Muscle function decrements in men undergoing androgen deprivation therapy (ADT). — ASN Events
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  3. Muscle function decrements in men undergoing androgen deprivation therapy (ADT).

Muscle function decrements in men undergoing androgen deprivation therapy (ADT). (#56)

Ada S Cheung 1 , Anthony Schache 2 , Hans Gray 2 , Philippe Dupuis 1 , Daryl Lim Joon 1 , Jeffrey D Zajac 1 , Marcus Pandy 2 , Mathis Grossmann 1
  1. Dept. of Medicine, University of Melbourne Austin Health, Heidelberg, Victoria, Australia
  2. Dept. of Mechanical Engineering, University of Melbourne, Parkville, Victoria, Australia

Background and aims: While testosterone is important for maintenance of muscle mass and strength in ageing men, it’s role in physical performance is less clear. We aimed to assess effects of androgen withdrawal on functional mobility, using a novel approach combining gait analysis with computational musculoskeletal modelling1 .

Methods: We conducted a longitudinal observational study in men with non-metastatic prostate cancer receiving 3-years of ADT adjuvant to radiotherapy. Quantitative gait analyses (level ground walking and stair climbing) at baseline (prior to ADT initiation), 6 and 12 months was performed to measure 3D joint motion, ground reaction forces, and muscle activation patterns. Musculoskeletal computer modelling was used to calculate lower-limb muscle forces and determine individual muscle contributions to three key biomechanical functions during walking: vertical support, forward progression, and mediolateral (sideways) balance.

Results: Preliminary results in 12 men receiving ADT are reported. Compared to baseline, 12 months of ADT was associated with significant reductions in the net muscle torques developed about the hip and knee joints (p<0.001), reduced peak forces developed by iliopsoas(iliacus p=0.0001 and psoas p=0.0003) and the quadriceps muscles (rectus femoris p=0.0005, vastus medialis p=0.0014, vastus intermedius p=0.0032, vastus lateralis p =0.002) affecting mediolateral balance. In contrast, gluteus maximus increased its contributions to both forward progression and mediolateral balance. Grip strength decreased and frailty score increased. No significant changes were observed in the behaviour of the other lower-limb muscles.

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Conclusions: Gait changes are evident in patients receiving 12 months of ADT. Gluteus maximus compensated for the reduced contributions of quadriceps and iliopsoas to support and balance. Further analyses of larger sample numbers and a control group are needed to confirm these findings. Quantitative 3D gait analysis when combined with musculoskeletal computer modelling is a potentially powerful tool for evaluating the efficacy of pro-myogenic interventions.

  1. Seth, A. & Pandy, M.G. (2007) A neuromusculoskeletal tracking method for estimating individual muscle forces in human movement. J Biomech 40, 356-366.
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