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An 18-month uncontrolled study of the effects of hyperbaric oxygen therapy was conducted in 97 individuals with multiple sclerosis. Two-thirds of the patients were classified as progressive and one-third as stable. Assessment was based mainly on three aspects of activities of daily living: bladder function, mobility and communication. Bladder function showed a tendency to improve over the 12 month period of treatment but there was no evidence that treatment led to an improvement of mobility or communication. There are several reports of immediate improvement in bladder function, objectively and subjectively determined, in response to hyperbaric oxygen. In one study similar to that reported here, lack of deterioration in bladder function amongst progressive patients over two years, was related to continued hyperbaric oxygen treatment.

The paper describes a number of methodological problems experienced in a long-term evaluation of hyperbaric treatment for MS. Among the problems discussed are those relating to the locus and logistics of assessment, the reliability of 'subjective' assessments, the feasibility of 'objective' measurements, the identification of outcome categories and patient drop-out and selectivity.