Comparative study of the effectiveness of a low-pressure hyperbaric oxygen treatment and physical exercise in women with fibromyalgia: randomized clinical trial

Abstract

Background: Fibromyalgia (FM) is characterized by chronic pain and fatigue, among other manifestations, thus advising interventions that do not aggravate these symptoms. The main purpose of this study is to analyse the effect of low-pressure hyperbaric oxygen therapy (HBOT) on induced fatigue, pain, endurance and functional capacity, physical performance and cortical excitability when compared with a physical exercise program in women with FM. Methods: A total of 49 women with FM took part in this randomized controlled trial. They were randomly allocated to three groups: physical exercise group (PEG, n = 16), low-pressure hyperbaric oxygen therapy group (HBG, n = 17) and control group (CG, n = 16). Induced fatigue, perceived pain, pressure pain threshold, endurance and functional capacity, physical performance and cortical excitability were assessed. To analyse the effect of the interventions, two assessments, that is, pre and post intervention, were carried out. Analyses of the data were performed using two-way mixed multivariate analysis of variance. Results: The perceived pain and induced fatigue significantly improved only in the HBG ( p < 0.05) as opposed to PEG and CG. Pressure pain threshold, endurance and functional capacity, and physical performance significantly improved for both interventions ( p < 0.05). The cortical excitability (measured with the resting motor threshold) did not improve in any of the treatments ( p > 0.05). Conclusions: Low-pressure HBOT and physical exercise improve pressure pain threshold, endurance and functional capacity, as well as physical performance. Induced fatigue and perceived pain at rest significantly improved only with low-pressure HBOT. Trial registration: ClinicalTrials.gov identifier NCT03801109.

Pain sensitivity is reduced by exercise training: Evidence from a systematic review and meta-analysis

“…Following the completion of the title and abstract screening there were 49 studies included in the full-text screening. The examination of full-texts resulted in 31 studies being excluded (Supplementary Table 2) and 18 studies [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42] being included for qualitative analysis (Supplementary Table 3). Of these, 15 studies were eligible for meta-analysis 25,[27][28][29][30][31][32][33]35,[37][38][39][40][41][42] ; three studies 26,34,36 could not be included in quantitative synthesis as the end intervention SD was not available and the contacted authors could not provide data.…”

“…The length of intervention ranged from 4 to 16 weeks. Of the included studies, one 26 investigated healthy populations, eight 27,28,32,35,37,38,40,42 examined fibromyalgia, seven studied upper quadrant pain (three 29,30,34 with neck pain, three 25,36,39 with neck and shoulder pain, one 31 with trapezius muscle pain), one 41 assessed type 2 diabetes and one 33 included people with Achilles tendon pain.…”

A General Overview on the Hyperbaric Oxygen Therapy: Applications, Mechanisms and Translational Opportunities

“…Frequently, this method utilizes between 2 to 3 atms of pressure. Nevertheless, it has also been obtained promising results in some studies from <2 atms (1.5 atms) for certain conditions [ 29 , 30 ], although according to all UHMS currently approved indications it is required a chamber pressurized to a minimum of 2 ATA [ 2 ]. Despite some protocols accept the use of 6 atms (i.e., treatment of gas embolism), little benefits are usually reported from >3 atms as it may be associated with a plethora of adverse effects [ 31 ].…”

Oxidative Stress in Fibromyalgia: From Pathology to Treatment

“…Therefore, healthy subjects might increase ROS synthesis. However, hyperbaric oxygen therapy has shown positive effects in clinical trials of fibromyalgia treatment, such as improved global functioning, pain reduction, psychological relief, and normalization of brain activity [52][53][54][55][56][57].…”