Denervation following spinal cord injury (SCI) limits beneficial application of neuromuscular
electrical stimulation (NMES). SCI with denervation results in extensive muscle atrophy that
is accompanied with several cardio-metabolic health risks. The current proposal provides a
novel intervention by examining the effects of long pulse width stimulation (LPWS) and
testosterone replacement therapy (TRT) on restoring muscle size and leg lean mass after
denervation in persons with SCI. This intervention will be rewarding for Veterans and
Civilians with SCI who do not benefit from exercising their lower extremity muscles because
denervation has limited the response to standard surface NMES. The investigators will study
the biochemical mechanisms that contribute to changes in muscle size following this novel
training. Combing both pharmaceutical and physical-therapeutic interventions will optimize
restoration of muscle size after SCI.