Intermittent hypoxia improves hand use


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The severity of a spinal cord injury depends on its height and severity. Higher cervical injuries significantly diminish hand function, negatively impacting on the quality of life. Restoring hand function, even if partially, is therefore of critical importance. Dr. Randy Trumbower, US, enrolled six patients with chronic injuries and completed a study to determine the effect of daily acute intermittent hypoxia combined with hand opening practice.

What is hypoxia?
Hypoxia is quite simply the fact of breathing air that has a lower concentration of oxygen. While severe hypoxia can be life threatening, lower levels of hypoxia seem to trigger some positive effects. The mechanisms are not finally known, but scientists believe that acute hypoxia triggers the release of brain-derived neurotrophic factor (BDNF) that induces some functional recovery.

In this particular study hypoxia is achieved by breathing into a special apparatus that delivers mild bouts of low oxygen. The six participants that joined this small study all had a cervical C5 injury and were at a chronic stage, ranging from 3 to 40 years after the injury. All participants received 15 short episodes of mild hypoxia per day followed by 20 repetitions of hand opening practice. This protocol was repeated for five days and all subjects were subsequently assessed. Special detectors were used to measure hand function and results are quite encouraging as the team could see that acute hypoxia could increase hand dexterity and muscle coordination.

Future steps
This study was done on a small number of patients so it is difficult to really understand to which extend acute intermittent hypoxia will benefit the recovery of hand function. But these preliminary results are exciting and should be followed by a larger clinical study. Such study should also measure if the functional recovery is permanent or limited to a certain amount of time.

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Source: “Effects of acute intermittent hypoxia on hand use after spinal cord trauma: A preliminary study”. Trumbower RD, Hayes HB, Mitchell GS, Wolf SL, Stahl VA. Neurology, September, 2017.