***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: Eighty-seven male inmates from a state prison and 70 inmates from a county jail volunteered as subjects . The subjects , age 20 to 35 yrs , were assigned r and omly into a control or exercise group . Their Vo2max and treadmill performance values were determined before and after a 20 week jogging program . Training intensity was between 85 and 90 percent of maximum heart rate and involved workouts 3 days/week for 15 , 30 , or 45-min duration at the state prison and for 30-min 1 , 3 , or 5 days/week at the country jail . Cardiorespiratory fitness improved in direct proportion to frequency and duration of training . Injury , occurred in 22 % , 24 % and 54 % of the 15 , 30 , and 45-min duration groups and in 0 % , 12 % , and 39 % of the 1 , 3 , and 5-day/week groups , respectively . Attrition result ing from injury occurred in 0 % , 0 % , and 17 % and in 0 % , 4 % , and 6 % of the same respective groups . Attrition due to lack of interest was similar for all training groups ( 25 % ) , but was significantly lower in the control groups ( 10 % ) . Although the results showed a greater increase in cardiorespiratory fitness for the 45-min duration and 5-day/week groups , these programs are not recommened for beginning joggers because of the significantly greater percent of injuries Three hundred fifty male recruits were r and omly allocated to either the st and ard recruit training program ( N = 180 ) or substituted a weighted-march activity for all formal run periods ( N = 170 ) in the physical training program . All injuries were seen at a single medical facility , and the cause , location , and severity of injury were recorded in the medical documents . Lower-limb injuries constituted 79.8 % of all Run injuries and 61.1 % of all Walk injuries . Foot ( 18.9 % ) , knee ( 16.7 % ) , ankle ( 13.3 % ) , and shoulder ( 8.9 % ) were the most common sites of injury in the Walk group . In the Run group , the most common sites were knee ( 32.1 % ) , ankle ( 18.3 % ) , foot ( 11.9 % ) , and shin ( 7.3 % ) . There were two stress fractures ( tibial ) in the Run group and none in the Walk group , giving the Run group an incidence of 1.1 % . There were 10 medical discharges  in the Walk group and 16 in the Run group . Ten ( 62.5 % ) of the Run and 2 ( 20 % ) of the Walk discharges were due to lower-limb causes . Of these , only 1 ( 10 % ) of the Walk and 4 ( 25 % ) of the Run injuries were not considered to be pre-existing conditions . Marching ( 30.0 % ) , physical training ( 25.5 % ) , and the obstacle course ( 11.1 % ) were the most frequent causes of injury in the Walk group . In the Run group , the leading causes were running ( 36.6 % ) , physical training ( 19.2 % ) , and the obstacle course ( 14.6 % ) . Running was the major cause of knee injury in the Run group ( 17/35 ) , whereas physical training was the major cause of knee injury in the Walk group ( 5/15 ) . Running was also the major cause of other lower-limb injuries in the Run group ( 19/58 ) , whereas marching was the major cause in the Walk group ( 19/50 ) . Lower-limb injuries were more frequent in the Run group , with running cited as the major cause of these injuries Three hundred fifty male recruits were r and omly allocated to either the st and ard recruit training program ( N = 180 ) or substituted a weighted march activity for all running periods in the physical training program ( N = 170 ) . There were no other differences in the formal training program . The incidence of injury was 37.6 and 46.6 % in the walk and run groups , respectively . The rate of injury was 52.9/100 recruits in the walk group and 61.7/100 in the run group . The exposure incidence was 12.8/1,000 hours of physical training in the walk group and 14.9/1,000 hours in the run group . There was no statistically significantly difference in the total number of injured recruits in the two groups ( 64 vs. 85 , chi(2 ) = 2.90 , p = 0.09 , relative risk [ RR ] = 1.24 ) . There were , however , significantly more lower-limb ( 43 vs. 75 , chi(2 ) = 9.77 , p = 0.0018 , RR = 1.65 ) and knee injuries ( 15 vs. 35 , chi(2 ) = 6.54 , p = 0.011 , RR = 2.14 ) in the Run group . Lower-limb injuries constituted 79.8 % of all Run injuries and 61.1 % of all Walk injuries . Injuries in the Run group produced more morbidity , with nearly double the number of days of restriction , hospitalization , and not fit for duty . St and ardized morbidity rates showed an average of 5.4 days of restriction per injury in the Run group and 3.96 days of restriction per injury in the Walk group . Reduction of running distance in the physical training program result