W. Todd Cade, PT, PhD, FAPTA

Todd Cade, PT, PhD
Division Chief; Professor in Orthopaedic Surgery, Core Faculty

Interprofessional Education and Care Building (IPE)

  • Certificate, Academic Medical Leadership Program for Physicians & Scientists, Washington University, 2015
  • Postdoctoral fellowship, Endocrinology & Metabolism, Washington University School of Medicine, 2002 – 2005
  • PhD, Rehabilitation Science, University of Maryland, Baltimore, 2002
  • MS, Physical Therapy, University of Miami, 1994
  • BS, Kinesiological Sciences, University of Maryland, College Park, 1991


  • Catherine Worthingham Fellow of the Association of Physical Therapists (APTA), 2023 
  • ACSM Mid-Atlantic Chapter President's Award, 2001 
  • VA Health Scholarship Award, 1993-1994


Cardiovascular physical therapy, neuromuscular disease, home health, Veterans' care


The overall goal of our laboratory is to study innovative and precision rehabilitation strategies to enhance cardiometabolic health. Through our studies, we aim to determine how exercise mode, frequency, intensity, and concomitant therapies (nutritional/pharmacologic/gene therapy) modulate physiologic and molecular mediators of cardiometabolic function, primarily focusing on substrate (e.g. amino acid, glucose, fatty acid) metabolism, energetic, and functional abnormalities in skeletal muscle and heart. We study metabolic diseases including Barth syndrome and other pediatric and adult cardiomyopathies, HIV-related metabolic syndrome, diabetes mellitus, and obesity. We are also interested in the effect of precision exercise during pregnancy on maternal and offspring health in women with obesity and diabetes. Our lab employs methodology used to measure whole-body substrate metabolism by stable isotope tracers and mass spectrometry, molecular mediators by metabolomics and extracellular vesicle analyses, heart and skeletal muscle energetics by magnetic resonance spectroscopy (MRS), exercise tolerance assessment by graded exercise testing and indirect calorimetry, cardiac function by echocardiography, vascular function by peripheral arterial tonometry and vascular ultrasound, body composition analysis by dual-energy x-ray absorptiometry (DXA) and air displacement plethysmography, muscle strength by isokinetic dynamometry, and daily physical activity by actigraphy.

