Spinal Cord Injuries (SCI)
Conditions
Keywords
Hypoxia, Spasticity, Reflex
Brief summary
This study aims to observe the effects of administration of a breathing intervention (Acute Intermittent Hypoxia (AIH)) on spasticity (tightness) in individuals with incomplete Spinal Cord Injury. It is hypothesized that hypoxia will decrease the reflex threshold of the biceps brachii, indicating an increase in spasticity following the AIH.
Detailed description
In the case of incomplete traumatic spinal cord injury, it is know now that muscular strength improves quickly after AIH administration, and this Increase in voluntary strength lasts from three to six hours. The Increase in strength, coupled with demonstrated improvements in spinal cord neural plasticity, makes AIH administration a potentially valuable new therapeutic intervention. AIH initially acts by releasing serotonin in the central nervous system, enhancing persistent sodium uptake (via the motor neuron soma) and activating voltage-gated calcium channels in motor neuron dendrites. There are also other effects of serotonin on motor neuron excitable channels. One potential complication of hypoxia is linked to the changes in motor neuron excitability in humans with SCI. These issues may be relevant to our potential work on the Therapeutic efficacy of AIH in persons with incomplete spinal cord injury. In other words, if individuals are highly spastic, it may indicate that their neuronal receptor sites are inaccessible, and increasing spinal cord serotonin levels may not be beneficial.
Interventions
This intervention involves breathing lowered levels of oxygen for 60 seconds, alternating with 60 seconds of room air breathing. Participants will be monitored and observed during the entire session for any changes in vital signs
Sponsors
Zev Rymer
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age \>= 18 * Non-progressive spinal Cord injury at least 6 months prior * Level of injury between C1-C8 * ISNCSCI ASIA classification C or D * Measurable Spasticity
Exclusion criteria
* Pre-existing hypoxic pulmonary disease * Positive Covid-Pneumonia diagnosis within 1 year of visit * Uncontrolled hypertension \>140/90 mmHg * Individuals who are currently pregnant/nursing or planning on becoming pregnant * Individuals with a tracheostomy or who utilize mechanical ventilation * A botulinum toxin injection to upper extremity musculature within the past 3 months * Currently taking Baclofen * Congestive Heart Failure * Cardiac arrhythmias * Uncontrolled diabetes mellitus * Chronic obstructive pulmonary disease * Emphysema * Severe Asthma * Previous myocardial infarction * Carotid/intracerebral artery stenosis * Orthopedic injuries or surgeries that impact the ability to use the upper extremity * History of Epilepsy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in reflex indentation threshold | Day 1 of Intervention | Similar to a tendon tap that a doctor may perform, this study uses an automated tendon tapper to measure the level of indentation needed to elicit a reflex in the bicep muscle. The aim is to observe any changes in reflex threshold following the AIH intervention |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Modified Ashworth Scale - Elbow | Day 1 of intervention | The modified Ashworth scale is a measure of Spasticity, performed by a trained administrator. This test involves rapidly rotating the participant's arm and feeling the spastic muscle response. This assessment is scored from 0 to 4, with 0 indicating no spasticity, and 4 indicating a fully contracted limb |
| Grip Strength | Day 1 of intervention | Using a handheld dynamometer, maximum grip strength of participants will be measured |
Countries
United States
Contacts
CONTACTWilliam Z Rymer, MD, PhD
CONTACTAlexander Barry, MS
PRINCIPAL_INVESTIGATORWilliam Z Rymer, MD, PhD
Shirley Ryan AbilityLab
Outcome results
None listed