Sports Medicine

, Volume 30, Issue 6, pp 395–403 | Cite as

The Role of Hyperbaric Oxygen Therapy in Sports Medicine

  • Shelina Babul
  • Edward C. Rhodes
Leading Article

Abstract

During the past decade, we have seen a growing number of individuals participating in sport and recreational activities. All indications show an increase in sport participation at every age level. However, the number of sport and recreational injuries as a result of this increase has also risen. Unfortunately, a primary cost related to injury recovery is the time lost from participating in and resuming normal functional activity. This has compelled health care professionals to seek more efficient and effective therapeutic interventions in treating such injuries. Hyperbaric oxygen (HBO) therapy may serve to provide a means of therapy to facilitate a speedier resumption to pre-injury activity levels as well as improve the short and long term prognosis of the injury.

Although a growing interest in sports medicine is becoming evident in the literature, the use of HBO as an intervention in this field has received a great deal of cynicism. To date, numerous professional athletic teams, including hockey (NHL), football (NFL), basketball (NBA) and soccer (MLS), utilise and rely on the use of HBO as adjuvant therapy for numerous sports-related injuries acquired from playing competitive sports. However, to date, very little has been published on the application benefits of hyperbaric therapy and sports injuries. The majority of clinical studies examining the efficacy of HBO in treating soft tissue injuries have been limited in their sample size and study design. Further research needs to be conducted suggesting and validating the significant effects of this treatment modality and further grounding its importance in sports medicine.

