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  4. Effect of acute intermittent hypoxia treatment on ventilatory load compensation and magnitude estimation of inspiratory resistive loads in an individual with chronic incomplete cervical spinal cord injury

Effect of acute intermittent hypoxia treatment on ventilatory load compensation and magnitude estimation of inspiratory resistive loads in an individual with chronic incomplete cervical spinal cord injury

The Journal of Spinal Cord Medicine, 2016 · DOI: 10.1179/2045772314Y.0000000277 · Published: January 1, 2016

Spinal Cord InjuryPulmonologyPhysiology

Simple Explanation

Spinal cord injuries can disrupt the signals between the brain and respiratory muscles, affecting breathing and the ability to respond to breathing challenges. This study explores if a treatment called acute intermittent hypoxia (AIH) can help improve breathing in someone with a spinal cord injury. AIH treatment involves repeated exposure to low oxygen levels with elevated carbon dioxide. The researchers wanted to see if AIH could improve how well the participant could handle increased breathing resistance and how sensitive they were to these changes. The study found that AIH treatment improved the participant's ability to compensate for increased breathing resistance. However, it didn't significantly change how sensitive they were to the feeling of increased resistance.

Study Duration
Not specified
Participants
One 55-year-old female with a C4 chronic, incomplete SCI
Evidence Level
Level 4; Case Report and Literature Review

Key Findings

  • 1
    Significant improvements in airflow generated in response to applied inspiratory resistive loads were found after AIH treatment compared to Baseline.
  • 2
    There were no significant changes in the respiratory perceptual sensitivity to applied inspiratory resistive loads after AIH treatment.
  • 3
    Values for percent-predicted forced vital capacity (FVC) increased significantly on Post Sham, and AIH Days 1 and 10 compared to Baseline.

Research Summary

This case report investigated the effect of acute intermittent hypoxia (AIH) treatment on ventilatory load compensation and respiratory perceptual sensitivity to inspiratory resistive loads (IRL) in an individual with chronic, incomplete cervical SCI. The key finding was an improvement in ventilatory load compensation and pulmonary function after ten days of exposure to AIH treatment. The ventilatory load compensation response to added IRL increased, but the perceptual sensitivity to IRL was not affected after AIH treatment.

Practical Implications

Rehabilitation Strategy

AIH treatment may be a beneficial rehabilitation intervention for individuals with chronic incomplete c-SCI to improve pulmonary function and ventilatory load compensation.

Discriminative vs. Affective Processing

The study paradigm might affect the discriminative but not affective processing of IRL, suggesting that individuals can learn to differentiate between loads without changing their affective response to each load.

Future Research

Further studies are required to determine the applicability of AIH treatment as a rehabilitative intervention for SCI individuals, including varied AIH protocols and larger sample sizes.

Study Limitations

  • 1
    The possibility that the reported improvements in P and AF may be due to the combined influence of AIH treatment and a learning effect of repeated exposure to the IRL protocol cannot be ruled out.
  • 2
    Ventilatory deficits in individuals with SCI vary dependingon leveland severityofinjury,time after injuryaswell as age and gender of individual.
  • 3
    It is unclear whether altered AIH protocols (e.g. protocols with different levels of hypoxia or days of exposure) may influence outcomes.

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