The Effect of Siberian Ginseng (Eleutherococcus Senticosus) on Substrate Utilization and Performance during Prolonged Cycling

2000 ◽  
Vol 10 (4) ◽  
pp. 444-451 ◽  
Author(s):  
L. Christopher Eschbach ◽  
Michael J. Webster ◽  
Joseph C. Boyd ◽  
Patrick D. McArthur ◽  
Tammy K. Evetovich
Keyword(s):  
Steady State ◽  
Perceived Exertion ◽  
Time Trial ◽  
Cycling Performance ◽  
Substrate Utilization ◽  
Rating Of Perceived Exertion ◽  
Time Interval ◽  
Double Blind ◽  
Eleutherococcus Senticosus ◽  
Siberian Ginseng

It has been suggested that Eleutherococcus senticosus (ES). also known as Siberian ginseng or ciwuija. increases fat utilization in humans. The purpose of this study was to examine the physiological responses to supplementation with ES in endurance cyclists. Using arandomized. double-blind crossover design. 9 highly-trained men (28 ± 2 years. V̇O2max 57.3±2.0 ml · kg−1 · min−1) cycled for 120 min at 60% V̇O2max followed by a simulated 10-km lime trial. Diet was controlled, and ES (1,200 mg · day−1) or a placebo (P) were administered for 7 days prior to each of the two trials. Oxygen consumption, respiratory exchange ratio, and heart rate were recorded every 30 min, and rating of perceived exertion. plasma [lactate], and plasma [glucose j were recorded every 20 min during the 120 min of steady state cycling. There were no significant differences (p > .05) between the ES and P groups at any steady-state time interval or during the cycling time trial (ES = 18.10 ± 0.42, P = 17.83 ± 0.47 min). In contrast with previous reports, the results of this study suggest that ES supplementation does not alter steady-state substrate utilization or 10-km cycling performance time.

scholarly journals Pre-Sleep Low Glycemic Index Modified Starch Does Not Improve Next-Morning Fuel Selection or Running Performance in Male and Female Endurance Athletes

Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2888
Author(s):  
Monique D. Dudar ◽  
Emilie D. Bode ◽  
Karly R. Fishkin ◽  
Rochelle A. Brown ◽  
Madeleine M. Carre ◽  
...  
Keyword(s):  
Glycemic Index ◽  
Perceived Exertion ◽  
Time Trial ◽  
Substrate Utilization ◽  
Rating Of Perceived Exertion ◽  
Endurance Running ◽  
Double Blind ◽  
Baseline Measure ◽  
Running Performance ◽  
Low Glycemic Index

To determine the effects of pre-sleep supplementation with a novel low glycemic index (LGI) carbohydrate (CHO) on next-morning substrate utilization, gastrointestinal distress (GID), and endurance running performance (5-km time-trial, TT). Using a double-blind, randomized, placebo (PLA) controlled, crossover design, trained participants (n = 14; 28 ± 9 years, 8/6 male/female, 55 ± 7 mL/kg/min) consumed a LGI, high glycemic index (HGI), or 0 kcal PLA supplement ≥ 2 h after their last meal and <30 min prior to sleep. Upon arrival, resting energy expenditure (REE), substrate utilization, blood glucose, satiety, and GID were assessed. An incremental exercise test (IET) was performed at 55, 65, and 75% peak volume of oxygen consumption (VO2peak) with GID, rating of perceived exertion (RPE) and substrate utilization recorded each stage. Finally, participants completed the 5-km TT. There were no differences in any baseline measure. During IET, CHO utilization tended to be greater with LGI (PLA, 56 ± 11; HGI, 60 ± 14; LGI, 63 ± 14%, p = 0.16, η2 = 0.14). GID was unaffected by supplementation at any point (p > 0.05). Performance was also unaffected by supplement (PLA, 21.6 ± 9.5; HGI, 23.0 ± 7.8; LGI, 24.1 ± 4.5 min, p = 0.94, η2 = 0.01). Pre-sleep CHO supplementation did not affect next-morning resting metabolism, BG, GID, or 5-km TT performance. The trend towards higher CHO utilization during IET after pre-sleep LGI, suggests that such supplementation increases morning CHO availability.

scholarly journals Mitochondria-targeted antioxidant supplementation improves 8 km time trial performance in middle-aged trained male cyclists