References

  1. 1.
    Mader JT. Hyperbaric oxygen therapy: a committee report. Bethesda (MD): Undersea and Hyperbaric Medical Society, 1989: 1–90Google Scholar
  2. 2.
    Fitzpatrick DT. Hyperbaric oxygen therapy. Missouri Med 1994; 91: 684–9PubMedGoogle Scholar
  3. 3.
    Bassett BE, Bennett PB. Introduction to the physical and physiological bases of hyperbaric therapy. In: Davis JC, Hunt TK, editors. Hyperbaric oxygen therapy. Bethesda (MD): Undersea Medical Society, 1977: 11–24Google Scholar
  4. 4.
    Doctor N, Pandya S, Supe A. Hyperbaric oxygen therapy in the diabetic foot. J Postgrad Med 1992; 38: 112–4PubMedGoogle Scholar
  5. 5.
    Hunt TK, Niinikoski J, Zederfeldt J, et al. Oxygen in wound healing enhancement: cellular effects of oxygen. In: Davis JC, Hunt TK, editors. Hyperbaric oxygen therapy. Bethesda (MD): Undersea Medical Society, 1977: 111–22Google Scholar
  6. 6.
    Hunt TK, Pai MP. The effect of varying ambient oxygen tensions on wound metabolism and collagen synthesis. Surg Gynecol Obstet 1971; 135: 561–7Google Scholar
  7. 7.
    Atroshenko ZB. Hyperbaric oxygenation in traumatic tissue edema. Soviet Med 1983; 9: 59–61Google Scholar
  8. 8.
    Hunt TK, Zederfeldt B, Goldstick T. Oxygen and healing. Am J Surg 1969; 118: 521–5PubMedCrossRefGoogle Scholar
  9. 9.
    Hohn DC. The effect of oxygen tensions on the microbial function of leukocytes in wounds and in vitro. Surg Forum 1976; 27: 18–20PubMedGoogle Scholar
  10. 10.
    Isakov IV, Atroschenko ZB, Balik IF, et al. Hyperbaric oxygenation in the prophylaxis of wound infection in the open trauma of the locomotor system. Undersea Biomed Res 1979; 6: 57–61Google Scholar
  11. 11.
    Hart GB. HBO and exceptional blood loss anemia. In: Kindwall EP, editor. Hyperbaric medicine practice. Flagstaff (AZ): Best Publishing Company, 1994: 517–24Google Scholar
  12. 12.
    Thom SR. Leukocytes in carbon monoxide-mediated brain oxidative injury. Toxicol Appl Pharmacol 1993; 123: 234–47PubMedCrossRefGoogle Scholar
  13. 13.
    Colignon M, Carlier AB, Khuc T, et al. Hyperbaric oxygen therapy in acute ischemia and crush injuries. In: Marroni A, Omani G, editors. Proceedings of the 13th Annual Meeting of European Undersea Biomedical Society; 1987 Sep 9–12; Palermo. 4–9Google Scholar
  14. 14.
    Davidkin NF. Experience with clinical use of hyperbaric oxygenation in cases of trauma and their complications. Ortop Traumatol Protez 1977; 9: 33–5Google Scholar
  15. 15.
    Grossman RA. Hyperbaric oxygen in the treatment of burns. Ann Plast Surg 1978; 1: 163–71PubMedCrossRefGoogle Scholar
  16. 16.
    Mainous EG. Osteogenesis enhancement utilizing hyperbaric oxygen therapy. HBO Rev 1982; 3: 181Google Scholar
  17. 17.
    Sheffield PJ. Tissue oxygen measurements with respect to soft tissue wound healing with normobaric and hyperbaric oxygen. Hyperb Oxygen Rev 1985; 6: 18–46Google Scholar
  18. 18.
    Neubauer RA, Gottlieb SF, Pevsner NH. Hyperbaric oxygen for treatment of closed head injury. South Med J 1994; 87 (9): 933–6PubMedCrossRefGoogle Scholar
  19. 19.
    Neubauer RA, Gottlieb SF. Hyperbaric oxygen for brain injury. J Neurosurg 1993; 78 (4): 687–8PubMedGoogle Scholar
  20. 20.
    Vorob’eva KP, Dziuba AN, Sorokin IN. Changes in autonomic regulation in patients with multiple sclerosis during hyperbaric oxygenation [in Russian]. Lik Sprava 1998; 7: 85–8PubMedGoogle Scholar
  21. 21.
    Kleijnen J, Knipschild P. Hyperbaric oxygen for multiple sclerosis: review of controlled trials. Acta Neurol Scand 1995; 91: 330–4PubMedCrossRefGoogle Scholar
  22. 22.
    Kindwall EP, McQuillen MP, Khatri BO, et al. Treatment of multiple sclerosis with hyperbaric oxygen: results of a national registry. Arch Neurol 1991; 48: 195–9PubMedCrossRefGoogle Scholar
  23. 23.
    Meneghetti G, Sparta S, Rusca F, et al. Hyperbaric oxygen therapy in the treatment of multiple sclerosis: a clinical and electrophysiological study in a 2 year follow-up. Riv Neurol 1990; 60: 67–71PubMedGoogle Scholar
  24. 24.
    van Bever Donker SC. Hyperbaric oxygen therapy for children with cerebral palsy. S Afr Med J 1999; 89 (4): 360-1PubMedGoogle Scholar
