Therapies for Cerebral Palsy: Hyperbarics (HBOT)

Showing posts with label Hyperbarics (HBOT). Show all posts

Tuesday, January 20, 2015

Study finds both HBOT and HBAT groups showed improvements

Well, I can't believe it's been almost 5 YEARS since I've posted any updates. Our son is now in first grade and is doing well, all things considered. He is very mobile, energetic and also nonverbal which really makes communication difficult at times. That being said, he has continued making steady improvements over the years and is a great kid.

What prompted this post was an email from a friend with a recently published HBOT study. Granted, this wasn't an HIE or CP study, but it was still looking at the effectiveness of HBOT (1.5 ATA, 100% oxygen) and HBAT (1.2 ATA, room air) in treating the brain (post concussion symptoms).

What I found interesting in this study published 11/21/2014 is that it shows similar findings as the Canada study in the 1990's. Compared with the no intervention group, HBOT and HBAT groups both showed improvement in symptoms!

Monday, January 4, 2010

Hyperbaric Oxygenation for Hypoxic Ischemic Encephalopathy

I recently read a blog entry titled "Why we don’t use hyperbaric oxygen for cerebral palsy but the Chinese do" and it got me thinking once again about hyperbarics and how it has helped our son. The post is a short commentary about hyperbarics and governments' willingness (or unwillingness) to utilize the therapy to treat brain injury.

The blog post references an article, the summary of which is below.

“Treatment with hyperbaric oxygen possibly reduces mortality and neurological sequelae in term neonates with hypoxic-ischemic encephalopathy. Because of the poor quality of reporting in all trials and the possibility of publication bias, an adequately powered, high quality randomised controlled trial is needed to investigate these findings. The Chinese medical literature may be a rich source of evidence to inform clinical practice and other systematic reviews.”
-Clinical effectiveness of treatment with hyperbaric oxygen for neonatal hypoxic-ischaemic encephalopathy: systematic review of Chinese literature (published 11 May 2006)

After doing much research (some of which I've written about on this blog) we decided to provide our son with 40 hours of hyperbaric oxygen therapy (HBOT) when he was 12 months old. Because he responded so well to his first round of HBOT, including decreased spasticity and increased vision, we went back for 40 more sessions 6 months later, this time coupled with intensive pediatric therapy. We witnessed continued improvements. Our son is now over 2 years old and we recently made the decision to purchase a soft chamber to provide him with hyperbaric air therapy (HBT or HBAT) at home.

We made this decision in part because the studies I am aware of have shown improvements in patients treated with pressurized room air (HBT or HBAT) as well as patients breathing oxygen in a hyperbaric environment (HBOT). Due to the increased atmospheric pressure, both groups benefit from increased oxygen absorption.

"The results of the only truly randomized trial were difficult to interpret because of the use of pressurized room air in the control group. As both groups improved, the benefit of pressurized air and of HBOT at 1.3 to 1.5 atm should both be examined in future studies."
-Hyperbaric Oxygen Therapy for Brain Injury, Cerebral Palsy, and Stroke

Sunday, September 13, 2009

The Oxygen Paradigm

This is a lecture by Dr. Philip James at the 2001 International Symposium of Hyperbaric Oxygen for the Brain-Injured Child. I think Dr. James gives a good overview of reasons to utilize HBOT for brain injury.

Tuesday, March 31, 2009

HBOT on Oprah

The hyperbaric chamber may look high-tech, but the concept is pretty simple.

When you take oxygen and pressurize it in a tube, Dr. Oz says the oxygen is forced into a person's cells. "It gets me to mobilize stem cells from my bone marrow," he says. "It gets those cells moving along so it goes out to heal areas. In some parts of the body, like the brain, where you don't always have a lot of oxygen in the tissues, it might improve memory. It might play a role in making those cells which have energy factories function more efficiently."

Oxygen therapy isn't just for people who want to live longer. It's also speeds up the healing process for wounds and helps repairs broken bones. If you're interested, Dr. Oz encourages you to seek out qualified technicians.

"They should usually be used in a hospital with folks really watching what's happening," he says. "You have to wear 100 percent cotton, because it's oxygen in there, and oxygen's combustible. If you have synthetic fabrics, those fabrics can rub and make a spark."

Source: Oprah.com :: High-Tech Ways to Extend Your Life

Friday, March 13, 2009

HBOT Effective Against Autism

Okay, this information isn't cerebral palsy specific, but I think it's worth mentioning. Both autism and cerebral palsy are based in the brain, so it's great to see a study that scientifically supports HBOT for such diagnoses.

