Objective To evaluate the role of early intensive rehabilitation training combined with hyperbaric oxygen therapy in improving dysfunction and prognosis of patients with traumatic brain injury.
Methods A total of 160 patients diagnosed as traumatic brain injury were randomly divided into four groups, namely intensive rehabilitation training (one time per day) group (IRT1 group), intensive rehabilitation training (one time per day) combined with hyperbaric oxygen therapy group (IRT1+HBO group), intensive rehabilitation training (two times per day) group (IRT2 group) and intensive rehabilitation training (two times per day) combined with hyperbaric oxygen therapy group (IRT2+HBO group), with 40 cases in each group. A total of 151 patients were finally included, including 39 cases in the IRT1 group, 38 cases in the IRT1+HBO group, 37 cases in the IRT2 group, and 37 cases in the IRT2+HBO group. Intensive rehabilitation training included functional electrical stimulation (20 minutes per day), acupuncture therapy (30 minutes per day), exercise therapy (45 minutes per day), occupational therapy (30 minutes per day), speech therapy (30 minutes per day) and cognitive behavioral therapy (30 minutes per day), with one month as a course of treatment for 3 courses in total. The patients received hyperbaric oxygen therapy at 2.0 times absolute atmospheric pressure for 1 hour per day, with 20 days as a course of treatment, and the next course of treatment began after 10 days in the end of each course. At the time points of before rehabilitation training (T0), 1 month after rehabilitation training (T1), 2 months after rehabilitation training (T2) and 3 months after rehabilitation training (T3) after hospital admission, the Mini-Mental State Examination (MMSE), the Modified Barthel Index (MBI), the Functional Independence Measure (FIM) and Fugl-Meyer Assessment Scale (FMA) were used to evaluate the patients.
Results Scores of MMSE at T1 and T2 in the IRT2+HBO group were significantly higher than those in the IRT1 group and the IRT2 group (P < 0.05). Score of MMSE at T3 in the IRT2+HBO group was significantly higher than that in the IRT1 group, the IRT1+HBO group and the IRT2 group (P < 0.05). Values of MBI at T1, T2 and T3 in the IRT2 group and the IRT2+HBO group were significantly higher than those in the IRT1 group and the IRT1+HBO group (P < 0.05). Scores of FIM at T1, T2 and T3 in the IRT2+HBO group were significantly higher than those in the IRT1 group, the IRT2 group and the IRT1+HBO group (P < 0.05). Scores of FIM at T1, T2 and T3 in the IRT2 group and the IRT1+HBO group were significantly higher than those in the IRT1 group (P < 0.05). Scores of FMA at T1, T2 and T3 in the IRT2 group and the IRT2+HBO group were significantly higher than those in the IRT1 group and the IRT1+HBO group (P < 0.05).
Conclusion Early intensive rehabilitation training combined with hyperbaric oxygen therapy can effectively improve the cognitive function, motor function and ability of daily activity in patients with traumatic brain injury.
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