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  4. Effect of acute intermittent hypoxia on motor function in individuals with chronic spinal cord injury following ibuprofen pretreatment: A pilot study

Effect of acute intermittent hypoxia on motor function in individuals with chronic spinal cord injury following ibuprofen pretreatment: A pilot study

The Journal of Spinal Cord Medicine, 2017 · DOI: 10.1080/10790268.2016.1142137 · Published: May 1, 2017

Spinal Cord InjuryNeuroplasticityRehabilitation

Simple Explanation

This study investigates whether ibuprofen, an anti-inflammatory drug, can enhance the effects of acute intermittent hypoxia (AIH) on leg strength in people with chronic spinal cord injury (SCI). AIH involves short periods of low oxygen, which can improve motor function after SCI. Researchers tested if ibuprofen could boost the benefits of AIH because inflammation might hinder the spinal cord's ability to adapt and recover after injury. They compared leg strength improvements after AIH with and without ibuprofen pretreatment. The study found that AIH increased leg strength in individuals with chronic SCI, but ibuprofen did not significantly enhance this effect. This suggests that a single dose of ibuprofen may not be sufficient to augment the benefits of AIH in this population.

Study Duration
Not specified
Participants
9 adults with chronic motor-incomplete SCI
Evidence Level
Level II; Randomized, double-blinded, placebo-controlled crossover study

Key Findings

  • 1
    AIH significantly increased maximal voluntary plantar flexion torque (leg strength) at 30 and 60 minutes post-AIH compared to baseline in individuals with chronic incomplete SCI.
  • 2
    Ibuprofen pretreatment did not significantly augment the effects of AIH on plantar flexion torque. There were no significant differences in torque values between ibuprofen and placebo conditions at any of the time points.
  • 3
    A significant association was found between increases in torque and EMG activity in both gastrocnemius and soleus muscles, suggesting a relationship between muscle activity and strength gains.

Research Summary

This pilot study investigated whether pretreatment with ibuprofen could enhance the effects of acute intermittent hypoxia (AIH) on lower extremity motor function in individuals with chronic incomplete spinal cord injury (SCI). The results showed that AIH increased ankle torque generation in individuals with chronic incomplete SCI, reaffirming its ability to enhance lower extremity strength. However, ibuprofen pretreatment did not significantly augment the effects of AIH. The study suggests that while AIH can improve leg strength in people with chronic SCI, a single dose of ibuprofen may not be effective in further enhancing this effect. Further research is needed to explore the role of anti-inflammatory pretreatment in AIH-induced neuroplasticity.

Practical Implications

Rehabilitation Strategy

AIH can be used as a valuable tool to induce further plasticity in spared neural pathways following incomplete SCI.

Further Research

Future studies should investigate repeated dosing protocols of ibuprofen, alternative NSAIDs, or even corticosteroids to determine the role of inflammation in AIH-induced neuroplasticity.

Personalized Approach

Future studies should identify a population of individuals with SCI who have elevated serum markers of pro-inflammatory cytokines, to investigate this question further.

Study Limitations

  • 1
    The relatively low number of subjects is a limitation.
  • 2
    Blood samples were not obtained, we cannot be certain that systemic inflammation was present in our subjects before the drug administration.
  • 3
    A single dose of ibuprofen (i.e. 800 mg) differential AIH-induced neuro-recovery in ankle plantar flexion strength may have been missed given the limited duration of our experiment.

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