# Hydrotherapy with hydrogen-rich water compared with RICE protocol following acute ankle sprain in professional athletes: a randomized non-inferiority pilot trial.
> 急性足関節捻挫後の水素水浴療法とRICEプロトコルの比較：プロアスリートを対象とした無作為化非劣性パイロット試験


## Abstract

This randomized non-inferiority pilot trial enrolled 18 professional male athletes (mean age 23.7 years) who sustained acute ankle sprains during sport activities. Participants were allocated to either a hydrogen-rich water (HRW) bath group (n=9) or a conventional RICE group (n=9). The HRW group underwent six 30-minute ankle immersion sessions at 4-hour intervals within the first 24 hours post-injury, while the RICE group followed standard rest, icing, compression, and elevation procedures. Outcomes including ankle swelling reduction (2.1±0.9% vs. 1.6±0.8%; P=0.26), range of motion (2.4±1.3 cm vs. 2.7±0.8 cm; P=0.60), and single-leg balance with eyes open (18.4±8.2 s vs. 10.7±8.0 s; P=0.06) and closed (5.6±8.4 s vs. 3.9±4.2 s; P=0.59) showed no statistically significant differences between groups. These findings indicate that HRW hydrotherapy performs comparably to RICE in managing acute ankle sprains, though larger studies across diverse soft tissue injuries are warranted.

### Mechanism

Hydrogen-rich water is hypothesized to exert anti-inflammatory and antioxidant effects that may reduce post-injury edema and tissue damage, though the specific molecular mechanisms were not directly investigated in this trial.

## Bibliographic

- **Authors**: Javorac D, Stajer V, Ratgeber L, Olah A, Betlehem J, Acs P, et al.
- **Journal**: Res Sports Med
- **Year**: 2021
- **PMID**: [33356580](https://pubmed.ncbi.nlm.nih.gov/33356580/)
- **DOI**: [10.1080/15438627.2020.1868468](https://doi.org/10.1080/15438627.2020.1868468)
- **Study type**: human randomized controlled trial
- **Delivery route**: hydrogen bath
- **Effect reported**: null

## Delivery context

Hydrogen bathing has reports of localized effects, but for systemic hydrogen intake the most efficient route is inhalation. Inhalation carries explosion risk (empirical LFL of 10%; high-concentration devices are documented in the Consumer Affairs Agency accident database and are not recommended).

## Safety notes

Hydrogen bathing has reports of localized effects, but for systemic hydrogen intake the most efficient route is inhalation. Inhalation carries explosion risk (empirical LFL of 10%; high-concentration devices are documented in the Consumer Affairs Agency accident database and are not recommended).

See also:
- [Inhalation concentration and LFL / UFL](https://h2-papers.org/en/safety-notes/inhalation-concentration)
- [Consumer Affairs Agency accident cases](https://h2-papers.org/en/safety-notes/accident-cases)

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> **Cite as**: H2 Papers — PMID 33356580. https://h2-papers.org/en/papers/33356580
> **Source**: PubMed PMID [33356580](https://pubmed.ncbi.nlm.nih.gov/33356580/)