human
***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: Background : Monophasic high voltage stimulation ( MHVS ) is widely prescribed for the treatment of inflammation associated with muscle injury . However , limited scientific evidence exists to support its purported benefits in humans . Objective : To examine the efficacy of early initiation of MHVS treatment after muscle injury . Methods : In a r and omised , cross over design , 14 men performed repetitive eccentric contractions of the elbow flexor muscles followed by either MHVS or control treatment . MHVS treatments were applied five minutes and 3 , 6 , 24 , 48 , 72 , 96 , and 120 hours after eccentric contractions . Results : MHVS result ed in a significant reduction ( p<0.05 ) in delayed onset muscle soreness 24 hours after eccentric exercise compared with controls . Elbow extension was significantly increased immediately after administration of MHVS compared with controls . No significant differences were observed between MHVS treatment and controls for maximal isometric strength , flexed arm angle , or arm volume . Conclusions : Early and frequent application of MHVS may provide transient relief from delayed onset muscle soreness and short term improvements in range of motion after injurious exercise . However , MHVS treatment may not enhance recovery after muscle injury because of lack of improvements in strength and active range of motion Chapman , DW , Newton , MJ , McGuigan , MR , and Nosaka , K. Effect of slow-velocity lengthening contractions on muscle damage induced by fast-velocity lengthening contractions . J Strength Cond Res 25(1 ) : 211 - 219 , 2011-This study tested the hypothesis that the first exercise bout consisting of slow-velocity ( 30 ° ·s−1 ) maximal lengthening contractions would not affect muscle damage in a subsequent bout consisting of fast-velocity ( 210 ° ·s−1 ) lengthening contractions . Eighteen men were r and omly assigned into either a repeated bout group ( n = 10 ) or control group ( n = 8) . The repeated bout group performed 2 bouts of exercise consisting of 210 maximal lengthening contractions of the elbow flexors separated by 14 days at a velocity of 30 ° ·s−1 for the first and 210 ° ·s−1 for the second bout . The control group performed a single bout of the fast-velocity exercise . Changes in maximal isometric strength , range of motion ( ROM ) , upper-arm circumference , muscle thickness , muscle soreness , serum creatine kinase , and lactate dehydrogenase activities were measured before , immediately after , and 24 to 96 hours after exercise . The repeated bout group showed significantly ( p < 0.05 ) smaller changes in all criterion measures except for muscle soreness after the fast-velocity exercise compared with the control group . A significant ( p < 0.05 ) difference was evident only for ROM between the slow- and fast-velocity bouts of the repeated bout group . These results suggest that slow-velocity exercise  reduced muscle damage induced by fast-velocity exercise , although the reduction was not large This study compared maximal ( MAX-ECC ) and submaximal ( 50%-ECC ) eccentric exercise of the elbow flexors . Untrained male students ( n = 8) performed 3 sets of 10 repetitions of MAX-ECC with one arm and 50%-ECC with the other arm , separated by 4 weeks . In MAX-ECC , the elbow joint was forcibly extended from a flexed ( 90 ° ) to a full-extended position ( 180 ° ) in 3 seconds while producing maximal force . For 50%-ECC , a dumbbell set at 50 % of the maximal isometric strength at 90 ° of the elbow joint was lowered from the flexed to the extended position in 3 seconds . Changes in indicators of muscle damage were compared between the bouts by a 2-way repeated- measures analysis of variance . Changes in isometric strength , range of motion , upper arm circumference , and plasma creatine kinase activity were significantly smaller and the recovery was significantly faster for 50%-ECC compared with MAX-ECC , although the differences in the changes immediately after exercise were small . It appeared that the magnitude of initial muscle damage was similar between the bouts ; however , secondary damage was less after 50%-ECC UNLABELLED Protease supplementation has been purported to reduce the damaging effects of eccentric exercise and accelerate recovery of muscle function , possibly by regulating inflammation . PURPOSE To determine the effectiveness of protease supplementation in attenuating eccentric exercise-induced skeletal muscle damage and inflammation . METHODS After st and ard physical and hemodynamic assessment and fasting venous blood