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Babel S, Bosco G, Camporesi E. Hyperbaric Oxygen Treatment for Enhancing Athletic Recovery: A

Systematic Review and Meta-Analysis. Undersea Hyperb Med. 2026 Second Quarter; 53(2):305-318.

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.

Keywords: athletic performance; hyperbaric oxygen treatment; lactate; meta-analysis; sports medicine