Functional electrical stimulation (FES) assisted resistance trammg has been effective in increasing muscular strength and endurance in spinal cord injured men and women in preparation for FES-assisted cycle programs and for FES-assisted standing and walking. Increases in blood pressure and a concomitant bradycardia suggestive of autonomic dysreflexia have been reported during FES-assisted resistance training. Self-induced autonomic dysreflexia in athletes who use wheelchairs suppressed the normal exercise induced serum testosterone increase. We, therefore, examined the changes in hematocrit and circulating levels of testosterone, sex hormone binding globulin (SHBG), cortisol, prolactin, norepinephrine and epinephrine during FES assisted resistance exercise in five high spinal cord injured men (SCI) and comparable maximal exercise in five able bodied controls (AB). Mean serum testosterone levels significantly increased with FES-assisted resistance training in SCI and maximal resistance exercise in AB with no significant change in hematocrit or SHBG. Prolactin, cortisol and epinephrine levels were unchanged while norepinephrine levels were significantly increased in SCI and AB. These findings suggest that there is no concern over inadequate physiological androgen response to an exercise stimulus in SCI. The data do not support the previous findings that elevated levels of norepinephrine in autonomic dysreflexia suppress testosterone response to exercise.Keywords: functional electrical stimulation; catecholamines; norepinephrine; epinephrine; testosterone; cortisol
IntroductionThe endocrine system at rest is characterized by endogenous rhythmic fluctuations in hormone levels. Superimposed on the internal rhythms is the capacity to respond to changes in the external environment. Thus, in the short term, stress, feeding, trauma, physical activity and other stimuli are followed by adjustments in hormonal control. Chronic alterations in the environment may also induce changes in hormonal milieu. In the able-bodied, serum total and free testosterone levels increase during short term strenuous exercise and decrease during and after prolonged activity. 1 , 2 While the mechanism(s) and effects of such changes remain(s) disputed, recent evidence suggests that testosterone is 'consumed' during and subsequent to prolonged, strenuous physical activity. 3 It is tempting to believe that testosterone consumption during and following activ- ity may be important in tissue repair m muscle and bone. 4 Spinal cord injury (SCI) has been reported to cause both acute and long term changes in the endocrine milieu in at least some individuals. 5 --1 0 Physical activity induced hormonal changes have been little studied in individuals who use wheelchairs. 11-13 Such responses could be important for several reasons; for example, abnormal responses to exercise and training may limit wheelchair users' tolerance of increased activity, or may limit muscle or bone development with training.Functional electrical stimulation (FES) inducing muscular ...