sample s , subjects performed isokinetic extension/flexion of the quadriceps group on a Biodex isokinetic dynamometer at 60 ° ·s(-1 ) , followed by VO2max testing . Subjects were r and omly assigned to consume 5.83 g daily of either a cellulose placebo  ( N = 15 ; 22.27 ± 3.33 yr , 71.17 ± 2.91 inches , 179.4 ± 24.05 lb , 50.55 ± 5.66 mL·kg(-1)·min(-1 ) ) or a proteolytic supplement containing fungal proteases , bromelain , and papain ( N = 14 ; 22.85 ± 5.9 yr , 70.0 ± 2.67 inches , 173.11 ± 29.94 lb , 49.69 ± 6.15 mL·kg(-1)·min(-1 ) ) for a period of 21 d. After the supplementation period , subjects donated blood sample s before performing a 45-min downhill ( -17.5 % ) treadmill protocol at 60 % of VO2max . An additional four blood draws and three muscle function tests were performed during the next 48 h. Blood was analyzed using st and ard hematology and clinical chemistry , enzyme-linked immunosorbent assay , and bead array . Blood data were analyzed using multivariate analysis of variance ( MANOVA ) with repeated measures , whereas Biodex data were analyzed using a MANOVA on % Δ values . RESULTS Significant group differences ( T1-T3 , P = 0.033 ; T1-T4 , P = 0.043 ) and another strong trend ( T1 - 3 h , P = 0.055 ) were observed for flexion ( peak torque % Δ at 60 ° ·s(-1 ) ) indicating higher force production in the protease group . Significant group × time interactions ( P < 0.05 ) were observed , including elevations in circulating eosinophils and basophils in the protease group coinciding with lower levels of serum cyclooxygenase 2 , interleukin 6 , and interleukin 12 in this group . CONCLUSIONS Protease supplementation seems to attenuate muscle strength losses after eccentric exercise by regulating leukocyte activity and inflammation PURPOSE This study investigated changes in indirect markers of muscle damage after  endurance exercise of the elbow flexors  and compared the changes with those after maximal eccentric actions ( Max-ECC ) of the elbow flexors . METHODS Eighteen male students  rhythmically lifted ( 1 s ) and lowered ( 1 s ) a light dumbbell ( 1.1 - 1.8 kg : 9 % of MIF ) in 60 - 180 degrees of elbow joint angle for 2 h ( 2-h Ex ) .  Maximal isometric force ( MIF ) , relaxed ( RANG ) and flexed elbow joint angles ( FANG ) , upper-arm circumference ( CIR ) , muscle soreness ( SOR ) , B-mode ultrasound ( US ) , and plasma creatine kinase ( CK ) activity were assessed before and immediately after , and up to 96 h after exercise . RESULTS All measures were altered significantly ( P < 0.05 ) after 2-h Ex in a similar time course to Max-ECC ; however , changes in RANG , FANG , CIR , US , and CK ( peak : 356 + /- 121 IU.L-1 ) were significantly ( P < 0.05 ) smaller compared with those after Max-ECC . SOR developed immediately after 2-h Ex and peaked 24 - 48 h after exercise . MIF dropped to 44.1 % of the preexercise level , which was significantly ( P < 0.05 ) lower than that after Max-ECC ( 58.1 % ) , immediately postexercise . MIF recovered to 79.8 % at 24 h , and 97.8 % at 96 h postexercise , which was a significantly ( P < 0.05 ) faster recovery compared with that of Max-ECC ( 73.1 % at 96 h ) . CONCLUSION These results showed low-intensity continuous muscle contractions ( 3600 times ) result ed in muscle damage ; however , the magnitude of the muscle damage was less severe , and the recovery was faster compared with 12 maximal eccentric muscle actions 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 Background Both acute bouts of prior exercise ( preconditioning ) and antioxidant nutrients have been used in an attempt to attenuate muscle injury or oxidative stress in response to  resistance  exercise  .  However , most studies have focused on untrained participants rather than on athletes . The purpose of this work was to determine the independent and combined effects of antioxidant supplementation ( vitamin C + mixed tocopherols/tocotrienols ) and prior eccentric exercise in attenuating markers of skeletal muscle injury and oxidative stress in resistance trained men . Methods Thirty-six men were r and omly assigned to : no prior exercise + placebo ; no prior exercise + antioxidant ; prior exercise + placebo ; prior exercise + antioxidant . Markers of muscle/cell injury ( muscle performance , muscle soreness , C-reactive protein , and creatine kinase activity ) , as well as oxidative stress ( blood protein carbonyls and peroxides ) , were measured before and through 48 hours of exercise recovery . Results No group by time interactions were noted for any variable ( P > 0.05 ) . Time main effects were noted for creatine kinase