***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 purpose of this study was to investigate the physiological and psychological effects of massage on  delayed onset muscle soreness ( DOMS ) . METHODS Eighteen volunteers were r and omly assigned to either a massage or control group . DOMS was induced with six sets of eight maximal eccentric contractions of the right hamstring , which were followed 2 h later by 20 min of massage or sham massage ( control ) . Peak torque and mood were assessed at 2 , 6 , 24 , and 48 h postexercise . Range of motion ( ROM ) and intensity and unpleasantness of soreness were assessed at 6 , 24 , and 48 h postexercise . Neutrophil count was assessed at 6 and 24 h postexercise . RESULTS A two factor ANOVA ( treatment v time ) with repeated measures on the second factor showed no significant treatment differences for peak torque , ROM , neutrophils , unpleasantness of soreness , and mood ( p > 0.05 ) . The intensity of soreness , however , was significantly lower in the massage group relative to the control group at 48 h postexercise ( p < 0.05 ) . CONCLUSIONS Massage administered 2 h after exercise induced muscle injury did not improve hamstring function but did reduce the intensity of soreness 48 h after muscle insult Massage therapy is commonly used following endurance running races with the expectation that it will enhance post-run recovery of muscle function and reduce soreness . A limited number of studies have reported little or no influence of massage therapy on post-exercise muscle recovery . However , no studies have been conducted in a field setting to assess the potential for massage to influence muscle recovery following an actual endurance running race . To evaluate the potential for repeated massage therapy interventions to influence recovery of quadriceps and hamstring muscle soreness , recovery of quadriceps and hamstring muscle strength and reduction of upper leg muscle swelling over a two week recovery period following an actual road running race . Twelve adult recreational runners ( 8 male , 4 female ) completed a half marathon ( 21.1 km ) road race . On days 1,4 , 8 , and 11 post-race , subjects received 30 minutes of st and ardized massage therapy performed by a registered massage therapist on a r and omly assigned massage treatment leg , while the other ( control ) leg received no massage treatment . Two days prior to the race ( baseline ) and preceding the treatments on post-race days 1 , 4 , 8 , and 11 the following measures were conducted on each of the massage and control legs : strength of quadriceps and hamstring muscles , leg swelling , and soreness perception . At day 1 , post-race quadriceps peak torque was significantly reduced ( p < 0.05 ) , and soreness and leg circumference significantly elevated ( p < 0.05 ) relative to pre-race values with no difference between legs . This suggested that exercise-induced muscle disruption did occur . Comparing the rate of return to baseline measures between the massaged and control legs , revealed no significant differences ( p > 0.05 ) . All measures had returned to baseline at day 11 . Massage did not affect the recovery of muscles in terms of physiological measures of strength , swelling , or soreness . However , question naires revealed that 7 of the 12 participants perceived that the massaged leg felt better upon recovery . Key PointsMassage does not appear to affect physiological indices of muscle recovery post exercise . Massage does appear to positively influence perceptions of recovery . More research needs to be completed on the purported benefits of massage PURPOSE The intention of this study was to assess the effectiveness of massage on muscle recovery as a function of therapist education in participants who completed a 10-km running race . METHODS Race participants were offered a 12- to 15-min massage immediately post-event . Participants were r and omly assigned to a student therapist with either 450 , 700 , or 950 h of didactic training in massage .  