The purpose of this study was to evaluate the effect of an eight-week progressive resistance training programme on lower extremity strength, ambulatory function, fatigue and self-reported disability in multiple sclerosis (MS) patients (mean disability score 3.79-0.8). Eight MS subjects volunteered for twice weekly training sessions. During the first two weeks, subjects completed one set of 8 -10 reps at 50% of maximal voluntary contraction (MVC) of knee flexion, knee extension and plantarflexion exercises. In subsequent sessions, the subjects completed one set of 10 -15 repetitions at 70% of MVC. The resistance was increased by 2 -5% when subjects completed 15 repetitions in consecutive sessions. Isometric strength of the quadriceps, hamstring, plantarflexor and dorsiflexor muscle groups was assessed before and after the training programme using an isokinetic dynamometer. Magnetic resonance images of the thigh were acquired before and after the exercise programme as were walking speed (25-ft), number of steps in 3 min, and self-reported fatigue and disability. Knee extension (7.4%), plantarflexion (52%) and stepping performance (8.7%) increased significantly (PB-0.05). Self-reported fatigue decreased (PB-0.05) and disability tended to decrease (P -0.07) following the training programme. MS patients are capable of making positive adaptations to resistance training that are associated with improved ambulation and decreased fatigue.

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Adipose tissue secretes adiponectin, an adipocytokine that is involved in the regulation of insulin sensitivity. Following acute exercise, insulin sensitivity has been shown to increase. Increased adiponectin following exercise may be related to the change in insulin sensitivity. The purpose of the present study was to characterize the effect of a single cycle exercise session on adiponectin and to compare the exercise effects between healthy male and female subjects. Plasma concentrations of adiponectin, tissue necrosis factor-alpha (TNF-alpha), insulin, glucose, and leptin were assessed before and immediately after a 60-minute stationary cycle ergometry session at 65% of Vdot;O(2max). Male and female subjects were matched for cardiorespiratory fitness and body composition and dietary intake was controlled for the three days prior to the exercise trial. At rest, adiponectin concentration was not associated with percentage body fat, body mass index (BMI), fitness, or resting plasma variables ( P>0.05). Following exercise, neither male nor female subjects exhibited changes in adiponectin or leptin concentrations ( P>0.05). TNF-alpha exhibited a time main effect increase with exercise ( P<0.05), but there were no gender differences. These results suggest that plasma adiponectin concentrations do not change with exercise in healthy male or female subjects. Results are given as mean (SE).

SC, Cannady DF 2nd, Shuster JJ. Musculoskeletal and prostate effects of combined testosterone and finasteride administration in older hypogonadal men: a randomized, controlled trial. Am J Physiol Endocrinol Metab 306: E433-E442, 2014. First published December 10, 2013; doi:10.1152/ajpendo.00592.2013.-Testosterone acts directly at androgen receptors and also exerts potent actions following 5␣-reduction to dihydrotestosterone (DHT). Finasteride (type II 5␣-reductase inhibitor) lowers DHT and is used to treat benign prostatic hyperplasia. However, it is unknown whether elevated DHT mediates either beneficial musculoskeletal effects or prostate enlargement resulting from higher-than-replacement doses of testosterone. Our purpose was to determine whether administration of testosterone plus finasteride to older hypogonadal men could produce musculoskeletal benefits without prostate enlargement. Sixty men aged Ն60 yr with a serum testosterone concentration of Յ300 ng/dl or bioavailable testosterone Յ70 ng/dl received 52 wk of treatment with testosterone enanthate (TE; 125 mg/wk) vs. vehicle, paired with finasteride (5 mg/day) vs. placebo using a 2 ϫ 2 factorial design. Over the course of 12 mo, TE increased upper and lower body muscle strength by 8 -14% (P ϭ 0.015 to Ͻ0.001), fat-free mass 4.04 kg (P ϭ 0.032), lumbar spine bone mineral density (BMD) 4.19% (P Ͻ 0.001), and total hip BMD 1.96% (P ϭ 0.024) while reducing total body fat Ϫ3.87 kg (P Ͻ 0.001) and trunk fat Ϫ1.88 kg (P ϭ 0.0051). In the first 3 mo, testosterone increased hematocrit 4.13% (P Ͻ 0.001). Coadministration of finasteride did not alter any of these effects. Over 12 mo, testosterone also increased prostate volume 11.4 cm 3 (P ϭ 0.0051), an effect that was completely prevented by finasteride (P ϭ 0.0027). We conclude that a higher-than-replacement TE combined with finasteride significantly increases muscle strength and BMD and reduces body fat without causing prostate enlargement. These results demonstrate that elevated DHT mediates testosterone-induced prostate enlargement but is not required for benefits in musculoskeletal or adipose tissue. testosterone; hypogonadal; prostate enlargement SOME STUDIES OF TESTOSTERONE TREATMENT in older, hypogonadal men report substantial increases in muscle strength and bone mineral density (BMD) (12, 21), whereas others report only modest improvements (31, 41). Studies documenting substantial effects typically employed intramuscular (im) doses of Ն100 mg/wk im injection of long-acting testosterone esters (12, 21). In contrast, lower doses of testosterone that result from transdermal patch or gel administration produce only modest myotrophic effects (31, 32, 41). Meta-analysis data indicate that im testosterone produces a 4% increase in lumbar spine BMD, while transdermal testosterone has no effect (39). Unfortunately, higher doses of testosterone also increase the risk of adverse events, including three that have been confirmed by meta-analysis: polycythemia, a small reduction in HDL-cholesterol, and increased inci...