activity , muscle soreness , maximal isometric force and peak velocity ( P < 0.0001 ) . Protein carbonyls and peroxides were relatively unaffected by exercise . Conclusion There appears to be no independent or combined effect of a prior bout of eccentric exercise or antioxidant supplementation as used here on markers of muscle injury in resistance trained men . Moreover , eccentric exercise as used in the present study results in minimal blood oxidative stress in resistance trained men . Hence , antioxidant supplementation for the purpose of minimizing blood oxidative stress in relation to eccentric exercise appears unnecessary in this population PURPOSE This study investigated the effect of lengthening contraction velocity on exercise-induced muscle damage . METHODS Sixteen men were placed into two groups performing either 30 ( N = 8) or 210 ( N = 8) maximal lengthening contractions of the elbow flexors on an isokinetic dynamometer .  Dominant and nondominant arms were r and omly assigned for a slow-velocity ( S : 30 degrees.s(-1 ) ) or a fast-velocity ( F : 210 degrees.s(-1 ) ) exercise separated by 14 d. Maximal voluntary strength of isometric contractions ( iMVC ) and isokinetic concentric contractions ( cMVC ) , range of motion ( ROM ) , upper-arm circumference , muscle soreness , and serum creatine kinase ( CK ) activity were measured before , immediately after , and 1 - 120 h after exercise . Changes in these measures over time were compared by a two-way repeated- measures ANOVA to examine the effect of velocity in the same number of contractions ( S30 vs F30 ; S210 vs F210 ) or the effect of contraction number at the same velocity ( S30 vs S210 ; F30 vs F210 ) . RESULTS A significant ( P < 0.05 ) interaction effect was evident only for iMVC between S30 and F30 , but it was evident for iMVC , cMVC , ROM , and CK between S210 and F210 . Changes in most of the measures were significantly ( P < 0.05 ) smaller after 30 contractions ( S30 and F30 ) than after 210 contractions ( S210 and F210 ) . CONCLUSION These results suggest that the effect of contraction velocity on the magnitude of muscle damage after 30 contractions is minor ; however , when 
    Output:
    
agent
Conclusion Overall , our findings do not support the presence of a secondary loss of strength following an acute muscle injury , and strongly suggest that strength , on average , recovers steadily over the first 3 days post-injury
***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: Background : Monophasic high voltage stimulation ( MHVS ) is widely prescribed for the treatment of inflammation associated with muscle injury . However , limited scientific evidence exists to support its purported benefits in humans . Objective : To examine the efficacy of early initiation of MHVS treatment after muscle injury . Methods : In a r and omised , cross over design , 14 men performed repetitive eccentric contractions of the elbow flexor muscles followed by either MHVS or control treatment . MHVS treatments were applied five minutes and 3 , 6 , 24 , 48 , 72 , 96 , and 120 hours after eccentric contractions . Results : MHVS result ed in a significant reduction ( p<0.05 ) in delayed onset muscle soreness 24 hours after eccentric exercise compared with controls . Elbow extension was significantly increased immediately after administration of MHVS compared with controls . No significant differences were observed between MHVS treatment and controls for maximal isometric strength , flexed arm angle , or arm volume . Conclusions : Early and frequent application of MHVS may provide transient relief from delayed onset muscle soreness and short term improvements in range of motion after injurious exercise . However , MHVS treatment may not enhance recovery after muscle injury because of lack of improvements in strength and active range of motion Chapman , DW , Newton , MJ , McGuigan , MR , and Nosaka , K. Effect of slow-velocity lengthening contractions on muscle damage induced by fast-velocity lengthening contractions . J Strength Cond Res 25(1 ) : 211 - 219 , 2011-This study tested the hypothesis that the first exercise bout consisting of slow-velocity ( 30 ° ·s−1 ) maximal lengthening contractions would not affect muscle damage in a subsequent bout consisting of fast-velocity ( 210 ° ·s−1 ) lengthening contractions . Eighteen men were r and omly assigned into either a repeated bout group ( n = 10 ) or control group ( n = 8) . The repeated bout group performed 2 bouts of exercise consisting of 210 maximal lengthening contractions of the elbow flexors separated by 14 days at a velocity of 30 ° ·s−1 