Research Reports - The effect of hyperbaric oxygen on persistent postconcussion symptoms

J Head Trauma Rehabil. 2014 Jan-Feb;29(1):11-20

Cifu DX, Hart BB, West SL, Walker W, Carne W

BACKGROUND: The high incidence of persistent postconcussion symptoms in service
members with combat-related mild traumatic brain injury has prompted research in
the use of hyperbaric oxygen (HBO2) for management.
OBJECTIVE: The effects of HBO2 on persistent postconcussion symptoms in 60
military service members with at least 1 combat-related mild traumatic brain
injury were examined in a single-center, double-blind, randomized,
sham-controlled, prospective trial at the Naval Medicine Operational Training
Center at Naval Air Station Pensacola.
METHODS: Over a 10-week period, subjects received a series of 40, once-daily,
hyperbaric chamber compressions at 2.0 atmospheres absolute (ATA). During each
session, subjects breathed 1 of 3 preassigned oxygen fractions (10.5%, 75%, or
100%) for 60 minutes, resulting in an oxygen exposure equivalent to breathing
surface air, 100% oxygen at 1.5 ATA, or 100% oxygen at 2.0 ATA, respectively.
Individual, subscale and total item responses on the Rivermead Postconcussion
Symptom Questionnaire and individual and total Posttraumatic Disorder
Checklist-Military Version were measured just prior to intervention and
immediately postintervention.
RESULTS: Between-group testing of pre- and postintervention means revealed no
significant differences on individual or total scores on the Posttraumatic
Disorder Checklist-Military Version or Rivermead Postconcussion Symptom
Questionnaire, demonstrating a successful randomization and no significant main
effect for HBO2 at 1.5 or 2.0 ATA equivalent compared with the sham compression.
Within-group testing of pre- and postintervention means revealed significant
differences on several individual items for each group and difference in the
Posttraumatic Disorder Checklist-Military Version total score for the 2.0 ATA
HBO2 group.
DISCUSSION: The primary analyses of between group differences found no evidence
of efficacy for HBO2. The scattered within group differences are threatened by
Type 2 errors and could be explained by nonspecific effects.
CONCLUSION: This study demonstrated that HBO2 at either 1.5 or 2.0 ATA equivalent
had no effect on postconcussion symptoms after mild traumatic brain injury when
compared with sham compression.

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