We examined the acute effect of cold-water temperature on post-exercise energy intake (EI) for 1 h. In a randomized, crossover design, 11 men (25.6 +/- 5 y) exercised for 45 min on a submersed cycle ergometer at 60 +/- 2% VO2max in 33 degrees C (neutral) and 20 degrees (cold) water temperatures, and also rested for 45 min (control). Energy expenditure (EE) was determined using indirect calorimetry before, during, and after each condition. Following exercise or rest, subjects had free access to a standard assortment of food items of known caloric value. EE was similar for the cold and neutral water conditions, averaging 505 +/- 22 (+/- standard deviation) and 517 +/- 42 kcal, respectively (P = NS). EI after the cold condition averaged 877 +/- 457 kcal, 44% and 41% higher (P < 0.05) than for the neutral and resting conditions, respectively. Cold-water temperature thus stimulated post-exercise EI. Water temperature warrants consideration in aquatic programs designed for weight loss.

This study was designed to compare intramyocellular lipid (IMCL) changes during 60 min of submaximal exercise in men and women. Eighteen moderately active (18-38 yr) men (n = 9) and women (n = 9) were recruited. Maximum oxygen consumption (O(2)max) and body composition were used to match subjects for aerobic fitness and body composition. Subjects performed cycle ergometry for 1 h at 65% of O(2)max. Expired gases were collected throughout exercise to determine caloric expenditure and substrate use. Blood samples were collected before and after exercise to evaluate markers of lipid metabolism. Pre- and postexercise proton spectra were acquired from the vastus lateralis using a 3-T whole-body imaging system. Spectra were acquired from an 18-mm(3) region of interest (echo time = 45 msec; repetition time = 2000 msec) for IMCL evaluation. IMCL decreased significantly with exercise (11.5-28.5% for men and 17.1-21.7% for women) (P < 0.05); however, there were no significant differences between men and women. Although changes were found for many plasma variables [free fatty acids, glycerol, and norepinephrine (P < 0.05)], group differences were only evident for norepinephrine. In conclusion, a significant decrease in IMCL was observed during 60 min of cycling in matched men and women.

Background Fatigue occurs in 75%-95% of people with multiple sclerosis (MS) and is frequently reported as the most disabling symptom. A multicomponent group program of six weekly 2-hour sessions, Fatigue: Take Control (FTC), was developed from an international MS fatigue management guideline. Objective To determine whether FTC is associated with greater improvements in fatigue than MS: Take Control (MSTC), a similarly structured general MS education program. Methods This four-site, parallel, single-blind, randomized controlled trial compared FTC and MSTC in 204 ambulatory participants with MS. The primary outcome, the Modified Fatigue Impact Scale (MFIS), and secondary outcomes of self-efficacy, physical activity, sleep, and medications were assessed at baseline, program completion, and 3 and 6 months later. Results Mean MFIS scores improved in both groups between baseline and program completion (FTC -4.4, p < 0.001; MSTC -3.8, p < 0.001), between baseline and 3 months after program completion (FTC -3.2, p = 0.01; MSTC -3.3, p = 0.01), and between baseline and 6 months after program completion (FTC -5.2, p < 0.001; MSTC -4.8, p < 0.001). These improvements were not statistically different between groups ( p = 0.64, 0.92, and 0.82, respectively). Conclusion Participation in FTC modestly improved self-reported fatigue for up to 6 months. This improvement did not differ significantly from that occurring with the control program.