Hyperbaric oxygen therapy for delayed onset muscle soreness and closed soft tiss

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(Note: someone asked about HBOT this last week, and while looking

for something else I found this - although it is 2 years old ~ G)

Cochrane Database Syst Rev. 2005 Oct 19;(4):CD004713.

Hyperbaric oxygen therapy for delayed onset muscle soreness and

closed soft tissue injury.

M, Best TM, Babul S, Taunton J, Lepawsky M.

Prince of Wales Hospital, Department of Diving and Hyperbaric

Medicine, Barker Street, Randwick, New South Wales 2031, Australia.

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.