cohort study. American Journal of Respiratory and Critical Care Medicine, 185(2), 192–198. https://doi.org/10.1164/rccm.201108-1396OC
  22. Roach, R. C., Hackett, P. H., Oelz, O., Bärtsch, P., Luks, A. M., MacInnis, M. J., Baillie, J. K., & Lake Louise AMS Score Consensus Committee. (2018). The 2018 Lake Louise acute mountain sickness score. High Altitude Medicine & Biology, 19(1), 4–6. https://doi.org/10.1089/ham.2017.0164
  23. Sareban, M., Schiefer, L. M., Macholz, F., Schäfer, L., Zangl, Q., Inama, F., Reich, B., Mayr, B., Schmidt, P., Hartl, A., Bärtsch, P., Niebauer, J., Treff, G., & Berger, M. M. (2020). Endurance athletes are at increased risk for early acute mountain sickness at 3450 m. Medicine & Science in Sports & Exercise, 52(5), 1109–1115. https://doi.org/10.1249/MSS.0000000000002232
  24. Schommer, K., & Bärtsch, P. (2011). Basic medical advice for travelers to high altitudes. Deutsches Ärzteblatt International, 108(49), 839–848. https://doi.org/10.3238/arztebl.2011.0839
  25. Schoene, R. B. (2008). Illnesses at high altitude. Chest, 134(2), 402–416. https://doi.org/10.1378/chest.07-0561
  26. Sharma, P., Mohanty, S., & Ahmad, Y. (2023). A study of survival strategies for improving acclimatization of lowlanders at high altitude. Heliyon, 9(4), e14929. https://doi.org/10.1016/j.heliyon.2023.e14929
  27. Simancas-Racines, D., Arevalo-Rodriguez, I., Osorio, D., Franco, J. V. A., Xu, Y., & Hidalgo, R. (2018). Interventions for treating acute high altitude illness. Cochrane Database of Systematic Reviews, 6(6). https://doi.org/10.1002/14651858.CD009567.PUB2
  28. Stoltz, P. G. (1997). Adversity quotient: Turning obstacles into opportunities. John Wiley & Sons.
  29. Tsai, T. Y., Lin, J. X., Ou, J. C., & Huang, T. Y. (2025). The role of heart rate variability in acute mountain sickness: A meta-analysis. Medicine, 104(24), e42692. https://doi.org/10.1097/MD.0000000000042692
  30. Wang, B., Peng, M., Kou, G., Fang, F., & Gao, J. (2025). Systemic inflammatory response syndrome and multiple organ dysfunction syndrome caused by acute mountain sickness: A case report and literature review. Frontiers in Physiology, 16. https://doi.org/10.3389/fphys.2025.1546307
  31. West, J. B. (2006). Human responses to extreme altitudes. Integrative and Comparative Biology, 46(1), 25–34. https://doi.org/10.1093/icb/icj005
  32. Wu, Y., Zhang, C., Chen, Y., & Luo, Y. J. (2018). Association between acute mountain sickness (AMS) and age: A meta-analysis. Military Medical Research, 5(1), 14. https://doi.org/10.1186/S40779-018-0161-X
  33. Xie, J., Xie, S., Zhong, Z., Dong, H., Huang, P., Zhou, S., Tian, H., Zhang, J., Wu, Y., & Li, P. (2024). Hypoxic preacclimatization combining intermittent hypoxia exposure with physical exercise significantly promotes tolerance to acute hypoxia. Frontiers in Physiology. https://doi.org/10.3389/fphys.2024.1367642
  34. Zhang, J., Guo, S., Dou, B., Liu, Y., Wang, X., Li, Q., Li, Y., & Chen, H. (2025). High-altitude hypoxia injury: Systemic mechanisms and intervention strategies on immune and inflammatory responses. Antioxidants. https://doi.org/10.3390/antiox15010036
  35. Zhao, C., Zhao, X., Ma, W., Liu, Y., Chen, R., & Sha, L. (2024). Dynamics in the prevalence and clinical manifestations of acute mountain sickness of different ascent protocols during high-altitudes exposure. Frontiers in Public Health, 12. https://doi.org/10.3389/fpubh.2024.1472935