Bone and non-contractile soft tissue changes following open kinetic chain resistance training and testosterone treatment in spinal cord injury: an exploratory study

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.

INTRODUCTION

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.

METHODS

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.

RESULTS

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).

CONCLUSIONS

This pilot suggests longer TT + RT interventions may be a viable rehabilitation technique to combat bone loss following SCI.

CLINICAL TRIAL REGISTRATION

Registered with clinicaltrials.gov : NCT01652040 (07/27/2012).

[Immunoregulatory cytokines and chronization of type C hepatitis: matching of clinical and immunological manifestations]

The study demonstrates significant changes of cytokine-producing ability of mononuclear blood leucocytes in type 'hepatitis, correlating with the degree of hepatic lesion. The results showed that various morphologic types of chronic virus type C hepatitis were associated with disbalance in production of pro- and antiinflammatory cytokines, i.e. decrease of tumor necrosis factor (TNF)-alpha concentration and a significant rise of interleukin (IL)-4 and IL-10 concentations, which were the most prominent in cases of severe hepatic fibrosis and high histologic activity of hepatitis. The study established a direct correlation between increase of the ability of mononuclear blood leucocytes to synthesize IL-4, and the progress of the pathologic process.