By: Kevin F. Barrett, M.D.; Kevan P. Corson, Certified Hyperbaric Technician; Jon T. Mader, M.D.
Objective
To determine if 1.5 ATA hyperbaric oxygen therapy can ameliorate the neurologic deficits associated with pediatric cerebral palsy.
Background
Numerous anecdotal reports attest to the amelioration of neurologic deficits in a variety of chronic cerebral insults including cerebral palsy. Improvement is attributed to the metabolic upregulation through improved local cerebral blood flow in a residual chronic ischemic penumbra.
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Methods
Five children, average age 41.8 months, were treated with 1.5 ATA hyperbaric oxygen therapy (HBOT) for a total of sixty treatments administered for one hour daily, five days per week. A modified test of gross motor and fine motor function (GMFM-m) and a modified Ashworth Spasticity Scale were employed before and after hyperbaric therapy. One patient with cortical blindness was assessed with visual evoked potentials before and after HBOT. One patient dropped out of the study before completion. Information was obtained on only four patients.
Results
Modest decreases in spasticity and improvements in the modified GMFM scores for all patients completing the study. Cortical visual evoked potentials, which were absent before therapy in one patient were measurable after HBOT.
Conclusion
Hyperbaric oxygen therapy effected improvements in tests of gross motor and fine motor function and decreased spasticity as measured by the modified Ashworth spasticity score in patients with chronic cerebral palsy. Functional reorganization in the visual cortex is suggested by the reappearance of visual evoked potentials.
Layperson Summary
A study conducted by Kevin F. Barrett, M.D., Kevan P. Corson, Certified Hyperbaric Technician, and Jon T. Mader, M.D., aimed to determine if hyperbaric oxygen therapy (HBOT) could improve neurologic deficits associated with pediatric cerebral palsy.
The study involved five children with cerebral palsy, with an average age of 41.8 months. These children received a total of sixty HBOT sessions at 1.5 atmospheres absolute (ATA), administered daily for one hour over five days per week. The researchers utilized a modified test of gross motor and fine motor function (GMFM-m) and a modified Ashworth Spasticity Scale to assess the effects of HBOT on the participants’ neurologic deficits. Visual evoked potentials were also measured in one patient with cortical blindness before and after HBOT. One patient dropped out of the study before completion, leaving information on four patients.
The results of the study indicated modest decreases in spasticity and improvements in the modified GMFM scores for the participants who completed the study. In addition, cortical visual evoked potentials, which were absent before therapy in one patient, became measurable after HBOT.
Based on these findings, the study concluded that hyperbaric oxygen therapy led to improvements in gross motor and fine motor function tests, as well as a reduction in spasticity according to the modified Ashworth spasticity score, in pediatric patients with chronic cerebral palsy. The reappearance of visual evoked potentials suggested functional reorganization in the visual cortex as a result of HBOT.