Curtis

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

Clinical bottom line:

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:

 

Measure

Control Group

HBOT Group

Difference

95% CI

Mean

SD

Mean

SD

FIQR* score [0 (normal) to 100 (maximum)] at 8 to 12 weeks

73.1

6.5

45.9

6.1

27.2

-13.8 to 68.2

HADS-Depression+ [0 (none) to 21 (maximum)] at 8 to 12 weeks

12.4

1.6

7.4

1.5

5.0

2.5 to 7.5

FSS# [9 (none) to 63 (maximum)] at 8 to 12 weeks

6.5

0.6

5.4

0.5

1.1

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

 

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