Multi-site Study Explores New Approach to Upper Limb Dysfunction After Spinal Cord Injury

A five-year grant from National Institute on Disability, Independent Living, and Rehabilitation Research funds multi-site study of intermittent hypoxia in spinal cord injury

East Hanover, NJ – Kessler Foundation has been awarded an $857,600 sub-award from the Department of Health and Human Services, Administration for Community Living, National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), to study a promising new intervention for upper limb dysfunction after spinal cord injury (SCI). The study, “A Multi-Center Clinical Trial to Evaluate the Effectiveness of Intermittent Hypoxia Therapy in Individuals with Spinal Cord Injury (SCI),” is being conducted by an experienced team of scientists and clinicians at three leading SCI rehabilitation institutions: Shirley Ryan AbilityLab  (lead investigator, William Zev Rymer, MD, PhD), Kessler Foundation (Gail Forrest, PhD; Steven Kirshblum, MD), and the University of Miami  (Monica A. Perez, PT, PhD). The total awarded for the five-year federal grant is $4.5 million.

Acute intermittent hypoxia is a new strategy that may have the potential to increase neuroplasticity in individuals with injuries of the spinal cord. Scientists plan to test whether repetitive administration of AIH can result in better hand and arm function in individuals with incomplete cervical SCI. “This is an exciting project that may change the way we think about rehabilitation for spinal cord injury,” said Dr. Kirshblum, senior medical officer and chief of SCI Rehabilitation at Kessler Institute for Rehabilitation. “AIH stimulates the synthesis and release of specific spinal proteins that increase neural plasticity and improve muscle contractions. This effect could augment the results we achieve with traditional rehabilitation therapies.”

AIH therapy consists of low-oxygen treatments administered via facemask, according to Dr. Forrest, associate director of Human Performance and Engineering Research at Kessler Foundation. “We will evaluate AIH alone, and in combination with conventional treatments,” explained Dr. Forrest, “including task-specific traditional training, and training with a sensorized robotic device (RAPAEL Smart Glove). We anticipate that combination protocols with AIH will produce better outcomes than conventional therapies alone.”

Improving upper limb function in this population could have broader implications, such as increased participation in work and social and community activities.

Funding: NIDILRR grant award number is 90SIMS0001

About Kessler Foundation:

Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that seeks to improve cognition, mobility, and long-term outcomes—including employment—for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation also leads the nation in funding innovative programs that expand employment opportunities for people with disabilities.

For more information on Kessler Foundation’s research, visit

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