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Background: Abdominal pain due to menses (primary dysmenorrhea) is an extremely pervasive and debilitating symptom affecting up to 90% of menstruating individuals. Objective: The objective of this randomized control trial was to investigate the effect of a commercial transcutaneous electrical nerve stimulation unit, Therabody PowerDot® (Therabody Inc., Los Angeles) on dysmenorrhea compared with non-steroidal anti-inflammatory drug use. Design: This was a randomized cross-over study. Methods: A total of 47 participants agreed to participate in the study, with 34 completing it. Participants completed treatments across three consecutive menstrual cycles in randomized order: single-unit transcutaneous electrical nerve stimulation (Uno), dual unit transcutaneous electrical nerve stimulation (Duo), and non-steroidal anti-inflammatory drug use (Control). Upon onset of dysmenorrhea, participants applied transcutaneous electrical nerve stimulation to their abdomen for a minimum of 30 min. Control participants were instructed to take non-steroidal anti-inflammatory drugs as needed. Surveys were used to record pain before and after treatment. We hypothesized that the PowerDot would decrease self-reported pain scores, and decrease non-steroidal anti-inflammatory drug consumption during menses. Results: Participants experienced a statistically and clinically significant reduction in pain during the Control (−3.52 ± 1.9), Uno (−2.10 ± 1.6), and Duo (−2.19 ± 1.7) cycles (p < 0.001). The doses of non-steroidal anti-inflammatory drugs consumed during the Control cycle (3.5 ± 2.6), was significantly different as compared with that of Uno (1.5 ± 3.0), or Duo (1.1 ± 2.6) (p = 0.004). Conclusions: Use of a commercial transcutaneous electrical nerve stimulation unit results in significant decrease in pain. Although not as robust as the relief in pain induced by non-steroidal anti-inflammatory drugs, the adverse events of transcutaneous electrical nerve stimulation are minimal in comparison. Therefore, transcutaneous electrical nerve stimulation appears to be a viable alternative to pain relief from dysmenorrhea. Clinical Trial Registration: NCT05178589 Plain Language Summary: The role of electrical signals for period pain relief Menstruation, also known as the period, is a cyclicly occurring event in people who are assigned female at birth. Often, the period is associated with abdominal pain that can be debilitating for many. This abdominal pain is typically treated using over-the-counter medications, such as ibuprofen; however, there several noted side effects that can arise from use of such medication. As such, this study aimed to understand if a device (Therabody PowerDot®; Therabody Inc., Los Angeles) that sends an electrical current to pads placed over the abdomen, much like a heating pad, could be used to decrease pain during the period to a similar level as medication. The research team studied three consecutive periods with differing setups: a single, elongated pad, placed on the lower abdomen (Uno), two circular pads placed on the lower abdomen (Duo), or no use of the device, only medication (Control). The researchers analyzed data from 34 individuals. It was found that all three cycles experienced a significant decrease in pain, with the control cycle having a greater decrease in pain than both the Uno and Duo. This study suggests that the electrical stimulation used here can greatly decrease pain during the period, though not as substantial as medication. [ABSTRACT FROM AUTHOR]

Purpose: Acute muscle damage after exercise triggers subsequent regeneration, leading to hypertrophy and increased strength after repeated exercise. It has been debated whether acute exercise-induced muscle damage is altered under various premenopausal estrogen conditions. Acute contraction-induced muscle damage was compared during exogenous (oral contraceptive, OC), endogenous (luteal phase, HI), or low (menses, LO) estrogen in healthy young women aged 21 to 30 years old. Methods: Women (OC, n = 9; HI, n = 9; LO, n = 8; total N = 26) performed 1 neuromuscular electrical stimulation (NMES) bout. Soreness, measured via visual analog scale and the Likert Scale of Muscle Soreness for Lower Limb (LSMSLL), quadriceps strength, and plasma myoglobin (Mb), interleukin (IL)-6, IL-8, and granulocyte-colony stimulating factor were measured before and after NMES. Results: NMES performance was similar across groups. Meaningful within-group increases in Mb (effect size [ES] = 1.12) and IL-8 (ES = 0.38) occurred in LO; ES for HI and OC were trivial. ES of the between-group difference in change was moderate for Mb (LO vs. HI = 1.15) and IL-8 (LO vs. HI = 0.86; LO vs. OC = 0.73). 17-ß estradiol correlated moderately and negatively with Mb relative change (r = -0.52, p < 0.05). LO had ~5% greater strength loss than OC and HI. The mean change score for the LSMSLL 2 days post-NMES was clinically greater in LO than OC or HI. Conclusions: Acute NMES-induced indicators of muscle fiber damage and qualitative muscle soreness may be attenuated during the luteal phase or active OC pill consumption compared with the menstrual phase.

