{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T16:16:58Z","timestamp":1790093818653,"version":"4.0.1"},"reference-count":54,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T00:00:00Z","timestamp":1748995200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Department of Veteran Affairs, Veteran Health Administration, Rehabilitation Research and Development Service","award":["B7867-W"],"award-info":[{"award-number":["B7867-W"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Study Design: Pilot randomized clinical trial. Objective: To examine the effect of electrically evoked muscle hypertrophy on indices of spasticity, as measured by Biodex after spinal cord injury (SCI). Setting: Medical research center. Methods: Thirteen males with chronic SCI were randomized into sixteen weeks of either surface neuromuscular resistance training (NMES-RT) + testosterone treatment (TT) (n = 7) or a TT-only group (n = 6). A Biodex isokinetic dynamometer was used to measure knee extensor and flexor muscle spasticity at the beginning (baseline; BL) and at the end (post-intervention; PI) of 16 weeks. The passive tension of the right knee extensor and flexor muscle groups were evaluated at angles of 5\u00b0, 30\u00b0, 60\u00b0, 90\u00b0, 180\u00b0, and 270\u00b0 per second (sec). Dual energy X-ray absorptiometry and magnetic resonance imaging were used to measure leg lean mass and thigh muscle cross-sectional areas (CSAs). Results: Robust muscle hypertrophy was noted in leg lean mass [11%, p = 0.023] as well as whole thigh [17%, p = 0.001] and knee extensor muscle [28%, p = 0.001] CSAs in the NMES-RT+TT compared to the TT-only group. There was no difference in extensor or flexor spasticity between the NMES-RT+TT or TT-only groups at different angular velocities following 16 weeks of intervention. Collapsing the extensor passive torques indicated an (24\u201328%) increase (p &lt; 0.004) in response to angular velocities at BL and following PI measurements [180 deg\/sec (23%; p = 0.03) and 270 deg\/sec (32%; p = 0.009)] compared to 5 deg\/sec. The extensor slope showed a non-significant (p &gt; 0.05) decrease of 15\u201328% across all angular velocities. The catch-AB slopes were non-significantly lower in the TT-only group compared to the NMES-RT+TT at higher speeds [90 deg\/sec and 270 deg\/sec] and attained a trend towards lower passive torque at 180 deg\/sec [180 deg\/sec: 15.5%, p = 0.05]. Conclusions: Evoking skeletal muscle hypertrophy did not increase spasticity indices at different angular velocities following sixteen weeks of NMES-RT+TT or TT in persons with chronic SCI. Augmenting muscle hypertrophy is likely to attenuate the hyper reflexive slope of the extensor spasticity. The findings may suggest that evoking muscle hypertrophy following NMES-RT does not increase indices of spasticity after SCI. The clinical implications are highly important in managing spasticity after SCI.<\/jats:p>","DOI":"10.3390\/jcm14113972","type":"journal-article","created":{"date-parts":[[2025,6,4]],"date-time":"2025-06-04T11:14:12Z","timestamp":1749035652000},"page":"3972","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Role of Electrically Evoked Muscle Hypertrophy on Spasticity in Persons with Spinal Cord Injury"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3179-9647","authenticated-orcid":false,"given":"Momal A.","family":"Wasim","sequence":"first","affiliation":[{"name":"Spinal Cord Injury and Disorders Center, Richmond VA Medical Center, Richmond, VA 23249, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad M.","family":"Alazzam","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury and Disorders Center, Richmond VA Medical Center, Richmond, VA 23249, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9157-6034","authenticated-orcid":false,"given":"Ashraf S.","family":"Gorgey","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury and Disorders Center, Richmond VA Medical Center, Richmond, VA 23249, USA"},{"name":"Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA 23298, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1179\/204577211X13207446293695","article-title":"International standards for neurological classification of spinal cord injury (revised 2011)","volume":"34","author":"Kirshblum","year":"2011","journal-title":"J. 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