  25. 25.
    Cronje F. Hyperbaric oxygen therapy for children with cerebral palsy. S Afr Med J 1999; 89 (4): 359–60PubMedGoogle Scholar
  26. 26.
    Venter A, Leary M, Schoeman J, et al. Hyperbaric oxygen therapy for children with cerebral palsy. S Afr Med J 1998; 88 (11): 1362–3PubMedGoogle Scholar
  27. 27.
    Leach RE. Hyperbaric oxygen therapy in sports. Am J Sports Med 1998; 26: 489–90Google Scholar
  28. 28.
    Bakker DJ. Hyperbaric oxygen therapy: past, present and future indications. In: Erdmann W, Bruley DF, editors. Oxygen transport to tissue XIV. New York (NY): Plenum Press, 1992: 95–105CrossRefGoogle Scholar
  29. 29.
    Soolsma S. The effects of intermittent hyperbaric oxygen on short term recovery from grade II medial collateral ligament injuries [dissertation]. Vancouver: University of British Columbia, 1996Google Scholar
  30. 30.
    Staples J, Clement D. Hyperbaric oxygen chambers and the treatment of sports injuries. Sports Med 1996; 22: 219-27PubMedCrossRefGoogle Scholar
  31. 31.
    Anderson LH, Watson B, Herring RF, et al. Influence of intermittent hyperoxia on hypoxic fibroblasts. J Hyperb Med 1992; 7: 103–14Google Scholar
  32. 32.
    Young T. Hyperbaric oxygen therapy in wound management. Br J Nursing 1995; 4: 796–803Google Scholar
  33. 33.
    Brown RB, Sands M. Infectious disease indications for hyperbaric oxygen therapy. Compr Ther 1995; 21: 663–7PubMedGoogle Scholar
  34. 34.
    Kindwall EP. Uses of hyperbaric oxygen therapy in the 1990s. Cleve Clin J Med 1992; 59: 517–28PubMedGoogle Scholar
  35. 35.
    Tibbles PM, Edelsberg JS. Hyperbaric oxygen therapy. N Engl J Med 1996; 33: 1642–8CrossRefGoogle Scholar
  36. 36.
    Grim PS, Gottlieb LJ, Boddie A, et al. HBO therapy. JAMA 1990; 263: 2216–25PubMedCrossRefGoogle Scholar
  37. 37.
    Clarkson PM, Ebbeling C. Investigation of serum creatine kinase variability after muscle-damaging exercise. Clin Sci 1988; 75: 257–61PubMedGoogle Scholar
  38. 38.
    Friden J, Sjostrom M, Ekblom B. Myofibrillar damage following intense eccentric exercise in man. Int J Sports Med 1983; 4: 170–6PubMedCrossRefGoogle Scholar
  39. 39.
    Banda MI, Knighton DR, Hunt TK, et al. Oxygen tension regulates the expression of angiogenesis factor by macrophages. Science 1983; 221: 1283–5PubMedCrossRefGoogle Scholar
  40. 40.
    Perrins JD, Davis JC. Enhancement of healing in soft tissue wounds. In: Davis JC, Hunt TK, editors. Hyperbaric oxygen therapy. Bethesda (MD): Undersea Medical Society, 1977: 229–48Google Scholar
  41. 41.
    Hohn DC. Oxygen and leukocyte microbial killing. In: Davis JC, Hunt TL, editors. Hyperbaric oxygen therapy. Bethesda (MD): Undersea Medical Society, 1977: 101–10Google Scholar
  42. 42.
    Knighton DR, Fiegel VD, Halverson T, et al. Oxygen as an antibiotic. Arch Surg 1990; 12: 97–100CrossRefGoogle Scholar
  43. 43.
    Youn BA. Oxygen and its role in wound healing [online]. Available from: URL: http://www.etcuda.com/wound.htm [Accessed 2000 Oct 4]Google Scholar
  44. 44.
    Prockop DJ, Divirikko KI, Tuderman L. Biosynthesis of collagen and its disorders. N Engl J Med 1979; 301: 13–21PubMedCrossRefGoogle Scholar
  45. 45.
    Pentinnen R, Niinikoski P, Kulonen E. Hyperbaric oxygenation and fracture healing. Acta Chir Scand 1972; 138: 39-44Google Scholar
  46. 46.
    Pal MP, Hunt TK. The effect of varying ambient oxygen tensions on wound metabolism and collagen synthesis. Surg Gynecol Obstet 1972; 135: 561–7Google Scholar
  47. 47.
    Baboir BM. Oxygen dependent microbial killing by phagocytes. N Engl J Med 1974; 298: 659–68, 721-6CrossRefGoogle Scholar
  48. 48.
    DeChatelet LR. Oxidative bactericidal mechanisms of polymorphonuclear leukocytes. J Infect Dis 1975; 131: 295–303PubMedCrossRefGoogle Scholar
  49. 49.
    Curtis A, Konrad HR, Zamboni WA. Hyperbaric oxygen therapy: an overview. Plast Surg Nurs 1990; 10: 63–8PubMedGoogle Scholar
  50. 50.
    Bird AD, Telfer AB. Effect of hyperbaric oxygenation on limb circulation. Lancet 1965; I: 355–6CrossRefGoogle Scholar
  51. 51.
    Adameic L. Effect of hyperbaric oxygen therapy on some basic vital functions. Acta Physiol 1977; 28: 215–24Google Scholar
