Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Key Laboratory of Rehabilitation Medicine in Sichuan Province, Chengdu, Sichuan, China.
J Back Musculoskelet Rehabil. 2021;34(6):905-913. doi: 10.3233/BMR-200157.
The effects of hyperbaric oxygen therapy (HBO) for spinal cord injury (SCI) are controversial.
The purpose of this study was to evaluate the effects of HBO therapy on motor function, sensory function, and psychology after SCI.
We searched the following databases: Medline, Embase, PubMed, Ovid, Cochrane library, China National Knowledge Infrastructure (CNKI), Wan Fang, and VIP up to May 2020. We included Randomized Controlled Trials (RCTs) which investigated patients with SCI received HBO during hospitalization. Motor function, sensory function, and psychology status were measured by commonly used scales including American Spinal Injury Association (ASIA) motor score, Modified Barthel Index (MBI), ASIA sensory score, Hamilton Depression Scale (HAMD), and Hamilton Anxiety Scale (HAMA). We performed a meta-analysis by calculating mean difference (MD) to determine the effect of HBO on three levels of function on patients with SCI. We evaluated heterogeneity by I2 test, and I2> 50% was significant.
A total of 1746 studies were identified initially, and 11 studies were included, involving 875 participants. HBO therapy significantly improved the ASIA motor score (MD 15.84, 95% CI 9.04 to 22.64, I2= 87%). Six trails suggested that HBO therapy statistically promoted ASIA sensory score (MD 66.30, 95% CI 53.44 to 79.16, I2= 95%). The other four trails suggested that HBO therapy statistically increased the light touch score (MD 9.27, 95% CI 3.89 to 14.65, I2= 91%) and needling score (MD 10.01, 95% CI 8.60 to 11.43, I2= 95%), respectively. HBO therapy was implicated in the significant improvement of MBI (MD 13.80, 95% CI 10.65 to 16.94, I2= 0%). HBO therapy also decreased the HAMA (MD -2.37, 95% CI -2.72 to -2.02, I2= 0%) and HAMD (MD -3.74, 95% CI -5.82 to -1.65, I2= 90%).
HBO therapy may improve motor function, sensory function and psychology after SCI compared to conventional treatments. More high-quality, large sample size RCTs are needed to support these perspectives.
高压氧疗法（HBO）治疗脊髓损伤（SCI）的效果存在争议。
本研究旨在评估 HBO 治疗对 SCI 后运动功能、感觉功能和心理的影响。
我们检索了以下数据库：Medline、Embase、PubMed、Ovid、Cochrane 图书馆、中国知网（CNKI）、万方和维普，截至 2020 年 5 月。我们纳入了住院期间接受 HBO 治疗的 SCI 患者的随机对照试验（RCT）。运动功能、感觉功能和心理状态通过常用量表进行测量，包括美国脊髓损伤协会（ASIA）运动评分、改良巴氏指数（MBI）、ASIA 感觉评分、汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）。我们通过计算均数差（MD）进行荟萃分析，以确定 HBO 对 SCI 患者三个功能水平的影响。我们通过 I2 检验评估异质性，I2>50%为显著。
最初共确定了 1746 项研究，其中 11 项研究纳入了 875 名参与者。HBO 治疗显著改善 ASIA 运动评分（MD 15.84，95%CI 9.04 至 22.64，I2=87%）。6 项试验表明，HBO 治疗可显著提高 ASIA 感觉评分（MD 66.30，95%CI 53.44 至 79.16，I2=95%）。另外 4 项试验表明，HBO 治疗可显著提高轻触评分（MD 9.27，95%CI 3.89 至 14.65，I2=91%）和针刺评分（MD 10.01，95%CI 8.60 至 11.43，I2=95%）。HBO 治疗与 MBI 的显著改善有关（MD 13.80，95%CI 10.65 至 16.94，I2=0%）。HBO 治疗还降低了 HAMA（MD-2.37，95%CI-2.72 至-2.02，I2=0%）和 HAMD（MD-3.74，95%CI-5.82 至-1.65，I2=90%）评分。
与常规治疗相比，HBO 治疗可能改善 SCI 后的运动功能、感觉功能和心理。需要更多高质量、大样本量的 RCT 来支持这些观点。
