Article

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.

Langue : ANGLAIS