  52. 52.
    Tabrah FL, Tanner R, Vega R, et al. Baromedicine today: rational uses of hyperbaric oxygen therapy. Hawaii Med J 1994; 53: 112–9PubMedGoogle Scholar
  53. 53.
    Schaefer SE. Fundamentals of hyperbaric oxygen therapy. Orthop Nurs 1992; 11: 9–15PubMedCrossRefGoogle Scholar
  54. 54.
    Wells CH. Tissue gas measurements during hyperbaric oxygen exposure. In: Smith G, editor. Proceedings of the 6th International Congress on Hyperbaric Medicine. Aberdeen: Aberdeen University Press, 1977: 118–24Google Scholar
  55. 55.
    Weglicki WB, Whalen RE, Thompson HK, et al. Effects of hyperbaric oxygenation on excess lactate production in exercising dogs. Am J Physiol 1966; 210: 473–7PubMedGoogle Scholar
  56. 56.
    Melamed Y, Shupak A, Bitterman H. Medical problems associated with underwater diving. N Engl J Med 1992; 326: 30–5PubMedCrossRefGoogle Scholar
  57. 57.
    Davis JC, Hunt TK. Problem wounds: the role of oxygen. New York (NY): Elsevier, 1988Google Scholar
  58. 58.
    Kindwall EP, Goldman RW. Hyperbaric medicine procedures. Milwaukee (WI): St Luke’s Medical Center, 1988Google Scholar
  59. 59.
    Clark JM, Fisher AM. Oxygen toxicity and extension of tolerance in oxygen therapy. In: Davis JC, Hunt TK, editors. Hyperbaric oxygen therapy. Bethesda (MD): Undersea Medical Society, 1977: 11–24Google Scholar
  60. 60.
    Clark JM, Gelfard R, Stevens WL, et al. Pulmonary function in men after oxygen breathing at 3.0 ATA for 3.5 hours. J Appl Physiol 1991; 71: 878–85PubMedGoogle Scholar
  61. 61.
    Clark JM, Gelfard WL, Stevens WL, et al. Extension of pulmonary oxygen tolerance in man at 2.0 ATA by intermittent exposure of oxygen on normoxic pattern in predictive studies [abstract]. Undersea Biomed Res 1990; 17: 25Google Scholar
  62. 62.
    Stevens WC, Clark JM, Paolone AM, et al. Interacting effects of 2.0 ATA PO2 and exercise on cardiopulmonary parameters [abstract]. Undersea Biomed Res 1991; 18: 86Google Scholar
  63. 63.
    Hill RK. Is more better? A comparison of different clinical hyperbaric treatment pressures: a preliminary report [abstract]. Undersea Hyperb Med 1993; 20: 12Google Scholar
  64. 64.
    Korn HN, Wheeler ES, Miller TA. Effect of hyperbaric oxygen on second-degree burn wound healing. Arch Surg 1977; 12: 732–7CrossRefGoogle Scholar
  65. 65.
    Cianci P, Petrone G, Shapiro R, et al. Adjunctive hyperbaric oxygen therapy in treatment of severe burns [abstract]. Joint Meeting on Diving and Hyperbaric Medicine; 1990 Aug 11–18; Bethesda. Undersea Hyperb Med 1990; 17 Suppl. a: 44Google Scholar
  66. 66.
    Cianci P, Petrone G, Shapiro R et al. Adjunctive hyperbaric oxygen therapy in treatment of severe burns [abstract]. Joint Meeting on Diving and Hyperbaric Medicine; 1990 Aug 11–18; Bethesda. Undersea Hyperb Med 1990; 17 Suppl. b: 42Google Scholar
  67. 67.
    Cianci P, Sato R. Adjunctive hyperbaric oxygen therapy in the treatment of thermal burns: a review. Burns 1994; 20: 5–14PubMedCrossRefGoogle Scholar
  68. 68.
    Waisbren BA, Schutz D, Collentine G, et al. Hyperbaric oxygen in severe burns. Burns Incl Therm Inj 1982; 8: 176–9PubMedCrossRefGoogle Scholar
  69. 69.
    Nylander G, Nordstrom H, Eriksson E. Effects of hyperbaric oxygenation on edema formation after a scald burn. Burns 1984; 10: 193–6CrossRefGoogle Scholar
  70. 70.
    Stewart RJ, Mason SW, Kemp M, et al. Hyperbaric oxygen treatment of burn wounds: effect on ATP, phosphocreatine, and collagen synthesis in an animal model. Undersea Hyperb Med 1992; 19: 55Google Scholar
  71. 71.
    LaVan FB, Hunt TK. Oxygen and wound healing. Clin Plast Surg 1990; 17: 463–72PubMedGoogle Scholar
  72. 72.
    Mehm WJ, Pimsler M, Becker RL, et al. The effect of oxygen on in vitro fibroblast proliferation and biosynthesis. J Hyperb Med 1988; 3: 340–6Google Scholar
  73. 73.
    Skyhar MJ, Hargens AR, Strauss MB, et al. Hyperbaric oxygen reduces edema and necrosis of skeletal muscle in compartment syndromes associated with hemorrhagic hypotension. J Bone Joint Surg 1986; 68: 1218–24PubMedGoogle Scholar
  74. 74.
