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Hyperbaric Oxygen Therapy for Kids with Cerebral Palsy


FORT WORTH, Texas - When he started hyperbaric oxygen therapy last February, Kenton Morgan's leg muscles had become so constricted, his knees clamped together and his lower legs scissored across each other. He could no longer straddle a horse.

For the 13-year-old with cerebral palsy, that was tragic.

Kenton, who lives in the Fort Worth suburb of Burleson, loves therapeutic riding. It's his main social activity. His mother says he talks nonstop to the three helpers who lead and walk alongside the horse he's riding.

``I do love horses,'' Kenton says. ``I got thrown off a horse once. It was scary - for Mom. ... My side walker caught me.''

Kenton's orthopedic surgeon recommended muscle-release surgery to correct the problem but warned that the procedure might have to be repeated as Kenton grows.

His father, Ken Morgan, got on the Internet and says he made ``about a jillion phone calls,'' looking for alternatives. He found an experimental hyperbaric oxygen treatment program for cerebral palsy at the University of Texas Medical Branch at Galveston.

Breathing pure oxygen under increased pressure allows blood vessels to carry more oxygen deeper into tissue throughout the body, including the brain. The capillaries diffuse blood farther (into tissue) when they are under pressure, so that oxygen-rich blood is carried into areas it can't reach under normal pressure.

Hyperbaric oxygen is most often used to treat carbon monoxide poisoning and for hard-to-heal wounds such as crush injuries involving severe trauma to bone, soft tissue, nerves and blood vessels. It also is used to heal radiation and thermal burns, poisonous spider bites and foot injuries associated with diabetes.

For brain injuries, research guidelines call for 60 ``dives,'' one hour each day, five days a week. A treatment is called a dive because oxygen is administered under atmospheric pressure equivalent to that of diving underwater - 17 feet underwater, in the case of CP treatments.

For the Morgans, it meant moving to Galveston, temporarily.

After only a week of treatment, Kenton - who for years was fed intravenously and with feeding tubes and has never had any appetite - was demanding hamburgers and french fries. He has been off all supplemental feedings since a week after starting the oxygen therapy last February and has gained 10 pounds.

``After 20 dives, we noticed a definite improvement in the elasticity of his muscles,'' says Tamie Morgan, Kenton's mom.

``It was hard to get him dressed with his legs in a vise lock. Now, both his legs and arms have more elasticity, and his hands are not in such tight little fists. He had begun to keep his arm pulled up tight to his chest. Now, you can extend his arms and he can relax them,'' she says.

The Morgans are hopeful that other Fort Worth-area children with cerebral palsy will benefit from the hyperbaric oxygen treatments.

They have helped organize a medical study that will include 20 children at the Wound Healing and Hyperbaric Medicine Center at the Osteopathic Medical Center of Texas.

``This is as exciting a day for us as the day Kenton started the treatment in Galveston,'' Ken Morgan said recently at an orientation session for participants and their families. The first of four groups of children will begin receiving hyperbaric oxygen treatment here in mid-August.

``We will know more after we follow the first group for six months,'' says Dr. Alvin Mathe, who is directing the study. ``We know oxygen therapy helps with spasticity. I'll be happy if I see some improvements, whatever they are.''

Mathe is associate director of the Wound Healing and Hyperbaric Oxygen Medicine Center at Osteopathic Medical and an associate professor of internal medicine at the University of North Texas Health Science Center.

OMCT has had the hyperbaric chamber since 1993, but it was not used for cerebral palsy until this summer, when Ken Morgan found out about it and asked Mathe to set up a program to help Kenton and other children with CP.

Mathe has provided 20 follow-up treatments for Kenton since his return from Galveston, as well as 20 follow-up dives for Katie Jones, a 10-year-old Fort Worth girl.

``She had 40 treatments in Toronto, and we could definitely see improvements,'' says Angela Jones, Katie's mom. ``She has always been nonverbal, and now she does a lot of jabbering and makes new sounds she hasn't before. The speech pathologist here says there is a big difference in her facial muscle tone. Also, she had a really tight left arm that was always drawn up with her hand in a tight fist, and now she's trying to use that hand.''

Katie's endurance is a lot better, too. Before the treatments, she could only take six or seven steps with support from her mother or therapist before she collapsed. Now she has started dancing with her 8-year-old sister, her mother says.

``She just keeps going and going, and she's a lot more alert. We were planning on going back to Canada, but then Dr. Mathe agreed to give her HO here. They are doing it all over the world, but only 13 places in the U.S. offer the treatment for CP. To have it close to home where she can also continue her physical therapy is unbelievably better.''

Osteopathic Medical Center will provide physical therapy three days a week and other medical support for children in the study, including ear tubes for children who have difficulty clearing their ears in atmospheric pressure equal to that at 17 feet underwater.

``HO will not regenerate lost brain cells that have died from lack of oxygen, but it can rejuvenate or revive some of the inactive cells that may just not be getting enough oxygen to do much other than maintain themselves,'' says Dr. Irvine Prather, director of hyperbaric medicine at OMCT.

``For all these families, there is a certain amount of desperation involved in all this, so we definitely want to avoid offering false hope, but right now it looks good for CP. These kids are going to make some developmental milestones,'' Prather says. If this study goes well, he adds, the medical center hopes to follow up with enlarged studies.

Cerebral palsy is a disorder that results from a wide spectrum of brain injuries, often associated with premature birth and including strokes before birth, bleeding in the brain at birth, brain injuries in early childhood accidents or near drownings. It is marked by different levels of mental and physical impairment, depending on which part of the brain is injured.

The only known risks associated with hyperbaric oxygen treatment at the levels to be used in the study are difficulty clearing the ears, some sinus pressure, temporary vision changes and possible twitching. Lung problems and decompression sickness are sometimes associated with higher pressures.

The hyperbaric oxygen chamber is a 30,000-pound steel cylinder that looks like a small submarine. It has space for 12 people.

Funding for the study, which is free to the families involved, is coming from private donations and trusts. Doctors are donating their time, and the hospital is donating the equipment needed for the study, Mathe says.

The medical center is seeking additional funding for the program.

``For families, it's so uplifting,'' Ken Morgan says. ``There are so many dead-ends with CP. You are constantly reminded that eventually we are going to have to cut this tendon or that muscle. This just seems so much better. Kenton's quality of life is better and ours as parents is better.

``There's hope where there wasn't hope. All of us are scared of what the future will be, and this just gives us more hope for the future.''

(From HealthWorld Online)
  

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