A multicenter, randomoized, double-blind, placebo-controlled study (the strongest kind of research) was published today that shows significant improvements in autistic children after 40 hours of hyperbaric oxygen therapy. The study, A Controlled Trial of the Clinical Effects of Hyperbaric Therapy in Autistic Children, included 62 children with autism between the ages of 2 and 7 years of age who were randomly assigned to 40 hourly treatments of either hyperbaric treatment at 1.3 atmosphere (atm)and 24% oxygen or slightly pressurized room air at 1.03 atm and 21%oxygen.

To quote the study
"Children with autism who received hyperbaric treatment at 1.3 atm and 24% oxygen for 40 hourly sessions had significant improvements in overall functioning, receptive language, social interaction, eye contact, and sensory/cognitive awareness compared to children who received slightly pressurized room air."

For more details, please read the study - Hyperbaric treatment for children with autism: a multicenter, randomized, doubleblind, controlled trial

News storied regarding the research study:
Hyperbaric Therapy Called Effective Against Autism
Oxygen therapy benefit in autism

Tuesday, February 17, 2009

HBOT for veterans with TBI

The video found here is from a Louisiana TV news station interview with Dr. Paul Harch regarding the small ongoing study currently in progress looking into the effects of HBOT on veterans with TBI. Hopefully larger studies focused on HBOT and brain injury will take place. In my opinion, if HBOT can measurably help people with brain injury recover some lost function, it's worth putting time, energy and resources into further research.

Saturday, February 14, 2009

Improvement in cerebral palsy cognition by oxygen therapy

A while back I signed up to receive Google Alerts for topics of interest, like "hyperbarics and cerebral palsy" and "alternative therapies for cerebral palsy". If I find something relevant I try to write about it here.

Our son did 40 sessions of HBOT when he was 12 months old. It's hard to quantify the results we witnessed, but needless to say we saw positive physical and cognitive changes with HBOT. We're getting ready for another 40 sessions is a few weeks, coupled with intensive pediatric therapy.

Source: http://www.abilitydisability.com/index.php/2009/02/improvement-in-cerebral-palsy-cognition-by-oxygen-tx/
Study from The Indian Journal of Occupational Therapy

"Adjunctive hyperbaric oxygen therapy significantly improves cognition for children with cerebral palsy, compared with standard therapy alone, according to an open, ongoing, observational study.

All participants significantly improved their physical, speech, and motor
Capabilities after 6 months, compared with baseline. Interim results for 84 children whose parents chose hyperbaric oxygen therapy (HBOT) and 20 children in a non-HBOT group were presented at a symposium on hyperbaric oxygen therapy.

Changes in cognition were distinctive. “Children receiving HBOT showed statistically significant improvements in cognitive-only parameters. This is interesting and what is driving us to go on with this treatment,” said Dr. Arun Mukherjee of Majeedia Hospital, New Delhi, India.

Researchers used a modified 49-item Gross Motor Function Measure to monitor clinical progress at 2-month intervals. In an attempt to assess the effects of hyperbaric oxygenation, researchers focused on 26 cognitive-only items, which are less dependent on therapist input. “This is the closest measure we can get to brain repair,” said Dr. Mukherjee, who is also director of the UDAAN Project for Cerebral Palsy at the Foundation for Spastic and Mentally Handicapped Persons in New Delhi. UDAAN is a Hindi word for flight (of freedom).

Hyperbaric therapy consisted of 100% oxygen delivered at 1.5 atmospheres. Not included in this interim analysis is a recently added third group of patients who receive a low pressure HBOT option (ambient air delivered at 1.3 atmospheres).

Dr. Mukherjee and his associates launched the UDAAN HBOT-Based Multimode Long-Term Observational Study in 2001 to assess the benefits, if any, of adjunctive therapy for children with cerebral palsy. They tried nerve block with Botox and phenol, computer-assisted biofeedback, and pulsed magnetic field therapy. “We were not impressed with their cost-to-benefit ratio as per Indian prices. Hence, we have dropped them.”

Standard therapy consists of special education, occupational therapy, speech therapy and physiotherapy totaling 2 hours daily. After 5 months of HBOT, clinicians administer 60 sessions of electro acupuncture using transcutaneous electrical nerve stimulation (TENS) specifically designed for cerebral palsy. This therapy reduces pain and discomfort of intensive exercises and helps the brain recognize pathways revived by HBOT, Dr. Mukherjee said at the symposium sponsored by the Ocean Hyperbaric Neurology Center in Fort Lauderdale, Fla. “This alerts the brain that these circuits are now working,” he said.

Short-term treatment has limited other pediatric studies of hyperbaric oxygen for cerebral palsy, Dr. Mukherjee said. In the current investigation, it took 6 months before cognitive differences between groups reached statistical significance. He said this suggests the need for a long-term commitment to hyperbaric therapy for cerebral palsy."

