Biomechanical Leg Muscle Function During Stair Ambulation in Men Receiving Androgen Deprivation Therapy

• Published in: The journals of gerontology. Series A, Biological sciences and medical sciences Vol. 75; no. 9; p. 1715
• Main Authors: Cheung, Ada S, Gray, Hans A, Schache, Anthony G, Hoermann, Rudolf, Bicknell, Jarrod, Joon, Daryl Lim, Zajac, Jeffrey D, Pandy, Marcus G, Grossmann, Mathis
• Format: Journal Article
• Language: English
• Published: United States 16.09.2020
• Subjects: Activities of Daily Living; Aged; Androgen Antagonists - adverse effects; Androgen Antagonists - therapeutic use; Biomechanical Phenomena; Case-Control Studies; Humans; Leg - physiology; Male; Middle Aged; Muscle, Skeletal - drug effects; Muscle, Skeletal - physiology; Prospective Studies; Prostatic Neoplasms - drug therapy; Stair Climbing - drug effects; Stair Climbing - physiology; Testosterone - blood; Sarcopenia; Muscle function; Androgen deprivation; Prostate cancer; Kinematics
• ISSN: 1758-535X
• DOI: 10.1093/gerona/glz169

The role of testosterone in maintaining functional performance in older men remains uncertain. We conducted a 12-month prospective, observational case-control study including 34 men newly commencing androgen deprivation therapy for prostate cancer and 29 age-matched prostate cancer controls. Video-based motion capture and ground reaction force data combined with computational musculoskeletal modeling, and data were analyzed with a linear mixed model. Compared with controls over 12 months, men receiving androgen deprivation therapy had a mean reduction in circulating testosterone from 14.1 nmol/L to 0.4 nmol/L, associated with reductions in peak knee extension torque, mean adjusted difference (MAD) -0.07 Nm/kg (95% confidence interval [CI]: -0.18, 0.04), p = .009, with a corresponding more marked decrease in quadriceps force MAD -0.11 × body weight (BW) [-0.27, 0.06], p = .045 (equating to a 9 kg force reduction for the mean body weight of 85 kg), and decreased maximal contribution of quadriceps to upward propulsion, MAD -0.47 m/s2 [-0.95, 0.02], p = .009. We observed between-group differences in several other parameters, including increased gluteus maximus force in men receiving androgen deprivation therapy, MAD 0.11 × BW [0.02, 0.20], p = .043, which may be compensatory. Severe testosterone deprivation over 12 months is associated with selective deficits in lower-limb function evident with an important task of daily living.