We evaluated changes in myostatin, follistatin, and MyoD messenger RNA (mRNA) gene expression using eccentric exercise (EE) and concentric exercise (CE) as probes to better understand the mechanisms of muscle hypertrophy in young women. Twelve women performed single-leg maximal eccentric (n = 6, 25 [+ or -] 1 years, 59 [+ or -] 7 kg) or concentric (n = 6, 24 [+ or -] 1 years, 65 [+ or -] 7 kg) isokinetic knee extension exercise for 7 sessions. Muscle biopsies were taken from the vastus lateralis at baseline, 8 hours after the first exercise session, and 8 hours after the seventh exercise session. In the EE group, there were no changes in myostatin and follistatin (p [greater than or equal to] 0.17); however, MyoD expression increased after 1 exercise bout (p = 0.02). In the CE group, there were no changes in myostatin, follistatin, or MyoD mRNA gene expression (p [greater than or equal to] 0.07). Differences between the EE and CE groups were not significant (p [greater than or equal to] 0.05). These data suggest that a single bout or multiple bouts of maximal EE or CE may not significantly alter myostatin or follistatin mRNA gene expression in young women. However, MyoD mRNA expression seems to increase only after EE. KEY WORDS eccentric, concentric, MyoD, resistance training, hypertrophy

This study examined the validity of the CardioCoachC[O.sub.2] metabolic system to measure oxygen capacity by comparison to a previously validated device. Fourteen subjects (8 men and 6 women; 25.9 [+ or -] 6.6 years of age) completed 2 maximal graded exercise tests on a cycle ergometer. Subjects were randomly tested on the CardioCoachC[O.sub.2] and Medical Graphics CardiO2/CP (MedGraphics) system on 2 separate visits. The exercise test included 3 submaximal 3-minute stages (50, 75, and 100 W for women; 50, 100, and 150 W for men) followed by incremental, 25 W, 1-minute stages until volitional fatigue ([Vo.sub.2]max). There was no significant difference between the CardioCoachC[O.sub.2] and MedGraphics except at the 100 W stage (22.4 [+ or -] 4.8 and 20.3 [+ or -] 3.7 ml x [kg.sup.-1] x [min.sup.-1], p = 0.048, respectively). Spearman correlations demonstrated a strong correlation between the 2 devices at maximal [Vo.sub.2] (R = 0.94). Bland-Altman plots demonstrated small limits of agreement, indicating that the 2 devices are similar in measuring oxygen consumption. This study indicates that the CardioCoachC[O.sub.2] is a valid device for testing [Vo.sub.2] at submaximal and maximal levels. Validation of this device supports the CardioCoachC[O.sub.2] as a feasible and convenient method for testing participants and may be useful in the field or clinic. KEY WORDS ergometer, oxygen consumption, fitness levels, endurance athletes

Background. Maximal voluntary muscle strength (MVMS) and leg power are important measures of physical function in older adults. We hypothesized that performing these measures twice within 7-10 days would demonstrate a > 5% increase due to learning and familiarization of the testing procedures. Methods. Data were collected from three studies in older adult men (60-87 years) and were divided into two cohorts defined by study site and type of exercise equipment. MVMS was assessed in 116 participants using the one-repetition maximum method at two separate study visits for the chest press, latissimus pull-down, leg press, leg flexion, and leg extension exercises along with unilateral leg extension power. Results. Test-retest scores were not different and did not exceed 0.8 [+ or -] 9.0% in Cohort 1 or 2.3 [+ or -] 9.8% in Cohort 2, except for leg extension, which improved by 6.6 [+ or -] 14.4% (p < .009) and 3.4 [+ or -] 6.8% (p < .016), respectively. Repeat tests were closely correlated with initial tests (all p < .001). Pearson correlation coefficients ranged from 0.74 for leg extension power to 0.96 for leg press. Coefficients of variation were < 10% (4.2%-9.0%) for all exercises except for leg extension power, which was 15.5%. Conclusions. Our findings demonstrated that test--retest measures of MVMS and power in older adult men do not differ by more than 2.3% except for leg extension, and have relatively low coefficients of variation using data collected from three studies. Moreover, these findings were similar between two study sites using different equipment, which further supports the reliability of MVMS and power testing in older adult men.

