Transcutaneous Carbon Dioxide Improves Contractures After Spinal Cord Injury in Rats

Clin Orthop Relat Res, 2019 · DOI: 10.1097/CORR.0000000000000808 · Published: May 16, 2019

Spinal Cord Injury Orthopedics Rehabilitation

Simple Explanation

Joint contractures are a common issue for individuals with spinal cord injuries, limiting their range of motion and quality of life. Current treatments like stretching and physical therapy don't always prevent or fully resolve these contractures. This study explores a new approach: transcutaneous carbon dioxide (CO2) therapy. The idea is that CO2 therapy mimics some of the beneficial effects of exercise, potentially improving muscle and joint function. Researchers used a rat model of spinal cord injury to see if CO2 therapy could reduce contractures, improve muscle and joint health, and decrease fibrosis (scarring) in the affected tissues.

Study Duration

2 or 4 weeks

Participants

36 Wistar rats

Evidence Level

Level III, Basic Research

Key Findings

1
CO2 therapy improved knee extension range of motion (ROM) in rats with spinal cord injuries, both when used as a preventative measure and as a treatment.
2
The therapy reduced muscular factors (limitations in tendons and fascia) contributing to contractures in treated rats compared to untreated rats.
3
CO2 therapy also improved articular factors (limitations in joint components) contributing to contractures, and decreased muscle fibrosis.

Research Summary

This study investigated the potential of transcutaneous CO2 therapy to prevent and treat joint contractures in a rat model of spinal cord injury. The researchers assessed the impact of CO2 therapy on range of motion, muscular and articular factors, and tissue fibrosis. The results showed that CO2 therapy improved knee extension ROM and reduced both muscular and articular factors contributing to contractures. CO2 therapy also decreased muscle fibrosis and fibrosis-related gene expression. The study suggests that CO2 therapy may be a useful strategy for preventing and treating contractures after spinal cord injuries, particularly in the early stages of contracture development. However, the therapy didn't fully restore ROM to the levels seen in control rats.

Practical Implications

Potential Therapeutic Strategy

Transcutaneous CO2 therapy may offer a novel approach to preventing and treating joint contractures in patients with spinal cord injuries, potentially improving their range of motion and quality of life.

Early Intervention

The study suggests that CO2 therapy may be most effective when implemented early in the course of contracture development, before irreversible tissue degeneration occurs.

Combined Therapy

CO2 therapy could be combined with conventional treatments like positioning, stretching, and physical therapy to achieve better outcomes in patients with spinal cord injuries.

Study Limitations

1
The study used a small animal model (rats), which may not fully reflect the variability found in humans; therefore, results may not be directly translatable to human patients.
2
The mechanisms by which CO2 therapy improves muscular and articular factors responsible for contractures are not fully understood and require further investigation.
3
The study used the right and left knees as different samples, which has the advantages of minimizing the number of experimental animals needed. However, its use cannot preclude chance ﬁndings attributable to intra- animal and inter-animal variation.

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