Tuesday, January 27, 2009

Why does HBOT and intensive pediatric therapy work so well together?

"Plasticity is one of the most important mechanisms of brain repair and involves the redirection and reeducation of neurons to make new pathways to learn and improve both cognitive and motor skills. Following any brain insult there is a period of plasticity while the brain and body compensate and attempt to overcome and rewire their connections to learn to take over the tasks of the damaged neurons. In children, plasticity is ongoing, as the brain is in development and still growing new brain cells. Just as babies need to be taught to walk and talk, newly awakened neurons need to be redirected and retrained. HBOT, the safe, non-invasive use of 100% oxygen under greater than atmospheric pressure, has been clearly proven to reactivate and facilitate dormant, idling, damaged neurons that had been receiving enough oxygen to exist but not enough to function or fire electrically. The reactivation of these cells with HBOT opens up whole new areas of plasticity so that the brain is able to learn or relearn the skills that are necessary for proper function of both the brain, as it relates to cognitive function, and the body as the brain makes new connections for recovery of trunk, limb and muscle movement. New neurons are like newborn babies. They need direction for their optimal growth and development. This is why a multi-disciplinary approach to brain injury in cerebral palsy and the brain injured child is so crucial to the outcome. The sooner the new neurons can be redirected to take on the tasks of the damaged areas the more promising the prognosis. It is the intensive therapy and strength training that redirect the brain cells when they are reactivated by HBOT to form the necessary pathways for functional recovery. The synergy of the two approaches combined demonstrates a good and positive outcome for the child."
-from The Synergy of Body/Brain Repair by Virginia Neubauer

We are planning to complete another 40 sessions of HBOT coupled with intensive physical, occupational, and speech therapy over the course of a very busy month! Our schedule will look something like this:

HBOT session (60 minutes at 1.5 atmospheres, ~30 minutes to pressurize/depressurize)
Intensive PT, OT and Speech (4 hours)
HBOT session (60 minutes at 1.5 atmospheres, ~30 minutes to pressurize/depressurize)

This is 7 hours of therapy every weekday for a month!

It will make for very busy days, but hopefully our son will recover even more function by coupling intensive pediatric therapy with HBOT.

Tuesday, January 20, 2009

How HBOT Helped Sophia

Thursday, January 8, 2009

Treating Chronic Neurologic Conditions with Low Pressure HBOT

Linked below are a couple articles that support the use of low pressure HBOT to treat neurologic conditions. The first article is a must read in my opinion for families with children who have CP.

Before I knew much about hyperbarics, I read The Oxygen Revolution and found it to be a well organized text and a good overview of the off-label use of hyperbarics. I also would recommend this book to anyone interested in HBOT.

Monday, December 29, 2008

Intensive Pediatric Therapy and HBOT for Children with Cerebral Palsy

Our immediate goal is to provide our son with intensive physical, occupational, and speech therapy coupled with another 40 sessions of HBOT in the spring of 2009.

Nestor Serrano and his daughter Amelia are featured in the clip below. Amelia was diagnosed with Cerebral Palsy early in her life and the Serranos have provided similar therapy for their daughter. You can read more about her story here.

Friday, November 14, 2008

News Story about Hyperbarics

NBC 15 in Madison, WI published a story yesterday about a family doing hyperbarics at the same clinic we treated our son, the Wisconsin Interactive Hyperbaric Center.

http://www.nbc15.com/home/headlines/34422984.html

Tuesday, November 4, 2008

Article Conclusion: Children Should be Allowed Access to HBOT

The Journal of American Physicians and Surgeons published a great article in Volume 12 Number 4 - Winter 2007 reviewing and comparing the currently accepted therapies with HBOT in the treatment of cerebral palsy. I really appreciated the conclusion of the article, which is quoted below.

============
"Hyperbaric Oxygenation Therapy in the Treatment of Cerebral Palsy: A Review and Comparison to Currently Accepted Therapies"
Carole Sénéchal, Ph.D.; Serge Larivée, Ph.D.; Engelbert Richard; Pierre Marois, M.D.
Download article in PDF format

Conclusions
"Previous studies of HBOT in CP have shown noteworthy favorable results, but to produce conclusive evidence, additional, more systematic trials are needed.

Much is at stake. Improvement in the function, independence, and comfort of persons with a severely disabling neurologic conditioncould lead to significant improvements in health and quality of life as well as to significant cost savings in the long term. While other treatment modalities are paid for by government programs, parents must bear the cost of HBOT as the controversies continue.

In the meantime, given the very low risk of adverse effects and the promising results, children should be allowed access to HBOT."

