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The Scotson Technique Library

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Hyperbaric Oxygen - or High Dosage Oxygen Therapy (HDOT)

The first respiratory adaptations an infant has to make after birth are to differences in the oxygen content of the air and the atmospheric pressures in the world around it.

As the mother bends over her baby to whisper "I love you" the baby breathes in her exhaled carbon dioxide. As the weather changes and the seasons change atmospheric pressure changes. Changes in pressure govern how much oxygen is dissolved in the liquid part of the blood (plasma) - so the baby must learn to breath more deeply or more quickly to ensure adequate levels of oxygen are available for metabolic use regardless of the weather or how much it is breathed upon.

A healthy baby with a strong diaphragm rapidly adapts to such environmental fluctuations. The diaphragm has a high level of blood flow which gives it a high level of electrical activity. This ensures a quick response to signals from the brain's respiratory centre when more oxygen is required.

A child with cerebral palsy doesn't develop this kind of quick respiratory responsiveness to changes in atmospheric pressure or local oxygen levels in the surrounding area. One probable cause is that blood flow through the diaphragm was reduced as a direct consequence of the raised metabolic demands of brain injury and this consequence left the organ weaker. Thus the child with cerebral palsy has a respiratory system that is intrinsically weak and so less flexible than that of a normal child. While The Scotson Technique exercises increase blood flow to the diaphragm and upper respiratory muscles it is possible to retrain respiratory flexibility by the use of a hyperbaric pressure chamber.

Under its former title the Hyperbaric Oxygen Trust, Advance was the pioneer of hyperbaric oxygen for children with cerebral palsy. At that time the standard pressure increase in the chamber was 1¾ of an atmosphere (like diving at 24ft of seawater). This increased oxygen levels in the blood plasma and so capillary healing in the injured brain. Our experience eventually showed the approach to have a limited value in the rehabilitation process because it could not alter the child's diaphragm strength or respiratory flexibility. Moreover it was shown that smaller changes in pressure could be equally effective.

High Dosage Oxygem Therapy (HDOT) therefore was developed at Advance to provide a spread of variations of pressure which are closer to normal experience. In this way the child with cerebral palsy both receives the healing of increased capillary oxygenation and a respiratory training that will help increase respiratory flexibility to metabolic demands.

At Advance parents and children spend approximately one hour on each day of their 5 day visit in an attractively decorated chamber where they listen to music, chat and play.

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