***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objectives : The reproducibility of clinical tests for skin extensibility and consistency , essential for differentiating between types of Ehlers – Danlos syndrome ( EDS ) and benign joint hypermobility syndrome ( BJHS ) , is unknown . Para clinical methods may provide objective differential diagnostic methods . Methods : Six EDS , 11 BJHS , and 19 controls completed the trial . We analysed the overall inter‐examiner agreement on clinical tests  for skin extensibility and consistency , in addition to analyses on suction cup ( SC ) and soft tissue stiffness meter ( STSM ) methods . Results : Overall agreement on tests for skin extensibility and consistency varied between 0.44 and 0.72 . Extensibility evaluated by SC showed an insignificant difference between EDS patients and controls ( p = 0.056 ) . Consistency evaluated by STSM showed significant differences ( p = 0.001 ) . Conclusions : Overall inter‐examiner agreement on clinical tests for skin extensibility and consistency was below 0.80 , which was required a priori to conduct a reproducibility study . Further refinement of tests and a training phase are necessary . The SC and STSM results are encouraging but must be reproduced in a larger study population Simple but objective measurement of soft tissue consistency would be advantageous in the assessment of many neurological , lymphostatic and venous disorders . The aim of the present study was to evaluate the feasibility of using a novel h and -held computerized soft tissue stiffness meter ( STSM ) . The STSM describes the soft tissue stiffness ( STS ) in the form of the instantaneous force ( N ) by which the tissue resists the constant deformation produced by a cylindrical intender . Firstly , the STSM was used to test elastomer sample s with known mechanical properties . In the in vivo assessment , 12 healthy , nondisabled adults ( age range , 24 - 57 years ) and 16 subjects with chronic myofascial neck pain syndrome ( age range , 27 - 55 years ) were studied . To study the reproducibility ( coefficient of variation ( CV(% ) ) ) of the method , the measurement sites were either marked with a marker pen ( marked points ) or localized anatomically ( unmarked points ) . Measurements were made from the dorsal forearm ( Arm ) , trapezius ( Tra ) , levator scapulae ( Lev ) , infraspinatus ( Inf ) and deltoideus ( Del ) muscle areas . STS in the forearm was studied during different types of short-term relative isometric loading of the muscle as well as during venous occlusion . STS values of the myofascial trigger points in the Lev muscles were evaluated bilaterally . A linear , positive relationship was found between the indenter force ( N ) and the dynamic compressive modulus ( MPa ) of elastomer stiffness ( r(2 ) = 0.90 , n = 9 ) . Intra- and interrater CVs of marked and unmarked sites varied between 4.31 % and 12.06 % . STS increased linearly along the relative muscle load ( r(2 ) = 0.96 ) and nonlinearly during the venous occlusion ( r(2 ) = 0.97 ) . Statistically significant regional variation of STS was found between the different measurement sites ( p < 0.05 ) . In conclusion , STSM can evaluate tissue stiffness quantitatively and yield reproducible data 
    Output:
    
Quantitative measures of tissue mechanics have the potential to contribute towards more objective diagnosis of hEDS/HSD .