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Hyperbaric Oxygen Chambers and the Treatment of Sports Injuries

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Summary

Hyperbaric oxygen therapy, an established therapeutic intervention in diving medicine, is being investigated in wound management, where oxygen is an integral part of the healing process. Currently, the evidence is controversial as to whether there is a basis for using hyperbaric oxygen in normal wounds. This review explains the rationale for the use of hyperbaric oxygen therapy and reports on the initial research in the area of hyperbaric oxygen in sports-induced injury. In addition to the increased dissolved content of oxygen in the plasma, the combination of pressure and oxygen seems to promote systemic vasoconstriction and yet inhibition of vasoconstriction in the injured area, which will limit oedema.

The safety of hyperbaric oxygen in otherwise healthy athletes is examined. Potential contraindications to hyperbaric oxygen therapy include individuals who are febrile, suffer from upper respiratory infections, or have suffered a trauma to the chest where a pneumothorax is suspected or have a predisposition to tension pneumothorax. The initial human and animal model studies have shown promising, and in some instances significant, acceleration of healing. The potential benefits for sports injuries appear to be a blunting of initial injury, possibly by controlling the neutrophil adhesion and release of oxygen free radicals as well as an enhancement of healing processes requiring oxygen-like collagen formation phagocytosis.

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References

  1. Mader JT, editor. Hyperbaric oxygen therapy: a committee report. Bethesda (MD): Undersea and Hyperbaric Medical Society, 1989: 1–90

    Google Scholar 

  2. Hunt TK, Pai MP. The effect of varying ambient oxygen tensions on wound metabolism and collagen synthesis. Surg Gynecol Obstet 1972; 135: 561–7

    PubMed  CAS  Google Scholar 

  3. 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: 111–22

    Google Scholar 

  4. Hart GB. Treatment of decompression sickness and air embolism with hyperbaric oxygen. Aerospace Med 1974; 45: 1190–3

    PubMed  CAS  Google Scholar 

  5. Leitch DR. Treatment of decompression illness in the Royal Navy. In: Davis JC, editor. Treatment of serious decompression sickness and arterial gas embolism. Bethesda (MD): Undersea Medical Society, 1979; 11–22

    Google Scholar 

  6. Thorn SR. Leukocytes in carbon monoxide-mediated brain oxidative injury. Toxicol Appl Pharmacol 1993; 123: 234–47

    Article  Google Scholar 

  7. Cianci P, Sato R. Adjunctive hyperbaric oxygen therapy in the treatment of thermal burns: a review. Burns 1994; 20(1): 5–14

    Article  PubMed  CAS  Google Scholar 

  8. Colignon M, Carlier AB, Khuc T, et al. Hyperbaric oxygen therapy in acute ischemia and crush injuries. In: Marroni A, Oriani G, editors. Proceedings of 13th Annual Meeting of European Undersea Biomedical Society; 1987 Sep 9–12; Palermo, Italy, 1989: 4–9

    Google Scholar 

  9. Davidkin NF. Experience with clinical use of hyperbaric oxygenation in cases of trauma and their complications. Ortop Traumatol Protez 1977; 9: 33–5

    Google Scholar 

  10. Grossman AR. Hyperbaric oxygen in treatment of burns. Ann Plast Surg 1978; 1(2): 163–71

    Article  PubMed  CAS  Google Scholar 

  11. Hart GB, O’Reilly RR, Broussard ND, et al. Treatment of burns with hyperbaric oxygen. Surg Gynecol Obstet 1974; 139: 693–6

    PubMed  CAS  Google Scholar 

  12. Malnous EG. Hyperbaric oxygen in maxillofacial osteomyelitis, osteoradionecrosis, and osteogenesis enhancement. In: Davis JC, Hunt TK, editors. Hyperbaric oxygen therapy. Bethesda (MD): Undersea Medical Society, 1977: 191–216

    Google Scholar 

  13. Skyhar MJ, Hargens AR, Strauss MB, et al. Hyperbaric oxygenation reduces edema and necrosis of skeletal muscles in compartment syndromes associated with hemorrhagic hypotension. J Bone Joint Surg (Am) 1986; 68A: 1218–24

    Google Scholar 

  14. Jain KK. Textbook of hyperbaric oxygen. Toronto: Hogrefe and Huber, 1990

    Google Scholar 

  15. 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: 11–24

    Google Scholar 

  16. Adameic L. Effect of hyperbaric oxygen therapy in some basic vital functions. Acta Physiol Pol 1977; 28: 215–24

    Google Scholar 

  17. Nylander G, Lewis D, Nordstrom H, et al. Reduction of post ischemic edema with hyperbaric oxygen. Plast Reconstr Surg 1985; 76: 596–603

