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Meta-Analysis
. 2005 Oct 19;2005(4):CD004713.
doi: 10.1002/14651858.CD004713.pub2.

Hyperbaric oxygen therapy for delayed onset muscle soreness and closed soft tissue injury

M Bennett  1 , T M Best, S Babul, J Taunton, M Lepawsky
Affiliations
Meta-Analysis

Hyperbaric oxygen therapy for delayed onset muscle soreness and closed soft tissue injury

M Bennett et al. Cochrane Database Syst Rev. .

Abstract

Background: Soft tissue injuries (including muscle damage after unaccustomed exercise) are common and are often associated with athletic activity. Hyperbaric oxygen therapy (HBOT) is the therapeutic administration of 100% oxygen at environmental pressures greater than one atmosphere.

Objectives: To assess the benefits and harms of HBOT for treating soft tissue injury, including delayed onset muscle soreness (DOMS).

Search strategy: We searched the following in July 2004: CENTRAL, MEDLINE, EMBASE, CINAHL, DORCTIHM and reference lists from relevant articles. Relevant journals were handsearched and researchers in the field contacted.

Selection criteria: Randomised trials comparing the effect on closed soft tissue injury (including DOMS) of therapeutic regimens which include HBOT with those that exclude HBOT (with or without sham therapy).

Data collection and analysis: Four reviewers independently evaluated study quality and extracted data. Most of the data presented in the review were extracted from graphs in the trial reports.

Main results: Nine small trials involving 219 participants were included. Two trials compared HBOT versus sham therapy on acute closed soft tissue injuries (ankle sprain and medial collateral knee ligament injury respectively). The other seven trials examined the effect of HBOT on DOMS following eccentric exercise in unconditioned volunteers. All 32 participants of the ankle sprain trial returned to their normal activities. There were no significant differences between the two groups in time to recovery, functional outcomes, pain, or swelling. There was no difference between the two groups in knee function scores in the second acute injury trial; however, intention-to-treat analysis was not possible for this trial. Pooling of data from the seven DOMS trials showed significantly and consistently higher pain at 48 and 72 hours in the HBOT group (mean difference in pain score at 48 hours [0 to 10 worst pain] 0.88, 95% CI 0.09 to 1.67, P = 0.03) in trials where HBOT was started immediately. There were no differences between the two groups in longer-term pain scores or in any measures of swelling or muscle strength. No trial reported complications of HBOT but careful selection of participants was evident in most trials.

Authors' conclusions: There was insufficient evidence from comparisons tested within randomised controlled trials to establish the effects of HBOT on ankle sprain or acute knee ligament injury, or on experimentally induced DOMS. There was some evidence that HBOT may increase interim pain in DOMS. Any future use of HBOT for these injuries would need to have been preceded by carefully conducted randomised controlled trials which have demonstrated effectiveness.

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Conflict of interest statement

Dr Bennett is a hyperbaric physician who does not routinely treat soft‐tissue injuries or delayed onset muscle soreness. Several included trials have been conducted by authors of this review (JB, SB, JT, ML). These individuals were not involved in the selection or critical appraisal of their own studies.

Figures

1.1
1.1. Analysis
Comparison 1 Acute ligament injury: HBOT versus sham HBOT, Outcome 1 Time to return to prior function (days).
1.2
1.2. Analysis
Comparison 1 Acute ligament injury: HBOT versus sham HBOT, Outcome 2 Ankle function score (0 to 7: full function).
1.3
1.3. Analysis
Comparison 1 Acute ligament injury: HBOT versus sham HBOT, Outcome 3 Subjective recovery scores after knee injury (0 to 100: full recovery).
1.4
1.4. Analysis
Comparison 1 Acute ligament injury: HBOT versus sham HBOT, Outcome 4 Pain scores (0 to 100: worst pain).
1.5
1.5. Analysis
Comparison 1 Acute ligament injury: HBOT versus sham HBOT, Outcome 5 Change in knee girth at 4 weeks post medial collateral ligament injury (cm).
1.6
1.6. Analysis
Comparison 1 Acute ligament injury: HBOT versus sham HBOT, Outcome 6 One legged jump distance (difference between non‐injured and injured side) (cm).
2.1
2.1. Analysis
Comparison 2 Induced DOMS: HBOT versus control, Outcome 1 Pain score (10 = worst pain) after exercise (immediate treatment).
2.2
2.2. Analysis
Comparison 2 Induced DOMS: HBOT versus control, Outcome 2 Pain score (10 = worst pain) after exercise (immediate treatment) by muscle group at 48 hours.
2.3
2.3. Analysis
Comparison 2 Induced DOMS: HBOT versus control, Outcome 3 Pain score (10 = worst pain) after exercise (delayed treatment).
2.4
2.4. Analysis
Comparison 2 Induced DOMS: HBOT versus control, Outcome 4 'Swelling' (immediate treatment).
2.5
2.5. Analysis
Comparison 2 Induced DOMS: HBOT versus control, Outcome 5 'Swelling' (delayed treatment).
2.6
2.6. Analysis
Comparison 2 Induced DOMS: HBOT versus control, Outcome 6 Muscle strength (immediate treatment): outcome measures defined in text.
2.7
2.7. Analysis
Comparison 2 Induced DOMS: HBOT versus control, Outcome 7 Muscle strength (delayed treatment): outcome measures defined in text.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD004713

References

References to studies included in this review

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