ed in significant reductions in both the incidence of lower-limb injury and the overall severity of injury Objective : To determine if measurable lower extremity alignment is a risk factor for overuse running injuries . Design : Prospect i ve cohort study . Setting : Thirty-two week marathon training program . Patients or Participants : Three hundred fifty-five volunteers from the marathon training program began the study ; 255 finished the study . Interventions : None . Main Outcome Measures : Past training and injury history was determined by question naire , and five lower extremity alignment measures were performed at the beginning of the training program : arch index ( AI ) , heel valgus ( HV ) , knee tubercle-sulcus angle ( TSA ) , knee varus ( KV ) , and leg-length difference ( LLD ) . Overuse injuries , incurred by the runners and categorized by anatomic parts , were recorded during the training period . Results : Ninety subjects experienced overuse injuries .  Multivariate analyses with stepwise Poisson regression showed few consistent relationships between alignment and overuse injury rates . Higher AI was protective against overall injuries and knee injuries ; higher HV was protective against knee and foot injuries ; higher TSA was associated with shin injuries ; higher KV was associated with shin injuries ; and low LLD was associated with more overall injuries . Conclusions : Minor variations in lower extremity alignment do not appear conclusively to be major risk factors for overuse injuries in runners . Because of the study limitations and the likely multifactorial nature of running injuries , further study is suggested , perhaps in more novice runners The purpose of this intervention study was to prove that increasing flexibility of the hamstring musculotendinous unit would decrease the number of lower extremity overuse injuries that occur in military infantry basic trainees . Two different companies going through basic training at the same time were used . Hamstring flexibility was checked at the beginning and at the end of the 13-week infantry basic training course . The control company ( N 148 ) proceeded through normal basic training . The intervention company ( N 150 ) followed the same program but added three hamstring stretching sessions to their already scheduled fitness program . All subsequent lower extremity overuse injuries were recorded through the troop medical clinic . Hamstring flexibility increased significantly in the intervention group compared with the control group . The number of injuries was also significantly lower in the intervention group . Forty-three injuries occurred in the control group for an incidence rate of 29.1 % , compared with 25 injuries in the intervention group for an incidence rate of 16.7 % . Thus , in this study , the number of lower extremity overuse injuries was significantly lower in infantry basic trainees with increased hamstring flexibility Sedentary individuals , particularly new military recruits , who start a physical training program have a substantial risk of developing an overuse injury of the lower limb . In this study we investigated the effect of neoprene insoles on the incidence of overuse injuries during 9 weeks of basic military training . The experimental group consisted of 237 r and omly selected new recruits , while 1151 recruits were the control group . Insoles were given to the experimental group and compliance was monitored . A panel of doctors documented and classi fied all injuries occurring during the 9 week period . A total of 54 ( 22.8 % ) and 237 ( 31.9 % ) injuries were reported in the experimental and control groups , re spectively . In both groups , the majority of injuries were overuse ( experimental group , 90.7 % ; control group , 86.4 % ) . The mean weekly incidence of total overuse injuries and tibial stress syndrome was significantly lower ( P < 0.05 ) in the experimental group . The mean incidence of stress fractures was lower in the experimental group but not significantly so ( 0.05 < P < 0.1 ) . This study shows that the incidence of total overuse injuries and tibial stress syndrome during 9 weeks of basic military training can be reduced by wearing insoles The purpose of this study was to evaluate the effect of a health education intervention on  running injuries .  The intervention consisted of information on , and the sub sequent performance of , st and ardized warm-up , cool- down , and stretching exercises .  