***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: Abstract The effect of analgesics on pathological pain in a double‐blind , complete cross‐over design was assessed by means of two rating scales , a  verbal rating scale ( VRS ) and visual analogue scale ( VAS ) .  The VRS is widely used , but has several disadvantages as compared to the  VAS  . The results obtained by means of the VRS showed higher F‐ratios ( analysis of variance and Kruskall‐Wallis H‐test ) than those obtained by means of the VAS . The VRS , which transfers a continous feeling into a digital system , seems to augment artificially the measurement of effects produced by analgesics , and the VAS seems to assess more closely what a patient actually experiences with respect to change in pain intensities . The correlation between the two scales was highly significant ( r = 0.81 , P < 0.001 ) . The calculated regression line ( y = −29.6 + 0.55 · x ) was not similar to the line of identity and showed much lower values for the VAS , supporting our intepretation . The distribution of the variances of the values obtained by means of both scales was not homogenous . This indicates that the homogeneity of the distribution of variances should always be checked and a Kruskall‐Wallis H‐test used , if they are inhomogenously distributed We recently showed that resistance exercise and ingestion of essential amino acids with carbohydrate ( EAA+CHO ) can independently stimulate mammalian target of rapamycin ( mTOR ) signaling and muscle protein synthesis in humans . Providing an EAA+CHO solution postexercise can further increase muscle protein synthesis . Therefore , we hypothesized that enhanced mTOR signaling might be responsible for the greater muscle protein synthesis when leucine-enriched EAA+CHOs are ingested during postexercise recovery . Sixteen male subjects were r and omized to one of two groups ( control or EAA+CHO ) . The EAA+CHO group ingested the nutrient solution 1 h after resistance exercise .  mTOR signaling was assessed by immunoblotting from repeated muscle biopsy sample s. Mixed muscle fractional synthetic rate ( FSR ) was measured using stable isotope techniques . Muscle protein synthesis and 4E-BP1 phosphorylation during exercise were significantly reduced ( P < 0.05 ) . Postexercise FSR was elevated above baseline in both groups at 1 h but was even further elevated in the EAA+CHO group at 2 h postexercise ( P < 0.05 ) . Increased FSR was associated with enhanced phosphorylation of mTOR and S6K1 ( P < 0.05 ) . Akt phosphorylation was elevated at 1 h and returned to baseline by 2 h in the control group , but it remained elevated in the EAA+CHO group ( P < 0.05 ) . 4E-BP1 phosphorylation returned to baseline during recovery in control but became elevated when EAA+CHO was ingested ( P < 0.05 ) . eEF2 phosphorylation decreased at 1 and 2 h postexercise to a similar extent in both groups ( P < 0.05 ) . Our data suggest that enhanced activation of the mTOR signaling pathway is playing a role in the greater synthesis of muscle proteins when resistance exercise is followed by EAA+CHO ingestion High-performance physical activity and postexercise recovery lead to significant changes in amino acid and protein metabolism in skeletal muscle . Central to these changes is an increase in the metabolism of the BCAA leucine .  During exercise , muscle protein synthesis decreases together with a net increase in protein degradation and stimulation of BCAA oxidation . The decrease in protein synthesis is associated with inhibition of translation initiation factors 4E and 4 G and ribosomal protein S6 under regulatory controls of intracellular insulin signaling and leucine concentrations . BCAA oxidation increases through activation of the branched-chain alpha-keto acid dehydrogenase ( BCKDH ) . BCKDH activity increases with exercise , reducing plasma and intracellular leucine concentrations . After exercise , recovery of muscle protein synthesis requires dietary protein or BCAA to increase tissue levels of leucine in order to release the inhibition of the initiation factor 4 complex through activation of the protein kinase mammalian target of rapamycin ( mTOR ) . Leucine 's effect on mTOR is synergistic with insulin via the phosphoinositol 3-kinase signaling pathway . Together , insulin and leucine allow skeletal muscle to coordinate protein synthesis with physiological state and dietary