Weak
evidence that hyperbaric oxygenation may improve the rate at which strength
recovers following unaccustomed eccentric exercise.
Clinical Bottom Line:
1.
There may be some improvement in the speed of strength recovery after
unaccustomed eccentric exercise with a five day course of HBOT.
2.
No improvement in pain with hyperbaric oxygen.
Appraised
by: Mike Bennett, Dept. of Diving and
Hyperbaric Medicine, Prince of Wales Hospital, Sydney, Monday, 3 April 2000
Clinical
Scenario: An athlete in training presents
for management of muscle soreness following training.
Three-part
Question: In subjects likely to develop
delayed onset of muscle soreness (DOMS) after exercise, does treatment with
hyperbaric oxygen, compared with no specific therapy, result in any reduction in
pain or improvement in muscle strength during recovery?
Search
Terms: DOMS, injuries, musculoskeletal
The
Study:
Double-blinded concealed
randomised controlled trial without intention-to-treat.
Healthy volunteer, untrained,
college students. All had undergone a standard eccentric exercise protocol
involving the quadriceps of the non-dominant leg. The study was run in two
phases with sham and 'early' HBOT groups in both phases.
Control group (N = 30; 28
analysed): 10 subjects had no specific intervention, 20 had sham HBOT by
exposure to 1.2ATA breathing air at 0, 24, 48, 72 and 96 hours for one hour on
each occasion.
Experimental group (N = 40; 38
analysed): 20 subjects had 100% oxygen at 2ATA for 1 hour at 0, 24 and 48 hours
after exercise, followed by two sham treatments at 72 and 96 hours. 10 subjects
had sham at 0 and 24 hours, followed by HBOT at 48, 72 and 96 hours, while 10
further subjects had HBOT on five occasions at 0, 24, 48, 72 and 96 hours.
The
Evidence:
Non-Event
Outcomes Time
to outcome Control
group
HBO group
P-value
Muscle
pain (VAS 0-10)
24 hrs
4.3
4.3
NS
Strength
(Nm)
48
hrs
158
153
Unknown
Strength
recovery (Nm)
0-96 hrs
34
46
Unknown
Comments:
1. Study design in two phases
makes interpretation difficult as two arms with the same treatment yield quite
different results.
2. All numbers in the evidence
table above were read from figures in the paper and averaged as required.
3. Authors report a significant
improvement in strength recovery in HBO group in phase I compared to all other
groups. May be due to greater reduction in strength on exercise.
4. Authors report a significant
improvement in strength recovery in 5 HBOT group compared to sham. This may be
due to a greater drop in strength following exercise.
5. This study does not allow
firm conclusions.
6. Any findings may only apply
to non-athletes.
Expiry date: February 2005
References:
1.
Staples JR, Clement DB, Taunton JE, McKenzie DC. Effects of hyperbaric oxygen on
a human model of injury. Am Journal of Sports Medicine 1999; 27:600-605
