RCT 2016
From the library

The effects of hyperbaric oxygen therapy on post-training recovery in jiu-jitsu athletes

Branco BHM, Fukuda DH, Andreato LV, Santos JFS, Esteves JV, Franchini E

PLOS One n = 11 1.5 ATA 1 sessions
Plain English

Branco et al. (2016, PLOS One) is one of the few placebo-controlled HBOT studies in trained athletes — and it returned a NULL finding. Saturate's site philosophy holds that null findings are as informative as positive ones; this trial is the cornerstone of the Athletic Recovery condition page's honest, downgraded evidence assessment. What the trial measured. Two categories of post-exercise recovery markers at four time points (baseline, immediately post-exercise, 2 hours post, 24 hours post): hormonal markers (cortisol and total testosterone) and cellular damage markers (creatine kinase, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase). Subjective rating of perceived exertion (RPE) and blood lactate were also tracked. Who was studied. Eleven experienced Brazilian jiu-jitsu athletes — a small but well-defined sample of trained competitive athletes representative of the population most often targeted by HBOT marketing. Protocol parameters. A crossover design: each athlete completed two 90-minute training sessions one week apart. After one session they received 2 hours of HBOT; after the other, 2 hours of passive recovery. The order was randomized. The crossover allowed each athlete to act as their own control, addressing between-subject variability. Results. The headline finding: NO statistically significant difference between HBOT and passive recovery on any biomarker — not lactate, not creatine kinase, not AST/ALT/LDH, not cortisol, not testosterone. RPE was also not different at any time point. The only difference was that athletes reported feeling more recovered subjectively after HBOT — but the authors explicitly attributed this to a likely placebo effect, not a measurable biological difference. Limitations. Sample size is small (n=11), so the trial is underpowered to detect small effect sizes. Single-session HBOT may not generalize to a 12-session protocol. Brazilian jiu-jitsu may not generalize to other sports. However, the larger Huang 2021 systematic review (PMID 34887780) of 10 trials reached a compatible conclusion — pre/post-exercise HBOT showed no statistically significant effect on either performance or recovery in healthy athletes. What it means in practice. For trained, healthy athletes seeking acute recovery acceleration, the published evidence does not support HBOT as routinely useful. The case is different for injury rehabilitation (where stem-cell mobilization, angiogenesis, and reduced inflammation may help) — but routine post-training HBOT is not a supported use case. This is exactly the position the Saturate Athletic Recovery condition page takes. How it relates to other indexed trials. Branco 2016 + Huang 2021 (the meta-analysis confirming the same null finding) anchored Session 7's honest reassessment of the Athletic Recovery condition page (downgraded from Strong to Emerging). The trial sits in deliberate contrast to the strong-evidence pages on the site (TBI, Long COVID, longevity) — it demonstrates that Saturate's evidence framework treats null findings with the same seriousness as positive ones. Source: PubMed PMID 26959652.

Key findings

What the trial documented.

  • No statistically significant difference between HBOT and passive recovery for blood lactate, creatine kinase, AST, ALT, LDH, cortisol, or testosterone
  • No difference in rating of perceived exertion (RPE) at any time point
  • Greater perceived recovery in the HBOT condition — authors note this is consistent with a placebo effect rather than a measurable biological difference
  • Conclusion: HBOT exerted no influence on hormonal status or cellular damage markers in this trained-athlete cohort

Branco et al. (2016, PLOS One) is one of the few placebo-controlled HBOT studies in trained athletes — and it returned a NULL finding. Saturate’s site philosophy holds that null findings are as informative as positive ones; this trial is the cornerstone of the Athletic Recovery condition page’s honest, downgraded evidence assessment.

What the trial measured. Two categories of post-exercise recovery markers at four time points (baseline, immediately post-exercise, 2 hours post, 24 hours post): hormonal markers (cortisol and total testosterone) and cellular damage markers (creatine kinase, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase). Subjective rating of perceived exertion (RPE) and blood lactate were also tracked.

Who was studied. Eleven experienced Brazilian jiu-jitsu athletes — a small but well-defined sample of trained competitive athletes representative of the population most often targeted by HBOT marketing.

Protocol parameters. A crossover design: each athlete completed two 90-minute training sessions one week apart. After one session they received 2 hours of HBOT; after the other, 2 hours of passive recovery. The order was randomized. The crossover allowed each athlete to act as their own control, addressing between-subject variability.

Results. The headline finding: NO statistically significant difference between HBOT and passive recovery on any biomarker — not lactate, not creatine kinase, not AST/ALT/LDH, not cortisol, not testosterone. RPE was also not different at any time point. The only difference was that athletes reported feeling more recovered subjectively after HBOT — but the authors explicitly attributed this to a likely placebo effect, not a measurable biological difference.

Limitations. Sample size is small (n=11), so the trial is underpowered to detect small effect sizes. Single-session HBOT may not generalize to a 12-session protocol. Brazilian jiu-jitsu may not generalize to other sports. However, the larger Huang 2021 systematic review (PMID 34887780) of 10 trials reached a compatible conclusion — pre/post-exercise HBOT showed no statistically significant effect on either performance or recovery in healthy athletes.

What it means in practice. For trained, healthy athletes seeking acute recovery acceleration, the published evidence does not support HBOT as routinely useful. The case is different for injury rehabilitation (where stem-cell mobilization, angiogenesis, and reduced inflammation may help) — but routine post-training HBOT is not a supported use case. This is exactly the position the Saturate Athletic Recovery condition page takes.

How it relates to other indexed trials. Branco 2016 + Huang 2021 (the meta-analysis confirming the same null finding) anchored Session 7’s honest reassessment of the Athletic Recovery condition page (downgraded from Strong to Emerging). The trial sits in deliberate contrast to the strong-evidence pages on the site (TBI, Long COVID, longevity) — it demonstrates that Saturate’s evidence framework treats null findings with the same seriousness as positive ones.

Source: PubMed PMID 26959652.

Protocol used

Crossover design — single 2-hour HBOT exposure following a 90-minute training session, vs. 2 hours of passive recovery

Full citation

Branco BHM, Fukuda DH, Andreato LV, Santos JFS, Esteves JV, Franchini E. The effects of hyperbaric oxygen therapy on post-training recovery in jiu-jitsu athletes. PLOS One. 2016.