Recent publications

  1. Cao C, Yang L, Cade WT, Racette SB, Park Y, Cao Y, Friedenreich C, Hamer M, Stamatakis E, Smith L. Association between cardiorespiratory fitness and premature death among young and middle-aged Americans in recent generations. Am J Med. 2021 May 1;147(5):460-468. PMID: 33704356 
  2. Schultz SA, Byers J, Benzinger TLS, Reeds D, Vlassenko AG, Cade WT, Goyal MS. Comparison of the Ekblom-Bak submaximal test to a maximal test in a cohort of healthy younger and older adults in the United States. Front Physiol 2020 Nov 6;11:550285.  PMID: 33240095 PMCID: PMC7677573 
  3. Hooley C, Baumann AA, Mutabazi V, Brown A, Reeds D, Cade WT, Fuentes LL, Proctor EK, Karengera S, Schecthman K, Goss C, Launois P, Davila-Roman VG, Mutimura E.  The TDR MOOC training in implementation research: evaluation of feasibility and lessons learned in Rwanda. Pilot Feasibility Stud. 2020 May 15;6:66. PMID: 32467769 PMCID: PMC7229620
  4. Bittel AJ, Bittel DC, Mittendorfer B, Patterson BW, Okunade AL, Abumrad NA, Reeds DN, Cade WT. A single bout of premeal resistance exercise improves postprandial glucose metabolism in obese men with prediabetes. Med Sci Sports Exerc. 2020 Oct 7.  PMID: 33044441 PMCID: PMC7969361
  5. Cade WT, Bohnert KL, Bittel AJ, Chacko SJ, Patterson BW, Pacak CA, Byrne BJ, Vernon HJ, Reeds DN. Arginine kinetics are altered in a pilot sample of adolescents and young adults with Barth syndrome. Mol Genet Metab Rep. 2020 Nov 4;25:100675. PMID: 33204638 PMCID: PMC7649643
  6. Tinius RA, Blankenship MM, Furgal K, Cade WT, Duchette C, Pearson KJ, Maples JM. Metabolic flexibility during late pregnancy is associated with neonatal adiposity. Appl Physiol Nutr Metab. 2021 Feb 5. PMID: 33544662. 
  7. Cao C, Cade WT, Li S, McMillan J, Friedenreich C, Yang L. Association of balance function with all-cause and cause-specific mortality among US adults. JAMA Otolaryngol Head Neck Surg. 2021 Mar 11. doi: 10.1001/jamaoto.2021.0057. Online ahead of print. PMID: 33704356
  8. Maples JM, Ehrlich SF, Zite NB, Pearson KJ, Cade WT, Riedinger CJ, Blankenship MM, Tinius RA. Elevated lipid oxidation is associated with exceeding gestational weight gain recommendations and increased neonatal anthropometrics: a cross-sectional analysis. BMC Pregnancy Childbirth. 2021 Aug 21;21(1):575. PMID: 34419005
  9. Bohnert KL, Ditzenberger G, Bittel AJ, de las Fuentes L, Corti M, Pacak CA, Taylor C, Byrne BJ, Reeds DN, Cade WT. Resistance exercise training with protein supplementation improves skeletal muscle strength and improves quality of life in late adolescents and young adults with Barth syndrome: A pilot study. JIMD Rep. 2021 Aug 9;62(1):74-84. doi: 10.1002/jmd2.12244. eCollection 2021 Nov. PMID: 34765401
  10. Tinius RA, Blankenship M, Maples JM, Pitts BC, Furgal K, Norris ES, Hoover DL, Olenick A, Lambert J, Cade WT. Validity of the 6-minute walk test and YMCA submaximal cycle test during mid-pregnancy. J Strength Cond Res. 2021 Nov 1;35(11):3236-3242. PMID: 35258271
  11. Kilgore CB, Strain JF, Nelson B, Cooley SA, Rosenow A, Glans M, Cade WT, Reeds DN, Paul RH, Ances BM. Cardiorespiratory fitness is associated with better white matter integrity in persons living with HIV. J Acquir Immune Defic Syndr. 2022 Apr 15;89(5):558-565. PMID: 34966145
  12. Chowdhury S, Jackson L, Byrne BJ, Bryant RM, Cade WT, Churchill TL, Buchanan J, Taylor C.  Longitudinal observational study of cardiac outcome risk factor prediction in children, adolescents, and adults with Barth syndrome. Pediatr Cardiol. 2022 Mar 3. Online ahead of print. PMID: 35238957.
  13. Ntaganda E, Mugeni R, Harerimana E, Ngoga G, Dusabeyezu S Uwinkindi F, Utumatwishima JA, Mutimura E, Davila-Roman VG, Schechtman K, Nishimwe A, Twizeyimana L, Brown AL, Cade WT, Bushaku M, De las Fuentes L, Reeds DN, Twagirumukiza M. High rates of undiagnosed and uncontrolled hypertension upon a screening campaign in rural Rwanda: A cross-sectional study. BMC Cardiovasc Disord. 2022 Apr 26;22(1):197. PMID: 35473501.
  14. Wisch JK, Cooley SA, Yarasheski KE, Cade WT, Reeds DN, Nelson B, Alemu R, Burdo TH, Ances BM.
    Socioeconomic status largely explains integrase inhibitors-related body composition differences in chronically infected men living with HIV. Antivir Ther. 2022 Jun;27(3):13596535221109748. PMID: 35730471.
  15. Llane JP, Suzuki-Hatano S, Jain A, Perez Medina VA, Cade WT, Pacak CA, Simmons CS. Matrix produced by diseased cardiac fibroblasts affects early myotube formation and function. Acta Biomater. 2022 Oct 15;152:100-112. PMID: 36055608
  16. Yoshino M, Yoshino J, Smith GI, Stein RI, Bittel AJ, Bittel DC, Reeds DN, Sinacore DR, Cade WT, Patterson BW, Cho K, Patti GJ, Mittendorfer B, Klein S. Worksite-based intensive lifestyle therapy has profound cardiometabolic benefits in people with obesity and type 2 diabetes. Cell Metab. 2022 Oct 4;34(10):1431-1441.  PMID: 36084645
  17. Cade WT, Mittendorfer B, Patterson BW, Haire-Joshu D, Cahill AG, Stein RI, Schechtman KB, Tinius RA, Brown K, Klein S. Effect of excessive gestational weight gain on insulin sensitivity and insulin kinetics in women with overweight/obesity. Obesity (Silver Spring) 2022 Oct;30(10):2014-2022. PMID: 36150208 PMCID: PMC9512396 
  18. Mittendorfer B, Patterson BW, Haire-Joshu D, Cahill AG, Cade WT, Stein RI, Klein S. Insulin Sensitivity and β-Cell Function During Early and Late Pregnancy in Women With and Without Gestational Diabetes Mellitus. Diabetes Care. 2023 Jun 1:dc221894. doi: 10.2337/dc22-1894. Online ahead of print. PMID: 37262059
  19. Schweitzer GG, Ditzenberger GL, Hughey CC, Finck BN, Martino MR, Pacak CA, Byrne BB, Cade WT. Elevated Liver Glycogenolysis Mediates Higher Blood Glucose During Acute Exercise in Barth Syndrome. PLoS One 2023 Aug 31;18(8):e0290832.
  20. Pacak CA, Suzuki-Hatano S, Khadir F, Daugherty AL, Sriramvenugopal M, Gosiker BJ, Kang PB, Cade WT.  One episode of low-intensity aerobic exercise prior to systemic AAV9 administration augments transgene delivery to the heart and skeletal muscle. J Transl Med. 2023 Oct 24;21(1):748.

