Many said they spoke out to heal their own wounds and prevent future sexual abuse, many choosing to testify only after watching fellow survivors express a sense of catharsis.
The NCAA has signaled that it may investigate potential rules violations related to Nassar's crimes.
The school's governing board last week unanimously approved Engler as a temporary replacement for Lou Anna Simon, who resigned last month.
News of Nassar's sexual abuse comes at an especially important moment in light of the #MeToo movement, which survivors such as McKayla Maroney have specifically mentioned as motivating them to come forward about their experiences with Nassar.
Reporters tagged along Friday as investigators collected some records, a step that was knocked as a "political stunt" by a spokesman for John Engler, MSU's interim president and the state's former governor.
Maia Christopher, executive director of the Association for the Treatment of Sexual Abusers in OR, said many people like to joke about what might happen to sex offenders in prison, but such comments are counter-productive.
Former Michigan State athletic director Mark Hollis retired last week in the wake of the Larry Nassar sex abuse scandal and just before ESPN published a report detailing various allegations involving Michigan State football and basketball players, questioning how the athletic department handled those cases.
As Cunningham delivered Nassar's sentence on Monday, Rachael Denhollander, the first woman to make her allegations of abuse public in 2016, smiled broadly and squeezed her husband's hand.
Around the country, the former Roman Catholic priest John Geoghan, who was convicted of child sex abuse and murdered in his MA cell in 2003, is among the more notorious inmates to die violently behind bars.
USA Gymnastics reported Nassar to the Federal Bureau of Investigation in July 2015, but he continued to see patients at MSU until a newspaper exposed him in September 2016.
Boyce says she feels relief, as if a chapter in her life has ended.
Nassar continued to treat, and assault, patients at a Michigan State clinic until August 2016, when another victim filed a complaint with Michigan State police and told her story to the Indianapolis Star. But more than 260 women and girls say he abused them, including while he worked at Michigan State University and USA Gymnastics.
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With the criminal proceedings done, she said, victims "will now be turning our attention with even greater force to the institutional dynamics that led to the greatest sexual assault scandal in history". America's most accomplished gymnasts have said Nassar sexually abused them, including 2016 gold medalists Aly Raisman, Simone Biles, and Gabby Douglas.
"The defendant methodically planned and carried out years of molestation against children", said Cunningham in her Eaton County courtroom.
Larry Nassar's final sentence for serial sexual assault now turns the scandal's spotlight toward major institutions, including Michigan State University, where many of his abuses occurred.
But he also had a very dark side, sexually assaulting 265 known victims over two decades.
Cunningham says Nassar's conduct "spans the country and the world". "You don't get it and I do not believe there is a likelihood that you could be reformed".
Nassar told the court: "It's impossible to convey the breadth and depth of how sorry I am to each and every one".
Nassar - formerly renowned as a top doctor for U.S. Gymnastics and MSU and now disgraced as a man who repeatedly abused the young athletes who trusted him and came to him for help - is to be sentenced for sexual assault in Eaton County Circuit Court today. Nassar's victims vow to keep fighting for accountability after Monday's sentence in MI. The case centers on sexual assaults at Twistars, a gym for elite gymnasts.
In both Ingham and Eaton counties, girls and women gave wrenching and powerful accounts of how Nassar abused them, sometimes with their own parents present in the exam room. USA Gymnastics, the US Olympic Committee and Michigan State University all employed Nassar for decades. It is also facing scores of lawsuits filed by victims and parents. She says Nassar was believed by authorities for years and "each time he got away, he was empowered to continue and ideal his abuse".
Nassar, 54, is expected to spend the remainder of his life in prison. He listened to dozens of victims last week and was nearly attacked by a man whose three daughters said they were molested.
Those inquiries include a special prosecutor and a legislative probe in MI, a law firm investigating the U.S. Olympic Committee and a Texas Rangers review of claims that Nassar assaulted some of the world's best gymnasts while they trained at a ranch southeast of Huntsville.
Nassar pleaded guilty to federal child pornography charges and was sentenced to 60 years in prison in December.