Abstract
IntroductionHyperbaric oxygen therapy (HBOT) has been used to increase endurance performance but has yet to be evaluated in placebo-controlled clinical trials. The current study aimed to evaluate the effect of an intermittent HBOT protocol on maximal physical performance and mitochondrial function in middle-aged master athletes.MethodsA double-blind, randomized, placebo-controlled study on 37 healthy middle-aged (40–50) master athletes was performed between 2018 and 2020. The subjects were exposed to 40 repeated sessions of either HBOT [two absolute atmospheres (ATA), breathing 100% oxygen for 1 h] or SHAM (1.02ATA, breathing air for 1 h).ResultsOut of 37 athletes, 16 HBOT and 15 SHAM allocated athletes were included in the final analysis. Following HBOT, there was a significant increase in the maximal oxygen consumption (VO2Max) (p = 0.010, effect size(es) = 0.989) and in the oxygen consumption measured at the anaerobic threshold (VO2AT)(es = 0.837) compared to the SHAM group. Following HBOT, there were significant increases in both maximal oxygen phosphorylation capacity (es = 1.085, p = 0.04), maximal uncoupled capacity (es = 0.956, p = 0.02) and mitochondrial mass marker MTG (p = 0.0002) compared to the SHAM sessions.ConclusionHBOT enhances physical performance in healthy middle-age master athletes, including VO2max, power and VO2AT. The mechanisms may be related to significant improvements in mitochondrial respiration and increased mitochondrial mass.Trial Registration ClinicalTrials.gov Identifier: https://clinicaltrials.gov/ct2/show/NCT03524989 (May 15, 2018).
Highlights
Hyperbaric oxygen therapy (HBOT) has been used to increase endurance performance but has yet to be evaluated in placebo-controlled clinical trials
By the use of muscle biopsies, it was demonstrated that the mechanisms related to HBOT induce significant increase in mitochondrial respiration and mitochondrial mass
Two additional athletes were excluded from the final analysis; one participant did not achieve maximal exercise in his baseline cardiopulmonary exercise tests (CPET), and the other had a VO2Max which was five standard deviations higher than the rest of the athletes (Fig. 1)
Summary
Hyperbaric oxygen therapy (HBOT) has been used to increase endurance performance but has yet to be evaluated in placebo-controlled clinical trials. Maximal aerobic fitness, evaluated by measuring the maximal oxygen capacity (VO2max) and anaerobic threshold (AT), strongly correlates with skeletal muscle mitochondria content (mitochondrial quantity) and skeletal muscle respiratory capacity, i.e., mitochondrial respiration (mitochondrial quality) [1,2,3]. Athletic training can increase both mitochondrial quality and quantity parallel to the improvements in VO2max and AT, measured during maximal cardiopulmonary exercise tests (CPET) [2, 4]. Several approaches have been suggested to enhance aerobic fitness by inducing mitochondrial adaptions beyond standard physical exercises. Long-term mitochondrial adaptations and aerobic fitness changes were not observed after standard exposure to normobaric hyperoxia [9]
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