EEG Biofeedback and Multimodal Neuro-Physiological Monitoring in Elite Male Judokas: Neural Efficiency, Peak Power Preservation, and Strength Recovery under Hypoxia and Normoxia

This record documents a pilot randomized controlled trial investigating whether combining real-time EEG neurofeedback with normobaric hypoxia can improve post-exercise neuromuscular recovery in elite male judokas from the Polish National Judo Senior Team. Eight international-level judokas (age 24 ± 3 years; ~14.5 ± 2.3 years of judo training experience) were randomized to six weeks of EEG neurofeedback training performed either under normoxic conditions (FiO₂ ≈ 0.21; ENG, n = 4) or under simulated altitude hypoxia (FiO₂ ≈ 0.16, ~2400 m; EHG, n = 4). After 18 supervised neurofeedback sessions (3×/week), athletes completed a heavy resistance bout (back squat and bench press at 70% and 85% 1RM) followed by 72 hours of recovery monitoring. The primary outcome was peak power output in squat and bench press, normalized to body mass and specific to judo throwing and grappling mechanics. Secondary outcomes included strength-endurance (total repetitions at 70% + 85% 1RM), EEG frontal alpha asymmetry (FAI) as a marker of neural efficiency, heart rate variability (RMSSD) as an index of autonomic recovery, and a panel of serum biomarkers (creatine kinase, cortisol, testosterone, testosterone-to-cortisol ratio). Results showed a significant group × time interaction for peak power (F₄,₁₆ = 5.23, p = 0.005), with the hypoxic neurofeedback group preserving substantially more peak power 24 h after exercise (−9.9% vs. −19.5% in the normoxia group, ~170 W absolute difference). The hypoxia group also performed more total repetitions at 24 h, maintained a more stable fatigue index, exhibited more favorable 24 h HRV (ΔRMSSD +19 ms), and showed blunted creatine kinase response and faster hormonal recovery (higher 24 h testosterone-to-cortisol ratio), with no adverse events reported. These findings suggest that pairing EEG-based neurofeedback with moderate normobaric hypoxia is feasible in elite combat sport athletes and may synergistically enhance central (cortical) and peripheral (muscular) recovery mechanisms, accelerating functional readiness between closely spaced matches. The study provides a proof-of-concept for integrating neurofeedback and hypoxic conditioning in high-performance judo and motivates larger, multi-sport trials to establish generalizability and real-world performance benefits.