Resistance Training and Testosterone After Spinal Cord Injury

Summary

The goal of this proposal is to investigate the efficacy of a complimentary approach of evoked resistance training and testosterone replacement therapy on the changes in body composition and metabolic profile after SCI. The proposed method could become a recommended and simple intervention especially for individuals with limited access and poor tolerance to exercise. The rationale is based on the evidence that individuals with SCI experience decline in anabolic hormones which may be responsible for the deterioration in body composition and metabolic profiles and leads to increase obesity, type 2 diabetes mellitus, dyslipidemia and subsequently cardiovascular disease. The designed study will provide explanation to the adaptations in the energy source of the muscle cells in response to training.

Timeline

Start

2012-07-02

Primary completion

2017-12-30

Completion

2017-12-30

Publications

• Background Gorgey AS, Khalil RE, Gill R, O'Brien LC, Lavis T, Castillo T, Cifu DX, Savas J, Khan R, Cardozo C, Lesnefsky EJ, Gater DR, Adler RA. Effects of Testosterone and Evoked Resistance Exercise after Spinal Cord Injury (TEREX-SCI): study protocol for a randomised controlled trial. BMJ Open. 2017 Apr 4;7(4):e014125. doi: 10.1136/bmjopen-2016-014125.
• Background Gorgey AS, Moore PD, Wade RC, Gill RS, Lavis T, Adler RA. Disruption in bone marrow fat may attenuate testosterone action on muscle size after spinal cord injury: a case report. Eur J Phys Rehabil Med. 2017 Aug;53(4):625-629. doi: 10.23736/S1973-9087.17.04452-5. Epub 2017 Mar 13.
• Background Wade RC, Gorgey AS. Anthropometric prediction of skeletal muscle cross-sectional area in persons with spinal cord injury. J Appl Physiol (1985). 2017 May 1;122(5):1255-1261. doi: 10.1152/japplphysiol.01042.2016. Epub 2017 Mar 2.
• Background O'Brien LC, Wade RC, Segal L, Chen Q, Savas J, Lesnefsky EJ, Gorgey AS. Mitochondrial mass and activity as a function of body composition in individuals with spinal cord injury. Physiol Rep. 2017 Feb;5(3):e13080. doi: 10.14814/phy2.13080.
• Background Moore PD, Gorgey AS, Wade RC, Khalil RE, Lavis TD, Khan R, Adler RA. Neuromuscular electrical stimulation and testosterone did not influence heterotopic ossification size after spinal cord injury: A case series. World J Clin Cases. 2016 Jul 16;4(7):172-6. doi: 10.12998/wjcc.v4.i7.172.
• Background Gorgey AS, Caudill C, Khalil RE. Effects of once weekly NMES training on knee extensors fatigue and body composition in a person with spinal cord injury. J Spinal Cord Med. 2016;39(1):99-102. doi: 10.1179/2045772314Y.0000000293. Epub 2015 Jan 23.
• Background Gorgey AS, Mather KJ, Cupp HR, Gater DR. Effects of resistance training on adiposity and metabolism after spinal cord injury. Med Sci Sports Exerc. 2012 Jan;44(1):165-74. doi: 10.1249/MSS.0b013e31822672aa.
• Background Gorgey AS, Shepherd C. Skeletal muscle hypertrophy and decreased intramuscular fat after unilateral resistance training in spinal cord injury: case report. J Spinal Cord Med. 2010;33(1):90-5. doi: 10.1080/10790268.2010.11689681.
• Background Khalil RE, Gorgey AS, Janisko M, Dolbow DR, Moore JR, Gater DR. The role of nutrition in health status after spinal cord injury. Aging Dis. 2013 Feb;4(1):14-22. Epub 2012 Nov 30.
• Background Gorgey AS, Dolbow DR, Cifu DX, Gater DR. Neuromuscular electrical stimulation attenuates thigh skeletal muscles atrophy but not trunk muscles after spinal cord injury. J Electromyogr Kinesiol. 2013 Aug;23(4):977-84. doi: 10.1016/j.jelekin.2013.04.007. Epub 2013 May 15.
• Background Nightingale TE, Moore P, Harman J, Khalil R, Gill RS, Castillo T, Adler RA, Gorgey AS. Body composition changes with testosterone replacement therapy following spinal cord injury and aging: A mini review. J Spinal Cord Med. 2018 Nov;41(6):624-636. doi: 10.1080/10790268.2017.1357917. Epub 2017 Aug 3.
