Effects of Breathing and Walking Treatments on Recovery Post-Spinal Cord Injury
| Status: | Completed |
|---|---|
| Conditions: | Hospital, Neurology, Orthopedic |
| Therapuetic Areas: | Neurology, Orthopedics / Podiatry, Other |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 4/21/2016 |
| Start Date: | May 2010 |
| End Date: | August 2014 |
Intermittent Hypoxia and Locomotor Training: Effects Following SCI
Change to Reflect What Was Done and reason Changes Were Made.
The purpose of this study is to determine (1) if a specific breathing treatment
(intermittent hypoxia) can promote changes in breathing function and (2) if pairing
breathing treatments (hypoxia) with locomotor training can enhance the benefits of walking
recovery observed with locomotor training alone (without breathing treatments).
The purpose of this study is to determine (1) if a specific breathing treatment
(intermittent hypoxia) can promote changes in breathing function and (2) if pairing
breathing treatments (hypoxia) with locomotor training can enhance the benefits of walking
recovery observed with locomotor training alone (without breathing treatments).
Spinal cord injury (SCI) is a very disabling health problem. Paralysis and paresis of limb
and trunk muscles are major consequences of SCI and result in the inability to walk or
difficulty walking. The most commonly stated goal by individuals with SCI during
rehabilitation is the desire to walk again. Locomotor training (LT) that uses a body-weight
support system and treadmill (BWST) is a task-specific rehabilitation intervention that
allows practice of walking at normal speeds while loading the lower extremities,
facilitating upright posture, and hip extension. Substantial improvement in ambulation can
occur following locomotor training (LT) in individuals with motor incomplete spinal cord
injury (iSCI). Despite these advances in activity-dependent rehabilitation, a need exists
for defining complementary strategies that further amplify endogenous neuroplasticity. The
proposed study will assess the therapeutic potential of (1) a respiratory training
intervention (acute intermittent hypoxia, or AIH) on breathing function and (2) a combined
locomotor (LT) and respiratory (AIH) training intervention for enhancing walking recovery.
and trunk muscles are major consequences of SCI and result in the inability to walk or
difficulty walking. The most commonly stated goal by individuals with SCI during
rehabilitation is the desire to walk again. Locomotor training (LT) that uses a body-weight
support system and treadmill (BWST) is a task-specific rehabilitation intervention that
allows practice of walking at normal speeds while loading the lower extremities,
facilitating upright posture, and hip extension. Substantial improvement in ambulation can
occur following locomotor training (LT) in individuals with motor incomplete spinal cord
injury (iSCI). Despite these advances in activity-dependent rehabilitation, a need exists
for defining complementary strategies that further amplify endogenous neuroplasticity. The
proposed study will assess the therapeutic potential of (1) a respiratory training
intervention (acute intermittent hypoxia, or AIH) on breathing function and (2) a combined
locomotor (LT) and respiratory (AIH) training intervention for enhancing walking recovery.
Inclusion Criteria:
- Adults at least 18 years of age
- At least 12 months post-incomplete spinal cord injury (I-SCI), including but not
limited to the following syndromes: Brown Sequard and Central Cord Syndromes
- Upper motor neuron lesion (with upper motor neuron signs (i.e. presence of clonus,
spasms, and/or hyperreflexia))
- A diagnosis of first time SCI including etiology from trauma, vascular, or orthopedic
pathology
- Resting oxygen saturation (SpO2) levels of 95-99%
- Individuals who ambulate independently, with an assistive device, or who can walk
when provided manual assistance
- Persons using anti-spasticity medication must maintain stable medication dosage
during the study
- Able to give informed consent.
- Medical approval by individual's physician
Exclusion Criteria:
- Current participation in a rehabilitation program/research protocol that could
interfere or influence the outcome measures of the current study
- History of congenital SCI (e.g. myelomeningocele, intraspinal neoplasm, Frederich's
ataxia) or other degenerative spinal disorders (e.g. spinocerebellar degeneration,
syringomyelia) that may complicate the protocol
- Inappropriate or unsafe fit of the harness due to the participant's body size and/or
joint contractures or severe spasticity that would prohibit the safe provision of
either training modality.
- Severe spasticity that would prohibit the safe provision of training.
- Pregnancy - all women of childbearing age will be required to undergo pregnancy
testing prior to enrollment
- Unstable medical condition that could interfere with safety during participation in
study (i.e. symptomatic cardiopulmonary complication, osteoporosis, contractures or
other significant medical complications that would prohibit or interfere with testing
of walking function and training or alter compliance with a training protocol)
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