Department
Rehabilitation Medicine
Post-stroke recovery, TBI/post-concussion, Long COVID, fibromyalgia
Rehabilitation Medicine applies HBOT as an adjunct in the recovery phase — supporting functional recovery and neuroplasticity after neurological injury and in chronic disabling conditions. The evidence here is emerging and investigational: HBOT is studied as a complement to, not a replacement for, standard rehabilitation. Applications span chronic post-stroke recovery, traumatic brain injury and post-concussion syndrome, Long COVID, and fibromyalgia.
HBOT Applications
Chronic Post-Stroke Recovery
A prospective randomised trial in patients 6–36 months after stroke reported improved neurological function after 40 HBOT sessions at 2 ATA, with gains correlating with SPECT brain-activity changes (Efrati 2013). An independent feasibility RCT combining HBOT with an exercise and mental-imagery rehabilitation programme found the combined approach safe and feasible, with trends toward improved upper-limb motor function (Schiavo 2020). Investigational; not FDA-approved.
Protocol
Pressure
2 ATA
Duration
90 min
Sessions
40
Frequency
Once daily, 5×/week
Evidence basis: Efrati 2013 (RCT); Schiavo 2020 (feasibility RCT)
Traumatic Brain Injury / Post-Concussion Recovery
Evidence is mixed. Chronic-phase trials report benefit: a crossover RCT in adults with prolonged post-concussion syndrome 1–5 years after mild TBI showed cognitive and quality-of-life improvement with SPECT correlates (Boussi-Gross 2013), and a sham-controlled, double-blind RCT in children with persistent post-concussion syndrome showed cognitive and behavioural improvement with MRI microstructural correlates (Hadanny 2022). However, sham-controlled trials in military personnel with mild TBI found HBOT and a low-pressure-air control improving similarly, without a clear HBOT-specific benefit (Walker/Cifu 2014), and a critical appraisal argues the apparent effect may reflect a participation effect, amid unresolved debate over whether the low-pressure "sham" is itself biologically active (Bennett 2018). Investigational; not FDA-approved.
Protocol
Pressure
2 ATA
Duration
60 – 90 min
Sessions
40 – 60
Frequency
Once daily, 5×/week
Evidence basis: Mixed RCT evidence (Boussi-Gross 2013; Hadanny 2022; Walker/Cifu 2014)
Long COVID
Relevant to rehabilitation for its fatigue, cognitive and functional-recovery dimensions. See the Long COVID indication for the full evidence and protocol.
Protocol
Pressure
2.0 ATA
Duration
90 min
Sessions
40
Frequency
5×/week
Evidence basis: Zilberman-Itskovich et al., 2022 (RCT)
Fibromyalgia
Relevant to rehabilitation for chronic pain and functional impairment. See the Fibromyalgia indication for the full evidence and protocol.
Protocol
Pressure
2.0 ATA
Duration
90 min
Sessions
40
Frequency
5×/week
Evidence basis: Efrati et al., 2015 (prospective controlled trial)
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