2020 Journal of sports medicine (Hindawi Publishing Corporation) Pilot / Observational Human H₂ therapy Bath / Topical Sports & Exercise
2020 · Todorovic et al. — The Effects of Supersaturated Hydrogen-Rich Water Bathing on Biomarkers of Muscular Damage and Soreness Perception in Young Men Subjected to High-Intensity Eccentric Exercise
Super-Abstract
In six young men, a single 30-minute whole-body bath in water with 8 mg of hydrogen per litre after hard eccentric exercise kept serum creatine kinase similar to baseline at 24 hours, while it rose after a control bath (group difference P = 0.04). Muscle soreness scores fell more after the hydrogen bath, both right after bathing (P = 0.02) and at 24 hours (P = 0.03). The abstract calls the rise after the control bath significant but gives P > 0.05, and the study does not report randomisation. (Journal of Sports Medicine, 2020.)
Commentary
High-intensity eccentric exercise can cause delayed-onset muscle soreness with muscle damage and tenderness, and the authors note that no data existed on whole-body bathing in supersaturated hydrogen-rich water after such exercise. Six healthy young men took part in a double-blind crossover pilot study. Per full text, they performed eccentric leg press exercise and had a 2-week wash-out between the two conditions, and random allocation is not described. Immediately after exercise they sat immersed up to the neck for 30 minutes in a 200 L bathtub with hydrogen-rich water (8 mg of H₂ per litre) or control water without hydrogen. Per full text, the bath was 28 °C, the hydrogen came from dissolving magnesium tablets, and control tablets produced carbon dioxide bubbles so that both baths looked alike. Blood markers of inflammation and muscle damage and soreness on a visual analogue scale were measured before exercise and after 24 hours. Per full text, the primary outcome was the change in serum creatine kinase.
Key quotes
- „Two-way ANOVA revealed a significant difference between two groups in serum creatine kinase (CK) response over the period of intervention (P=0.04).“ — the result for creatine kinase, the primary outcome according to the full text
- „On the other hand, serum CK, aldolase, and aspartate transaminase were significantly elevated at 24-hour follow-up as compared to the baseline levels after the control bath (342 ± 309 U/L vs. 465 ± 295 U/L; P > 0.05).“ — the control bath result, where the stated P value contradicts the word significant
- „This pilot study suggests that the whole-body bathing in supersaturated HRW is a safe procedure that attenuates muscular damage and can ease sore muscles after high-intensity eccentric exercise.“ — the authors' conclusion from a pilot study with six participants
Our assessment
The crossover design and blinding with baths that looked alike are strengths. Creatine kinase, the primary marker, responded differently after the two baths (P = 0.04), and soreness scores fell more after the hydrogen bath. Limitations: only six men, one bath and 24 hours of follow-up. Neither the abstract nor the full text mentions randomisation, so it is unclear how the order of the baths was assigned. The abstract gives no creatine kinase values for the hydrogen bath, and for the control bath it calls the rise significant while giving P > 0.05. The full text gives P < 0.05. Per full text, only creatine kinase differed between groups among the many markers tested. Safety rests on six participants, and per full text one reported a mild, brief burning sensation from a partly dissolved tablet. The results suggest an effect on short-term damage markers in this very small sample, which larger randomised trials would need to confirm.
Study design
- Type: double-blind crossover pilot study, randomisation not reported · n: 6 healthy young men · H₂ delivery: single 30-minute whole-body bath in 200 L of supersaturated hydrogen-rich water (8 mg H₂ per litre) right after eccentric exercise, per full text at 28 °C with hydrogen produced by dissolving magnesium tablets
- Comparator: control water without hydrogen, per full text with non-hydrogen-producing magnesium tablets that made carbon dioxide bubbles, 2-week wash-out between conditions
- Result: serum creatine kinase response differed between conditions (P = 0.04, primary outcome per full text). After the hydrogen bath all damage markers stayed similar to baseline (P > 0.05). After the control bath CK, aldolase and AST were described as significantly raised (342 ± 309 vs. 465 ± 295 U/L, abstract gives P > 0.05). Soreness reduction 32.7 ± 8.6% vs. 20.0 ± 12.8% right after bathing (P = 0.02) and 31.6 ± 24.3% vs. 22.4 ± 27.5% at 24 hours (P = 0.03). No major side effects reported
Abstract
High-intensity eccentric exercise can cause a delayed onset of muscle soreness (DOMS), a short-term condition characterized by muscle damage and tenderness that might hold up recovery and jeopardize exercise routine. Previous studies indicated that hydrogen-rich water (HRW) might be a helpful topical intervention to boost recovery in musculoskeletal medicine, yet no data are available concerning the effectiveness and safety of whole-body bathing with supersaturated HRW after DOMS-inducing exercise. This study evaluates the effects of a single-session bathing with HRW on biochemical markers of muscular damage in healthy young men. The six volunteers who were exposed to DOMS-inducing eccentric exercise were assigned to either supersaturated HRW or control whole-body bathing in a double-blind crossover design. Immediately after an exercise session, the participants were immersed up to the neck into a 200 L bathtub with supersaturated HRW (8 mg of H2 per L) or control water (no hydrogen) for 30 min. Blood biomarkers of inflammation and muscular damage and Visual Analogue Scale (VAS) scores for muscle soreness were assessed at baseline (before exercise) and at 24-hour follow-up. Two-way ANOVA revealed a significant difference between two groups in serum creatine kinase (CK) response over the period of intervention (P=0.04). A single-session bathing in HRW prevented a rise in circulating biomarkers of muscular damage induced by exercise at 24-hour follow-up, retaining the levels of all biomarkers similar to the baseline values (P > 0.05). On the other hand, serum CK, aldolase, and aspartate transaminase were significantly elevated at 24-hour follow-up as compared to the baseline levels after the control bath (342 ± 309 U/L vs. 465 ± 295 U/L; P > 0.05). HRW bath also induced a significant drop in VAS scores for muscle soreness in comparison with control water, both immediately after an intervention (32.7 ± 8.6% vs. 20.0 ± 12.8%; P=0.02) and at 24-hour follow-up (31.6 ± 24.3% vs. 22.4 ± 27.5%; P=0.03), respectively. No participants reported any major side effects during the trial. This pilot study suggests that the whole-body bathing in supersaturated HRW is a safe procedure that attenuates muscular damage and can ease sore muscles after high-intensity eccentric exercise.
Source & links
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