Conference held with focus on hyperbaric oxygen therapy

Bengaluru: The Second Annual conference of Kaveri Association of Rehabilitation Medicine (KARM) was held at Sakra World Hospital, Bengaluru, (JV of Secom and Toyota Tsusho Japan) which houses India's best advanced rehabilitation centre incorporating hi-tech rehabilitation facilities including cutting edge robotics. The conference was attended by 40 physiatrists who are specialised in rehabilitation medicine.

The inauguration was chaired by Chief Guest Dr. Upender Singh, (Professor and Head, department of PMR, AIIMS, Delhi), Naoya Matsumi (DMD Sakra World Hospital), Lovekesh Phasu,(COO Sakra World Hospital), KARM president Dr Kurian Zachariah (Professor and Head, department of PMR, St. Johns Medical College), organising chairman Dr. Maheswarappa B M, (HOD and Sr. consultant, Sakra Institute of Rehabilitation Sciences) and organising secretary Dr Anand Verma (HOD, department of physical medicine and Rehabilitation Karnataka Institute of Medical Sciences, Hubli).

It's estimated that 1 in 50 among our fellow Indian brothers and sisters currently live with some form of disability. One individual's disability, more often than not, also shackles caregivers and limits their productivity in society as well. Optimizing the functionality of people with disabilities reduces their dependence on caregivers and improves the productivity of the entire family, adding confidence, self-reliance and thus making them efficient contributors to society and the economy as a whole.

There is a lesser known yet vital branch of modern medicine called Rehabilitation medicine a.k.a. Physical Medicine and Rehabilitation (PMR), a speciality dedicated to the upliftment of people suffering with disabilities or pain and their families via medical care, education and research. PMR has its roots as an exclusive speciality all the way back in the 2nd World War catering to persons with spinal cord injury and amputations. PMR has grown to be an established and well-known speciality in all western countries since then. PMR had a late start in India over half a decade ago and has seen a slow yet steady growth.

The Indian association of PMR (IAPMR) was set up in 1972 and now has numerous state chapters, the youngest of which is our very own chapter in Karnataka, the Kaveri Association of Rehabilitation Medicine (KARM), established in 2021. PMR services are readily available in most medical colleges in Tamil Nadu and Kerala in the south but has seen a slow progression in Karnataka. With the dawn of our state chapter for PMR and with the help of public awareness, PMR services are now expected to grow rapidly.

People with disabilities are often neglected and do not know where to seek quality medical attention. Sadly, most doctors are not trained or aware of the specific medical needs to the disabled population. Thus, the patient is not treated up-to their true potential and maximal independence. With the expansion of PMR services in the state, any person with disability or pain can seek medical attention from doctors who are trained to cater to their unique set of medical problems, complications and disabilities. KARM being the proverbial trunk of a year-old sapling, aims to grow branches to provide medical rehabilitation cover to all corners of Karnataka.

KARM is celebrating the first anniversary of its inception by conducting a conference on a relatively new technology in rehabilitation – HBOT i.e. Hyperbaric Oxygen therapy. Its utility is best seen in the acute or subacute stages of tissue injury- nerve, brain, limbs etc and is FDA approved. Injured tissues typically have 3 zones of viability- an irreversibly dead central zone, a live outer zone and a middle grey zone that is still viable (alive) but damaged. Without intervention, over time this area too will die thus increasing the overall size of irreversibly of the dead tissues.

HBOT is the only way to provide a larger dose of dissolved oxygen via the blood to the damaged tissue in an attempt to salvage the borderline tissue and hasten healing. Naturally, humans breathe air at 21% oxygen at 1ATA pressure. The patient availing HBOT is completely placed within a glass chamber wherein the pressure of the enclosed atmospheric air is raised to 1.5 to 3 ATA pressure. This results in a higher dissolved blood oxygen concentration which delivers turbo charged healing i.e. more oxygen to damaged grey zones results in faster and more complete healing, thus translating to better patient outcomes.

Though the medical effects of HBOT is known for centuries, it has not been utilised effectively. The conference theme was focused on application of HBOT in different medical conditions. After inception of this new speciality of rehabilitation medicine, HBOT has been used effectively for treating acute and chronic non-healing wounds, Diabetic foot, Pressure sores, burns, gangrene, lung disease like ILD, infections, fungal infections mucomycosis, non-healing fractures, neurological conditions like TBI, stroke, HIE, facial palsy, sensory neural deafness etc.

HBOT in rehabilitation is currently under subscribed due to lack of awareness. Sakra Institute of Rehabilitation Sciences, having a rich experience in the field of HBOT has thus conducted the conference to educate the rest of the medical fraternity in the nuances of HBOT related patient care. In Bengaluru, HBOT is also available under the PMR department of Whitefield Manipal Hospital, Aster CMI, Narayana health City and Institute of Aerospace Medicine, Bengaluru.

We should be aware that anyone of us or our loved ones can get disabled overnight after an accident or stroke. Wouldn't we prefer the access to high quality medical rehabilitation services? Shouldn't we do our part to nourish the year-old sapling? Lack of awareness is the biggest hurdle in its growth. Awareness creation regarding the KARM chapter, the speciality of PMR and HBOT is the need of the hour as a stepping stone towards optimal rehabilitation service availability in Karnataka and India as a whole. Let us Turbo-charge Rehabilitation.