Addition
of hyperbaric oxygen to the treatment of acute ankle sprains did not accelerate
recovery.
Clinical Bottom Line:
1.
There was no improvement in the time to recovery by the addition of hyperbaric
oxygen to a standard treatment protocol.
2.
Both groups recovered function and lost symptoms over 15 to 16 days.
3.
There was no improvement in resolution of oedema or active/passive movement
range.
Appraised
by: Mike Bennett, Dept. of Diving and
Hyperbaric Medicine, Prince of Wales Hospital
Sydney; Wednesday, 16 December,
1998
Clinical
Scenario: A patient with a soft-tissue
sprain to the ankle.
Three-part
Question: In patients with an acute ankle
sprain does the addition of hyperbaric oxygen therapy to standard therapy result
in any reduction in the time taken to recover function?
Search
Terms: Athletic injury, soft-tissue
trauma, sprains and strains.
The
Study:
Double-blinded randomised
controlled trial without intention-to-treat.
Young adults with lateral ankle
sprains evaluated by an orthopaedic surgeon within 72 hours and who had not
received treatment other than rest, ice and elevation.
Control group (N =16 ;16
analysed): Standard program of treatment including posterior splint, crutches,
naproxen, active range of motion and ankle stirrup. Sham hyperbaric exposure of
air at 1.1ATA for 90 minutes, then twice more for 60 minutes within 7 days.
Experimental group (N =16 ;16
analysed): Standard treatment program plus 100% oxygen at 2ATA on the same time
protocol as above.
Non-Event
Control group HBO
group
P-value
Outcomes
Time
to recovery
of
function (days)
15.4
16.0
>0.05
Improvement
in
functional
score
(initial
to final)
4.5
5.9
<0.05
Comments:
1. The greater improvement
reported in functional score in the hyperbaric group from the start to finish of
treatment is probably of little real significance.
2. There is a delay to treatment
of over 30 hours in both groups.
3. A methodologically sound
study but of low power.
4. Three treatment regime may be
considered a low dose.
Expiry date: February 2005
References:
1. Borromeo CN, Ryan JL,
Marchetto PA, Peterson R, Bove AA. Hyperbaric oxygen therapy for acute ankle
sprains. American Journal of Sports Medicine 1997;25:619-625.