Four hundred twenty- one male recreational runners were matched for age , weekly running distance , and general knowledge of preventing sports injuries . They were r and omly split into an intervention and a control group : 167 control and 159 intervention subjects participated throughout the study . During the 16-week study , both groups kept a daily diary on their running distance and time , and reported all injuries . In addition , the intervention group was asked to note compliance with the st and ardized program . At the end of the study period , knowledge and attitude were again measured . There were 23 injuries in the control group and 26 in the intervention group . Injury incidence for control and intervention sub jects was 4.9 and 5.5 running injuries per 1000 hours , respectively . The intervention was not effective in re ducing the number of running injuries ; it proved signifi cantly effective ( P < 0.05 ) in improving specific knowl edge of warm-up and cool-down techniques in the intervention group . This positive change can perhaps be regarded as a first step on the way to a change of behavior , which may eventually lead to a reduction of running injuries As the number of runners has increased dramatically , so has the incidence of running-related injuries . In order to determine what training factors are associated with running-related injuries , as well as what percentage of injured runners seeks professional medical attention , a r and om sample of entrants to a 10 kilometer race was asked to complete a question naire . There were 451 respondents , 355 men and 96 women , with a nonre sponse rate of 12.7 % . Nonrespondents did not differ from respondents with regard to age or sex . Forty- seven percent of respondents indicated that they had sustained a running-related injury in the last 2 years . Injured runners differed significantly from noninjured runners in that they were more likely to have ( 1 ) run more miles per week , ( 2 ) run more days per week , ( 3 ) run a faster pace , ( 4 ) run more races in the last year , ( 5 ) stretched before running , and ( 6 ) not participated regularly in other sports . Associated with injury , but not statistically significant , were those who had run mara thons and had done muscle-strengthening exercises . No association was found with regard to the length of time running , running surfaces , part of the foot first contacting the ground , or running intervals , sprints , or hills . Seventy percent of those injured sought profes sional medical care , with 76 % of these having a good or excellent recovery from their injuries . Compliance with medical advice correlated well with treatment suc cess This prospect i ve study of 583 habitual runners used baseline information to examine the relationship of several suspected risk factors to the occurrence of  running-related injuries of the lower extremities that were severe enough to affect running habits , cause a visit to a health professional , or require use of medication . During the 12-month follow-up period , 252 men ( 52 % ) and 48 women ( 49 % ) reported at least one such injury . The multiple logistic regression results identified that running 64.0 km ( 40 miles ) or more per week was the most important predictor of injury for men during the follow-up period ( odds ratio = 2.9 ) . Risk also was associated with having had a previous injury in the past year ( odds ratio = 2.7 ) and with having been a runner for less than 3 years ( odds ratio = 2.2 ) . These results suggest that the incidence of lower-extremity injuries is high for habitual runners , and that for those new to running or those who have been previously injured , reducing weekly distance is a reasonable preventive behavior In a prospect i ve study , quantitative measures of the structure of the longitudinal arch of the foot were established and related to the incidence of stress fractures in the bones of the lower limbs of military recruits . In addition , the role of a semirigid orthotic device ( Langer military stress orthotic ) in preventing stress fractures was evaluated as a function of the structure of the longitudinal arch . Femoral and tibial stress fractures were found to be more prevalent in the presence of feet with high arches , whereas the incidence of metatarsal fractures was higher in feet with low arches . The use of an orthotic device reduced the incidence of femoral stress fractures only in the presence of feet with high arches and the incidence of metatarsal fractures only among feet with low arches . The findings 
    Output:
    
Runners can reduce risk of injury by using established training programs that gradually increase distance or time of running and provide appropriate rest .
Orthoses and heel lifts can correct malalignments of the leg .
Prevention addresses factors proven to cause running injuries .