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Polycystic ovarian syndrome is linked with insulin resistance and increased sympathetic drive and was therefore an appropriate condition to study the effects of modulating sympathetic activity on Achilles tendon and musculoskeletal symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A secondary analysis of a double-blinded, randomised controlled trial on women with polycystic ovarian syndrome was conducted. Participants received 12\u2009weeks of moxonidine (<jats:italic>n<\/jats:italic>\u2009=\u200914) or placebo (<jats:italic>n<\/jats:italic>\u2009=\u200918). Musculoskeletal symptom and Victorian Institute of Sport Assessment \u2013 Achilles (VISA-A) questionnaires were distributed, and ultrasound tissue characterisation quantified tendon structure at 0 and 12\u2009weeks. 2-way ANOVA was used for multiple comparisons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was no difference in mean change in musculoskeletal symptoms (\u2212\u20090.6\u2009\u00b1\u20091.7 vs \u2212\u20090.4\u2009\u00b1\u20091.8,<jats:italic>p<\/jats:italic>\u2009=\u20090.69) or VISA-A (moxonidine \u2212\u20090.2\u2009\u00b1\u20098.8 vs placebo +\u20094.2\u2009\u00b1\u200914.6,<jats:italic>p<\/jats:italic>\u2009=\u20090.24) attributable to the intervention. There was no difference in any measures of Achilles structure. Moxonidine did not reduce sympathetic drive when compared to placebo.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This was the first study to investigate the effects of blocking sympathetic drive on musculoskeletal and Achilles tendon symptoms in a metabolically diverse population. While the study was limited by small sample size and lack of sympathetic modulation, moxonidine did not change tendon pain\/structure or musculoskeletal symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration<\/jats:title><jats:p>ClinicalTrials.gov,<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT01504321\">NCT01504321<\/jats:ext-link>. Registered 5 January 2012.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12902-020-00610-8","type":"journal-article","created":{"date-parts":[[2020,8,26]],"date-time":"2020-08-26T04:12:03Z","timestamp":1598415123000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Does moxonidine reduce Achilles tendon or musculoskeletal pain in women with polycystic ovarian syndrome? 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Written, informed consent to participate was sought and obtained from all eligible participants for the study.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The laboratory of GL has recently received funding from Medtronic, Servier Australia, Abbott Pharmaceuticals, Allergan Inc. GL has acted as a consultant for Medtronic and has received honoraria from Medtronic, Pfizer and Wyeth Pharmaceuticals for presentations. These organisations played no role in the study or manuscript writing in any way.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"131"}}