Hyperbaric oxygen for children with cerebral palsy: a randomised multicentre trial

Background The use of hyperbaric oxygen for children with cerebral palsy ha s spread worldwide, despite little scientific evidence of efficacy. We did a randomised trial to assess the efficacy and side-effects of this form of therapy in children with cerebral palsy. Methods 111 children with cerebral palsy aged 3-12 years were randomly assi gned hyperbaric oxygen (n=57) or slightly pressurised room air (n=54). All children received 40 treatments over 2 months. Hyperbaric oxygen treatment was Ih in 100% oxygen at 1.75 atmospheres absolute (ATA); children on sligh tly pressurised air received air at 1.3 ATA (the lowest pressure at which p ressure can be felt, thereby ensuring the maintenance of masking). The main outcome measure was gross motor function. Secondary outcomes included perf ormance in activities of daily living, attention, working memory, and speec h. Findings For all outcomes, both groups improved over the course of the stud y, but without any difference between the two treatments. The score on the global gross motor function measure increased by 3.0% in the children on sl ightly pressurised air and 2.9% in those on hyperbaric oxygen. The mean dif ference between treatments was -0.40 (95% CI -1.69 to 0.90, p=0.544). Other changes were seen in speech, attention, memory, and functional skills. Ear problems occurred in 27 children treated by hyperbaric oxygen and in 15 tr eated with hyperbaric air (p=0.004). Interpretation In this study, hyperbaric oxygen did not improve the conditi on of children with cerebral palsy compared with slightly pressurised air. The improvement seen in both groups for all dimensions tested deserves furt her consideration.