Low pressure hyperbaric therapy is quite effective against cerebral palsy in children, according to a new study conducted in India. It thus refutes previous assumptions that 100% oxygen under higher pressure is a superior treatment.
The largest sample of children studied to assess neuro-developmental improvements focuses on a combination of standard rehabilitation therapies, such as Occupational, Physical, Speech Therapies and HBOT.
HBOT raises the oxygen molecule content in the body through oxygen-carrying blood cells and all body fluids. A person enters a treatment chamber, and the air pressure is compressed with more molecules of air and oxygen. Lately, HBOT has garnered much attention in the media, with athletes using it to train and recover from injuries, diabetics literally saving limbs, patients able to kill resistant bacteria, and most recently, new applications in neurology--brain injuries, traumas and disorders.
In fact, this new study out of India compares the use of various hyperbaric pressures with the use of (ambient) air alone or oxygen-enrichment in the treatment of children with Cerebral Palsy (CP). The study shows that low pressure ambient air hyperbaric therapy (1.3 atmospheres-ATA) is as or more effective than high pressure 100% oxygen (1.5 or 1.75 ATA) in the treatment of CP. The children were studied by Dr. Arun Mukherjee, director of the UDAAN Disabled Children's Center, a non-profit organization, recognized and aided by the Indian Ministry of Social Justice & Empowerment.
This landmark study, co-authored with Dr. Pierre Marois (McGill University in Montreal, Canada), further develops the 1999 ground-breaking McGill study (Lancet, February 2001) by expanding the number of subjects and by implementing an accurate placebo-control testing method. Subjects with a functional diagnosis of spastic diplegia cerebral palsy received one of four hyperbaric options, in addition to standard therapies: 1) the placebo therapy (20 subjects); 2) hyperbaric therapy at 1.3 ATA breathing ambient air under pressure (36 subjects); 3) hyperbaric therapy breathing 100% oxygen at 1.5 ATA (32 subjects); and 4 ) 1.75 ATA with 100% oxygen (58). All subjects were reevaluated at six months after conclusion of therapy to negate any traces of the placebo effect. The study showed significant improvements for all three groups receiving therapy (the placebo group showed little or no improvement). There were no significant improvement differences between the therapies, with a slight preference (cognitive improvement) shown towards 1.3 ATA with air only.
In the areas of cognitive development, the milder therapy does not trigger the narrowing of the blood vessels (vasoconstriction) in the brain in the way that the other therapies do, thus allowing additional oxygen to pass through tissue unrestricted.
"It brings into focus that the much more affordable mild hyperbaric therapy is an accessible alternative to expensive high-pressure hyperbaric therapy and does not compromise a patient's standard of care," Dr. Mukherjee stresses.
This study has far-reaching implications for other neurological conditions as well. Facing the sky-rocketing costs of treating traumatic brain injury for recovering veterans, stroke, and autism, this study brings hope to those families struggling to afford this greatly desired therapy.
Dr. Arun Mukherjee is Senior Consultant in Internal Medicine, Majeedia Hospital, and Hamdard University, New Delhi, India, and a member of the International Hyperbarics Association.