Effects of Halotherapy as an Adjunct to Preseason Training on Respiratory and Aerobic Outcomes in Elite Female Football Players: A Randomized Controlled Trial

Background: Aerobic capacity and respiratory efficiency are critical determinants of performance in elite female football, characterized by repeated high-intensity efforts and rapid recovery demands. Halotherapy, involving the inhalation of dry salt aerosol, has been shown to improve pulmonary health; however, its effects on exercise-related outcomes in athletic populations remain insufficiently investigated. This study aimed to examine the effects of a 12-week post-training halotherapy intervention on respiratory muscle strength, pulmonary function, and aerobic performance in elite female football players. Methods: Twenty-eight elite female football players competing in the Turkish Women's First League were randomly assigned to a halotherapy group (HG, n = 14) or a control group (CG, n = 14). Both groups completed an identical preseason training program, while the HG additionally performed 45 min halotherapy sessions three times per week in a controlled halochamber. Pre-and post-intervention assessments included maximal inspiratory and expiratory pressures (MIP, MEP), spirometric parameters (FVC, FEV1, PEF, MVV), and maximal oxygen uptake (VO(2)max) estimated using the Yo-Yo Intermittent Recovery Test Level 1 (Yo-Yo IRT1), along with total distance covered. A 2 & times; 2 mixed-model ANOVA was used to assess time and group & times; time interaction effects. Results: Significant group & times; time interactions were observed for MIP, MEP, VO(2)max, FEV1, PEF, MVV, and Yo-Yo IRT1 performance (p < 0.05), with large effect sizes (eta p(2) = 0.269-0.924), favoring the halotherapy group. Forced vital capacity (FVC) increased over time in both groups (p = 0.141), with no significant interaction effect. Changes in the control group were comparatively smaller across most outcomes. Conclusion: Post-training halotherapy was associated with improvements in respiratory muscle strength, ventilatory function, aerobic capacity, and intermittent running performance in elite female football players. These findings suggest that halotherapy may be considered as a complementary, non-invasive strategy to support respiratory and aerobic adaptations. Further research is required to confirm these findings and to clarify the underlying physiological mechanisms. Trial registration: NCT07406386; 6 February 2026.