Intermittent Hypoxia Elicits Prolonged Restoration of Motor Function in Human SCI
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Purpose
The goal of the study is to determine whether repeatedly breathing low oxygen levels for brief periods (termed intermittent hypoxia) will improve limb function after spinal cord injury. This idea stems from animal studies on respiration, in which investigators have shown that mild intermittent hypoxia improves breathing in spinally injured rats. These studies have shown that intermittent hypoxia induces spinal plasticity, strengthening neural connections and motor neuron function within the spinal cord. Exposure to mild intermittent hypoxia triggers a cascade of events, including increased production of key proteins and increased sensitivity of spinal cord circuitry necessary for improved breathing.
The ultimate goal of this research is to assess the potential of mild intermittent hypoxia as a therapeutic approach to stimulate recovery of limb function in human patients.
| Condition | Intervention | Phase |
|---|---|---|
|
Spinal Cord Injury |
Other: Acute intermittent hypoxia Other: Room air |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Crossover Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Intermittent Hypoxia Elicits Prolonged Restoration of Motor Function in Human SCI |
- Walking performance [ Time Frame: 1 Week ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 40 |
| Study Start Date: | December 2010 |
| Estimated Study Completion Date: | September 2013 |
| Estimated Primary Completion Date: | September 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Low oxygen |
Other: Acute intermittent hypoxia
30 minutes of intermittent breathing low oxygen followed by walking on a body-weight support treadmill
Other Name: breathing low oxygen
|
| Sham Comparator: Room Air |
Other: Room air
30 minutes of breathing room air followed by walking on a body-weight support treadmill
Other Name: breathing room air
|
Detailed Description:
: The goal of the study is to determine whether repeatedly breathing low oxygen levels for brief periods (termed intermittent hypoxia) will improve limb function after spinal cord injury. This idea stems from animal studies on respiration, in which investigators have shown that mild intermittent hypoxia improves breathing in spinally injured rats. These studies have shown that intermittent hypoxia induces spinal plasticity, strengthening neural connections and motor neuron function within the spinal cord. Exposure to mild intermittent hypoxia triggers a cascade of events, including increased production of key proteins and increased sensitivity of spinal cord circuitry necessary for improved breathing.
The investigators initially hypothesize that daily exposure to intermittent hypoxia for 7 consecutive days will improve limb function in rats and in humans with chronic spinal injuries. First, the investigators will compare limb function in spinally-injured rats which receive mild intermittent hypoxia treatment with rats that did not. The investigators will measure grip strength and locomotor abilities in both groups before treatment and for several months after treatment. The investigators will also examine the spinal cords of these rats to look for the key proteins, which are indicators of spinal plasticity. The investigators will use this information to guide the treatment protocols when the investigators compare limb function in spinal-injured persons with and without intermittent hypoxia treatment.
The second hypothesis is that combining intermittent hypoxia with locomotor training will further improve limb function after spinal injury. To test this idea, the investigators will compare limb function in spinally-injured rats which have received combined intermittent hypoxia and treadmill training with rats which only received intermittent hypoxia or locomotor training alone. The investigators will examine key proteins in the spinal cords of these rats to determine whether the combination of hypoxia and training further alters these indicators of plasticity. The investigators will also compare limb function in spinally-injured humans who receive both intermittent hypoxia and locomotor treadmill training with those who receive either treatment alone.
The ultimate goal of this research is to assess the potential of mild intermittent hypoxia as a therapeutic approach to stimulate recovery of limb function in human patients.
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- medical clearance to participate
- lesion below C5 and above T12 with non-progressive etiology
- classified as motor-incomplete
- injury greater than 12 months
- ambulatory with minimal assistance
Exclusion Criteria:
- Concurrent severe medical illness (i.e., infection, cardiovascular disease, ossification, recurrent autonomic dysreflexia, unhealed decubiti, and history of cardiac or pulmonary complications)
- Pregnant women because of the unknown affects of AIH on pregnant women and fetus
- History of seizures, brain injury, and/or epilepsy
- Diagnosed with obstructive sleep apnea
- Undergoing concurrent physical therapy
- Any contraindications to EMG testing procedures (skin sensitivity)
- Any contraindications to passive movement of the limbs (e.g., joint immobility, hemodynamic instability)
- Score of < 24 on Mini-Mental Exam
Contacts and Locations| Contact: Randy Trumbower | 404-712-5985 | randy.trumbower@emory.edu |
| Contact: Heather Hayes | 404-727-5985 | hbhayes@emory.edu |
| United States, Georgia | |
| Shepherd Center | Recruiting |
| Atlanta, Georgia, United States, 30309 | |
| Contact: Randy D Trumbower, PT, PhD 404-727-3065 randy.trumbower@emory.edu | |
| Contact: Heather B Hayes, PhD 404-387-2562 heather.brant.hayes@gmail.com | |
| Principal Investigator: Randy D Trumbower, PT, PhD | |
| United States, Illinois | |
| Rehabilitation Institute of Chicago | Recruiting |
| Chicago, Illinois, United States, 60611 | |
| Contact: Randy D Trumbower, PT, PhD 404-727-3065 randy.trumbower@emory.edu | |
| Contact: Heather Hayes 404-387-2562 heather.brant.hayes@gmail.com | |
| Principal Investigator: William Z Rymer, MD, PhD | |
| Principal Investigator: | Randy D Trumbower, PT, PhD | Emory University |
More Information
Additional Information:
No publications provided
| Responsible Party: | Randy D. Trumbower, Assistant Professor, Emory University |
| ClinicalTrials.gov Identifier: | NCT01272349 History of Changes |
| Other Study ID Numbers: | W81XWH-10-1-0832 |
| Study First Received: | January 4, 2011 |
| Last Updated: | March 27, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Emory University:
|
spinal cord injury walking low oxygen air strength |
Additional relevant MeSH terms:
|
Spinal Cord Injuries Anoxia Spinal Cord Diseases Central Nervous System Diseases Nervous System Diseases |
Trauma, Nervous System Wounds and Injuries Signs and Symptoms, Respiratory Signs and Symptoms |
ClinicalTrials.gov processed this record on June 17, 2013