There are no scientifically valid data on which to base firm recommendations for the treatment of persistent or residual DI. Further research is required using standardized disability recording systems. Concerning spinal cord injuries, a validated scoring system (e.g., the ASIA scale) is generally recommended for pre- and post-treatment evaluation and during the two-year follow up. Randomized prospective studies are needed to better evaluate the effectiveness of hyperbaric oxygen therapy and rehabilitation. At this time a maximum of 10 additional hyperbaric treatment sessions are recommended, based on clinical response, after the initial recompression in combination with rehabilitation therapy. If a clinical plateau has not been achieved by 10 treatments, and there is objective evidence of ongoing improvement, HBO2 may be continued - (ECHM Type 3 recommendation: optional). However, as with any neurological injury, conventional rehabilitation should be started as soon as possible (ECHM Type 1 recommendation: strongly recommended) 131,132.
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