Some
evidence that bladder function was improved following hyperbaric oxygen
treatment in chronic progressive multiple sclerosis.
Clinical Bottom Line:
1.Possible
improvement in bladder function for patients after hyperbaric oxygen exposure.
2.Reportedly
no change in neurologic examination, Kurtze disability scale, ambulation,
visual acuity or evoked potentials.
Appraised
by: Mike Bennett, Dept of Diving and
Hyperbaric Medicine, Prince of Wales Hospital
Sydney; Friday, 12 March 1999
Clinical
Scenario: A patient with chronic
progressive multiple sclerosis presented for consideration of hyperbaric oxygen
therapy.
Three-part Question: For
patients with chronic progressive multiple sclerosis, does the addition of
hyperbaric oxygen treatment to the usual care result in any improvement in
disability or symptoms?
Search
Terms: Hyperbaric oxygenation,
multiple sclerosis
The
Study:
Double-blinded randomised
controlled trial without intention-to-treat.
Patients with chronic
progressive multiple sclerosis. No other details.
Control group (N = 18; 18
analysed): Sham hyperbaric oxygen treatments on 10% oxygen at 2ATA for 90
minutes daily for 20 treatments over four weeks.
Experimental group (N = 18; 18
analysed): Oxygen at 2ATA for 90 minutes on the same schedule as above.
The
Evidence:
|
Outcome |
Time
to Outcome |
Air
group |
HBO
group |
Relative
risk reduction |
Absolute
risk reduction |
NNT |
|
Bladder
function improved |
unknown |
0.111 |
0.5 |
78% |
0.389 |
-3 |
|
95%
CI: |
|
|
|
23%
- 100% |
0.116
to 0.662 |
-9
to -2 |
Comments:
1. Abstract reports only with
little detail.
2. No explanation of how bladder
function was evaluated.
3. Multiple other parameters
used as outcome measures were reported to show no differences between the
groups.
4. Follow-up was 10 months but
it is not clear when the data reported was taken.
Expiry
date: January 2005
References:
1. Massey EW, Shelton DL, Pact
V, Greenburg J, Erwin W, Satzman H, Bennett P. Hyperbaric oxygen in multiple
sclerosis: a double-blind crossover study of 18 patients. Neurology 1985; 35 (suppl
1):104.
