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Effects of hyperbaric oxygen on motor function in children with cerebral palsy
Daniel J Lacey1, Adrienne Stolfi, Louis E Pilati
1Department of Neurology, Children's Medical Center of Dayton, Dayton, OH, USA. laceyd@childrensdayton.org
Insights
Hyperbaric oxygen (HBO) did not improve gross motor function in children with cerebral palsy. This therapy was no more effective than hyperbaric air (HBA) for improving other functional measures.
Area of Science:
- Pediatric Neurology
- Rehabilitative Medicine
- Oxygen Therapy
Background:
- Cerebral palsy (CP) is a group of movement disorders affecting muscle tone and posture.
- Gross motor function is a key developmental milestone impacted by CP.
- Hyperbaric oxygen (HBO) therapy is being explored for various neurological conditions.
Purpose of the Study:
- To evaluate the efficacy of hyperbaric oxygen (HBO) therapy in improving gross motor function in children with cerebral palsy (CP).
- To compare HBO therapy with hyperbaric air (HBA) as a control in children with CP.
Main Methods:
- A randomized, double-blind, controlled clinical trial involving 49 children (3-8 years) with spastic cerebral palsy.
- Participants received 40 treatments of either HBO (100% oxygen) or HBA (14% oxygen) over 8 weeks.
- Primary outcome: Gross Motor Function Measure (GMFM); Secondary outcome: Pediatric Evaluation of Disability Inventory (PEDI).
Main Results:
- No significant improvement in GMFM scores was observed in either the HBO or HBA group, nor between the groups.
- Both groups showed statistically significant increases in PEDI scores, with no discernible difference between HBO and HBA.
- The study was terminated early due to a low probability of detecting a significant difference between groups.
Conclusions:
- Hyperbaric oxygen (HBO) therapy is not effective for improving gross motor function in young children with cerebral palsy.
- HBO therapy demonstrated no superior benefit compared to hyperbaric air (HBA) for functional improvements in this pediatric CP population.
- Current evidence does not support the use of HBO as a therapeutic intervention for young children with CP, excluding those with neonatal hypoxic-ischemic encephalopathy.
Objective:
We conducted a randomized, double-blind, controlled clinical trial to determine whether hyperbaric oxygen (HBO) improves gross motor function in children with cerebral palsy.
Methods:
Forty-nine children aged 3 to 8 years with spastic cerebral palsy were randomized to 40 treatments of HBO (100% oxygen at 1.5atm) or hyperbaric air (HBA, 14% oxygen at 1.5atm) over an 8-week period. The primary outcome was the Gross Motor Function Measure (GMFM) global score. Other outcomes included the Pediatric Evaluation of Disability Inventory (PEDI). Assessments were made before and immediately, 3 months, and 6 months after the treatment period. Within-group changes were analyzed with paired t tests or repeated measures analysis of variance. Analysis of covariance was used for between-group comparisons.
Results:
Forty-six children (24 HBO, 22 HBA) were analyzed at the second interim analysis, which was scheduled to take place when at least half of the required number of patients in each group had completed pre- and post-treatment testing. No changes occurred in the GMFM from pre- to post-treatment in either group or between groups. Statistically significant increases occurred in both groups on the PEDI, with no difference between groups. The study was stopped because the calculated conditional probability of obtaining a difference between groups if the study continued to the end was only between 0.5% and 1.6%.
Interpretation:
HBO was not effective in improving GMFM scores, and was no more effective than HBA in improving PEDI scores. These results do not support use of HBO as a therapy for cerebral palsy in young children who did not have neonatal hypoxic-ischemic encephalopathy.