    Niinikoski JR, Hunt TK. Oxygen tensions in healing bone. Surg Gynecol Obstet 1972; 134: 746–50PubMedGoogle Scholar
  75. 75.
    Hammarlund C, Sundberg T. Hyperbaric oxygen reduced size of chronic leg ulcers: a randomized double blind study. Plast Reconstr Surg 1994; 93: 829–34PubMedCrossRefGoogle Scholar
  76. 76.
    Vujnovic D. The influence of oxygen on fracture healing. In: Dekleva N, editor. Symposium on hyperbaric medicine. Belgrad: 1983: 57–61Google Scholar
  77. 77.
    Kivisaari J, Niinikoski J. Effects of hyperbaric oxygenation and prolonged hypoxia on healing of open wounds. Acta Chir Scand 1975; 141: 14–9PubMedGoogle Scholar
  78. 78.
    Favalli A, Zottola V, Lovisetti G. External fixation and hyperbaric oxygen therapy in the treatment of open fractures of the tibial shaft [abstract]. Undersea Biomed Res 1990; 17: 172Google Scholar
  79. 79.
    Oriani G, Barnini C, Marroni G, et al. HBO therapy in treatment of various orthopaedic disorders. Minerva Med 1987; 73: 2983–8Google Scholar
  80. 80.
    Bouachour G, Cronier P, Gouello JP, et al. Hyperbaric oxygen therapy in the management of crush injuries: a randomized double-blind placebo-controlled clinical trial. J Trauma 1996; 41: 333–9PubMedCrossRefGoogle Scholar
  81. 81.
    Nylander G. Tissue ischemia and HBO: an experimental study. Acta Chir Scand 1986; 533: 109–10Google Scholar
  82. 82.
    Nylander G, Nordstrom H, Larsson J, et al. Reduction of post ischemic edema with hyperbaric oxygen. Plast Reconstr Surg 1985; 76: 596–603PubMedCrossRefGoogle Scholar
  83. 83.
    Jones RF, Unsworth IP, Marosszeky JE. Hyperbaric oxygen and acute spinal cord injuries in humans. Med J Aust 1978; 2: 573–5PubMedGoogle Scholar
  84. 84.
    Strauss MB. Role of hyperbaric oxygen therapy in acute ischemias and crush injuries, an orthopedic perspective. Hyperb Oxygen Rev 1981; 2: 87–106Google Scholar
  85. 85.
    Zamboni WA, Roth AC, Bergmann BA, et al. Experimental evaluation of oxygen in treatment of ischemic skeletal muscle [abstract]. Undersea Biomed Soc 1992; 19: 56Google Scholar
  86. 86.
    Zamboni WA, Roth AC, Russel RC, et al. Morphological analysis of microcirculation during reperfusion of ischemic skeletal muscle and the effect of hyperbaric oxygen. Plast Reconstr Surg 1993; 91: 1110–23PubMedCrossRefGoogle Scholar
  87. 87.
    James PB, Scott B, Allen MW. Hyperbaric oxygen therapy in sports injuries. Physiotherapy 1993; 79: 571–2CrossRefGoogle Scholar
  88. 88.
    Potera C. Healing under pressure. Physician Sports Med 1995; 25: 46–7Google Scholar
  89. 89.
    Leach RM, Rees PJ, Wilmshurst P. ABC of oxygen: hyperbaric oxygen therapy. BMJ 1998; 317: 1140–3PubMedCrossRefGoogle Scholar
  90. 90.
    Borromeo CN, Ryan JL, Marchetto PA, et al. Hyperbaric oxygen therapy for acute ankle sprains. Am J Sports Med 1997; 25: 619–25PubMedCrossRefGoogle Scholar
  91. 91.
    Staples JR. Effects of intermittent hyperbaric oxygen on pain perception and eccentric strength in a human model injury [dissertation]. Vancouver: University of British Columbia, 1996Google Scholar
  92. 92.
    Staples JR, Clement DB, McKenzie DC, et al. The effects of intermittent hyperbaric oxygen on biochemical muscle metabolites of eccentrically-exercised rats [abstract]. Can J Appl Physiol 1995; 20 Suppl.: 49Google Scholar
  93. 93.
    Best TM, Loitz-Ramage B, Corr DT, et al. Hyperbaric oxygen in the treatment of acute muscle stretch injuries: results in an animal model. Am J Sports Med 1998; 26: 367–72PubMedGoogle Scholar
  94. 94.
    Harrison BC, Robinson D, Davidson BJ, et al. Treatment of exercise induced muscle injury via hyperbaric oxygen therapy. 46th Annual Meeting of the American College of Sports Medicine (ACSM); 1999 Jun 2–5; Seattle (WA), S74Google Scholar

Copyright information

© Adis International Limited 2000

Authors and Affiliations

  • Shelina Babul
    • 1
    • 2
  • Edward C. Rhodes
    • 2
  1. 1.British Columbia Injury Research and Prevention Unit, British Columbia Children’s HospitalUniversity of British ColumbiaVancouverCanada
  2. 2.Department of Human KineticsUniversity of British ColumbiaVancouverCanada

Personalised recommendations