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  4. Effects of Remote Ischemic Conditioning on Hand Engagement in individuals with Spinal cord Injury (RICHES): protocol for a pilot crossover study

Effects of Remote Ischemic Conditioning on Hand Engagement in individuals with Spinal cord Injury (RICHES): protocol for a pilot crossover study

F1000Research, 2022 · DOI: https://doi.org/10.12688/f1000research.52670.2 · Published: March 7, 2022

Spinal Cord InjuryNeuroplasticityRehabilitation

Simple Explanation

This study explores a new rehabilitation approach for individuals with spinal cord injuries (SCI) that uses remote ischemic conditioning (RIC) to improve hand function. RIC involves briefly restricting blood flow to an arm to potentially enhance neuroplasticity, the brain's ability to reorganize itself. The study will measure changes in corticospinal excitability, pinch force, and inflammatory biomarkers to understand how RIC affects hand function.

Study Duration
24 Months
Participants
16 participants: 8 able-bodied, 8 with chronic cervical SCI
Evidence Level
Not specified

Key Findings

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    The primary outcome is the change in corticospinal excitability, measured by the motor evoked potential of the abductor pollicis brevis muscle.
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    Secondary outcomes include maximal volitional pinch force and inflammatory biomarkers.
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    The study will also monitor tolerability and hemodynamic responses during RIC to ensure safety.

Research Summary

This study protocol outlines a prospective randomized-order crossover trial to investigate the effects of remote ischemic conditioning (RIC) on hand engagement in individuals with spinal cord injury (SCI). The trial will involve eight able-bodied participants and eight participants with chronic cervical SCI, with serial evaluations conducted at baseline, after RIC, immediately after pinch exercise, and 15-minutes later. The primary outcome is the change in corticospinal excitability, with secondary outcomes including maximal volitional pinch force and inflammatory biomarkers.

Practical Implications

Potential for Improved Hand Function

If RIC demonstrates a beneficial effect on neuroplasticity, it could be easily coupled with rehabilitation training in clinical or home settings to improve hand function in individuals with cervical SCI.

Understanding Mechanisms of Neuroplasticity

The study will provide preliminary information regarding the mechanism by which RIC promotes neuroplasticity and improves functional training effects through analysis of neurophysiology and inflammatory mediators.

Future Research Directions

The findings will inform future studies testing RIC coupled with various other rehabilitation interventions to enhance long-term functional movements in people with cervical spinal cord injury.

Study Limitations

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