intake This study investigated the effects of acute branched-chain amino acid ( BCAA ) supplementation on recovery from exercise-induced muscle damage among experienced resistance-trained athletes . In a double-blind matched-pairs design , 16 resistance-trained participants , routinely performing hypertrophy training , were r and omly assigned to a BCAA ( n = 8) or placebo ( n = 8) group . The BCAAs were administered at a dosage of 0.087 g/kg body mass , with a 2:1:1 ratio of leucine , isoleucine , and valine . The participants performed 6 sets of 10 full-squats at 70 % 1-repetition maximum to induce muscle damage . All participants were diet-controlled across the study . Creatine kinase , peak isometric knee-extensor force , perceived muscle soreness , and countermovement jump ( CMJ ) height were measured immediately before ( baseline ) and at 1 h , 24 h , and 48 h postexercise . There were large to very large time effects for all measurements between baseline and 24 - 48 h. Between-group comparisons , expressed as a percentage of baseline , revealed differences in isometric strength at 24-h ( placebo ∼87 % vs. BCAA ∼92 % ; moderate , likely ) , CMJ at 24 h ( placebo ∼93 % vs. BCAA ∼96 % ; small , likely ) , and muscle soreness at both 24 h ( placebo ∼685 % vs. BCAA ∼531 % ; small , likely ) and 48 h ( placebo ∼468 % vs. BCAA ∼350 % ; small , likely ) . Acute supplementation of BCAAs ( 0.087 g/kg ) increased the rate of recovery in isometric strength , CMJ height , and perceived muscle soreness compared with placebo after a hypertrophy-based training session among diet-controlled , resistance-trained athletes . These findings question the need for longer BCAA loading phases and highlight the importance of dietary control in studies of this type PURPOSE This study aim ed to evaluate the benefit of using low-intensity running or electromyostimulation ( EMS ) to hasten the recovery process from eccentric-contraction-induced injury . METHODS Before and 30 min , 24 h , 48 h , and 96 h after a one-legged downhill run , electrical stimulations were applied to the femoral nerve of healthy volunteers . Superimposed twitches were delivered during isometric maximal voluntary contraction ( MVC ) to determine the voluntary activation level ( % VA ) . For 4 d after the exercise , each subject performed either ( i ) 30 min of running at 50 % VO2max , ( ii ) 30 min of low-frequency EMS on the lower limb extensor muscles , or ( iii ) passive recovery . RESULTS Recovery time courses of the different variables did not differ significantly among the three experimental conditions . MVC decreased 30 min after the exercise and did not recover thereafter ( P < 0.001 ) . Percent VA was depressed after the exercise ( P < 0.05 ) but did not contribute to MVC decrement thereafter . Mechanical responses to 80- and 20-Hz stimulation ( P80 and P20 , respectively ) were significantly reduced over time ( P < 0.01 and P < 0.001 , respectively ) . Interestingly , MVC , P20 , and P80 decrements were not statistically different ( -9.6 + /- 14.5 % , -13.2 + /- 14.2 % , and -12.3 + /- 11.3 % , respectively ) at 48 h , and the P20.P80(-1 ) ratio showed complete recovery at this time . CONCLUSIONS The different recovery modes had no significant effect on the recovery time course of contractile properties . The prolonged torque loss is mainly due to peripheral alterations . Our results suggest that an alteration of the excitation-contraction coupling might be involved during the first 2 d after the eccentric exercise . From 2 to 4 d , damage to force-generating structures could account for the remaining torque deficit In the present study , we proposed an original and robust methodology which combines the spatial normalization of skeletal muscle images , the statistical parametric mapping ( SPM ) analysis and the use of a specific parcellation in order to accurately localize and quantify the extent of skeletal muscle damage within the four heads of the quadriceps femoris . T2 maps of thigh muscles were characterized before , two ( D2 ) and four ( D4 ) days after 40 maximal isometric electrically-evoked contractions in 25 healthy young males . On the basis of SPM analysis of coregistrated T2 maps , the alterations were similarly detected at D2 and D4 in the superficial and distal regions of the vastus medialis ( VM ) whereas the proportion of altered muscle was higher in deep muscle regions