A Cochrane review [Abstract] 1 included 9 studies with a total of 219 subjects. In ankle sprain, there was no statistical significance in the mean time to recovery of full function with hyperbaric oxygen therapy (HBOT) compared to sham HBOT: mean difference (MD) 0.60 days, 95% confidence interval (CI) -12.91 to 14.11 days (1 trial; n=32). In acute injury to the medial collateral ligament of the knee, there was no difference between the groups in knee function scores (1 trial; n=14). In the treatment of delayed onset muscle soreness (DOMS), there was significantly and consistently higher pain at 48 and 72 hours in the HBOT group (mean difference in pain score at 48 hours [0 to 10 worst pain] 0.88, 95% CI 0.09 to 1.67, P = 0.03) in trials where HBOT was started immediately. There were no differences between the two groups in longer-term pain scores or in any measures of swelling or muscle strength.
Comment: The quality of evidence is downgraded by imprecise data (limited study size for each comparison) and by uncertainty of directness (differences in reported outcomes).
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