• Background Gorgey AS, Lester RM, Wade RC, Khalil RE, Khan RK, Anderson ML, Castillo T. A feasibility pilot using telehealth videoconference monitoring of home-based NMES resistance training in persons with spinal cord injury. Spinal Cord Ser Cases. 2017 Jun 29;3:17039. doi: 10.1038/scsandc.2017.39. eCollection 2017.
• Background Nightingale TE, Gorgey AS. Predicting Basal Metabolic Rate in Men with Motor Complete Spinal Cord Injury. Med Sci Sports Exerc. 2018 Jun;50(6):1305-1312. doi: 10.1249/MSS.0000000000001548.
• Background Abilmona SM, Gorgey AS. Associations of the trunk skeletal musculature and dietary intake to biomarkers of cardiometabolic health after spinal cord injury. Clin Physiol Funct Imaging. 2018 Feb 6. doi: 10.1111/cpf.12505. Online ahead of print.
• Background Rankin KC, O'Brien LC, Gorgey AS. Quantification of trunk and android lean mass using dual energy x-ray absorptiometry compared to magnetic resonance imaging after spinal cord injury. J Spinal Cord Med. 2019 Jul;42(4):508-516. doi: 10.1080/10790268.2018.1438879. Epub 2018 Feb 20.
• Background McCauley LS, Sumrell RM, Gorgey AS. Anthropometric Prediction of Visceral Adipose Tissue in Persons With Motor Complete Spinal Cord Injury. PM R. 2018 Aug;10(8):817-825.e2. doi: 10.1016/j.pmrj.2018.02.007. Epub 2018 Feb 21.
• Background Gorgey AS, Cirnigliaro CM, Bauman WA, Adler RA. Estimates of the precision of regional and whole body composition by dual-energy x-ray absorptiometry in persons with chronic spinal cord injury. Spinal Cord. 2018 Oct;56(10):987-995. doi: 10.1038/s41393-018-0079-x. Epub 2018 Mar 6.
• Background O'Brien LC, Graham ZA, Chen Q, Lesnefsky EJ, Cardozo C, Gorgey AS. Plasma adiponectin levels are correlated with body composition, metabolic profiles, and mitochondrial markers in individuals with chronic spinal cord injury. Spinal Cord. 2018 Sep;56(9):863-872. doi: 10.1038/s41393-018-0089-8. Epub 2018 Mar 20.
• Results O'Brien LC, Chen Q, Savas J, Lesnefsky EJ, Gorgey AS. Skeletal muscle mitochondrial mass is linked to lipid and metabolic profile in individuals with spinal cord injury. Eur J Appl Physiol. 2017 Nov;117(11):2137-2147. doi: 10.1007/s00421-017-3687-9. Epub 2017 Sep 1.
• Results Rankin KC, O'Brien LC, Segal L, Khan MR, Gorgey AS. Liver Adiposity and Metabolic Profile in Individuals with Chronic Spinal Cord Injury. Biomed Res Int. 2017;2017:1364818. doi: 10.1155/2017/1364818. Epub 2017 Aug 30.
• Gorgey AS, Khalil RE, Gill R, Khan R, Adler RA. 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. Physiol Rep. 2021 Nov;9(21):e15089. doi: 10.14814/phy2.15089.
• Holman ME, Chang G, Ghatas MP, Saha PK, Zhang X, Khan MR, Sima AP, Adler RA, Gorgey AS. Bone and non-contractile soft tissue changes following open kinetic chain resistance training and testosterone treatment in spinal cord injury: an exploratory study. Osteoporos Int. 2021 Jul;32(7):1321-1332. doi: 10.1007/s00198-020-05778-2. Epub 2021 Jan 14.
• Gorgey AS, Graham ZA, Chen Q, Rivers J, Adler RA, Lesnefsky EJ, Cardozo CP. Sixteen weeks of testosterone with or without evoked resistance training on protein expression, fiber hypertrophy and mitochondrial health after spinal cord injury. J Appl Physiol (1985). 2020 Jun 1;128(6):1487-1496. doi: 10.1152/japplphysiol.00865.2019. Epub 2020 Apr 30.
• Holman ME, Gorgey AS. Testosterone and Resistance Training Improve Muscle Quality in Spinal Cord Injury. Med Sci Sports Exerc. 2019 Aug;51(8):1591-1598. doi: 10.1249/MSS.0000000000001975.
• Gorgey AS, Khalil RE, Gill R, Gater DR, Lavis TD, Cardozo CP, Adler RA. Low-Dose Testosterone and Evoked Resistance Exercise after Spinal Cord Injury on Cardio-Metabolic Risk Factors: An Open-Label Randomized Clinical Trial. J Neurotrauma. 2019 Sep 15;36(18):2631-2645. doi: 10.1089/neu.2018.6136. Epub 2019 Mar 28.

Drugs

Indications