Citation

Cifu DX, Hart BB, West SL, Walker W, Carne W. J. Head Trauma Rehabil. 2014; 29(1): 11-20.

Affiliation

Physical Medicine and Rehabilitation Program Office, Department of Veterans Affairs, Washington, District of Columbia (Dr Cifu); Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond (Drs Cifu, West, Walker, and Carne); Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia (Drs Cifu, Walker, and Carne); Naval Medicine Operational Training Center, Pensacola, Florida (Dr Hart); and Richmond Defense and Veterans Brain Injury Center, Richmond, Virginia (Drs Walker and Carne).

Copyright

(Copyright © 2014, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0b013e3182a6aaf0

PMID

24052094

Abstract

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.

Language: en