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Med Sci Sports Exerc. 2019 Mar 5. doi: 10.1249/MSS.0000000000001975. [Epub ahead of print]

Testosterone and Resistance Training Improve Muscle Quality in Spinal Cord Injury.

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Spinal Cord Injury and Disorders, Hunter Holmes McGuire VA Medical Center, Richmond, VA.



Spinal cord injury (SCI) negatively impacts muscle quality and testosterone levels. Resistance training (RT) has been shown to increase muscle cross-sectional area (CSA) following SCI, while testosterone replacement therapy (TRT) has been shown to improve muscle quality in other populations. The purpose of this pilot study was to examine if the combined effects of these interventions, TRT+RT, may maximize the beneficial effects on muscle quality after SCI.


Twenty-two SCI subjects randomized into either a TRT+RT (n = 11) or TRT (n = 11) intervention for 16 weeks. Muscle quality measured by peak torque at speeds of 0, 60, 90, and 180°·sec (PT-0°, PT-60°, PT-90°, PT-180°), knee extensor CSA (KE-CSA), specific tension (ST), and contractile speed (rise time [RTi], and half-time to relaxation [½TiR]) was assessed for each limb at baseline and post-intervention using 2x2 mixed models.


Following 16-weeks subjects in the TRT+RT group increased PT-0° (48.4%, P = 0.017), KE-CSA (30.8%, P < 0.0001), and RTi (17.7%, P = 0.012); with no significant changes observed in the TRT group. Regardless of the intervention, changes to PT-60° (28.4% P = 0.020), PT-90° (26.1%, P = 0.055), and PT-180° (20.6% P = 0.09) for each group were similar.


The addition of mechanical stress via RT to TRT maximizes improvements to muscle quality following complete SCI when compared to TRT administered alone. Our evidence shows that this intervention increases muscle size and strength, while also improving muscle contractile properties.

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