Link to complete list of publications

Grants and Awards

Current Research Studies

Wheelchair User Physical Activity Training Intervention to Enhance Cardiometabolic Health
Funding Source: 1 R01 HD111022-01 (PI: Morgan K, Washington University, Sub-Award PI: Cade WT)
The major goal of this project is to determine the effects of a community-based physical activity program on the cardiometabolic health of wheelchair users.

Mechanisms and Treatment of Cardioskeletal Dysfunction in Barth Syndrome
Funding Source: R01 HL136759 (PI: Pacak C, University of Minnesota, Sub-Award PI: Cade WT))     
The main purpose of this study is to characterize skeletal and cardiac muscle pathology in human-derived inducible pluripotent stem cells differentiated myocytes.                       

Past Research Studies

Acute Effects of Aerobic and Resistance Exercise on Maternal Glucose Metabolism and Vascular Function in Obese Pregnancy Funding Source: National Rehabilitation Research Resource to Enhance Clinical Trials
Funding source: (REACT) P2C HD086851 (Sub-Award PI: Cade WT)                     
This study will collect preliminary data on the independent effects of acute aerobic and resistance rehabilitative exercise in obese women during pregnancy.

Characterization of the ‘Metabolic Phenotype’ in Barth Syndrome with Cardiac Transplantation

Funding Source: Barth Syndrome Foundation (PI: Cade WT)
The goal of this study is to characterize the metabolic ‘phenotype’ (cardioskeletal morphology, substrate metabolism, energetics and function) of participants with BTHS who with cardiac transplantation.

HIV- and ART-Associated Cardiometabolic Research Training in Rwanda

Funding Source: Fogarty Center D43 TW010335 01 (PI: Mutimura E, Role: Co-I)
The overall goal of this training strategy is to develop scientific leadership in HIV- and ART-associated cardiometabolic (CM) research in Rwanda through developing a dynamic team of scholars to implement well- designed contextually relevant studies, publish and present results at scientific meetings, and for networking, and develop expertise for independent research funding.

Effectiveness of Resistance Exercise Training Program in Youth with CF
Funding Source: Cystic Fibrosis Foundation (PI: Granados A, Role: Co-I)                

Effects of Resistance Exercise Training on Cardiac, Metabolic and Muscle Function and Quality of Life in Barth Syndrome: Part 2

Funding Source: Barth Syndrome Foundation (PI: Cade WT)

Planning for Clinical Gene Therapy Program for Barth Syndrome

Funding Source: Barth Syndrome Foundation (PI: Byrne BJ, Role: Co-I)

Heart and Skeletal Muscle Nutrient Metabolism, Energetics and Function in Barth Syndrome

Funding Source: R01 HL107406-01A1 (PI: Cade WT)

Exercise Training to Improve Brain Health in HIV+ Individuals

Funding Source: R01 NR015738-01A1 (PI: Ances BM, Role: Co-I)

Combining Testosterone Therapy and Exercise to Improve Function Post-hip Fracture
Funding Source: R01 AG051647-01 (PI: Binder E, Role: Co-I)
The Inorganic Nitrate for Exercise in Heart Failure (INIX-HF) Trial
Funding Source: R34 HL138253 02 (PI: Peterson LR, Role: Co-I)            

Safety and Efficacy of Aerobic Exercise Training in Barth Syndrome 
Funding Source: Barth Syndrome Foundation (PI: Cade WT)

Maternal Lipid Metabolism and Neonatal Heart Function in Diabetes Mellitus 
Funding Source: Thrasher Research Fund (PI: Cade WT)

Exercise and TZD Effects on Myocardial Substrate Metabolism and Function in HIV
Funding Source: K01 DK074343 (PI: Cade WT)

Lipid Kinetics During Acute Exercise in HIV
Funding Source: F32 DK066977 (PI: Cade WT)