M.bennett at 04:54, 21 December 2021

2021-12-21T04:54:10Z

M.bennett at 04:17, 20 October 2021

2021-10-20T04:17:48Z

M.bennett: Created page with " '''Some evidence the add..."

2021-10-20T04:12:11Z

Created page with " '''Some evidence the add..."

New page

'''Some evidence the addition of hyperbaric oxygen in the treatment of severe fibromyalgia improves disability scores.'''

'''Clinical bottom line:'''

{| class="Table" style="width:442.25pt; border:undefined" width="0"
|- style="height:47.5pt"
|
1. The use of HBOT seemed safe and the trial was feasible. 2. Scores for functional ability and sleep improved with HBOT in both arms.

|}

----

'''Citation/s:'''1.Curtis K, Katz J, Djaiani C, O'Leary G, Uehling J, Carroll J, Santa Mina D, Clarke H, Gofeld M, Katznelson R. Evaluation of a Hyperbaric Oxygen Therapy Intervention in Individuals with Fibromyalgia. Pain Med. 2021 Jun 4;22(6):1324-1332. doi: 10.1093/pm/pnaa416. PMID: 33594439. '''Lead author's name and fax: '''Rita Katznelson: rita.katznelson@uhn.ca.

'''Three-part Clinical Question:'''For patients with fibromyalgia, does the use of hyperbaric oxygen, compared to standard therapy, result in any symptomatic improvement in symptoms? '''Search Terms:''' Fibromyalgia; feasibility; chronic pain

'''The Study:'''Single-blinded concealed randomised controlled trial with intention-to-treat. '''The Study Patients:''' Adult patients with an established diagnosis of severe fibromyalgia as defined by the American College of Rheumatology and attending a chronic pain clinic. '''Control group''' (N = 9; 8 analysed): Standard care with usual medications, exercise regimens and other therapies already in use for each individual. Crossed to receive HBOT at 3 months. '''Experimental group''' (N = 9; 9 analysed): As above plus 100% oxygen breathing at 2.0 ATA for 90 minutes daily five times each week for eight weeks - 40 sessions in total.

'''The Evidence:'''

 

{| class="Table" style="border:solid windowtext 1.0pt"
|-
| rowspan="2" style="width:181.8pt; border:solid windowtext 1.0pt" width="245" | '''Measure'''
| colspan="2" style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | '''Control Group'''
| colspan="2" style="width:69.4pt; border:solid windowtext 1.0pt" width="95" | '''HBOT Group'''
| rowspan="2" style="width:55.2pt; border:solid windowtext 1.0pt" width="77" | '''Difference'''
| rowspan="2" style="width:66.05pt; border:solid windowtext 1.0pt" width="91" | '''95% CI'''
|-
| style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | '''Mean'''
| style="width:33.9pt; border:solid windowtext 1.0pt" width="47" | '''SD'''
| style="width:41.05pt; border:solid windowtext 1.0pt" width="57" | '''Mean'''
| style="width:26.85pt; border:solid windowtext 1.0pt" width="38" | '''SD'''
|-
| style="width:181.8pt; border:solid windowtext 1.0pt" width="245" |
'''FIQR* score [0 (normal) to 100 (maximum)] at 8 to 12 weeks'''

| style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | 73.1
| style="width:33.9pt; border:solid windowtext 1.0pt" width="47" | 6.5
| style="width:41.05pt; border:solid windowtext 1.0pt" width="57" | 45.9
| style="width:26.85pt; border:solid windowtext 1.0pt" width="38" | 6.1
| style="width:55.2pt; border:solid windowtext 1.0pt" width="77" | 27.2
| style="width:66.05pt; border:solid windowtext 1.0pt" width="91" | -13.8 to 68.2
|-
| style="width:181.8pt; border:solid windowtext 1.0pt" width="245" |
'''HADS-Depression+ [0 (none) to 21 (maximum)] at 8 to 12 weeks'''

| style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | 12.4
| style="width:33.9pt; border:solid windowtext 1.0pt" width="47" | 1.6
| style="width:41.05pt; border:solid windowtext 1.0pt" width="57" | 7.4
| style="width:26.85pt; border:solid windowtext 1.0pt" width="38" | 1.5
| style="width:55.2pt; border:solid windowtext 1.0pt" width="77" | 5.0
| style="width:66.05pt; border:solid windowtext 1.0pt" width="91" | 2.5 to 7.5
|-
| style="width:181.8pt; border:solid windowtext 1.0pt" width="245" |
'''FSS# [9 (none) to 63 (maximum)] at 8 to 12 weeks'''

| style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | 6.5
| style="width:33.9pt; border:solid windowtext 1.0pt" width="47" | 0.6
| style="width:41.05pt; border:solid windowtext 1.0pt" width="57" | 5.4
| style="width:26.85pt; border:solid windowtext 1.0pt" width="38" | 0.5
| style="width:55.2pt; border:solid windowtext 1.0pt" width="77" | 1.1
| style="width:66.05pt; border:solid windowtext 1.0pt" width="91" | 0.8 to 1.4
|}

*Fibromyalgia Impact Questionnaire Revised, +Hospital Anxiety and Depression Scale – Depression; Fatigue Severity Scale

'''Comments:''' 1. Participants randomised to a treatment group and a delayed treatment group who were treated after 12 weeks from recruitment. 2. This trial was also a feasibility study of recruitment and retention of participants in the trial, No sample size calculation was made. 3. The authors concluded that HBO led to a sustainable improvement in clinical outcomes for at least three months. 4. There is a strong possibility of participation bias as the patients were all aware of when they were having HBOT.

'''Appraised by:'''Mike Bennett m.bennett@unsw.edu.au; Wednesday, 20 October 2021 '''Kill or Update By:''' October 2025

@@ Line 4: / Line 4: @@
 <span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family:"><span style="color:black">Clinical bottom line:</span></span></span>'''</span>
-{| class="Table" style="width:442.25pt; border:undefined" width="0"
+{| class="Table" style="width: 663px;" width="0"
 |- style="height:47.5pt"
+| style="width: 651px;" |
 <span style="line-height:normal"><span style="height:47.5pt"><span style="font-size:14.0pt"><span style="font-family:">1. The use of HBOT seemed safe and the trial was feasible.<br/> 2. Scores for functional ability and sleep improved with HBOT in both arms.</span></span></span></span>

Curtis - Revision history

M.bennett at 04:54, 21 December 2021

M.bennett at 04:17, 20 October 2021

M.bennett: Created page with " '''Some evidence the add..."