Intensive rehabilitation combined with HBO2 therapy in children with cerebral palsy: a controlled longitudinal study

Objective: The present study aimed to assess the effect of intensive rehabilitation combined with hyperbaric oxygen (HBO2) therapy on gross motor function in children with cerebral palsy (CP). Methods: We carried out an open, observational, platform-independent study in 150 children with cerebral palsy with follow-up over eight months to compare the effects of standard intensive rehabilitation only (control group n = 20) to standard intensive rehabilitation combined with one of three different hyperbaric treatments. The three hyperbaric treatments used were: • air (FiO2 = 21%) pressurized to 1.3 atmospheres absolute/atm abs (n = 40); • 100% oxygen pressurized at 1.5 atm abs (n = 32); and • 100% oxygen, pressurized at 1.75 atm abs (n = 58). Each subject assigned to a hyperbaric arm was treated one hour per day, six days per week during seven weeks (40 sessions). Gross motor function measure (GMFM) was evaluated before the treatments and at two, four, six and eight months after beginning the treatments. Results: All four groups showed improvements over the course of the treatments in the follow-up evaluations (p <0.001). However, GMFM improvement in the three hyperbaric groups was significantly superior to the GMFM improvement in the control group (p <0.001). There was no significant difference between the three hyperbaric groups. Conclusion: The eight-month-long benefits we have observed with combined treatments vs. rehabilitation can only have been due to a beneficial effect of hyperbaric treatment.