Effects of Hyperbaric Oxygen Therapy on Mitochondrial Respiration and Physical Performance in Middle-Aged Athletes: A Blinded, Randomized Controlled Trial

Amir Hadanny, Yafit Hachmo, Daniella Rozali, Merav Catalogna, Eldad Yaakobi, Marina Sova, Hadar Gattegno, Ramzia Abu Hamed, Erez Lang, Nir Polak, Mony Friedman, Shachar Finci, Yonatan Zemel, Yair Bechor, Noga Gal, Shai Efrati, Amir Hadanny, Yafit Hachmo, Daniella Rozali, Merav Catalogna, Eldad Yaakobi, Marina Sova, Hadar Gattegno, Ramzia Abu Hamed, Erez Lang, Nir Polak, Mony Friedman, Shachar Finci, Yonatan Zemel, Yair Bechor, Noga Gal, Shai Efrati

Abstract

Introduction: Hyperbaric 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.

Methods: A 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).

Results: Out 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.

Conclusion: HBOT 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://ichgcp.net/clinical-trials-registry/NCT03524989 (May 15, 2018).

Keywords: Aging athlete; Athletic training; Hyperbaric oxygen therapy; Mitochondrial function; Oxygen consumption.

Conflict of interest statement

Amir Hadanny, Eldad Yaakobi, Yair Bechor and Yonatan Zemel work for AVIV Scientific LTD. Shai Efrati is a shareholder and co-founder of AVIV Scientific LTD. Yafit Hachmo, Daniella Rozali, Merav Catalogna, Marina Sova, Hadar Gattegno, Ramzia Abu Hamed, Erez Lang, Nir Polak, Money Friedman, Shachar Finci and Noga Gal declare they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Athletes’ flowchart
Fig. 2
Fig. 2
SHAM protocol quality control. Rates of group allocation perception by the HBOT group subjects (A) and SHAM group subjects (B)
Fig.3
Fig.3
Mitochondrial mass changes. High-resolution micrograph of muscle staining with MTG demonstrates a significant increase in the mitochondrial mass marker MTG compared to the SHAM group (17.12% ± 20.2 vs. − 8.54 ± 8.41, p = 0.0002). Positive counts are represented by green dots. Greener/brighter images reflect higher counts of MTG staining

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