Muscle soreness was recorded by question naire using a 0- to 10-point visual scale at time points immediately before and after massage , and 24 and 48 h post-event . Eight hundred ninety-five subjects were recruited , with 317 subjects returning question naires from all time points . RESULTS Race participants who received massage from student therapists with 950 h of didactic training reported significantly greater improvement in muscle soreness across time compared with those who received massage from therapists with 700 or 450 h of education in massage ( P < 0.01 ) . On study entry , there was no difference in muscle soreness ( P = 0.99 ) , with a group mean of 4.4 + /- 0.4 ; at the 24-h measurement , soreness was 2.4 + /- 0.6 , 3.7 + /- 0.5 , and 3.6 + /- 0.9 for the 950- , 700- , and 450-h groups , respectively ( P < 0.01 ) . CONCLUSION Level of therapist training was shown to impact effectiveness of  massage  as a post-race recovery tool ; greater reduction in muscle soreness was achieved by therapists with 950 h of training as opposed to those with 700 or 450 The physiological adaptations to sauna bathing could enhance endurance performance . We have therefore performed a cross-over study in which six male distance runners completed 3 wk of post-training sauna bathing and 3 wk of control training , with a 3 wk washout . During the sauna period , subjects sat in a humid sauna at 89.9+/-2.0 degrees C ( mean+/-st and ard deviation ) immediately post-exercise for 31+/-5 min on 12.7+/-2.1 occasions . The performance test was a approximately 15 min treadmill run to exhaustion at the runner 's current best speed over 5 km . The test was performed on the 1st and 2nd day following completion of the sauna and control periods , and the times were averaged . Plasma , red-cell and total blood volume were measured via Evans blue dye dilution immediately prior to the first run to exhaustion for each period . Relative to control , sauna bathing increased run time to exhaustion by 32 % ( 90 % confidence limits 21 - 43 % ) , which is equivalent to an enhancement of approximately 1.9 % ( 1.3 - 2.4 % ) in an endurance time trial . Plasma and red-cell volumes increased by 7.1 % ( 5.6 - 8.7 % ) and 3.5 % ( -0.8 % to 8.1 % ) respectively , after sauna relative to control . Change in performance had high correlations with change in plasma volume ( 0.96 , 0.76 - 0.99 ) and total blood volume ( 0.94 , 0.66 - 0.99 ) , but the correlation with change in red cell volume was unclear ( 0.48 , -0.40 to 0.90 ) . We conclude that 3 wk of post-exercise sauna bathing produced a worthwhile enhancement of endurance running performance , probably by increasing blood volume Delayed  onset muscle soreness  is a common problem that can interfere with rehabilitation as well as activities of daily living . The purpose of this study was to test the impact of therapeutic massage , upper body ergometry , or microcurrent electrical stimulation on muscle soreness and force deficits evident following a high-intensity eccentric exercise bout . Forty untrained , volunteer female subjects were r and omly assigned to one of three treatment groups or to a control group . Exercise consisted of high-intensity eccentric contractions of the elbow flexors . Resistance was reduced as subjects fatigued , until they reached exhaustion . Soreness rating was determined using a visual analog scale . Force deficits were determined by measures of maximal voluntary isometric contraction at 90 degrees of elbow flexion and peak torque for elbow flexion at 60 degrees/sec on a Cybex II isokinetic dynamometer . Maximal voluntary isometric contraction and peak torque were determined at the 0 hour ( before exercise ) and again at 24 and 48 hours postexercise . Treatments were applied immediately following exercise and again at 24 hours after exercise . The control group subjects rested following their exercise bout . Statistical analysis showed significant increases in soreness rating and significant decreases in force generated when the 0 hour was compared with 24- and 48-hour measures . Further analysis indicated no statistically significant differences between massage , microcurrent electrical stimulation , upper body ergometry , and control groups Abstract Objective To evaluate the effectiveness of acupressure in terms of disability , pain scores , and functional status . Design R and omised controlled trial . Setting Orthopaedic clinic in Kaohsiung , Taiwan . Participants 129 patients with chronic low back pain . Intervention Acupressure or physical therapy for one month . Main outcome measures Self administered Chinese versions of st and ard outcome measures for low back pain ( primary outcome : Rol and and Morris disability question naire ) at baseline , after treatment , and at six month follow-up . Results The mean total Rol and and Morris disability question naire score after treatment was significantly lower in the acupressure group than in the physical therapy group regardless of the difference in absolute score ( - 3.8 , 95 % confidence interval - 5.7 to - 1.9 ) or mean change from the baseline ( - 4.64 , - 6.39 to - 2.89 ) . Acupressure conferred an 89 % ( 95 % confidence interval 61 % to 97 % ) reduction in significant disability compared with physical therapy . The improvement in disability score in the acupressure group compared with the physical group remained at six month follow-up . Statistically significant