***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: This study monitored plasma and skeletal muscle markers of free-radical-mediated damage following maximum eccentric and concentric exercise , to examine the potential role of free radicals in exercise-induced muscle damage . Fourteen male volunteers performed either ( 1 ) a bout of 70 maximum eccentric and a bout of 70 maximum concentric muscle actions of the forearm flexors  ( the bouts being separated by 4 weeks ; n = 8) or ( 2 ) a  bout of 80 maximum eccentric and a bout of 80 maximum concentric muscle actions of the knee extensors  ( the bouts being separated by 1 week ; n=6 ) . Plasma markers of lipid peroxidation , thiobarbituric acid-reactive substances ( TBARS ) and diene-conjugated compounds ( DCC ) were monitored in the arm protocol and skeletal muscle markers of oxidative lipid and protein damage , malondialdehyde ( MDA ) and protein carbonyl derivatives ( PCD ) respectively , were monitored in the leg protocol . In both protocol s , the contralateral limb was used for the second bout and the order of the bouts was r and omised between limbs . Repeated measures ANOVA indicated significant changes from baseline following eccentric arm work on the measures of serum creatine kinase activity ( P < 0.05 ) , maximum voluntary torque production ( P < 0.01 ) and relaxed arm angle ( P < 0.01 ) . Subjective muscle soreness peaked 2 days after eccentric arm work ( P < 0.05 , Wilcoxon test ) . However , there were no changes in the plasma levels of TBARS or DCC following the eccentric or concentric arm exercise . Immediately after concentric leg exercise , skeletal muscle PCD concentrations was significantly higher than that observed immediately after eccentric work ( P < 0.05 ) . However , no significant difference between the eccentric and concentric knee extensor bouts was observed on the measure of skeletal muscle MDA concentration . The results of this study offer no support for the involvement of oxygen free radicals in exercise-induced muscle damage OBJECTIVES : The ability to maximally generate active muscle tension during resistance training has been established to be a primary determinant for strength development . The influence of intrasession rest intervals may have a profound effect on strength gains subsequent to short-term high intensity training . The purpose of this study was to examine the effects of rest interval on strength and functional performance after four weeks of isokinetic training . METHODS : Fifteen healthy college aged individuals were r and omly assigned to either a short rest interval group ( group 1 , n = 8) or a long rest interval group ( group 2 , n = 7 ) . Subjects were evaluated for quadriceps and hamstring isokinetic strength at 60 ( five repetitions ) and 180 ( 30 repetitions ) degrees/second and functional performance with the single leg hop for distance test . One leg of each subject was r and omly assigned to a four week , three days/week isokinetic strength training programme for concentric knee extension and flexion performed at 90 degrees/second . Subjects in group 1 received a 40 second rest interval in between exercise sets , whereas subjects in group 2 received a 160 second rest period . RESULTS : A two factor analysis of variance for the pre-test -- post-test gain scores ( % ) showed significantly greater improvements for isokinetic hamstring total work and average power at 180 degrees/second for the trained limb of subjects in group 2 than their contralateral non-trained limb and the subjects in group 1 . Significantly greater improvements for the single leg hop for distance were also found for the trained limbs of subjects in both groups as compared with the non-trained limbs . CONCLUSIONS : The findings indicate that a relatively longer intrasession rest period result ed in a greater improvement in hamstring muscle strength during short term high intensity training The effects of warm underwater water-jet massage on neuromuscular functioning , selected biochemical parameters ( serum creatine kinase , lactic dehydrogenase , serum carbonic anhydrase , myoglobin , urine urea and creatinine ) and muscle soreness were studied among 14 junior track and field athletes . Each subject spent , in a r and omized order , two identical training weeks engaged in five strength/power training sessions lasting 3 days . The training weeks differed from each other only in respect of underwater water jet massage treatments . These were used three times ( 20 min each ) during the treatment week and not used during the control week . During the treatment week continuous jumping power decreased and ground contact time increased significantly less ( P < 0.05 ) and serum myoglobin increased more than during the control week . It is suggested that underwater water-jet massage in connection with intense strength/power training increases the release of proteins from muscle tissue into the blood and enhances the maintenance of neuro-muscular performance capacity The effect of a combination of a warm-up , stretching exercises and massage on subjective scores for  delayed onset muscle soreness ( DOMS )  and objective functional and biochemical measures was studied . Fifty people , r and omly divided in a treatment and a control group , performed eccentric exercise with the forearm flexors for 30 min . The treatment group additionally performed a warm-up and underwent a stretching protocol before the eccentric exercise and massage afterwards .  