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  4. Effects of dose de-escalation following testosterone treatment and evoked resistance exercise on body composition, metabolic profile, and neuromuscular parameters in persons with spinal cord injury

Effects of dose de-escalation following testosterone treatment and evoked resistance exercise on body composition, metabolic profile, and neuromuscular parameters in persons with spinal cord injury

Physiological Reports, 2021 · DOI: 10.14814/phy2.15089 · Published: October 6, 2021

Spinal Cord InjuryEndocrinologyRehabilitation

Simple Explanation

This study looked at how reducing the dose of testosterone, combined with electrical stimulation and resistance training, affected body composition, metabolism, and muscle function in men with spinal cord injuries. Thirteen men with spinal cord injuries were monitored for 16 weeks after they had either testosterone treatment alone or testosterone treatment with resistance training. The group that received both testosterone and resistance training underwent a program with gradually decreasing ankle weights and a low dose of testosterone.

Study Duration
16 weeks
Participants
13 men with chronic complete spinal cord injury
Evidence Level
Not specified

Key Findings

  • 1
    Absolute thigh muscle cross-sectional areas decreased in the group that underwent testosterone treatment and resistance training, while it increased in the group that received no treatment.
  • 2
    There was a trend of increasing visceral adipose tissue (VAT) in both groups.
  • 3
    Basal metabolic rate decreased in the testosterone treatment and resistance training group but increased in the group that received no treatment.

Research Summary

The study investigated the effects of dose de-escalation (DD) of testosterone and evoked resistance training (RT) on body composition, cardiometabolic, and neuromuscular variables in men with spinal cord injury (SCI). The results indicated that the dose de-escalation program with low-dose testosterone and NMES-RT was minimally effective in maintaining muscle size and basal metabolic rate compared to the group without testosterone treatment. The study also found that neuromuscular adaptations were retained in men with SCI, suggesting a possible disconnect between spinal cord circuitry and muscle adaptations following detraining.

Practical Implications

Rehabilitation strategies

Highlighting the need to develop rehabilitation or pharmaceutical approaches to attenuate the loss in lean mass during a detraining program.

Longitudinal Trials

Findings are helpful for designing future studies to explore the effects of longitudinal trials via applications of telehealth technology to ensure adherence and long-term compliance.

Clinical Practice

The research suggests that reducing testosterone and NMES-RT doses may lead to loss of muscle size and decreased BMR and increase VAT in SCI patients, and interventions are necessary to retain gains.

Study Limitations

  • 1
    Small sample size
  • 2
    Failure to account for dietary habits during the training period
  • 3
    Inability to measure neural adaptations in the no-TT group

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