for the first and 210 ° ·s−1 for the second bout . The control group performed a single bout of the fast-velocity exercise . Changes in maximal isometric strength , range of motion ( ROM ) , upper-arm circumference , muscle thickness , muscle soreness , serum creatine kinase , and lactate dehydrogenase activities were measured before , immediately after , and 24 to 96 hours after exercise . The repeated bout group showed significantly ( p < 0.05 ) smaller changes in all criterion measures except for muscle soreness after the fast-velocity exercise compared with the control group . A significant ( p < 0.05 ) difference was evident only for ROM between the slow- and fast-velocity bouts of the repeated bout group . These results suggest that slow-velocity exercise  reduced muscle damage induced by fast-velocity exercise , although the reduction was not large This study compared maximal ( MAX-ECC ) and submaximal ( 50%-ECC ) eccentric exercise of the elbow flexors . Untrained male students ( n = 8) performed 3 sets of 10 repetitions of MAX-ECC with one arm and 50%-ECC with the other arm , separated by 4 weeks . In MAX-ECC , the elbow joint was forcibly extended from a flexed ( 90 ° ) to a full-extended position ( 180 ° ) in 3 seconds while producing maximal force . For 50%-ECC , a dumbbell set at 50 % of the maximal isometric strength at 90 ° of the elbow joint was lowered from the flexed to the extended position in 3 seconds . Changes in indicators of muscle damage were compared between the bouts by a 2-way repeated- measures analysis of variance . Changes in isometric strength , range of motion , upper arm circumference , and plasma creatine kinase activity were significantly smaller and the recovery was significantly faster for 50%-ECC compared with MAX-ECC , although the differences in the changes immediately after exercise were small . It appeared that the magnitude of initial muscle damage was similar between the bouts ; however , secondary damage was less after 50%-ECC UNLABELLED Protease supplementation has been purported to reduce the damaging effects of eccentric exercise and accelerate recovery of muscle function , possibly by regulating inflammation . PURPOSE To determine the effectiveness of protease supplementation in attenuating eccentric exercise-induced skeletal muscle damage and inflammation . METHODS After st and ard physical and hemodynamic assessment and fasting venous blood sample s , subjects performed isokinetic extension/flexion of the quadriceps group on a Biodex isokinetic dynamometer at 60 ° ·s(-1 ) , followed by VO2max testing . Subjects were r and omly assigned to consume 5.83 g daily of either a cellulose placebo  ( N = 15 ; 22.27 ± 3.33 yr , 71.17 ± 2.91 inches , 179.4 ± 24.05 lb , 50.55 ± 5.66 mL·kg(-1)·min(-1 ) ) or a proteolytic supplement containing fungal proteases , bromelain , and papain ( N = 14 ; 22.85 ± 5.9 yr , 70.0 ± 2.67 inches , 173.11 ± 29.94 lb , 49.69 ± 6.15 mL·kg(-1)·min(-1 ) ) for a period of 21 d. After the supplementation period , subjects donated blood sample s before performing a 45-min downhill ( -17.5 % ) treadmill protocol at 60 % of VO2max . An additional four blood draws and three muscle function tests were performed during the next 48 h. Blood was analyzed using st and ard hematology and clinical chemistry , enzyme-linked immunosorbent assay , and bead array . Blood data were analyzed using multivariate analysis of variance ( MANOVA ) with repeated measures , whereas Biodex data were analyzed using a MANOVA on % Δ values . RESULTS Significant group differences ( T1-T3 , P = 0.033 ; T1-T4 , P = 0.043 ) and another strong trend ( T1 - 3 h , P = 0.055 ) were observed for flexion ( peak torque % Δ at 60 ° ·s(-1 ) ) indicating higher force production in the protease group . Significant group × time interactions ( P < 0.05 ) were observed , including elevations in circulating eosinophils and basophils in the protease group coinciding with lower levels of serum cyclooxygenase 2 , interleukin 6 , and interleukin 12 in this group . CONCLUSIONS Protease supplementation seems to attenuate muscle strength losses after eccentric exercise by regulating leukocyte activity and inflammation PURPOSE This study investigated changes in indirect markers of muscle damage after  endurance exercise of the elbow flexors  and compared the changes with those after maximal eccentric actions ( Max-ECC ) of the elbow flexors . METHODS Eighteen male students  rhythmically lifted ( 1 s ) and lowered ( 1 s ) a light dumbbell ( 1.1 - 1.8 kg : 9 % of MIF ) in 60 - 180 degrees of elbow joint angle for 2 h ( 2-h Ex ) .  