1. Report of the SIG HBOT and Neurorehabilitation Chair Meeting, Abu Dhabi 5 th -8 th March, 2015 Chair: F.Gerstenbrand, Vienna Co-Chair: T.Sieber, Piestany

2. Main Aims of the SIG HBOT and Neurorehabilitation Application of HBOT method in the rehabilitation of TBI, stroke, paediatric neurology, vegetative state/apallic syndrome. Clinical trials in cooperation with competent SIG’s Working basis: HBO Department of Adeli Medical Center, Piestany, Slovakia.

3. Oxymed Department, HBOT Chamber Adeli Medical Center, Piestany, Slovakia

4. Special Treatment Program Adeli Center Piestany for Cerebral Palsy

5. History of Hyperbaric Oxygenation Chamber Oxymed Department Adeli Center Piestany “ The Domicilium” from 1662 Fontaine’s mobile hyperbaric operating room - 1879 Cunningham's hyperbaric chamber In Cleveland - 1928 12-seat hyperbaric chamber HAUX STARMED 2200 / 5.5 / XL – 2014 Oxymed Center, Piestany

6. Hyperbaric Oxygenation Therapy use of 100% Oxygen higher than atmospheric pressure

7. Under HBOT O 2 Increased in: Bone Urine Plasma Lymph And Most Importantly the Cerebrospinal Fluid

8. Under pressure free molecular oxygen is delivered directly to the cell for immediate metabolic use without energy exchange. Edward Teller

9. Effects of Pressurized Oxygen Chronic Brain Damage Restores the integrity of the blood brain barrier and cell membranes Improves cell respiration, Reduces cell byproducts – cytokines Promotes Neovascularization Promotes Epithelization

10. Effects of Pressurized Oxygen Chronic Brain Damage Reactivates idling neurons Enhances plasticity Efficiently elevates diffusional driving force for O 2 thereby increasing tissue oxygen availability Promotes phagocytosis (internal debridement) Ameliorates multiple biochemical changes

11. HBOT and hypoxic damage of the brain Early form of HBOT (within 24 hours) Deferred form of HBOT (months to years Treatment structure: 1,2 - 1,5 bar 75-90min 10-40x

12. Hyperbaric Oxygen Therapy Complex effect Stimulates DNA in each cell Promotes growth of new tissue Affects perfusion (NO) Produces oxygen free radicals Inhibits acute inflammation Attenuates the apoptosis of cells Reactivates “sleeping” (idling) neurons

13. Results – Cochrane review Traumatic Brain Injury – Artru (1976), Holbach (1974), Rockswold (1992), Ren (2001) Neonatal hypoxic encephalopathy – Hutchinson (1966), Liu (2006) Cerebral Palsy – Machado (1989), Montgomery (1999), Packard (2000), Collet (2001), Mathai (2005)

14. Presentation of patients treated in the Adeli Medical Center Piestany 2011-2013

15. Possibilities of cooperation with other SIG‘s - Paediatric neurorehabilitation -Early rehabilitation -Severe brain injury -Spinal cord injury -Neurological rehabilitation -Autonomic rehabilitation -Neurosurgical, reconstructive and restaurative rehabilitation