Acute serum androgen levels and post-rehabilitation functioning in spinal cord injury: findings from SwiSCI.
Vanessa Seijas, Jivko Stoyanov, Kristen D Brantley and 8 others
PMID 40202280WHAT IT FOUND
In men with new spinal cord injuries, lower baseline free testosterone was linked to slower functional recovery and lower discharge scores.
These associations lost significance after correcting for multiple tests, and results for women were null due to small numbers.
Key findings
01Lower baseline free testosterone in males was associated with a significantly lower rate of functioning improvement from admission to 3 months and to discharge in linear mixed models.
02In males, a one standard deviation increase in baseline free testosterone was associated with a 22.5% increase in functioning at discharge in fully adjusted models.
03After applying a Bonferroni correction for multiple comparisons, the results of the linear mixed models lost statistical significance.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study had a small sample size (80 participants, only 15 females), leading to low power and null results for women. Androgen levels were measured using immunoassays rather than the more accurate mass spectrometry. The study could not account for confounders like physical activity, diet, stress, or participation in other clinical trials. Results were exploratory; after Bonferroni correction for multiple comparisons, the primary findings on rates of change lost statistical significance. The population was drawn from specialized Swiss rehabilitation centers, which may limit generalizability to other settings.
Declared interests
Most authors declared no competing interests or funding for this project. One author (Stacey A. Missmer) reported grant funding from AbbVie for unrelated population-based research and from Frontiers in Reproductive Health as an editor, but stated no funding or competing interests for this specific project.
The easy way to misread this
Do not interpret the significant associations in unadjusted or single-comparison models as robust evidence for routine testosterone screening or supplementation. The primary findings on recovery rates lost statistical significance after correcting for multiple comparisons, and the study is observational, so it cannot prove that testosterone levels cause better outcomes.