Background. The purpose of our study was to assess the early effects of a potent anabolic androgen on muscle mass and strength, lower extremity power, and functional performance in older men. Methods. Thirty-two men 72 [+ or -] 6 years of age were randomized to receive oxandrolone (10 mg twice daily) or matching placebo in a 2:1 manner for 12 weeks. Total and appendicular lean body mass (LBM) were assessed by dual-energy x-ray absorptiometry (DEXA). Lower extremity muscle volume was determined by magnetic resonance imaging to validate DEXA changes. Results. Total LBM increased by 2.7 [+ or -] 1.6 kg after 6 weeks with oxandrolone (p < .00l), which was greater (p < .001) than the decline in LBM (-0.5 [+ or -] 0.9 kg) with placebo. Appendicular LBM increased by 1.2 [+ or -] 0.9 kg after just 6 weeks with oxandrolone (p < .001), which was greater (p < .001) than the decline in LBM (-0.4 [+ or -] 0.5 kg) with placebo. These changes were >90% of the gains in total and appendicular LBM (3.0 [+ or -] 1.5 kg and 1.3 [+ or -] 0.9 kg, respectively) after 12 weeks. Total thigh and hamstring muscle volume increased by 111 [+ or -] 29 [mm.sup.3] (p = .001) and 75 [+ or -] 18 [mm.sup.3] (p .001), respectively, after 12 weeks. Maximal strength increased for the leg press 6.3 [+ or -] 5.6% (p = .003), leg curl 6.7 [+ or -] 8.6% (p = .01), chest press 6.9 [+ or -] 6.5% (p = .001), and latissimus pull-down 4.8 [+ or -] 6.3% (p = .009) with oxandrolone after 6 weeks; these increases were different than those with placebo (p < .001) and were 93%, 96%, 74%, and 94% of the respective gains at week 12. There were no improvements in functional measures. Conclusion. Treatment with a potent anabolic androgen may produce significant increases in muscle mass and strength after only 6 weeks in healthy older men. However, such treatment did not improve leg muscle power or walking speed.

We investigated the musculoskeletal adaptations and efficacy of a whole-body eccentric progressive resistance-training (PRT) protocol in young women. Subjects (n = 37; mean age, 24.3) were randomly assigned to one of 3 groups: high-intensity eccentric PRT (HRT), low-intensity eccentric PRT (LRT), or control. Subjects performed 3 sets of 6 repetitions at 125% intensity or 3 sets of 10 repetitions at 75% intensity in the HRT and LRT groups, respectively, 2 times per week for 16 weeks. Strength was determined by the concentric l-repetition maximum (1RM) standard. Bone mass and body composition were measured by dual-energy x-ray absorptiometry (DXA). Blood and urine samples were obtained for deoxypyridinoline, osteocalcin, creatine kinase, and creatinine. Data were analyzed by repeated-measures analysis of variance with post hoc comparisons. Strength increased 20-40% in both training groups. Lean body mass increased in the LRT (0.7 [+ or -] 0.6 kg) and HRT (0.9 [+ or -] 0.9 kg) groups. Bone mineral content increased (0.855 [+ or -] 0.958 g) in the LRT group only. Deoxypyridinoline decreased and osteocalcin increased in the HRT and LRT groups, respectively. These findings suggest that submaximal eccentric training is optimal for musculoskeletal adaptations and that the intensity of eccentric training influences the early patterns of bone adaptation. KEY WORDS. bone mass, bone markers, muscle damage, strength training

The relationship of strength to muscle area was used to assess change in muscle quality after anabolic interventions. Study 1: asymptomatic human immunodeficiency virus-positive men (39 [+ or -] 9 yr) were randomized to nandrolone (600 mg/wk) [+ or -] resistance training (RT). Study 2: older healthy men (72 [+ or -] 5 yr) were randomized to oxandrolone (20 rag/day) or placebo. Maximum voluntary strength was determined by the 1-repetition maximum (1-RM) method for leg press, flexion and extension, and cross-sectional area of leg muscles by MRI. From study week 0 to study week 12, muscle quality was unchanged with nandrolone, oxandrolone, or oxandrolone placebo, respectively, for total thigh muscles (1.23 [+ or -] 0.012 vs. 1.27 [+ or -] 0.29 kg/[cm.sup.2]; 9.0 [+ or -] 1.1 vs. 8.9 [+ or -] 1.2 N/[cm.sup.2]; 8.9 [+ or -] 1.2 vs. 8.9 [+ or -] 1.9 N/[cm.sup.2]) and hamstrings (0.41 [+ or -] 0.08 vs. 0.43 [+ or -] 0.07 kg/[cm.sup.2]; 0.90 [+ or -] 0.14 vs. 0.95 [+ or -] 0.016 N/[cm.sup.2]; 0.94 [+ or -] 0.23 vs. 0.93 [+ or -] 0.21 N/[cm.sup.2]. Lower-extremity 1-RM strength increased several times greater with RT + nandrolone (51-63% increases) than with nandrolone alone (4.7-16%), despite similar increases in muscle area; therefore, muscle quality increased from 1.13 [+ or -] 0.17 to 1.51 [+ or -] 0.18 kg/[cm.sup.2] (+36 [+ or -] 19%; P < 0.001) for total thigh muscle, 0.37 [+ or -] 0.10 to 0.53 [+ or -] 0.08 kg/[cm.sup.2] (+49 [+ or -] 39%; P < 0.001) for hamstrings, and 0.73 [+ or -] 0.19 to 1.07 [+ or -] 0.16 kg/[cm.sup.2] (+55 [+ or -] 36%; P < 0.001) for quadriceps. Thus androgen therapy alone did not improve muscle quality, but the addition of RT to nandrolone produced substantive improvements. nandrolone decanoate; oxandrolone; resistance training; magnetic resonance imaging

