Combining Low Oxygen Therapy and an Adenosine A2a Receptor Antagonist to Improve Functional Mobility After Spinal Cord Injury

Trial statusNot yet recruiting
Trial phasePhase 1, Phase 2
Trial typeInterventional
Biological sexAll
Age18-75
SponsorRandy Trumbower, PT, PhD

About this trial

Breathing brief, moderate bouts of low oxygen trigger (low oxygen therapy, LOT) spinal plasticity (the ability of the nervous system to strengthen neural pathways based on new experiences), and improve walking after spinal cord injury (SCI). The greatest improvements in walking ability occur when LOT is administered prior to skill-based walking practice (WALK). However, the enduring benefits of LOT on walking recovery may be undermined by the accumulation of LOT-induced increase in extracellular adenosine. The goal of the study is to understand the extent to which istradefylline (adenosine 2a receptor antagonist) may limit the competing mechanisms of adenosine on LOT-induced walking recovery following SCI.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

age 18 and 75 years (the latter to reduce the likelihood of heart disease) medical clearance to participate

lesion at or below C2 and above T12 with non-progressive etiology

classified as motor-incomplete with visible volitional leg movement

injury greater than 12 months

Disqualifiers

Concurrent severe medical illness (i.e., infection, cardiovascular disease, ossification, recurrent autonomic dysreflexia, unhealed decubiti, and history of pulmonary complications)

Pregnant women because of the unknown effects of AIH on pregnant women and fetus

History of seizures, brain injury, and/or epilepsy

Undergoing concurrent physical therapy

Trial design

Design model

Crossover

Treatments tested in this trial

  • Istradefylline

    Drug

    Consume 20mg tablet of istradefylline for 28 consecutive days.

  • low oxygen therapy

    Device

    Breath intermittent low oxygen 4 days/week over 2 consecutive weeks. Intermittent low oxygen consists of 15, 90-second episodes of breathing low oxygen at 10% oxygen with 60-second intervals at 21% oxygen.

Treatment groups

40 Participants
are divided into 3 treatment groups
Group A: Istradefylline+low oxygen trainingExperimental treatment 2 interventions
Group B: Placebo+low oxygen trainingActive comparator 1 intervention
Group C: Istradefylline+SHAMActive comparator 1 intervention

Trial outcomes

Primary outcomes

1

Pre-Treatment Walking Speed

Pre-Treatment Walking Speed; 10MWT (time, seconds)

Time frame
within 5 days of first treatment
2

Walking Speed Post-Treatment 1

Post-Treatment Walking Speed; 10MWT (time, seconds)

Time frame
within 1 day after last treatment
3

Walking Speed Post-Treatment 2

Post-Treatment Walking Speed; 10MWT (time, seconds)

Time frame
between 7-10 days after Post-Treatment 1
4

Walking Speed Post-Treatment 3

Post-Treatment 10MWT (time, seconds)

Time frame
between 17-20 days after Post-Treatment 1

Secondary outcomes

1

Pre-Treatment Walking Distance

Pre-Treatment 6MWT (distance, meters)

Time frame
within 5 days of first treatment
2

Walking Distance Post-Treatment 1

Post-Treatment 6MWT (distance, meters)

Time frame
within 1 day after last treatment
3

Walking Distance Post-Treatment 2

Post-Treatment 6MWT (distance, meters)

Time frame
between 7-10 days after Post-Treatment 1
4

Walking Distance Post-Treatment 3

Post-Treatment 6MWT (distance, meters)

Time frame
between 17-20 days after Post-Treatment 1

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

Randy Trumbower, PT, PhD

Lead sponsor

Spaulding Rehabilitation Hospital

Sponsor institution

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