Monday, October 27, 2008

Hyperbaric Oxygen Therapy (HBOT)

I have contacted many subject matter experts in the field of hyperbaric medicine over the last several months and have received an overall positive response regarding the use of lower pressure (mild) HBOT to treat brain injury. I found this explanation of HBOT posted to an online support group by a medical doctor, some of which I’ve edited for clarity.

"There are two components to hyperbaric oxygen: increased ambient pressure and increased inspired oxygen concentration. The physics of hyperbaric oxygen in a nutshell is that under increased atmospheric pressure, more gas goes into substances.

This increased oxygenation, or hyperoxia, has several beneficial effects. First, the high level of oxygen in the blood allows improved oxygen delivery to tissues that are not getting enough oxygen at baseline (i.e. hypoxic tissues). Second, having times of alternating hyperoxia and hypoxia (as occurs during a series of HBO treatments) promotes the growth of new blood vessels into the hypoxic tissues, a process known as neovascularization.

In the case of a brain injury, whether from a traumatic brain injury, a stroke, a near-drowning, cerebral palsy, or any incident which causes lack of oxygen to part of the brain, there are some cells that have died.

It is thought that around the area of the dead cells or the "umbra" there is a surrounding area of damaged and dormant nerve cells--the "penumbra"--which can heal over time.

The theory--and there does seem to be considerable evidence to support it--is that when a patient is in a hyperbaric oxygen chamber and given 100% oxygen under increased atmospheric pressure, the oxygen dissolves not only into the red blood cells (as happens normally when we breathe) but also in much higher concentration into the blood plasma, the cerebral spinal fluid, the lymphatic system and all of the body's fluids, bathing all of the body's cells with increased oxygen levels.

The result is high levels of oxygen carried to the brain, bypassing the normal way the brain gets oxygen; by the circulation of the blood stream bringing oxygen rich red blood cells.

At least one study was conducted comparing the use of air, which has about 21 percent oxygen, to the use of 100 percent oxygen. The patients given room air were intended to be the "control" group, and they did as well as those with 100 percent oxygen. The conclusion, erroneously, I think, was that because there was no difference in outcome between the two groups, that hyperbaric oxygen was ineffective.

However, importantly BOTH groups improved. So the conclusion I believe is that the use of hyperbaric pressure does significantly help in healing injured tissue--in this case, the brain.

The KEY is the use of increased atmospheric pressure, so that increased oxygen dissolves into the cerebral spinal fluid to be delivered to the damaged brain tissue to speed up healing.

Dr. Harch and some of the other hyperbaric medicine physicians have found 1.5 ATA with 100 percent oxygen given either once or twice a day to be safe.

It appears--although it would be nice to have better studies--that any amount of oxygen from room air to 100 percent oxygen has a beneficial effect. We know that for prolonged periods, using 100 percent oxygen can be toxic, but those are under conditions of using 100 percent oxygen over days or weeks. The short periods of time used for hyperbaric oxygen chamber treatment don't carry that risk--the exposure is much shorter.

It is way past time for the US government to sponsor controlled studies using a variety of protocols, with careful assessments using SPECT scanning. It is clear to many of us that there is a very great benefit from hyperbaric oxygen in treating a variety of brain injuries and many studies as well as individual case reports which prove this is true."

Our son suffered from lack of oxygen at birth (hypoxic ischemic encephalopathy (HIE)), along with seizures shortly after birth. He has cerebral palsy, developmental delay and cortical vision impairment (CVI), as well as secondary microcephly (small head size) due to this lack of oxygen at birth.

I read The Oxygen Revolution by Paul G. Harch, M.D. and found it to be a well organized text and a good overview of the use of hyperbaric oxygen for off-label indications.

I spoke with a nurse who has been closely involved with clinical trials for many years using HBOT to treat acute traumatic brain injury. She told me in so many words that as a mother; she would be doing what we’re doing.

I also spoke with a clinical research nurse involved in an ongoing clinical trial in Ohio sponsored by the Department of Defense involving 80 some children with cerebral palsy. She informed me of many initial positive results from the study An Evaluation of Hyperbaric Treatments for Children With Cerebral Palsy. Many children see a decrease in spasticity and increased attention span.

Based on this research and the experts I spoke with we completed 40 sessions lasting 60 minutes each, twice a day (at least 4 hours apart). We observed a definite decrease in the spasticity of our son, as did his Physical and Occupational Therapists. His vision and attentiveness have also improved.

In conclusion, the use of HBOT (1.5 ATA) to treat brain injury has minimal negative side-effects and great potential for positive results. HBOT is certainly not a miracle cure, but it is a valuable therapy to ensure the most complete recovery possible.

The OxyHealth Fortius 420 Hyperbaric Chamber

Therapies for Cerebral Palsy