A Research Protocol to Study the Priming Effects of Breathing Low Oxygen on Enhancing Training-Related Gains in Walking Function for Persons With Spinal Cord Injury: The BO2ST Trial
Therapeutic acute intermittent hypoxia (tAIH), or brief low-oxygen breathing, may enhance transcutaneous spinal stimulation-enhanced walking therapy (WALKtSTIM), a treatment designed to improve walking in people with chronic (>1 year) spinal cord injuries (SCI). Pre-clinical studies in rodents show that combining tAIH with WALKtSTIM boosts neural plasticity, leading to better recovery.
We are conducting a multi-site clinical trial to test whether combining these therapies leads to faster and longer-lasting walking improvements compared to using them separately. Sixty participants with chronic SCI are randomly assigned to one of three groups: tAIH + WALKtSTIM, Placebo + WALKtSTIM, or tAIH + WALKtSHAM. Participants receive either real or placebo tAIH followed by 45 minutes of WALKtSTIM or a sham version. The study tracks walking speed, endurance, and balance, while also monitoring pain, spasticity, sleep, cognition, and risks like hypertension. Assessments occur before, during, and after the sessions, and at 1, 4, and 8 weeks post-treatment.
This research aims to determine if tAIH enhances the effects of spinal stimulation, offering a potential solution for restoring walking ability in people with SCI for a longer period of time. Since no single treatment currently resolves all walking deficits, combining therapies could be key to better recovery. For more information, refer to ClinicalTrials.gov, NCT05563103.
Neurotrauma Rep. 2023 Nov 6;4(1):736-750. doi: 10.1089/neur.2023.0036. eCollection 2023. PMID:38028272 | PMC:PMC10659019 | DOI:10.1089/neur.2023.0036
