Efficacy and time course of acute intermittent hypoxia effects in the upper extremities of people with cervical spinal cord injury

Exp Neurol, 2021 · DOI: 10.1016/j.expneurol.2021.113722 · Published: August 1, 2021

Spinal Cord Injury Neuroplasticity Rehabilitation

Simple Explanation

Spinal cord injuries disrupt communication between the brain and spinal cord, leading to motor function impairment. Acute intermittent hypoxia (AIH), involving brief exposure to low oxygen levels, is a technique to promote neural plasticity. This study examined the impact of AIH on hand strength and upper limb function in individuals with cervical SCI. It also assessed how long these improvements last. The research involved a randomized, placebo-controlled study where participants received either AIH or a sham treatment. Hand strength and function were measured before and after the intervention.

Study Duration

Not specified

Participants

14 individuals with chronic, incomplete cervical SCI

Evidence Level

Level 1: Randomized, blinded, placebo-controlled and cross-over design study

Key Findings

1
A single AIH session improved grip and pinch strength in both hands. The peak effect occurred around 3 hours after the intervention.
2
The increase in strength after AIH was greater compared to the sham treatment.
3
The box and block test (BBT) score was significantly higher on the day following AIH administration.

Research Summary

This study investigated the effects of acute intermittent hypoxia (AIH) on upper extremity function in individuals with cervical spinal cord injury (SCI). The study found that a single AIH session enhanced grip and pinch strength, with peak effects observed around 3 hours post-intervention. The study also revealed that the improvement in strength after AIH was significantly greater than that observed after a sham intervention, highlighting the potential of AIH as a therapeutic approach. Furthermore, participants showed improvements in the Box and Block Test (BBT) score one day after AIH treatment, suggesting potential benefits for hand function and dexterity. These findings support the use of AIH to improve upper limb function in individuals with cervical SCI.

Practical Implications

Rehabilitation strategy

AIH can be integrated into rehabilitation programs to enhance upper limb strength and function in individuals with cervical SCI.

Dosage optimization

Further studies are needed to determine the optimal AIH dosage and timing for sustained improvements in motor function.

Combined therapies

AIH paired with upper limb/hand training is an attractive possibility to improve hand function in people with cervical SCI.

Study Limitations

1
The magnitude of AIH-improved hand strength is lower than observed in lower extremities in previous studies.
2
Unexpected reductions in grip strength in sham experiments, possibly due to fatiguing properties of forearm muscles or disruption of wrist stabilizing forces.
3
The time course of response to successive AIH sequences showed unexpected results.

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