of the vastus lateralis at D4 ( deep : 35 ± 25 % , superficial : 23 ± 15 % ) as compared to D2 ( deep : 18 ± 13 % , superficial : 17 ± 13 % ) . The present methodology used for the first time on skeletal muscle would be of utmost interest to detect subtle intramuscular alterations not only for the diagnosis of muscular diseases but also for assessing the efficacy of potential therapeutic interventions and clinical treatment strategies Background Amino acid supplementation has been shown to potentially reduced  exercise-induced muscle soreness . Thus , the purpose of this study was to examine if branched chain amino acid and carbohydrate ( BCAACHO ) versus carbohydrate-only sports drink ( CHO ) supplementation attenuated markers of muscle damage while preserving performance markers following 3 days of intense weight training . Methods Healthy resistance-trained males ( n = 30 ) performed preliminary testing ( T1 ) whereby they : 1 ) donated a baseline blood draw , 2 ) performed knee extensor dynamometry to obtain peak quadriceps isometric and isokinetic torque as well as electromyography ( EMG ) activity at 60 ° /s and 120 ° /s , and 3 ) performed a one repetition maximum ( 1RM ) barbell back squat . The following week participants performed 10 sets x 5 repetitions at 80 % of their 1RM barbell back squat for 3 consecutive days and 48 h following the third lifting bout participants returned for ( T2 ) testing whereby they repeated the T1 battery . Immediately following and 24 h after the three lifting bouts , participants were r and omly assigned to consume one of two commercial products in 600 mL of tap water : 1 ) BCAAs and CHO ( 3 g/d L-leucine , 1 g/d L-isoleucine and 2 g/d L-valine with 2 g of CHO ; n = 15 ) , or 2 ) 42 g of CHO only ( n = 15 ) . Additionally , venous blood was drawn 24 h following the first and second lifting bouts and 48 h following the third bout to assess serum myoglobin concentrations , and a visual analog scale was utilized prior , during , and after the 3-d protocol to measure subjective perceptions of muscular soreness . Results There were similar decrements in 1RM squat strength and isokinetic peak torque measures in the BCAA-CHO and CHO groups . Serum myoglobin concentrations ( p = 0.027 ) and perceived muscle soreness ( p < 0.001 ) increased over the intervention regardless of supplementation . A group*time interaction was observed for monocyte percentages ( p = 0.01 ) whereby BCAA-CHO supplementation attenuated increases in this variable over the duration of the protocol compared to CHO supplementation . Conclusion BCAA-CHO supplementation did not reduce decrements in lower body strength or improve select markers of muscle damage/soreness compared to CHO supplementation over three consecutive days of intense lower-body training The aim of this study was to determine the effectiveness of a 7-day oral supplementation with branched-chain amino acids ( BCAA ) to prevent muscle damage during a marathon . Forty-six experienced runners were r and omly divided into two groups , one with BCAA supplementation ( n = 25 , supplemented with 5 g day−1 of powdered 1:0.5:0.5 leucine : isoleucine : valine , during the 7 days prior to the competition ) and the other as a control group ( n = 21 , supplemented with an isocaloric placebo ) . Before the marathon race and within 3 min of finishing , leg muscle power was measured with a maximal countermovement jump and a urine sample was obtained . During the race , running pace was measured by means of a time-chip . Myoglobin concentration was determined in the urine sample s as an indirect marker of muscle damage . A visual analog scale ( 0–10 points ) was used to assess leg muscle pain during the race . In the BCAA group , the mean running pace during the marathon was similar to the control group ( 3.3 ± 0.4 vs. 3.3 ± 0.5 m s−1 , respectively , 0.98 ) . The pre- to post-race reduction in muscle power was similar in both BCAA and control groups ( −23.0 ± 16.1 vs. −17.3 ± 13 
    Output:
    
Although a small number of studies were included , BCAAs supplementation can be efficacious on outcomes of exercise-induced muscle damage , as long as the extent of muscle damage was low-to-moderate , the supplementation strategy combined a high daily BCAAs intake ( > 200 mg kg-1 day-1 ) for a long period of time ( > 10 days ) ; it was especially effective if taken prior to the damaging exercise