Arch Phys Med Rehabil. 2025 Aug 08. pii: S0003-9993(25)00824-X. [Epub ahead of print]
OBJECTIVE: This meta-analysis aimed to assess the efficacy of hyperbaric oxygen therapy (HBOT) in facilitating recovery from exercise-induced muscle injury and soreness.
DATA SOURCES: China Knowledge Network (CNKI), Embase, Web of Science, Cochrane Library, PubMed, and Scopus database inception until September 28, 2024.
DATA SELECTION: A randomized controlled trial (RCT) to assess the effects on patients with exercise-induced muscle damage and soreness.
DATA EXTRACTION: Mean difference (MD) 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 < 0.00001)]. Subgroup analyses further revealed that both higher (> 2.0 ATA(atmosphere absolute), 95% CI: -89.45 to -19.06, P = 0.003) and lower (≤ 2.0 ATA, 95% CI: -82.12 to -27.65, P < 0.0001) atmospheric pressures, as well as intervention durations of 60 minutes (95% CI: -76.87 to -25.51, P < 0.0001) and 100 minutes (95% CI: -102.41 to -23.29, P = 0.002), were effective in alleviating muscle injury. These beneficial effects were observed in both college students (95% CI: -82.00 to -9.56, P = 0.01) and elite athletes (95% CI: -86.28 to -32.71, P < 0.0001). In contrast, HBOT did not provide a significant therapeutic benefit for exercise-induced muscle soreness (95% CI: -0.91 to 0.48, P = 0.54). 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 = 0.05), a pressure at or below 2.0 ATA (95% CI: 0.17 to 1.28, P = 0.01), and with a 100-minute intervention (95% CI: -2.05 to -0.26, P = 0.01), whereas a 60-minute intervention did not show a significant effect (95% CI: -0.17 to 0.92, P = 0.17).
CONCLUSION: HBOT was statistically effective in promoting recovery from exercise-induced muscle injury. However, it did not enhance recovery from exercise-induced muscle soreness.
Keywords: hyperbaric oxygen therapy; muscle injury; muscle soreness; recovery