The primary aim of this study is to determine, in hypogonadal older men with physical frailty, whether exercise training combined with testosterone replacement therapy can improve skeletal muscle strength, and lean mass, to a greater degree than exercise training alone.
Decreases in physical abilities, including losses of strength, endurance, balance, and coordination are major causes of disability and loss of independence in older men. Such individuals are at high risk for injurious falls, hospitalization, and use of supportive services. Age-associated testosterone deficiency may contribute to deficits in muscle mass and strength that are common in this patient population. The primary aim of this study is to determine, in hypogonadal older men with physical frailty, whether six months of exercise training combined with testosterone replacement therapy can improve skeletal muscle mass and skeletal muscle strength, to a greater degree than six months of exercise training alone. Secondary study aims are to determine in hypogonadal older men with physical frailty, whether six months of exercise training combined with testosterone replacement therapy can improve physical function, bone mineral density, and quality of life, to a greater degree than six months of exercise training alone. Comparison: Men age 65 years and older who meet criteria for physical frailty and have a serum testosterone level below 350 ng/dl are randomly assigned to one of two groups: 1) transdermal testosterone replacement therapy + supervised exercise training for six months vs. 2) inactive placebo gel + supervised exercise training for six months.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
25
Transdermal testosterone replacement therapy with Androgel(TM). Daily application of gel at 5 mg, 7.5 gm, or 10 gm for six months. Target serum total testosterone level between 500-900 ng/dl.
Supervised exercise training performed on site at academic medical center exercise facility. Exercise training consisted of 2 months of flexibility, balance, treadmill walking, and physical therapy-type exercises, followed by 4 months of progressive resistance training.
Washington University School of Medicine
St Louis, Missouri, United States
Mean Change in Total Lean Body Mass
Total Lean Mass measured by Dual X-ray Absorptiometry (DXA)
Time frame: Baseline and Six Months
Change in Skeletal Muscle Strength by 1-RM
One-repetition maximum strength for leg extension
Time frame: Baseline and Six Months
Change in Isokinetic Leg Extension Torque at 0 Deg/Sec
Leg Extension Torque measured with Cybex dynamometer at 0 deg/sec
Time frame: Baseline and Six Months
Change in Leg Extension Torque at 60 Deg/Sec
Leg Extension Torque measured with Cybex dynamometry at 60 deg/sec
Time frame: Baseline and Six Months
Change in Total Body Fat Mass
Total Body Fat Mass as measured by DXA
Time frame: Baseline and Six Months
Change in Femoral Bone Mineral Density (BMD)
Femoral Bone Mineral Density measured with Dual X-ray Absorptiometry (DXA)
Time frame: Baseline and Six Months
Change in Total Modified Physical Performance (mPPT) Score
The Modified Physical Performance Test (mPPT) is a direct observational test that assesses multiple dimensions of physical function (basic and complex activities of daily living \[ADL\]) with different levels of difficulty. The test consists of 9 performance tasks. The total score range is 0-36 (min-max), with higher scores indicating better performance. Sub-scores are assigned for each of 9 item tasks; sub-score range is 0-4 (min-max) with higher scores indicating better performance. The sub-scores are summed to compute the total score.
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Time frame: Baseline and Six Months
Change in Serum Testosterone Level
Total Serum Testosterone Level (ng/mL)
Time frame: Baseline and Six Months