To determine whether oxymetholone increases lean body mass (LBM) and skeletal muscle strength in older persons, 31 men 65-80 yr of age were randomized to placebo (group 1) or 50 mg (group 2) or 100 mg (group 3) daily for 12 wk. For the three groups, total LBM increased by 0.0 [+ or -] 0.6, 3.3 [+ or -] 1.2 (P < 0.001), and 4.2 [+ or -] 2.4 kg (P < 0.001), respectively. Trunk fat decreased by 0.2 [+ or -] 0.4, 1.7 [+ or -] 1.0 (P = 0.018), and 2.2 [+ or -] 0.9 kg (P = 0.005) in groups 1, 2, and 3, respectively. Relative increases in l-repetition maximum (1-RM) strength for biaxial chest press of 8.2 [+ or -] 9.2 and 13.9 [+ or -] 8.1% in the two active treatment groups were significantly different from the change (-0.8 [+ or -] 4.3%) for the placebo group (P < 0.03). For lat pull-down, 1-RM changed by -0.6 [+ or -] 8.3, 8.8 [+ or -] 15.1, and 18.4 [+ or -] 21.0% for the groups, respectively (1-way ANOVA, P = 0.019). The pattern of changes among the groups for LBM and upper-body strength suggested that changes might be related to dose. Alanine aminotransferase increased by 72 [+ or -] 67 U/1 in group 3 (P < 0.001), and HDL-cholesterol decreased by -19 [+ or -] 9 and -23 [+ or -] 18 mg/dl in groups 2 and 3, respectively (P = 0.04 and P = 0.008). Thus oxymetholone improved LBM and maximal voluntary muscle strength and decreased fat mass in older men. oxymetholone; androgen therapy; older men; sarcopenia; lean body mass

Thirty human immunodeficiency virus (HIV)-infected men were randomized to a high dose of nandrolone decanoate weekly (group 1) or nandrolone plus resistance training (group 2) for 12 wk. For the two groups, nandrolone had no significant effects on total cholesterol, LDL cholesterol, LDL phenotype, or fasting triglycerides, although triglycerides decreased by 66 [+ or -] 124 mg/dl for the entire population (P = 0.01). Group 2 subjects had a favorable increase of 5.2 [+ or -] 7.7[Angstrom] in LDL particle size (P = 0.03), whereas there was no change in group 1. Lipoprotein(a) decreased by 7.3 [+ or -] 6.8 mg/dl for group 1 (P = 0.002)and by 6.9 [+ or -] 8.1 forgroup2 (P = 0.013). However, HDL cholesterol decreased by 8.7 [+ or -] 7.4 mg/dl for group 1 (P < 0.001) and by 10.6 [+ or -] 5.9 for group 2 (P < 0.001). Percentages of HD[L.sub.2b] (9.7-12 nm) and HD[L.sub.2a] (8.8-9.7 nm) subfractions decreased similarly for the two groups, whereas HD[L.sub.3a] (8.2-8.8 nm) and HD[L.sub.3b] (7.8-8.2 nm) increased in the groups during study therapy (P [less than or equal to] 0.02 for all comparisons). There was no evidence of a decreased insulin sensitivity in either group, whereas fasting glucose, fasting insulin, and homeostasis model assessment improved in group 2 (P < 0.05). These metabolic effects were favorable (other than for HDL), but changes were generally transient (except for HDL in group 2), with measurements returning to baseline 2 mo after the interventions were completed. anabolic steroids; lipoprotein(a); androgen therapy; insulin resistance; high-density lipoprotein cholesterol; low-density lipoprotein cholesterol; serum triglycerides