Study investigates low-oxygen, low-pressure conditions for muscle recovery

The study, published in the Journal of Physiology, is the first to provide scientific evidence for faster and more effective recovery from muscle injuries through intermittent exposure to low oxygen availability (hypoxia) in a low-barometric pressure (hypobaric) chamber that simulates high-altitude geographic conditions.

The new approach is important for the recovery of athletes — especially in the competitive elite — but also to mitigate the socio-economic impact of the loss of work productivity caused by these injuries in the active population.

Hypobaric chambers have long been used to improve physical fitness in high-performance sports and in professional sectors. In hypobaric hypoxia conditions, the body is exposed to a low atmospheric pressure environment in which cells take up less oxygen and generate a physiological response.

The beneficial effects of intermittent hypoxia exposure on the body are well described, but its potential applications in biomedicine are still being explored.

“The study indicates that any type of muscle injury could recover more quickly with intermittent exposure to hypobaric hypoxia (simulated altitude), but probably also myotendinous injuries could accelerate their recovery,” says Professor Ginés Viscor, head of the Adaptive Physiology Group: Hypoxia, Exercise and Health at the UB.

In tissues, hypoxia causes local activation of the HIF (hypoxia-induced factor) pathway, which is a sensor of oxygenation levels.

“When the amount of oxygen reaching the cells is not sufficient, the HIF protein acts as a switch that activates a series of changes in metabolic pathways to compensate for this deficit,” explains Professor Garoa Santocildes.

Among other pathways, the HIF protein activates the proliferation of more capillary vessels through endothelial growth factor (VEGF), a process that would bring more growth factors, metabolic substrates and oxygen to the muscle level to support the muscle regeneration process after injury.

As Professor Teresa Pagès explains, “in parallel, the HIF protein would also enhance the synthesis of specific proteins, the activity of some enzymes and the efficiency of the mitochondria, which are the cell organelles that supply energy for cellular functions.”

In approaching muscle injuries, the classical view of RICE therapy (Rest, Ice, Compression and Elevation) has evolved toward a more holistic and active view, known as PEACE (Protection, Elevation, Avoid NSAIDs, Compression, Education) and LOVE (Load management, Optimism, Vascularization, Exercise).

“All this has meant a major paradigm shift in the field of muscle injury recovery,” said Professor Joan Ramon Torrella.

“Exposure to hypobaric hypoxia — the expert continues — is fully compatible with this new paradigm, and could even contribute to improving the effects of emerging therapies to accelerate the recovery of injured muscle.”

Therapy based on exposure to low concentrations of oxygen could also help to explore new treatments for pathophysiological injuries.

Thus, it would be important to test whether hypoxia can counteract the muscle atrophy typical of sarcopenia — a disease characterized by loss of muscle mass and strength — through the processes involved in muscle recovery (capillary proliferation, more effective oxidative metabolism, etc.).

“In these cases, hypobaric hypoxia intervention would most likely be improved if combined with individualized strength and endurance exercise activities. Even its application in the recovery of patients with persistent COVID-19 syndrome could be improved,” the team concluded.

For more information, visit web.ub.edu.

SOURCE: Science Daily