Hyperbaric Oxygen Therapy can be separated into two categories – high pressure and low pressure.

  • High-pressure HBOT, or hospital-grade HBOT is carried at 2 ATA and above that.
  • Low pressure or mild HBOT refers to pressures below 2 ATA.

In this presented study the authors have investigated the effects of low-pressure hyperbaric oxygen (mHBOT) treatment before and after maximal exercise on lactate concentration and heart rate and antioxidant capacity.

Ten healthy male college students were recruited from amateur soccer players. Subjects were performed a maximal exercise 3 times at intervals of at least 7 days according to the treatment method (control, pretreatment, posttreatment).

Lactate concentration, heart rate, and antioxidant capacity were measured before, post, and after recovery 30 min of maximal exercise. The lactate concentration and heart rate of recovery 30 min was significantly lower in the low-pressure mHBOT treated group after the maximal exercise compared with the control group and the low-pressure HBOT treated group before maximal exercise, and it could affect the removal of the fatigue substance caused by the maximal exercise. These results suggest that the low-pressure HBO treatment which is a new possibility for recovery of peripheral fatigue.

Park SH, et al. • Low-pressure hyperbaric oxygen treatment

As a World Anti-doping Agency (WADA)-approved treatment, hyperbaric oxygen (HBO2) therapy has been used to improve exercise performance in sports practice. The question remains if either the Mild Hyperbaric Oxygen Therapy (mHBOT) might have the same benefits as the high pressure HBOT.

Although the effects of the mild hyperbaric oxygen therapy for sport performance and recovery has not been studied enough in clinical setups, the number of elite athletes which are using the technology increased dramatically in the past 5 years.

The Hippocratic principle is “first, do no harm” (or “primum non nocere,” the Latin translation from the original Greek.)

In the case of mHBOT (Mild Hyperbaric Oxygen Therapy) It is only pressurized ambient air, it’s not pressurized oxygen, it can’t hurt anyone. And the elevated pressure it is only 9 up to 15 feet bellow the sea level.

The medical experience is the same, the oxygen is carried around the body by red blood cells that flow in blood vessels, either bound to hemoglobin or dissolved in blood plasma.

  • Oxygenated plasma is circulated to reach all injured tissues such as bruised muscles, sprained tendons, surgical wounds, strokes, areas of injury aggravated by damaged circulation.
  • The oxygen in the plasma will dissolve further into the damaged area than the oxygen attached to the red blood cell in the normal oxygen delivery system.
  • Red blood cells become oxygen saturated and the oxygen is distributed into all body fluids like the blood plasma, cerebrospinal fluid, the lymph, all the organs, including the brain.

Some studies even suggest that the pressures of 1.75 ATA and 1.3 ATA can be equally effective in some cases, and in other conditions (ex. Cerebral Palsy, Autism, TBI, Lyme disease, etc.) low-pressure protocols are recommended and more effective.



Fatigue refers to the inability to develop muscle strength and the power required for muscle contraction. Rapid removal of fatigue helps improve performance and exercise performance. Lactate accumulation causes fatigue, refers to the inhibition of muscle contraction by the accumulation of various metabolites such as lactate, hydrogen ion, inorganic phosphoric acid, and ammonia. The production and accumulation of lactate in the body causes acidosis by decreasing the pH, and it prevents oxidation of mitochondria and activation of enzyme. In addition, lactate increases the protein binding of calcium ions in myoplasmic reticulum to negatively affect muscle contraction.

The role of Oxygen in recovery

In humans, oxygen is used to produce energy and metabolism is inevitably incomplete during the metabolism. In many studies, exercise is known to increase reactive ox- ygen species. Reactive oxygen species refers to all types of deoxygenation that are unstable due to the absence of a pair of electrons such as hydrogen peroxide (H2O2), hydroxyl radical (OH-), super- oxide ion (O2.-). Exercise causes active skeletal muscle contraction and increases reactive oxygen production (Powers and Jackson, 2008), leading to oxidative stress. Oxidative stress caused by the increase of active oxygen production causes damage to cells, resulting in various diseases such as diabetes, car- diovascular diseases and nervous system diseases, cancer caused by DNA damage, and promotion of aging (Reddy et al., 2009).

Hyperbaric oxygen (HBOT) treatment is a minimal invasive treatment that inhales 100% oxygen in chambers pressurized at 2.0 to 2.5 atmospheres absolute (ATA) (Löndahl, 2012). Originally, HBO therapy has been useful in many injuries with edema and ischemia, such as wound healing and compression injuries. 

Hyperbaric Oxygen Therapy therapy increases the level of dissolved oxygen in the blood and increases the oxygen partial pressure of the peripheral tissues and is known to alleviate symptoms caused by low-pressure such as carbon monoxide poisoning, decompression sickness, and arterial embolism (Shimoda et al., 2015; Tibbles and Edelsberg, 1996). Recently, HBOT therapy with a lower pressure (1.2 to 1.3 ATA), called Mild Hyperbaric Oxygen Therapy (mHBOT) method has been used not only for medical but also for personal use (Edwards, 2010).

