A new treatment requiring spinal cord injury (SCI) patients to engage in hypoxia may hold promise in improving their ability to walk, according to a study. The study, which appears in the online issue of Neurology, reportedly encompassed 19 patients with spine injuries between levels C2 and T2, no joint shortening, some controlled ankle, knee, and hip movements, and the ability to walk at least one step without human assistance.
A news release from the American Academy of Neurology (AAN) states that participants breathed through a mask for about 40 minutes daily for 5 days, receiving 90-second periods of low oxygen levels followed by 60 seconds of normal oxygen levels. Researchers note that they tested participants’ walking speed and endurance prior to the study during the first and fifth days of treatment, and again one and 2 weeks post-treatment completion. In one group of patients, nine received either the treatment or sham treatment in which they received only normal oxygen levels. Two weeks later, the patients received the other treatment. In a second group, participants received the treatment or sham treatment and were asked to walk as fast as they could for 30 minutes within one hour of the treatment. They then received the other treatment two weeks later.
The results indicate that those who received the hypoxia treatment exhibited an increase in their walking speed in a test of walking 10 meters, walking an average of 3.8 seconds faster than when they did not receive the treatment. AAN notes that patients who had the treatment in addition to walking increased their endurance on a test of how far they could walk in 6 minutes by an average of 100 meters, a more than 250% increase compared to patients who had the sham treatment in addition to walking. The study reports that all participants improved their ability to walk and more than 30% of all participants increased their walking speed by at least tenth of a meter per second and more than 70% increased their endurance by at least 50 meters.
Randy D. Trumbower, PT, PhD, study author, Emory University, Atlanta, comments on the results, noting that 59% of all spinal injuries are incomplete and leave pathways that could potentially allow the spinal cord to change in a way that may allow patients to walk again. “Our research proposes a promising new way for the spinal cord to make the connections to walk better,” Trumbower adds.
Additional members of the research team, AAN says, were based at Georgia Institute of Technology, Shepherd Center in Atlanta, the Rehabilitation Institute of Chicago, and the University of Wisconsin, Madison.
AAN also notes that Michael G. Fehlings, MD, PhD, University of Toronto, wrote a corresponding editorial about the study which poses the question of how a treatment that requires patients to take in low levels of oxygen may help movement, “A possible answer is that the spinal serotonin, a neurotransmitter, sets off a cascade of changes in proteins that help restore connections in the spine,” Fehlings says.
In the release, Trumbower goes on to emphasize that use of chronic or sustained hypoxia by untrained individuals may cause serious injury and should not be attempted outside the scope of supervised medical treatment.