Tuesday, February 9, 2016

Unproven athlete training and recovery devices

A recent Wall Street Journal article reported that #1 ranked Novak Djokovic and several other tennis players frequently spend time in hyperbaric chambers after matches. This supposedly helps athletes recover and prevents injury.
A hyperbaric pod
Malcolm Hooper, the owner of the Melbourne "clinic" where the hyperbaric pods are located and a former chiropractor, said he has "seen gains in his patients, and the research suggests hyperbaric treatment can help many ailments." The article also quoted several athletes who favored the treatment but cited none of the research.

Also mentioned in the Wall Street Journal article was the Vacusport,, "a long tube with a skirt that seals the players legs in a vacuum and flushes lactic acid." Again, no evidence that it works was provided.

The Vacusport
I found a paper presented at a 2013 conference in Egypt called "Sport Science in the Arab Spring" that looked at 10 basketball players with an average age of 17 who exercised on a treadmill at increasing inclines for about 20 minutes. Lactate levels were drawn at several intervals during the period of exercise and after the subjects spent 30 minutes in the Vacusport. The average lactate concentration fell from 8.8 mmol/L after exercise to 1.1 mmol/L which the authors said was a significant difference [statistics not provided].

Before you jump on the Vacusport bandwagon, I must point out that we don't know how fast these athletes would have cleared their lactates without the device. That's what is known in research parlance as a "control group."

A study of 33 swimmers found that after intense racing they reduced their lactates of  >10.5 mmol/L to normal levels by simply swimming a modified workout for 20 minutes.

The Vacusport paper looks a like Nobel Prize candidate compared to a study of the Elevation Training Mask, a device which supposedly reduces the level of inspired oxygen without the expense of training at altitude where the percentage of oxygen in the air is lower due to the decreased atmospheric pressure.
Elevation Training Mask
Through a series of valves which can be opened or closed, the mask increases resistance to breathing. How this translates into lowering the partial pressure of oxygen in the air I do not know.

A case report published on the Elevation Training Mask website [but not in a scientific journal] must be read to be appreciated fully. An intrepid chiropractor wore the mask himself during 6 weeks of exercising.

Over the course of the experiment his peak expiratory flow rose 4%, his 1 second forced expiratory volume rose 1.3%, and his oxygen saturation rose from 96% to 99%,. No statistical analysis was performed, but the author said, "I do feel that this change was significant that oxygenation reached the 99%." I disagree. Even it was significant, an oxygen saturation rise of 3% is not clinically significant. [See my post on why oxygen is not a performance enhancing drug.]

A website called Bodybuilding.com explains in more detail why the mask could not possibly simulate altitude training.

Rather than rack my brain trying to come up with a pithy comment about the mask, I'll use one I found on Bodybuilding.com. "According to Alex Viada, a successful hybrid-training coach and founder of Complete Human Performance, such high-altitude devices 'simulate altitude in the same way sticking your head in a toilet simulates swimming.'"


Anonymous said...

One of the WSJ article's commenters helpfully dug up the history of "therapeutic" oxygen. Apparently it started with Priestley himself and ended (or should have ended) 200+ years ago.

Can repeated hyperbaric sessions over extended periods cause long-term side effects? With all this "recreational" use, we'll eventually find out I suppose.

Skeptical Scalpel said...

The WSJ article mentioned that last year a paper found a lower incidence of lung cancer in people who live at high elevations. The significance of this finding, if confirmed, was left to the reader's imagination. To me it would suggest that exposure to hyperbaric oxygen regularly might be detrimental in the long run.

RobertL39 said...

I'm sure there are lots of others, but the big one you didn't mention is the ultra-cold therapy that does everything but toast your bread.
I mean, if LeBron James says it works, it must work, right?

Skeptical Scalpel said...

Thanks for reminding me about that tragic case. It's another in the category of unproven devices that is worse than useless; it took a life.

artiger said...

I'm going to attend a week long training course in hyperbaric oxygen therapy for non-healing wounds here in the near future. I'm interested in hearing if any of the instructors will attempt to tout its use beyond wound care.

frankbill said...

Is there such a thing Toxic Joint Syndrome? If so does the Willow Curve help treat it?

Skeptical Scalpel said...

Artillery, I used HBO for leg ulcers 30 years ago. The patient's leg went into a little chamber. Worked when pt was in it. Ulcers healed but broke down a couple of weeks later.

Frank, I have no idea. Never heard of it or the treatment.

frankbill said...

If you never heard of the Willow Curve you must not watch TV. The Willow Curve is a home treatment device that cost $600 There web site https://willowcurve.com/
It is promoted on TV by Chuck Woolery.

I tend to think it is a scam

Here is more about where the name Toxic Joint syndrome came from http://wikibin.org/articles/dr.-ronald-shapiro.html

Dr. Ronald Shapiro MD, PhD, FACP (Born 1939), is an American nephrologist, inventor, and researcher. His innovative methods couple drug-free alternative treatments, along with mainstream medical sciences to treat patients in the safest and most effective way possible.
He has authored over 70 published scientific journals and papers over the course of his 50 years in medicine, making fresh discoveries and insights in the joint pain and renal fields.
He is best known in collaboration with David Sutton, for his development of the digital medical device The Willow Curve, and coining the condition, “Toxic Joint Syndrome.”

This site asked is The Willow Curve - Breakthrough or Scam?
Read more at http://www.consumerfraudreporting.org/productscams/WillowCurve.php#vGtl4rTgbc4pD0qS.99 http://www.consumerfraudreporting.org/productscams/WillowCurve.php

Skeptical Scalpel said...

I don't watch much TV. The device sounds a bit bogus to me.

Shai Efrati said...

A research shows that hyperbaric treatment heal brain injuries faster. In hyperbaric chamber huge amount of oxygen flows enhances our tissue function and helps our bodies fight e.g. infection that’s been slowing down our healing.

Skeptical Scalpel said...

Here's what UpToDate, an authoritative source, says about hyperbaric oxygen therapy (HBO): "Preliminary animal and human studies evaluating uses in syndromes as disparate as acute coronary syndrome, including myocardial infarction, the systemic inflammatory response syndrome, *traumatic brain* or spinal cord injury, sickle cell crisis, frostbite, fibromyalgia, and acute stroke have been conducted, with variable results. Further investigation will need to be conducted before HBO can be endorsed for these potential indications."

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