Maximal isometric force ( MIF ) , relaxed ( RANG ) and flexed elbow joint angles ( FANG ) , upper-arm circumference ( CIR ) , muscle soreness ( SOR ) , B-mode ultrasound ( US ) , and plasma creatine kinase ( CK ) activity were assessed before and immediately after , and up to 96 h after exercise . RESULTS All measures were altered significantly ( P < 0.05 ) after 2-h Ex in a similar time course to Max-ECC ; however , changes in RANG , FANG , CIR , US , and CK ( peak : 356 + /- 121 IU.L-1 ) were significantly ( P < 0.05 ) smaller compared with those after Max-ECC . SOR developed immediately after 2-h Ex and peaked 24 - 48 h after exercise . MIF dropped to 44.1 % of the preexercise level , which was significantly ( P < 0.05 ) lower than that after Max-ECC ( 58.1 % ) , immediately postexercise . MIF recovered to 79.8 % at 24 h , and 97.8 % at 96 h postexercise , which was a significantly ( P < 0.05 ) faster recovery compared with that of Max-ECC ( 73.1 % at 96 h ) . CONCLUSION These results showed low-intensity continuous muscle contractions ( 3600 times ) result ed in muscle damage ; however , the magnitude of the muscle damage was less severe , and the recovery was faster compared with 12 maximal eccentric muscle actions 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 Background Both acute bouts of prior exercise ( preconditioning ) and antioxidant nutrients have been used in an attempt to attenuate muscle injury or oxidative stress in response to  resistance  exercise  .  However , most studies have focused on untrained participants rather than on athletes . The purpose of this work was to determine the independent and combined effects of antioxidant supplementation ( vitamin C + mixed tocopherols/tocotrienols ) and prior eccentric exercise in attenuating markers of skeletal muscle injury and oxidative stress in resistance trained men . Methods Thirty-six men were r and omly assigned to : no prior exercise + placebo ; no prior exercise + antioxidant ; prior exercise + placebo ; prior exercise + antioxidant . Markers of muscle/cell injury ( muscle performance , muscle soreness , C-reactive protein , and creatine kinase activity ) , as well as oxidative stress ( blood protein carbonyls and peroxides ) , were measured before and through 48 hours of exercise recovery . Results No group by time interactions were noted for any variable ( P > 0.05 ) . Time main effects were noted for creatine kinase activity , muscle soreness , maximal isometric force and peak velocity ( P < 0.0001 ) . Protein carbonyls and peroxides were relatively unaffected by exercise . Conclusion There appears to be no independent or combined effect of a prior bout of eccentric exercise or antioxidant supplementation as used here on markers of muscle injury in resistance trained men . Moreover , eccentric exercise as used in the present study results in minimal blood oxidative stress in resistance trained men . Hence , antioxidant supplementation for the purpose of minimizing blood oxidative stress in relation to eccentric exercise appears unnecessary in this population PURPOSE This study investigated the effect of lengthening contraction velocity on exercise-induced muscle damage . METHODS Sixteen men were placed into two groups performing either 30 ( N = 8) or 210 ( N = 8) maximal lengthening contractions of the elbow flexors on an isokinetic dynamometer .  Dominant and nondominant arms were r and omly assigned for a slow-velocity ( S : 30 degrees.s(-1 ) ) or a fast-velocity ( F : 210 degrees.s(-1 ) ) exercise separated by 14 d. Maximal voluntary strength of isometric contractions ( iMVC ) and isokinetic concentric contractions ( cMVC ) , range of motion ( ROM ) , upper-arm circumference , muscle soreness , and serum creatine kinase ( CK ) activity were measured before , immediately after , and 1 - 120 h after exercise . Changes in these measures over time were compared by a two-way repeated- measures ANOVA to examine the effect of velocity in the same number of contractions ( S30 vs F30 ; S210 vs F210 ) or the effect of contraction number at the same velocity ( S30 vs S210 ; F30 vs F210 ) . RESULTS A significant ( P < 0.05 ) interaction effect was evident only for iMVC between S30 and F30 , but it was evident for iMVC , cMVC , ROM , and CK between S210 and F210 . Changes in most of the measures were significantly ( P < 0.05 ) smaller after 30 contractions ( S30 and F30 ) than after 210 contractions ( S210 and F210 ) . CONCLUSION These results suggest that the effect of contraction velocity on the magnitude of muscle damage after 30 contractions is minor ; however , when 
    Output:
    