Early Intensified Rehabilitation Training with Hyperbaric Oxygen Therapy Improves Functional Disorders and Prognosis of Patients with Traumatic Brain Injury

Abstract

Objective: Traumatic brain injury (TBI) is a global public health problem. Hyperbaric oxygen (HBO) therapy may be beneficial for TBI because it improves cerebral blood flow into tissues exhibiting low blood flow. This was done to observe the clinical therapeutic effect of different intensities of rehabilitation training and HBO therapy in early stages of TBI. Approach: In this multicenter, randomized, stratified case-controlled prospective clinical trial, we selected 158 patients with moderate-severe TBI and assigned them into (1) a control group receiving routine once-daily ( 1/d) rehabilitation training without HBO, (2) study group A receiving routine 1/d rehabilitation training with HBO, (3) study group B receiving twice-daily (2/d) intensified rehabilitation training with HBO, and (4) study group C receiving 2/d intensified rehabilitation training without HBO, all for 3 months. The cognitive ability, activities of daily life (ADL), and movement ability were assessed before and after training with the Fugl-Meyer Assessment (FMA), Functional Independence Measure (FIM), Modified Barthel Index (MBI), and Mini-Mental State Examination (MMSE). Results: FIM, FMA, MBI, and MMSE scores were improved significantly after 1-, 2-, and 3-month rehabilitation training in all TBI patients ( p < 0.01), and this improvement was especially remarkable in patients who received 2/d intensified rehabilitation training with HBO ( p < 0.01). Innovation: With extensive and intensive research on TBI rehabilitation, it was proved that TBI rehabilitation intervention should be initiated as early as possible. Conclusion: Early intensified rehabilitation training in combination with HBO is more beneficial to the recovery of cognitive, ADL, and movement abilities of TBI patients.

The neuroprotective effect of electro-acupuncture on cognitive recovery for patients with mild traumatic brain injury: A randomized controlled clinical trial

“…[ 23 ] LuY et al found that hyperbaric oxygen treatment can improve the prognosis of TBI patients by improving cerebral oxygen metabolism. [ 24 ] Therefore, the intervention of cerebral oxygen metabolism is the key point of TBI treatment.…”

HBOT has a better cognitive outcome than NBH for patients with mild traumatic brain injury: A randomized controlled clinical trial

“…[30] HBOH treatment has been shown to improve neurological function in TBI patients. [31] In TBI patients, it promotes angiogenesis, improves brain metabolism, and preserves the function of newly born and regenerated neurons, especially memory impairment, attention impairment, and executive dysfunction. [32] NBH therapy is applied earlier than HBOT, has lower environmental requirements for implementation, and is more easily accepted by patients.…”

Hyperbaric oxygen therapy promotes consciousness, cognitive function, and prognosis recovery in patients following traumatic brain injury through various pathways

“…HBO therapy has shown positive effects on patients with TBI by decreasing hospital stay, disability, and mortality, and improving social behavior and prognosis ( 8 , 9 , 50 ). A recent study has reported that HBO combined with rehabilitation training improves activities of daily living, movement ability, and cognitive function in patients after TBI ( 19 ). In our study, the DRS, FIM, and GOSE score at 6 months after discharge revealed that the patients receiving HBO therapy had better outcomes than controls in terms of cognition, communication ability, and the functional level, except employability.…”

“…The patients started HBO therapy when their vital signs had stabilized after admission, and received a total of 20 treatments continuously in monoplace hyperbaric oxygen chambers (Shanghai 701; Yang Garden Hyperbaric Oxygen Chamber Co., Ltd., Shanghai, China). A chamber pressure of 2.0 atmosphere absolute was chosen, with pressurization for 15 min, oxygen inhalation with constant pressure for 60 min, and decompression for 15 min, according to prior studies ( 10 , 19 , 20 ). During HBO, professional nurses closely monitored the patients and immediately suspended treatment if a serious adverse reaction or an event reflecting intolerance of HBO occurred.…”