Functional and biochemical measures were obtained before , and 1 , 24 , 48 , 72 and 96h after exercise . The median values at the five post-exercise time points differed significantly for DOMS measured when the arm was extended ( p = 0.043 ) . Significant main effects for treatment were found on the maximal force ( p = 0.026 ) , the flexion angle of the elbow ( p = 0.014 ) and the creatine kinase activity in blood ( p = 0.006 ) . No time-by-treatment interactions were found . DOMS on pressure , extension angle and myoglobin concentration in blood did not differ between the groups . This combination of a warm-up , stretching and massage reduces some negative effects of eccentric exercise , but the results are inconsistent , since some parameters were significantly affected by the treatment whereas others were not , despite the expected efficacy of a combination of treatments . The objective measures did not yield more unequivocal results than the subjective DOMS scores It was hypothesized that athletic massage administered 2 hours after eccentric exercise would disrupt an initial crucial event in acute inflammation , the accumulation of neutrophils . This would result in a diminished inflammatory response and a concomitant reduction in delayed onset muscle soreness ( DOMS ) and serum creatine kinase ( CK ) .  Untrained males were r and omly assigned to a  massage ( N = 7 ) or control ( N = 7 ) group . All performed five sets of isokinetic eccentric exercise of the elbow flexors and extensors . Two hours after exercise , massage subjects received a 30-minute athletic massage ; control subjects rested .  Delayed onset muscle soreness and CK were assessed before exercise and at 8 , 24 , 48 , 72 , 96 , and 120 hours after exercise . Circulating neutrophils were assessed before and immediately after exercise , and at 30-minute intervals for 8 hours ; cortisol was assessed before and immediately after exercise , and at 30-minute intervals for 8 hours ; cortisol was assessed at similar times . A trend analysis revealed a significant ( p < 0.05 ) treatment by time interaction effect for 1 ) DOMS , with the massage group reporting reduced levels ; 2 ) CK , with the massage group displaying reduced levels ; 3 ) neutrophils , with the massage group displaying a prolonged elevation ; and 4 ) cortisol , with the massage group showing a diminished diurnal reduction . The results of this study suggest that sports massage will reduce DOMS and CK when administered 2 hours after the termination of eccentric exercise . This may be due to a reduced emigration of neutrophils and /or higher levels of serum cortisol Manual massage is commonly assumed to enhance long term muscle recovery from intense exercise , partly due to its ability to speed healing via enhanced muscle blood flow . We tested these assumptions by daily ( for four days ) massaging the quadriceps muscles of one leg on subjects who had previously completed an intense bout of eccentric quadriceps work with both legs . Immediate post-exercise isometric and dynamic quadriceps peak torque measures had declined to approximately 60 - 70 % of pre-exercise values in both legs . Peak torques for both the massage and control leg tended to slowly return toward pre-exercise values through the subsequent four days ( 96 hrs ) . There was no significant difference between the isometric and dynamic peak torques between massage and control legs up to 96 hours post-exercise . Leg blood flow was estimated by determining femoral artery and vein mean blood velocities via pulsed Doppler ultrasound velocimetry . Massage of the quadriceps muscles did not significantly elevate arterial or venous mean blood velocity above resting levels , while light quadriceps muscle contractions did . The perceived level of delayed onset muscle soreness tended to be reduced in the massaged leg 48 - 96 hours post-exercise . It was concluded that massage was not an effective treatment modality for enhancing long term restoration of post-exercise muscle strength and its use for this purpose in athletic setting s should be question ed The purpose of this study was to compare the analgesic effect of pulsating ultrasound treatment and placebo on delayed onset of muscle soreness produced by an eccentric exercise bout . In addition , the effect of pulsed ultrasound on muscular performance following an eccentric exercise bout was studied . Eighteen untrained subjects were r and omly assigned to : 1 ) ultrasound ( A ) [ N = 6 ] over the areas of concentrated muscle soreness , i.e. proximal vastus lateralis and distal vastus medialis ; 2 ) placebo ultrasound ( B ) [ N = 6 ] ; and 3 ) no therapeutic intervention ( C ) [ N = 6 ] . Baseline data were recorded for maximum isometric knee extension contraction ( MVC ) , maximum knee extension torque ( MT ) , knee extension work ( W ) , and soreness perception ( SP ) . All values were subsequently reassessed 24 and 48 hours after intense muscular activity . Immediately following the 24 hour re assessment the A group received ultrasound treatment , the B group received placebo ultrasound , while the C group received no treatment . Percent deviation from baseline of SP , MVC , MT and W were significantly less for A than B and C ( p less than 0.05 ) at 48 hours post muscle soreness bout . These data indicate that pulsed ultrasound accelerates restoration of normal muscle performance , and thus is effective in decreasing delayed onset of muscle soreness . The mechanism for decreasing soreness perception in the muscle is unknown , but may be related to decreasing intramuscular pressure and /or decreasing the inflammatory response 
    Output:
    
However , most suggest that post-exercise massage may alleviate symptoms of DOMS .
CONCLUSIONS Massage therapy may be a promising treatment for DOMS .