    Article  PubMed  CAS  Google Scholar 

  18. Zamboni WA, Roth AC, Russell RC, et al. The effect of hyperbaric oxygen treatment on microcirculation of ischemic skeletal muscle. Undersea Biomed Soc 1990; 17 Suppl.: 26

    Google Scholar 

  19. Weglicki WB, Whalen RE, Thompson HK, et al. Effects of hyperbaric oxygenation on excess lactate production in exercising dogs. Am J Physiol 1966; 210(3): 473–7

    PubMed  CAS  Google Scholar 

  20. Sheffield PJ. Tissue oxygen measurements with respect to soft tissue wound healing with normobaric and hyperbaric oxygen. Hyperbaric Oxygen Rev 1985; 6(1): 18–46

    Google Scholar 

  21. Sheffield PJ. Tissue oxygen measurements. In: Davis JC, Hunt TK, editors. Problem wounds — the role of oxygen. New York: Elsevier, 1988: 17–51

    Google Scholar 

  22. Wells CH, Goodpasture JE, Horrigan DJ, et al. Tissue gas measurements during hyperbaric oxygen exposure. In: Smith G, editor. Proceedings of the 6th International Congress on Hyperbaric Medicine; 1977 Aug 31–Sep 2: Aberdeen, Scotland. Aberdeen: Aberdeen University Press, 1979: 118–24

    Google Scholar 

  23. Clark JM, Fisher AB. Oxygen toxicity and extension of tolerance in oxygen therapy. In: Davis JC, Hunt TK, editors. Hyperbaric oxygen therapy. Bethesda (MD): Undersea Medical Society, 1977: 61–77

    Google Scholar 

  24. Clark JM, Gelfand 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(3): 878–85

    PubMed  CAS  Google Scholar 

  25. Lambertsen CJ, Kough RH, Cooper KY, et al. Oxygen toxicity: effects in man of inhalation at 1 and 3.5 atm upon blood gas transport, cerebral circulation, and cerebral metabolism. J Appl Physiol 1953; 5: 471–86

    PubMed  CAS  Google Scholar 

  26. Adameic L. Influence of hyperbaric oxygen therapy on pulmonary function in man. In: Smith G, editor. Proceedings of the 6th International Congress on Hyperbaric Medicine; 1977 Aug 31–Sep 2; Aberdeen, Scotland. Aberdeen: Aberdeen University Press, 1979: 60–8

    Google Scholar 

  27. Fisher AB, Hyde RW, Puy RTM, et al. Effect of oxygen at 2 ATA on the pulmonary mechanics of normal man [abstract]. J Appl Physiol 1968; 24: 529

    PubMed  CAS  Google Scholar 

  28. Stevens WC, Clark JM, Paolone AM, et al. Interacting effects of 2.0 ATA PO2 and exercise on cardio-pulmonary parameters [abstract]. Undersea Biomed Res 1991; 18 Suppl.: 86

    Google Scholar 

  29. Hill RK. Is more better? A comparison of different clinical hyperbaric treatment pressures — a preliminary report [abstract]. Undersea Hyperbaric Med 1993; 20 Suppl.: 12

    Google Scholar 

  30. Chernyakov IN, Prodin VA, Azhevsky PY, et al. Safety limits of hyperbaric oxygenation. In: Yefung SN, editor. Proceedings of the 7th International Congress of Hyperbaric Medicine; 1981 Sep 2–6; Moscow: Acadamy of Sciences, 1981: 404–5

    Google Scholar 

  31. Foster JH. Hyperbaric oxygenation treatment — contraindications and complications. J Oral Maxillofac Surg 1992; 50(10): 1081–6

    Article  PubMed  CAS  Google Scholar 

  32. Kurenkov HI. Human work performance in hyperbaric environment. Forsvarmed 1973; 9: 332–6

    Google Scholar 

  33. 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(1): 57–61

    Google Scholar 

  34. LaVan FB, Hunt TK. Oxygen and wound healing. Clin Plastic Surg 1990; 17(3): 463–72

    CAS  Google Scholar 

  35. 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: 229–48

    Google Scholar 

  36. Anderson LH, Watson B, Herring RF, et al. Influence of intermittent hyperoxia on hypoxic fibroblasts. J Hyperbaric Med 1992; 7(2): 103–14

    Google Scholar 

  37. Criswell DW, Mehm WJ. Effects of hyperbaric oxygen and growth factor on fibroblast infiltration in mice. J Hyperbaric Med 1992; 7(1): 19–31

    Google Scholar 

  38. Criswell DW, Mehm WJ. Effects of hypoxia and epidermal growth factor on fibroblast infiltration in rats. J Hyperbaric Med 1992; 7(3): 155–64

