Effects of Pre-, Post-, and Intra-Exercise Hyperbaric Oxygen Therapy on Performance and Recovery
Summary
This systematic review and meta-analysis evaluates the efficacy of hyperbaric oxygen therapy (HBOT) when applied before, during, or after exercise for enhancing athletic performance and recovery [1]. After analyzing 14 studies involving healthy, physically active adults, the review found that intra-exercise HBOT may help delay muscle fatigue and improve performance metrics such as maximal grip strength and muscle torque [2] [3]. However, no significant benefits were observed for pre- or post-exercise HBOT in improving recovery (e.g., lactate, CK, LDH) [1]. HBOT was generally safe across trials. Overall, intra-exercise HBOT shows some promise, whereas recovery benefits remain unproven.
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Article
Hyperbaric oxygen therapy (HBOT) involves breathing 100% oxygen in a pressurized chamber, increasing oxygen delivery to tissues and potentially aiding athletic performance and recovery. Approved by the World Anti-Doping Agency (WADA), HBOT has been explored for use in sports medicine [1].
A 2021 systematic review and meta-analysis in Frontiers in Physiology analyzed 14 studies to assess the effects of pre-, post-, and intra-exercise HBOT on performance and recovery [1]. The study found that HBOT administered during exercise showed a potential benefit in reducing muscle fatigue, with improvements in maximal grip strength and muscle torque—as observed in Stewart et al., 2011 [2]
—and favorable electromyographic (EMG) responses during repetitive contractions reported by Shimoda et al., 2015 [3].
In contrast, HBOT before or after exercise did not significantly improve recovery markers such as blood lactate levels, CK, or LDH, indicating no substantial benefit for post-exercise recovery in healthy athletes [1]. Some studies noted minor oxidative stress modulation, but findings were inconsistent and likely influenced by exercise intensity and subject fitness levels.
No serious adverse events were reported across the trials, supporting the safety of HBOT in athletic populations. However, heterogeneity in protocols—varying pressure levels, exposure durations, and performance assessments—limits definitive conclusions.
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Conclusion
Intra-exercise HBOT may modestly delay muscle fatigue and enhance neuromuscular output, but pre- and post-exercise HBOT does not consistently improve recovery markers in trained individuals. Given logistical and financial costs and mixed evidence, routine HBOT use for recovery is not currently supported. Standardized, large-scale trials are needed to clarify optimal protocols and use cases.
References
[1] Huang X, Wang R, Zhang Z, Wang G, Gao B. (2021). Effects of Pre-, Post- and Intra-Exercise Hyperbaric Oxygen Therapy on Performance and Recovery: A Systematic Review and Meta-Analysis. Frontiers in Physiology, 12:791872. DOI: 10.3389/fphys.2021.791872. Source
[2] Stewart RR, McKenzie DC, Reid WD, Taunton JE. (2011). The effects of hyperbaric oxygen in recovery after high intensity eccentric handgrip exercise. Journal of Strength and Conditioning Research, 25(5):1243–1252. DOI: 10.1519/JSC.0b013e3181d39c48. Source
[3] Shimoda M, Enomoto M, Horie M, Miyakawa S, Yagishita K. (2015). Effects of hyperbaric oxygen on muscle fatigue after maximal intermittent plantar flexion exercise. Journal of Strength and Conditioning Research, 29(6):1648–1656. DOI: 10.1519/JSC.0000000000000809. Source
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