Danny Green, Philadelphia 76ers wing 

In this study, we investigated the effects of low-pressure HBOT therapy before and after maximal exercise on lactate concentration and heart rate recovery and antioxidant capacity.

Materials & methods

Ten healthy male volunteers were recruited from amateur soccer players who had no medical problems such as musculoskeletal diseases, cardiovascular diseases, and who does not take medication.

Before the experiment, all subjects were explained about the purpose and procedure of the experiment, and the experimental agreement. A total of three exercise tests were performed at 7 days intervals. The subjects were randomly divided into three groups: control group (n=10), low-pressure HBO-treated group before maximal exercise (n=10), low-pressure HBO-treated group after maximal exercise (n=10).

The following measurements wave been made:

  • Height and weight measurement
  • Blood lactate concentration
  • Antioxidant capacity
  • Heart rate
  • Maximal exercise load test

Mild hyperbaric oxygen therapy pressure protocol

Subjects were exposed to 30% oxygen at 1.3 ATA for 30 min. 1.3 ATA pressure is a pressure equivalent to 3-m depth and is the pressure that can safely provide high-pressure oxygen.


Hyperbaric oxygen therapy has been used as an adjunctive therapy for diseases, and the application of HBOT therapy for the treatment of sports injuries has been proposed as a therapy for primary treatment or adjunctive therapy. In addition, HBOT therapy has been shown to be effective in injuries associated with bones, muscles, and ligaments (Barata et al., 2011). In this study, we investigated the effects of low-pressure HBOT (mHBOT) treatment before and after maximal exercise on lactate concentration, heart rate and antioxidant capacity.

Lactate accumulation or muscle acidosis is a major determinant of fatigue. Lactate removal rate is a very important factor in exercise performance, and it means inhibition of anaerobic process. In the present study, the lowest lactate showed in the treated group with low-pressure HBO after maximal exercise compared with the control group and the treated group with low-pressure HBOT before maximal exercise group. The physiological response of HBOT and muscle metabolism are well known. High-pressure oxygen has been shown to increase arterial pressure and reduce heart rate (Lund et al., 1999), and hyperbaric conditions have been shown to reduce serum lactate accumulation during aerobic exercise (Neubauer et al., 1999; Stellingwerff et al., 2005). Ishii et al. (2005) reported that HBOT treatment showed fast recovery of lactate in the athletes. In this study, the lactate removal effect of low-pressure mHBOT after maximal exercise was consistent with the results of Sueblinvong et al. (2004). Heart rate recovery is known to change in response to acute changes in training load (Perini et al., 2006). Lactate con- centration is known to be closely related to heart rate (Ba et al., 2009). An attenuated heart rate recovery after exercise has been shown to be predictive of fatigue (Watanabe et al., 2001). The present study showed that low-pressure mHBOT treatment showed significant change. However, the highest heart rate recovery showed in the treated group with low-pressure mHBOT after maximal exercise. These results suggest that low-pressure mHBOT therapy after maximal exercise alleviates the peripheral fatigue.

Oxygen is important for cellular energy systems, but excess oxygen can cause functional problems in the human body (Halliwell and Gutteridge, 1999). Early studies have shown that HBO treatment results in an increase in intracellular reactive oxygen species (Boveris and Chance, 1973; Yusa et al., 1987). However, many studies have shown an increase in antioxidant defense after exposure to high-pressure oxygen (Alcaraz-García et al., 2008; Dennog et al., 1996; Eken et al., 2005). The present results indicate that low-pressure mHBOT therapy before and after maximal exercise cannot mediate intracellular changes of antioxidant defense action. Based on the present result, can be used as the new therapeutic agent for lactate control and fatigue recovery following exercise.

Practice recovery with the same zeal you work out.

mHBOT ( Mild Hyperbaric Oxygen Therapy)  can bring quick and efficient results for long-term injuries. Many studies have shown that mild hyperbaric therapy for athletes can work effectively as adjunctive therapy in conjunction with various other treatments, part of a recovery program to harness the highest healing potential for any type of sports-related injuries.

Studies confirm that mild hyperbaric devices facilitate a complimentary non-invasive way that can help physiotherapists, occupational therapists, chiropractors, osteopaths, and even naturopaths to complement their work.

Oxygen supplementation with soft Mild Hyperbaric Oxygen Chambers (mHBOT) can work with effective results as part of a system of therapies.

Given its low number of contraindications, risks, and side effects, it may be one of the safest therapies to use, within the correct protocols.

Source: The effects of low-pressure hyperbaric oxygen treatment before and after maximal exercise on lactate concentration, heart rate recovery, and antioxidant capacity

Authors: Si-Hwa Park, Sung-Jin Park, Mal-Soon Shin, Chang-Kook Kim*

School of Global Sport Studies, Korea University, Sejong, Korea

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