    Google Scholar 

  39. Goepfert H. Controversy over benefit of hyperbaric oxygenation to wound healing and angiogenesis in radiation damaged tissue [letter; comment]. Am J Surg 1992; 163(4): 457

    Article  PubMed  CAS  Google Scholar 

  40. Storch TG, Talley GD. Oxygen concentration regulates the proliferative response of human fibroblasts to serum and growth factors. Exp Cell Res 1988; 175: 317–25

    Article  PubMed  CAS  Google Scholar 

  41. Perrins JD, Barr PO. HBO and wound healing. In: Schmutz J, editor. Proceedings of the First Swiss Symposium of Hyperbaric Oxygenation; 1985 Sep 18–20; Basel: Foundation for Hyperbaric Medicine, 1986: 119–32

    Google Scholar 

  42. Niinikoski JR, Pentinnen R, Kulonen E. Effects of HBO on fracture healing in rats: a biochemical study. Calcif Tissue Res 1970; 4: 115–6

    Article  Google Scholar 

  43. Mehm WJ, Pimsler M, Becker RL, et al. The effect of oxygen on in vitro fibroblast proliferation and biosynthesis. J Hyperbaric Med 1988; 3(4): 340–6

    Google Scholar 

  44. Sadegani K, Gottlief SF, Van Meter K, et al. The effects of increased oxygen tension on healing surgical wounds [abstract]. Undersea Biomed Res 1989; 16: 42

    Google Scholar 

  45. Abbot NC, Beck JS, Carnochan FMT, et al. Daily HBO does not increase the severity of inflammation in the tuberculin reaction in healthy human volunteers. J Hyperbaric Med 1990; 5(3): 215–22

    Google Scholar 

  46. Abbot NC, Beck JS, Carnochan FMT, et al. Estimating skin respiration from transcutaneous PO2/PCO2 at 1 and 2 atm abs on normal and inflamed skin. J Hyperbaric Med 1990; 5(2): 91–102

    Google Scholar 

  47. Carnochan FMT, Abbot NC, Swanson Beck J, et al. Can hyperbaric oxygen correct hypoxia induced by inflammation? Preliminary findings. In: Schmutz J, Bakker D, editors. Proceedings of the Joint Meeting 2nd Swiss Symposium on Hyperbaric Medicine and 2nd European conference on Hyperbaric Medicine; 1988 Sep 22–24; Basel: Foundation for Hyperbaric Medicine, 1990: 47–54

    Google Scholar 

  48. Niinikoski JR, Hunt TK. Oxygen tensions in healing bone. Surg Gynecol Obstet 1972; 134: 746–50

    PubMed  CAS  Google Scholar 

  49. Niinikoski JR, Grislis G, Hunt TK. Respiratory gas tensions and collagen in infected wounds. Ann Surg 1972; 175: 588–93

    Article  PubMed  CAS  Google Scholar 

  50. Halva ZD, Koziel M, Zoch V. Application of hyperbaric oxygen in ankle joint injuries [abstract]. Beitr Orthop Traumatol 1978; 25: 324–7

    PubMed  CAS  Google Scholar 

  51. Oriani G, Barnini C, Marroni G, et al. HBO therapy in treatment of various orthopaedic disorders. Minerva Med 1987; 73: 2983–8

    Google Scholar 

  52. Thorn SR, Elbuken ME. Oxygen dependent antagonism of lipid peroxidation. Free Radic Biol Med 1991; 10: 413–20

    Article  Google Scholar 

  53. Vujnovic D. The influence of oxygen on fracture healing. In: Dekleva N, editor. Symposium on Hyperbaric Medicine; 1983 Sep 7–9; Belgrad; 1983: 57–61

    Google Scholar 

  54. Wilcox JW, Koloding SC. Acceleration of healing of maxillary and mandibular osteotomies by use of hyperbaric oxygen: a preliminary report. J Oral Maxillofac Surg 1976; 34: 370–5

    Google Scholar 

  55. Gray DH, Hamblin DL. The effects of hyperoxia upon bone organ culture. Clin Orthop Relat Res 1976; 119: 225–30

    PubMed  Google Scholar 

  56. Van Opstal M. Treatment of a complicated, refractory femur fracture by surgery and hyperbaric therapy [abstract]. In: 7th Annual Conference on Clinical Applications of HBO; 1982 Jun 9–11; Anaheim (CA)

    Google Scholar 

  57. Coulson DB, Ferguson AB, Diehl RC. Effect of hyperbaric oxygen on healing femur of rat. Surg Forum 1966; 17: 449–67

    PubMed  CAS  Google Scholar 

  58. Karapetian TS, Volozhin AT, Oleinik NN. Treatment of mandibular fractures using hyperbaric oxygenation. Stomatologiia(Mosk) 1985; 64: 33–8

