Spinal Cord Injury and Disorders, Hunter Holmes McGuire VAMC, Richmond, VA, 23249, USA.
Department of Radiology, NYU School of Medicine, New York, NY, 10016, USA.
Osteoporos Int. 2021 Jul;32(7):1321-1332. doi: 10.1007/s00198-020-05778-2. Epub 2021 Jan 14.
Twenty men with spinal cord injury (SCI) were randomized into two 16-week intervention groups receiving testosterone treatment (TT) or TT combined with resistance training (TT + RT). TT + RT appears to hold the potential to reverse or slow down bone loss following SCI if provided over a longer period.
Persons with SCI experience bone loss below the level of injury. The combined effects of resistance training and TT on bone quality following SCI remain unknown.
Men with SCI were randomized into 16-week treatments receiving TT or TT + RT. Magnetic resonance imaging (MRI) of the right lower extremity before participation and post-intervention was used to visualize the proximal, middle, and distal femoral shaft, the quadriceps tendon, and the intermuscular fascia of the quadriceps. For the TT + RT group, MRI microarchitecture techniques were utilized to elucidate trabecular changes around the knee. Individual mixed models were used to estimate effect sizes.
Twenty participants completed the pilot trial. A small effect for yellow marrow in the distal femur was indicated as increases following TT and decreases following TT + RT were observed. Another small effect was observed as the TT + RT group displayed greater increases in intermuscular fascia length than the TT arm. Distal femur trabecular changes for the TT + RT group were generally small in effect (decreased trabecular thickness variability, spacing, and spacing variability; increased network area). Medium effects were generally observed in the proximal tibia (increased plate width, trabecular thickness, and network area; decreased trabecular spacing and spacing variability).
This pilot suggests longer TT + RT interventions may be a viable rehabilitation technique to combat bone loss following SCI.
Registered with clinicaltrials.gov : NCT01652040 (07/27/2012).
20 名脊髓损伤（SCI）男性被随机分为两组，分别接受睾酮治疗（TT）或 TT 联合抗阻训练（TT+RT），干预 16 周。如果 TT+RT 治疗时间更长，可能具有逆转或减缓 SCI 后骨丢失的潜力。
SCI 患者在损伤水平以下会发生骨丢失。抗阻训练和 TT 联合对 SCI 后骨质量的综合影响尚不清楚。
SCI 男性被随机分为接受 TT 或 TT+RT 治疗的 16 周治疗组。在参与研究前和干预后，使用磁共振成像（MRI）对右侧下肢进行成像，以可视化股骨近端、中段和远端、股四头肌肌腱和股四头肌间筋膜。对于 TT+RT 组，使用 MRI 微观结构技术阐明膝关节周围的小梁变化。使用个体混合模型来估计效应大小。
20 名参与者完成了这项初步试验。研究结果表明，在接受 TT 治疗后，远端股骨的黄骨髓体积增加，而在接受 TT+RT 治疗后，黄骨髓体积减少。TT+RT 组股四头肌间筋膜长度的增加效果更大，与 TT 组相比，这是另一个小的效果。TT+RT 组的远端股骨小梁变化效应通常较小（小梁厚度变异性、间隔和间隔变异性降低，网络面积增加）。胫骨近端的效应通常为中等（板宽度、小梁厚度和网络面积增加，小梁间隔和间隔变异性降低）。
这项初步研究表明，更长时间的 TT+RT 干预可能是一种可行的康复技术，可用于治疗 SCI 后的骨丢失。
在 clinicaltrials.gov 注册：NCT01652040（2012 年 7 月 27 日）。
