Effect of Meditation and Hyperbaric Oxygen Therapy on Cognition, Healing Process and Overall Well-being in Elderly Patients With Chronic Wounds
Description:
Each year, Community Care Access Centers (CCAC) provide long-term wound care for over 22,000
patients in Ontario, with numbers steadily increasing with the aging population. In Ontario,
the cost of community care for lower leg ulcers has been estimated at over $500 million per
year. This does not include the additional cost of adjunctive HBOT, which averages over $120
thousand for a standard 40 treatment course. These costs are further compounded by the
psychological comorbidities that often accompany chronic disease, although these numbers are
difficult to capture. Across Canada, the health burden cost of anxiety and depression alone
totals over $14 billion annually, with disability costs comparable to those associated with
heart disease. Furthermore, recent evidence suggests that psychological interventions are
more cost-effective than drug treatment, with comparable results.
The elderly patients with chronic non-healing wounds experience a sense of powerlessness and
loss of autonomy that profoundly impacts subjective wellbeing. These psychological effects in
turn compromise healing, as growing evidence suggests that psychological stress impacts wound
repair [1, 2]. Recent studies have shown that structured meditation programs can improve
recovery from both physical and psychological disease. For example, meditation enhances
immune response [3, 4] while reducing blood pressure [5], insulin resistance [6], oxidative
stress [7], inflammation [8], and other risk indices. Furthermore, meditation therapy can be
broadly applied with few limitations, having successfully been used in elderly [9], ill [10]
and disabled [11] populations.
Hyperbaric oxygen therapy (HBOT) is an adjuvant therapy for chronic wounds. HBOT increases
oxygen delivery to tissues via inhalation of 100% oxygen at high barometric pressures. HBOT
has been shown to promote angiogenesis, cerebral blood and neuroplasticity in patients with
stroke, traumatic brain injury and chronic pain. Furthermore, HBOT also alleviates
inflammation, reduces oxidative stress, inhibits apoptosis and stimulates signaling pathways
essential for wound healing.
Patients referred for HBOT assessment often have "problem wounds" that have failed prolonged
courses of standard wound care. These refractory wounds may benefit from a multimodal
approach that targets both the physical and psychological manifestations of chronic disease.
Meditation is a simple and economical addition to HBOT that may further enhance the rate of
healing by alleviating psychological stressors. Meditation encompasses a spectrum of
mindfulness-based interventions that have been shown to improve mental and physical health in
randomized trials. Meditation reduces stress, pain, anxiety, depression and blood pressure
while improving cognition and memory performance. A variety of specialties have begun to use
meditation as a cost-effective, low-stigma adjunct to standard medical and psychiatric care.
Meditation and HBOT have been independently shown to improve healing, and may have
synergistic effects when applied together. This combined intervention has the potential to
improve mood while enhancing the healing process, offering improved health while reducing the
costs associated with chronic wounds.
Condition:
Wound
Treatment:
Meditation and Hyperbaric Oxygen Treament
Start Date:
September 10, 2018
Sponsor:
University Health Network, Toronto
For More Information:
https://clinicaltrials.gov/show/NCT03674749