    Google Scholar 

  59. Strauss MB, Hart GB. Clinical experience with hyperbaric oxygenation in fracture healing. In: Smith G, editor. Proceedings of the 6th International Congress on Hyperbaric Medicine; 1977 Aug 31–Sep 2; Aberdeen. Scotland. Aberdeen: Aberdeen University Press, 1979: 329–32

    Google Scholar 

  60. Zavesa PZ, Shvabe JJ, Abdushukurov A. Effect of hyperbaric oxygen therapy on reparative regeneration of the bone. Ortop Traumatol Protez 1977; 11: 71–2

    Google Scholar 

  61. 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 Suppl.: 172

    Google Scholar 

  62. Kivisaari J, Niinikoski J. Effects of hyperbaric oxygenation and prolonged hypoxia on healing of open wounds. Acta Chir Scand 1975; 141(1): 14–9

    PubMed  CAS  Google Scholar 

  63. Yablon IG, Cruess RL. The effect of hyperbaric oxygen on fracture healing in rats. J Trauma 1968; 8(2): 186–202

    Article  PubMed  CAS  Google Scholar 

  64. James PB, Scott B, Allen MW. Hyperbaric oxygen therapy in sports injuries: a preliminary study. Physiotherapy 1993; 79(8): 571–2

    Article  Google Scholar 

  65. Potera C. Healing under pressure. Physician Sports Med 1995 Nov; 25(11): 46–7

    Google Scholar 

  66. 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.: 49

    Google Scholar 

  67. Staples JR. Effects of intermittent hyperbaric oxygen on pain perception and eccentric strength in a human model injury [dissertation]. Vancouver: University of British Columbia, 1996

    Google Scholar 

  68. Webster DA, Horn P, Amin HM, et al. Effect of hyperbaric oxygen on ligament healing in a rat model [abstract]. Undersea Hyperb Med 1996; 23 Suppl.: 13

    Google Scholar 

  69. Abbot NC, Beck JS, Carnochan FMT, et al. Effect of hyperoxia at 1 and 2 ATA on hypoxia and hypercapnia in human skin during experimental inflammation. J Appl Physiol 1994; 77(2): 767–73

    PubMed  CAS  Google Scholar 

  70. Boykin JV, Eriksson E, Pittman N. In vivo microcirculation of a scald burn and the progression of postburn dermal ischemia. Plast Reconstr Surg 1980; 66: 191–8

    Article  PubMed  CAS  Google Scholar 

  71. Bird AD, Telfer ABM. Effect of hyperbaric oxygenation on limb circulation. Lancet 1965; I: 355–6

    Article  Google Scholar 

  72. Kihlstrom M, Kainulainen H, Salminen A. Enzymatic and non-enzymatic lipid peroxidation capacities and antioxidants in hypoxic and reoxygenated rat myocardium. Exper Mol Pathol 1989; 50: 230–8

    Article  CAS  Google Scholar 

  73. Thorn SR. Molecular mechanism for the antagonism of lipid peroxidation by hyperbaric oxygen [abstract]. Undersea Biomed Res 1990; 17 Suppl.: 52

    Google Scholar 

  74. Zamboni WA, Roth AC, Russell RC, et al. The effect of hyperbaric oxygenation on reperfusion of ischemic axial skin flaps: a laser Doppler analysis. Ann Plast Surg 1992; 28(4): 339–41

    Article  PubMed  CAS  Google Scholar 

  75. Thorn SR. Functional inhibition of leukocyte B2 integrins by hyperbaric oxygen in carbon monoxide-mediated brain injury in rats. Toxic Appl Pharmacol 1993; 123: 248–56

    Article  Google Scholar 

  76. Knighton DR, Fiegel VD, Halverson T, et al. Oxygen as an antibiotic. Arch Surg 1990; 125: 97–100

    Article  PubMed  CAS  Google Scholar 

  77. Zamboni WA, Roth AC, Russell RC, et al. Morphological analysis of microcirculation during reperfusion of ischemic skeletal muscle and the effect of hyperbaric oxygen. Plast Reconstr Surg 1993; 91(6): 1110–23

    Article  PubMed  CAS  Google Scholar 

  78. McCord JM. Free radicals and inflammation: protection of synovial fluid by Superoxide dismutase. Science 1974; 189: 529–30

    Article  Google Scholar 

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  1. Allan McGavin Sports Medicine Centre, Division of Sports Medicine, University of British Columbia, John Owen Pavillion, 3055 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada

    James Staples &  Douglas Clement

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  1. James Staples
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Staples, J., Clement, D. Hyperbaric Oxygen Chambers and the Treatment of Sports Injuries. Sports Med. 22, 219–227 (1996). https://doi.org/10.2165/00007256-199622040-00002

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