Intermittent Hypoxia and Upper Extremity EMG Recordings in Individuals With Spinal Cord Injury

Study Overview
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Brief Summary
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In this current study, the examiners examine some of the mechanisms of how Acute Intermittent Hypoxia (AIH) effects the upper extremity of survivors of spinal cord injury. This is accomplished both with the use of a load cell to determine elbow strength changes and high density grid electromyography (EMG) to record bicep muscle activations before and after bouts of AIH

Detailed Description
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It has been shown previously that there is an increase in strength in survivors of spinal cord injury after brief bouts of Acute Intermittent Hypoxia. In this study, participants are fitted with a high density EMG electrode on the biceps brachii, and attached to a load cell at the wrist, they are asked to flex and extend their elbow at various levels of intensity. This is performed before and after the 30 minute session of AIH. The investigators hope to identify specific types of motor units of the upper extremity of survivors of spinal cord injury after AIH to help further our understanding of what mechanisms may be causing the known increase in muscle strength post AIH

Official Title
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Intermittent Hypoxia and Upper Limb Training in Individuals With Spinal Cord Injury

Conditions
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Spinal Cord Injuries

Intervention / Treatment
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* Other: Acute Intermittent Hypoxia


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: History of Spinal Cord Injury from C3-T4 Non-progressive spinal cord injury More than 6 months since initial Spinal Cord injury Ability to understand and willingness to sign written informed consent Exclusion Criteria: Presence of any of the following medical conditions: Congestive heart failure, arrhythmia, uncontrolled high blood pressure, uncontrolled diabetes mellitus, COPD/emphysema and severe asthma Persons with known coronary artery disease, a history of myocardial infarction, or known carotid or intracerebral artery stenosis Medical clearance will be required if participant is taking any other investigational agents Women who are pregnant or nursing Individuals with tracheostomy Cannot pursue other research studies which may interfere Unable to consent Individuals who are not yet adults (infants, children, teenagers) Prisoners

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Interventional Model Description: Every participant in this study will receive the intervention
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Acute intermittent Hypoxia Therapy<br>This group will receive the acute intermittent hypoxia therapy (9% O2) for 30 minutes. Before and after the intervention the participant will perform flexion of the elbow at various levels of intensity | Other: Acute Intermittent Hypoxia<br>* Acute Intermittent Hypoxia is administered in 30-60 second bouts of 9% O2 concentration, followed by 60-90 seconds of normoxic air concentrations (21% O2, room air). This procedure is repeated 15 times for a 30 minute session<br>* Other names: AIH;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Maximal Elbow Strength [Newtons] | Recordings of the elbow joint torque are taken while the participant is asked to flex and extend the elbow voluntarily at a maximum level of intensity | 30 minutes Post intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Biceps Brachii Muscle activation [μv] | Peak electromyographic activation of the biceps brachii muscle during maximum voluntary flexion and extension tasks | 30 minutes post intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Acute Intermittent Hypoxia, Motor Unit, Upper Extremity