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Research Center for Endocrinology and Metabolism (G.J., B.Å-B.) and the Department of Rehabilitation Medicine (G.G., K.S.S.), Sahlgrenska University Hospital, Goteborg, Sweden
Address all correspondence and requests for reprints to: Gudmundur Johannsson, M.D., Ph.D., Research Center for Endocrinology and Metabolism, Sahlgrenska University Hospital, S-413 45 Goteborg, Sweden. E-mail: Gudmundur.Johannsson{at}ss.gu.se
GH deficiency in adults is associated with reduced muscle mass and
muscle strength. The objective of this trial was to follow the effect
of 2 yr of GH treatment in GH-deficient adults on muscle performance in
relation to a reference population. Knee extensor and flexor strengths
for isometric and isokinetic concentric muscle strength were measured
using a Kin-Com dynamometer. Hand-grip strength was measured in both
hands. The fatigue index was calculated as the percent reduction in
peak torque at 50 repeated isokinetic knee extensions. Superimposed,
single twitch electrical stimulation was performed. The GH-deficient
subjects had lower isometric knee extensor, knee flexor, and hand-grip
strength than the reference population. Two years of GH treatment
increased and normalized the mean isometric knee extensor and flexor
strengths. The concentric knee flexor and extensor strength at an
angular velocity of 
rad/s increased, as did the concentric knee
flexor strength at an angular velocity of /3 rad/s. The increase in
muscle strength was more marked in younger patients and in patients
with lower initial muscle strength than predicted. Quadriceps endurance
decreased, whereas the effect of superimposing single twitches on
isometric contraction and hand-grip strength was unaffected by the GH
treatment. Two years of GH therapy in GH-deficient adults increased and
normalized isokinetic and isometric muscle strength studied in proximal
muscle groups. Hand-grip strength and the degree of lack of maximal
motor unit activation on voluntary isometric knee extensor force did
not change. The dynamic local muscle fatigue index decreased.
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