Hyperbaric Oxygen Treatment for Enhancing Athletic Recovery: A Systematic Review and Meta-Analysis.

Introduction: Hyperbaric oxygen treatment (HBO₂) uses increased atmospheric pressure and fractional oxygen to enhance tissue oxygen delivery. HBO₂ has gained attention as a tool for athletic recovery and performance, but past reviews in the literature are limited or inconclusive. This systematic review and meta-analysis aim to provide an update and assess the effect of HBO₂ on athletic recovery. Methods: Literature searches were performed across PubMed, Cochrane Central, Google Scholar, and Embase (January 1, 2015-September 15, 2024), following PRISMA guidelines. Studies included healthy athletes undergoing HBO₂ to assess athletic performance, metabolic recovery, and physiological responses. Quality assessment was performed using Cochrane's risk of bias tools (ROB2 and ROBINS-1). A meta-analysis with subgroup analyses by age, body mass index, and body fat mass percentage was conducted, along with a meta-regression examining HBO₂ protocol characteristics and outcomes. Results: Eleven met the eligibility criteria; six studies were included in the meta-analysis. The meta-analysis showed that HBO₂ significantly reduced post-recovery blood lactate levels (effect size: -1.71; 95% CI: -3.10 to -0.32). Subgroup analysis revealed that younger athletes and those with lower fat mass receiving HBO₂ exhibited significant reductions in post-recovery lactate levels. Meta-regression was inconclusive but suggested treatment effect heterogeneity based on HBO₂ protocol characteristics. HBO₂ showed limited application in short-term power output and force production. Discussion: Hyperbaric oxygen treatment is an efficient method for improving athletic performance, particularly by reducing post-exercise lactate levels, thereby supporting faster metabolic recovery. Future studies should focus on standardized protocols, diverse populations, and long-term outcomes to better understand HBO₂'s potential in orthopedics and sports medicine.