Stopped: The study evolved into a multi day clinical trial and was recently awarded an extramural funding. The new study will begin enrollment in late August 2025
The goal of this clinical trial is to determine whether people with paralysis due to a spinal cord injury can benefit from breathing short intermittent bouts of air with low oxygen (O2) combined with slightly higher levels of carbon dioxide (CO2), interspaced by breathing room air. The technical name for this therapeutic air mixture is 'acute intermittent hypercapnic-hypoxia,' abbreviated as AIHH. Following exposure to the gas mixture, participants will receive non-invasive electrical stimulation to the spinal cord paired with specific and targeted exercise training. The main question this trial aims to answer is: Can the therapeutic application of AIHH, combined with non-invasive electrical stimulation to the spinal cord plus exercise training, increase the strength of muscles involved in breathing and hand function in people with paralysis due to a spinal cord injury? Participants will be asked to attend a minimum of five study visits, each separated by at least a week. During these visits, participants will be required to: * Answer basic questions about their health * Receive exposure to the therapeutic air mixture (AIHH) * Undergo non-invasive spinal electrical stimulation * Complete functional breathing and arm strength testing * Undergo a single blood draw * Provide a saliva sample Researchers will compare the results of individuals without a spinal cord injury to those of individuals with a spinal cord injury to determine if the effects are similar.
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Change in Respiratory cortical and spinal drive in minutes of intervention
Timeframe: Baseline
Change in Upper extremity cortical and spinal drive in minutes of intervention
Timeframe: Baseline
Change in Maximum respiratory voluntary force production in minutes of intervention
Timeframe: Baseline
Change in Airway occlusion pressure (P0.1) in minutes of intervention
Timeframe: Baseline
Change in Forced vital capacity in minutes of intervention
Timeframe: Baseline
Change in Upper extremity functional assessment in minutes of intervention
Timeframe: Baseline