Myth Busting: Hyperbaric Oxygen Therapy to Treat Cerebral Palsy

Hyperbaric oxygen therapy (HBOT) is the use of oxygen at concentrations and pressures higher than those in daily life as a form of treatment for a health problem. The treatment has been scientifically proven to be effective for conditions such as carbon monoxide poisoning, decompression sickness and difficult-to-treat infections in parts of the body with poor blood supply.

HBOT has also been proposed for cerebral palsy. This idea is based on the theory that, among damaged brain cells, there are inactive or dormant cells that have the potential to recover. Some people think that pressurized oxygen reactivates the dormant cells so they can function normally. Unfortunately, that is a peculiar interpretation of biology that is not supported by research.

HBOT and Cerebral Palsy: Just the Facts

Authors of several publications have demonstrated that for cerebral palsy, HBOT is no better than pressurized air. For instance, Collet and colleagues (2001), and more recently Lacey and colleagues (2012), carried out elegantly designed placebo-controlled trials – the highest quality of research possible. In the studies, children with cerebral palsy were exposed to either pressurized oxygen or pressurized regular air. There were no differences between the two groups in any of the outcomes measured. That means that HBOT is no more effective than compressed room air for the management of symptoms associated with cerebral palsy.

In spite of the shortage of evidence to support them, reports touting the benefits of HBOT for the management of cerebral palsy continue to surface. Not surprisingly, the reports are either testimonials or single-patient, poorly designed experiments from HBOT facilities. In a 2013 article, Novak and Badawi analyze all appropriately obtained scientific data on the subject and once again concluded that “hyperbaric oxygen does not have a clinically important effect on gross motor and self-care function in children with cerebral palsy.”

It is also important to mention that HBOT is not risk-free. Potential side effects of HBOT include ear pain, tympanic membrane perforation, lung collapse and seizures. These are in addition to the inherent risk of fire inside a closed chamber filled with oxygen, which in high concentrations is a highly flammable gas.

As pediatricians, it is our responsibility to warn well-meaning parents about so-called “therapies” that are based on, at best, anecdotal evidence and, at times, the rather unusual ideas about the biology of the health conditions to which they are being applied.

If your child has cerebral palsy, don’t put your faith in HBOT. Instead of trying untested — and possibly dangerous — therapies, talk with your child’s doctor about the best options for your child’s care. You can learn more about treatment for cerebral palsy at our website or by speaking with one of the physicians in our Cerebral Palsy Program.

Pedro Weisleder, MD
Pedro Weisleder, MD, PhD, is an attending pediatric neurologist at Nationwide Children's Hospital. He is Professor of Clinical Pediatrics and Director of the Pediatric Neurology Residency Program at The Ohio State University College of Medicine. Dr. Weisleder is Co-Chair of Nationwide Children's Hospital's Integrated Ethics Committee, as well as Co-Chair of Nationwide Children's Hospital's Graduate Medical Education Committee.
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2 thoughts on “Myth Busting: Hyperbaric Oxygen Therapy to Treat Cerebral Palsy

  1. Lynnette Barker on said:

    Regardless of what he thinks, I can tell you first hand that HBO2 therapy has helped my niece with spasms, range of motion, and lung infections. After 2 seperate rounds of HBO2 with a 6 month break between, my sister and brother in law, along with the rest of the family, could see such a drastic improvement (and noted the regression and increase in spasms after going without for several months as well as an increase in respiratory issues—and no they were not related to season or others being sick in the home) that they invested in their own personal HBO2 dive tank. Research and many phone calls to other parents who had tried HBO2 therapy with their CP children was done prior, and the testimonials do not lie….maybe if this country actually put money into doing research studies on therapies such as this instead of wasting money on studies noone really cares about (ie what does the color of your eyes say about your personality) we could actually DECREASE the cost of healthcare spent on these children and INCREASE their quality of life!

  2. Dr. A Mukherjee on said:

    Both references quoted (Collet and Lacey) say the same thing: Hyperbaric Therapy at 1.5 ATA pressure at 100% oxygen is equivalent to 13 ATA air.
    We agree, and that is where the controversy emerges. In (www.ncbi.nlm.nih.gov/pubmed/24851544), we have studied 150 children (world’s largest series, I presume), were given the same regimen of OT / PT / Special Education / Speech Therapy by the same set of Therapists, for the same duration per session by the same protocol, six days a week, for at least 6 months to a year at the same center, which is a non-profit center that has nothing to gain or lose whether the children improve or not. Thus long study took 12 years to do and showed that “Hyperbaric Therapy” (includes both HBOT and HBAT) improves the GMFM scores of spastic CP children given that as compared to children who were given only the standard rehab therapies.
    Since one swallow does not make it a summer, I would request the author to do a similar study as per what he considers Gold standards, comparing intensive standard rehab for AT LEAST six months (time taken for re-myelination of all axons of affected Pyramidal Cells in brain revived by hyperbaric therapy) in CP children below 5 years age preferably (because Neurodevelopment is mostly over by then), and given hyperbaric exposure at normal 1 ATA air, 1.3 ATA air or 1.5 ATA 100% oxygen, each for 40 sessions, one a day, and then compare GMFM scores at 2 month intervals for 12 months to arrive at a correct conclusion. Please note, standard Rehab is a must all through, with all groups getting the same standard of therapy because that is ethical and also a must for these children.

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