Effects of Hyperbaric Oxygen Therapy on Exercise-Induced Muscle Injury and Soreness: A Systematic Review and Meta-analysis.

Objective: To assess the efficacy of hyperbaric oxygen therapy (HBOT) in facilitating recovery from exercise-induced muscle injury and soreness.

Data sources: China Knowledge Network, Embase, Web of Science, Cochrane Library, PubMed, and Scopus database inception until September 28, 2024.

Study selection: A randomized controlled trial to assess the effects on patients with exercise-induced muscle damage and soreness.

Data extraction: Mean difference and 95% CI for all outcome indicators were estimated using a fixed-effects model, adjusting for (1) first author, (2) year of publication, (3) sample size, (4) age, (5) method of injury induction, (6) parameters of hyperbaric oxygen intervention, (7) outcome measure, and (8) risk of bias indicators.

Data synthesis: A total of 10 articles comprising 299 subjects were included in the analysis. The meta-analysis identified that HBOT significantly accelerated recovery from exercise-induced muscle injury (95% CI, -76.19 to -33.11; P<.0001). Subgroup analyses further revealed that both higher (>2.0 atmosphere absolute [ATA]; 95% CI, -89.45 to -19.06; P=.003) and lower (≤2.0 ATA; 95% CI, -82.12 to -27.65; P<.0001) atmospheric pressures, as well as intervention durations of 60 minutes (95% CI, -76.87 to -25.51; P<.0001) and 100 minutes (95% CI, -102.41 to -23.29; P=.002), were effective in alleviating muscle injury. These beneficial effects were observed in both college students (95% CI, -82.00 to -9.56; P=.01) and elite athletes (95% CI, -86.28 to -32.71; P<.0001). In contrast, HBOT did not provide a significant therapeutic benefit for exercise-induced muscle soreness (95% CI, -0.91 to 0.48; P=.54). However, subgroup analyses revealed that muscle soreness was significantly reduced with an atmospheric pressure above 2.0 ATA (95% CI, -1.58 to -0.00; P=.05), a pressure ≤2.0 ATA (95% CI, 0.17to 1.28; P=.01), and with a 100-minute intervention (95% CI, -2.05 to -0.26; P=.01), whereas a 60-minute intervention did not show a significant effect (95% CI, -0.17 to 0.92; P=.17).

Conclusions: The HBOT was statistically effective in promoting recovery from exercise-induced muscle injury. However, it did not enhance recovery from exercise-induced muscle soreness.