- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03643770
Effect of a Novel Intervention Using Daily Intermittent Hypoxia and High Intensity Training on Upper Limb Function in Individuals With Spinal Cord Injury
Currently, there are a variety of approaches utilized in attempts to improve upper extremity function, including: traditional therapy, neuroprostheses, botulinum toxin injections, or surgical interventions. In addition, regenerative and restorative therapies, such as: epidural stimulation, functional electrical stimulation, and stem cell therapies, show promise in animal models, but are not ready for clinical translation. Subsequently, there is a clear need to develop new strategies that can stimulate spinal plasticity and strengthen existing synaptic connections in order to maximize the benefits of training paradigms.
This study proposes the examine the effects of Acute Intermittent Hypoxia (AIH) in combination with upper extremity training, over the course of a month, to evaluate changes in upper extremity function, dexterity, and ability to complete activities of daily living. The use of acute intermittent hypoxia (AIH) has been demonstrated, through human and animal studies, to be an effective way of increasing spinal motor excitability and strengthening residual synaptic connectivity. AIH utilizes short duration (<2 min) exposures to reduced oxygen levels (~10% inspired oxygen), with alternating exposures to air with normal oxygen levels (~21% inspired oxygen).
Previous publications demonstrate that AIH is a safe and effective intervention to modify motor function in individual with chronic incomplete spinal cord injuries. The use of AIH has been shown to influence the activation in musculature, within 60-120 minutes of administration. In addition, when coupling AIH with overground gait training, an increase in functional endurance, as evaluated through the 6 minute walk test, and gait speed, as evaluated through the 10 meter walk test, were demonstrated. In addition, the use of hypoxic training has been studied in healthy individuals and athletes; however, literature examining the effect of a single bout of AIH on performance is limited.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This study proposes the examine the effects of Acute Intermittent Hypoxia (AIH) in combination with upper extremity training, over the course of a month, to evaluate changes in upper extremity function, dexterity, and ability to complete activities of daily living. The use of acute intermittent hypoxia (AIH) has been demonstrated, through human and animal studies, to be an effective way of increasing spinal motor excitability and strengthening residual synaptic connectivity. AIH utilizes short duration (<2 min) exposures to reduced oxygen levels (~10% inspired oxygen), with alternating exposures to air with normal oxygen levels (~21% inspired oxygen).
Previous publications demonstrate that AIH is a safe and effective intervention to modify motor function in individual with chronic incomplete spinal cord injuries. The use of AIH has been shown to influence the activation in musculature, within 60-120 minutes of administration. In addition, when coupling AIH with overground gait training, an increase in functional endurance, as evaluated through the 6 minute walk test, and gait speed, as evaluated through the 10 meter walk test, were demonstrated. In addition, the use of hypoxic training has been studied in healthy individuals and athletes; however, literature examining the effect of a single bout of AIH on performance is limited.
Study Type
Enrollment (Anticipated)
Phase
- Early Phase 1
Contacts and Locations
Study Contact
- Name: Alexander Barrry
- Phone Number: 312-238-1435
- Email: abarry@sralab.org
Study Contact Backup
- Name: Zev Rymer, MD
- Email: zrymer@sralab.org
Study Locations
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Illinois
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Chicago, Illinois, United States, 60611
- Recruiting
- Shirley Ryan AbilityLab
-
Contact:
- Alexander Barry, MS, CCRC
- Phone Number: 312-238-1435
- Email: abarry@sralab.org
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Principal Investigator:
- William Z Rymer, MD/PhD
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- History of a non-progressive spinal cord injury, inclusive of levels of C1-T1.
- Etiology of spinal cord injury is non-progressive in nature
- Be able to demonstrate some hand muscle activation, or use of a tenodesis grasp (wrist extension)
- At least 6 months post injury
- Participants do NOT have to stop taking antispasticity medications to participate in the study.
- Must be tested for anemia with a value of at least 10g/dl (for both men and women).
- Patients will be recommended to their primary care physician to correct anemia if low levels are detected
- Blood pressure must fall within this range- high: 160/110mmHg low: 85/55 mmHg
- Must be asymptomatic (no dizziness, lightheadedness, etc)
Exclusion Criteria:
- Medical conditions, including: congestive heart failure, cardiac arrhythmias, uncontrolled hypertension, uncontrolled diabetes mellitus, chronic obstructive pulmonary disease, emphysema, severe asthma, previous myocardial infraction, or known carotid/intracerebral artery stenosis.
- Women who are currently pregnant or planning on becoming pregnant
- Current tracheostomy placement
- Utilization of mechanical ventilator for breathing
- Current diagnosis of obstructive sleep apnea
- Orthopedic injuries or surgeries that would limit participation
- Concurrent participation in another research study or therapy services
- Comorbid traumatic brain injury or other neurologic injuries that would impact cognition
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Randomized
- Interventional Model: Single Group Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
No Intervention: Acute Intermittent Hypoxia (AIH) treatment
The mask will first provide a normoxic air (room air) mixture (FiO2 = 0.21) via the mask.
The mask is designed to couple with a universal mask circuit connecting to the air mixture system.
The purpose of the mask will be to minimize room air entrainment.
|
|
Active Comparator: AIH in combination with upper extremity training
The mask will first provide a normoxic air (room air) mixture (FiO2 = 0.21) via the mask.
The mask is designed to couple with a universal mask circuit connecting to the air mixture system.
The purpose of the mask will be to minimize room air entrainment.
In addition to this upper extremity training will be given using an upper-limb robotic rehabilitation device.
|
Armeo Spring is a gravity support system based on an ergonomic arm exoskeleton with integrated springs.
|
Active Comparator: Sham AIH therapy in combination with upper extremity training
Sham hypoxia followed by upper extremity training will be given using an upper-limb robotic rehabilitation device (Armeo Spring®, Hocoma AG, Switzerland).
Armeo Spring is a gravity support system based on an ergonomic arm exoskeleton with integrated springs.
|
Armeo Spring is a gravity support system based on an ergonomic arm exoskeleton with integrated springs.
|
No Intervention: Sham AIH therapy
Sham hypoxia
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
GRASSP
Time Frame: 4 weeks
|
Graded Redefined Assessment of Strength, Sensation and Prehension
|
4 weeks
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
9-hole peg test
Time Frame: 4 weeks
|
coordination
|
4 weeks
|
grip strength
Time Frame: 4 weeks
|
hand strength
|
4 weeks
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- STU 00206035
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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