differences also occurred between the two groups for all six domains of the core outcome , pain visual scale , and modified Oswestry disability question naire after treatment and at six month follow-up . Conclusions Acupressure was effective in reducing low back pain in terms of disability , pain scores , and functional status . The benefit was sustained for six months PURPOSE The purpose of the present study was to determine whether activity would affect the recovery of muscle function after high-force eccentric exercise of the elbow flexors . METHODS Twenty-six male volunteers were r and omly assigned to one of three groups for a 4-d treatment period : immobilization ( N = 9 ) , control ( N = 8) , and light exercise ( N = 9 ) . Relaxed arm angle ( RANG ) , flexed arm angle ( FANG ) , maximal isometric force ( MIF ) , and perceived muscle soreness ( SOR ) were obtained for 3 consecutive days pre-exercise ( baseline ) , immediately post-exercise , and for 8 consecutive days after the 4-d treatment period ( recovery ) . During the treatment period , the immobilization group had their arm placed in a cast and supported in a sling at 90 degrees . The control group had no restriction of their arm activity . The light exercise group performed a daily exercise regimen of 50 biceps curls with a 5-lb dumbbell . RESULTS All subjects showed a prolonged decrease in RANG , increase in FANG , loss in MIF , and increase in SOR in the days after eccentric exercise . During recovery , there was no significant interaction observed among groups over time in RANG ( P > 0.05 ) or FANG ( P > 0.05 ) , but there was a significant interaction observed among groups over time in both MIF ( P < 0.01 ) and SOR ( P < 0.01 ) . Recovery of MIF was facilitated by light exercise and immobilization , whereas recovery from SOR was facilitated by light exercise and delayed by immobilization . CONCLUSIONS The recovery of MIF in both the light exercise and immobilization groups suggests that more than one mechanism may be involved in the recovery of isometric force after eccentric exercise Thirteen males and 7 females completed their maximum number of leg extensions against a half maximum load . In a r and omised , crossover study they were exercised to fatigue using an ergonometer , ski-squats and leg extensions followed either by a 6 min massage or rest after which they again completed their maximum number of leg extensions against half maximum load . The process was repeated a few days later with the alternative condition ( rest or massage ) . The results showed that massage  after exercise fatigue significantly improved quadriceps performance compared to rest ( p = 0.001 ) . The data was further analysed in relation to age and gender The aim of this study was to examine the acute effects of pre- performance lower limb massage after warm-up on explosive and high-speed motor capacities and flexibility . Twenty-four physically active healthy Caucasian male subjects volunteered to participate in this study . All subjects were from a Physical Education and Sport Department in a large university in Turkey . The study had a counterbalanced crossover design . Each of the subjects applied the following intervention protocol s in a r and omised order ; ( a ) massage , ( b ) stretching , and ( c ) rest . Before ( pre ) and after ( post ) each of the interventions , the 10 meter  acceleration  ( AS ) , flying start 20 meter  sprint  ( FS ) , 30 meter sprint from st and ing position ( TS ) , leg reaction time ( LR ) , vertical jump ( VJ ) and sit & reach ( SR ) tests were performed . A Wilcoxon 's signed rank test was used to compare before and after test values within the three interventions ( massage , stretching and rest ) . The data showed a significant worsening , after massage and stretching interventions , in the VJ , LR ( only in stretching intervention ) , AS and TS tests ( p < 0.05 ) , and significant improvement in the SR test ( p < 0.05 ) . In contrast , the rest intervention led only to a significant decrement in TS performance ( p < 0.05 ) . In conclusion , the present findings suggest that performing 10 minute posterior and 5 minute anterior lower limb Swedish massage has an adverse effect on vertical jump , speed , and reaction time , and a positive effect on sit and reach test results . Key pointsPerforming 10 minute posterior and  
    Output:
    
Conclusion The effects of massage on performance recovery are rather small and partly unclear , but can be relevant under appropriate circumstances ( short-term recovery after intensive mixed training ) .
However , it remains question able if the limited effects justify the widespread use of massage as a recovery intervention in competitive athletes