M.bennett at 02:58, 10 January 2021

2021-01-10T02:58:50Z

M.bennett: Created page with " '''No benefit from hyperbaric oxygen compared to sham tre..."

2021-01-10T02:51:17Z

Created page with " '''No benefit from hyperbaric oxygen compared to sham tre..."

New page

'''No benefit from hyperbaric oxygen compared to sham treatment for post concussion symptoms.'''

{| class="Table" style="width: 694px;" width="500"
|-
| style="width: 682px;" |
'''Clinical bottom line:'''

'''1. No improvement in quality of life, neurological symptoms or reaction times afterHBOT compared to sham treatment.'''

|}

'''Citation/s:'''1. Miller RS, Weaver LK, Bahraini N, Churchill S, Price RC, Skiba V, Caviness J, Mooney S, Hetzell B, Liu J, Deru K. Effects of hyperbaric oxygen on symptoms and quality of life among service members with persistent postconcussion symptoms: a randomized clinical trial. JAMA Internal Medicine. 2015 Jan 1;175(1):43-52. 2. Churchill S, Miller RS, Deru K, Wilson SH, Weaver LK. Simple and procedural reaction time for mild traumatic brain injury in a hyperbaric oxygen clinical trial. Military Medicine. 2016 May 1;181(suppl_5):40-4. '''Lead author's name and fax: '''Robert Miller (robert.s.miller@us.army.mil

'''Three-part Clinical Question:'''For individuals with a history of mild traumatic brain injury, does treatment with hyperbaric oxygen compared to a sham exposure, result in any imporvement in quality of life? '''Search Terms:''' Post-concussion; mild TBI; quality of life

'''The Study:'''Double-blinded concealed randomised controlled trial with intention-to-treat. '''The Study Patients:''' Servicemen with a history of mTBI at least four months before enrolment. '''Control group''' (N = 25 ; 24 analysed): Routine post-concussion care with the addition of 40 sessions of air breathing at 1.2ATA for 60 minutes daily over 8 weeks. '''Experimental group''' (N = 24 ; 24 analysed): As above but exposure to 100% oxygen breathing at 1.5ATA on the same schedule.

'''The Evidence:'''

 

{| class="Table" style="border:solid windowtext 1.0pt"
|-
| rowspan="2" style="width:158.8pt; border:solid windowtext 1.0pt" width="212" | '''Measure'''
| colspan="2" style="width:69.45pt; border:solid windowtext 1.0pt" width="93" | '''Sham Group'''
| colspan="2" style="width:78.95pt; border:solid windowtext 1.0pt" width="105" | '''HBOT Group'''
| rowspan="2" style="width:54.35pt; border:solid windowtext 1.0pt" width="72" | '''Difference'''
| rowspan="2" style="width:80.25pt; border:solid windowtext 1.0pt" width="107" | '''95% CI'''
|-
| style="width:40.8pt; border:solid windowtext 1.0pt" width="54" | '''Mean'''
| style="width:27.15pt; border:solid windowtext 1.0pt" width="36" | '''SD'''
| style="width:53.95pt; border:solid windowtext 1.0pt" width="72" | '''Mean'''
| style="width:23.5pt; border:solid windowtext 1.0pt" width="31" | '''SD'''
|-
| style="width:158.8pt; border:solid windowtext 1.0pt" width="212" |
'''Rivermead Post-concussion Symptom Questionnaire 3 subscale (0 to 12)'''

| style="width:40.8pt; border:solid windowtext 1.0pt" width="54" | 3.5
| style="width:27.15pt; border:solid windowtext 1.0pt" width="36" | 3.3
| style="width:53.95pt; border:solid windowtext 1.0pt" width="72" | 4.2
| style="width:23.5pt; border:solid windowtext 1.0pt" width="31" | 3.0
| style="width:54.35pt; border:solid windowtext 1.0pt" width="72" | -0.70
| style="width:80.25pt; border:solid windowtext 1.0pt" width="107" | -6.48 to 5.08
|-
| style="width:158.8pt; border:solid windowtext 1.0pt" width="212" |
'''RPSQ total scores (0 to 36)'''

| style="width:40.8pt; border:solid windowtext 1.0pt" width="54" | 20.7
| style="width:27.15pt; border:solid windowtext 1.0pt" width="36" | 12.8
| style="width:53.95pt; border:solid windowtext 1.0pt" width="72" | 22.5
| style="width:23.5pt; border:solid windowtext 1.0pt" width="31" | 12.4
| style="width:54.35pt; border:solid windowtext 1.0pt" width="72" | -1.80
| style="width:80.25pt; border:solid windowtext 1.0pt" width="107" | -94.08 to 90.48
|}

'''Comments:''' 1. The trial also had a third arm randomised to no chamber exposure and routine care only. 2. An exploratory trial to assist with safety, feasibility and planning for future trials. No formal sample size calculation. 3. Both HBO and sham arms showed symptomatic improvement following treatment. 4. Neurobehavioural Symptom Inventory Scores were not importantly different between the two chamber arms but absolute results after treatment not given. 5. Changes in PTSD symptoms favoured the sham group as did health related quality of life scores. 6. Authors conclude a placebo effect is the most likely explanation of the symptomatic improvements described.. 7. HBO did not improve reaction times compared to the sham group but both chamber groups were better after the treatment period than those in the no chamber group.

'''Appraised by:'''Mike Bennett m.bennett@unsw.edu.au; Sunday, 10 January 2021 '''Kill or Update By:''' January 2023

← Older revision		Revision as of 02:58, 10 January 2021
Line 58:		Line 58:

	<span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Appraised by:</span></span></span>'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Mike Bennett m.bennett@unsw.edu.au; Sunday, 10 January 2021<br/> '''Kill or Update By:''' January 2023</span></span></span></span>		<span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Appraised by:</span></span></span>'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Mike Bennett m.bennett@unsw.edu.au; Sunday, 10 January 2021<br/> '''Kill or Update By:''' January 2023</span></span></span></span>
		+	<p style="text-align: center;"> </p> <p style="text-align: center;">[[File:Sumhorsa.gif\|center\|Sumhorsa.gif]]</p> <p style="text-align: center;"><span style="font-size:xx-large;">[[Head_Injury\|BACK]]</span></p>

Miller - Revision history

M.bennett at 02:58, 10 January 2021

M.bennett: Created page with " '''No benefit from hyperbaric oxygen compared to sham tre..."