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急性间歇性低氧作为改善脊髓损伤后步行功能的潜在辅助手段:证据、挑战及未来方向

Acute intermittent hypoxia as a potential adjuvant to improve walking following spinal cord injury: evidence, challenges, and future directions.

作者信息

Tan Andrew Quesada, Barth Stella, Trumbower Randy D

机构信息

Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA. USA.

Spaulding Rehabilitation Hospital, Boston MA.

出版信息

Curr Phys Med Rehabil Rep. 2020 Sep;8(3):188-198. doi: 10.1007/s40141-020-00270-8. Epub 2020 Jun 24.

DOI:10.1007/s40141-020-00270-8
PMID:33738145
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7963002/
Abstract

PURPOSE OF REVIEW

The reacquisition and preservation of walking ability are highly valued goals in spinal cord injury (SCI) rehabilitation. Recurrent episodes of breathing low oxygen (i.e., acute intermittent hypoxia, AIH) is a potential therapy to promote walking recovery after incomplete SCI via endogenous mechanisms of neuroplasticity. Here, we report on the progress of AIH, alone or paired with other treatments, on walking recovery in persons with incomplete SCI. We evaluate the evidence of AIH as a therapy ready for clinical and home use and the real and perceived challenges that may interfere with this possibility.

RECENT FINDINGS

Repetitive AIH is a safe and an efficacious treatment to enhance strength, walking speed and endurance, as well as, dynamic balance in persons with chronic, incomplete SCI.

SUMMARY

The potential for AIH as a treatment for SCI remains high, but further research is necessary to understand treatment targets and effectiveness in a large cohort of persons with SCI.

摘要

综述目的

重新获得并保持行走能力是脊髓损伤(SCI)康复中备受重视的目标。反复经历低氧呼吸(即急性间歇性缺氧,AIH)是一种通过神经可塑性内源性机制促进不完全性SCI后行走恢复的潜在疗法。在此,我们报告AIH单独或与其他治疗方法联合应用于不完全性SCI患者行走恢复方面的进展。我们评估AIH作为一种可用于临床和家庭治疗的疗法的证据,以及可能干扰这一可能性的实际和感知到的挑战。

最新发现

重复性AIH是一种安全有效的治疗方法,可增强慢性不完全性SCI患者的力量、行走速度和耐力,以及动态平衡能力。

总结

AIH作为SCI治疗方法的潜力仍然很大,但需要进一步研究以了解其在大量SCI患者中的治疗靶点和有效性。

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Am J Respir Crit Care Med. 2020 Sep 15;202(6):887-890. doi: 10.1164/rccm.202002-0245LE.
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Differential deficits in spatial and temporal interlimb coordination during walking in persons with incomplete spinal cord injury.不完全性脊髓损伤患者行走时空间和时间肢体间协调性的差异缺陷。
Gait Posture. 2020 Jan;75:121-128. doi: 10.1016/j.gaitpost.2019.10.023. Epub 2019 Oct 17.
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Prednisolone Pretreatment Enhances Intermittent Hypoxia-Induced Plasticity in Persons With Chronic Incomplete Spinal Cord Injury.泼尼松龙预处理增强慢性不完全性脊髓损伤患者间歇性低氧诱导的可塑性。
Neurorehabil Neural Repair. 2019 Nov;33(11):911-921. doi: 10.1177/1545968319872992. Epub 2019 Sep 15.
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Kinematic and Neuromuscular Adaptations in Incomplete Spinal Cord Injury after High- versus Low-Intensity Locomotor Training.高强度与低强度运动训练对不完全性脊髓损伤后运动学和神经肌肉适应性的影响。
J Neurotrauma. 2019 Jun 15;36(12):2036-2044. doi: 10.1089/neu.2018.5900. Epub 2019 Feb 1.
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Acute intermittent hypoxia and rehabilitative training following cervical spinal injury alters neuronal hypoxia- and plasticity-associated protein expression.急性间歇性低氧及颈髓损伤后康复训练改变神经元低氧和可塑性相关蛋白的表达。
PLoS One. 2018 May 18;13(5):e0197486. doi: 10.1371/journal.pone.0197486. eCollection 2018.
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Acute intermittent hypoxia enhances corticospinal synaptic plasticity in humans.急性间歇性低氧增强人类皮质脊髓突触可塑性。
Elife. 2018 Apr 24;7:e34304. doi: 10.7554/eLife.34304.
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Variability of Leg Kinematics during Overground Walking in Persons with Chronic Incomplete Spinal Cord Injury.慢性不完全性脊髓损伤患者在地面行走时下肢运动学的变异性。
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