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
S. C. Broome ◽  
A. J. Braakhuis ◽  
C. J. Mitchell ◽  
T. L. Merry
Keyword(s):  
Perceived Exertion ◽  
Average Power ◽  
Time Trial ◽  
Cycling Performance ◽  
Rating Of Perceived Exertion ◽  
Middle Aged ◽  
Double Blind ◽  
Nutritional Strategy ◽  
Exercise Induced ◽  
Respiratory Gases

Abstract Background Exercise increases skeletal muscle reactive oxygen species (ROS) production, which may contribute to the onset of muscular fatigue and impair athletic performance. Mitochondria-targeted antioxidants such as MitoQ, which contains a ubiquinone moiety and is targeted to mitochondria through the addition of a lipophilic triphenylphosphonium cation, are becoming popular amongst active individuals as they are designed to accumulate within mitochondria and may provide targeted protection against exercise-induced oxidative stress. However, the effect of MitoQ supplementation on cycling performance is currently unknown. Here, we investigate whether MitoQ supplementation can improve cycling performance measured as time to complete an 8 km time trial. Method In a randomized, double-blind, placebo-controlled crossover study, 19 middle-aged (age: 44 ± 4 years) recreationally trained (VO2peak: 58.5 ± 6.2 ml·kg− 1·min− 1, distance cycled per week during 6 months prior to study enrollment: 158.3 ± 58.4 km) male cyclists completed 45 min cycling at 70% VO2peak followed by an 8 km time trial after 28 days of supplementation with MitoQ (20 mg·day− 1) and a placebo. Free F2-isoprostanes were measured in plasma samples collected at rest, after 45 min cycling at 70% VO2peak and after completion of the time trial. Respiratory gases and measures of rating of perceived exertion (RPE) were also collected. Results Mean completion time for the time trial was 1.3% faster with MitoQ (12.91 ± 0.94 min) compared to placebo (13.09 ± 0.95 min, p = 0.04, 95% CI [0.05, 2.64], d = 0.2). There was no difference in RPE during the time trial between conditions (p = 0.82) despite there being a 4.4% increase in average power output during the time trial following MitoQ supplementation compared to placebo (placebo; 270 ± 51 W, MitoQ; 280 ± 53 W, p = 0.04, 95% CI [0.49, 8.22], d = 0.2). Plasma F2-isoprostanes were lower on completion of the time trial following MitoQ supplementation (35.89 ± 13.6 pg·ml− 1) compared to placebo (44.7 ± 16.9 pg·ml− 1p = 0.03). Conclusion These data suggest that MitoQ supplementation may be an effective nutritional strategy to attenuate exercise-induced increases in oxidative damage to lipids and improve cycling performance.

Increased Cardiorespiratory Stress During Submaximal Cycling After Ketone Monoester Ingestion in Endurance-Trained Adults

2021 ◽  
Author(s):  
Devin Goddard McCarthy ◽  
William Bostad ◽  
Fiona Jane Powley ◽  
Jonathan P. Little ◽  
Douglas Richards ◽  
...  
Keyword(s):  
Body Mass ◽  
Ketone Body ◽  
Perceived Exertion ◽  
Bolus Dose ◽  
Ventilatory Threshold ◽  
Time Trial ◽  
Rating Of Perceived Exertion ◽  
Threshold Intensity ◽  
Double Blind ◽  
And Performance

There is growing interest in the effect of exogenous ketone body supplementation on exercise responses and performance. The limited studies to date have yielded equivocal data, likely due in part to differences in dosing strategy, increase in blood ketones, and participant training status. Using a randomized, double-blind, counterbalanced design, we examined the effect of ingesting a ketone monoester (KE) supplement (600 mg/kg body mass) or flavour-matched placebo in endurance-trained adults (n=10 males, n=9 females; VO2peak=57±8 ml/kg/min). Participants performed a 30-min cycling bout at ventilatory threshold intensity (71±3% VO2peak), followed 15 min later by a 3 kJ/kg body mass time-trial. KE versus placebo ingestion increased plasma [β-hydroxybutyrate] before exercise (3.9±1.0 vs 0.2±0.3 mM, p<0.0001, dz=3.4), ventilation (77±17 vs 71±15 L/min, p<0.0001, dz=1.3) and heart rate (155±11 vs 150±11 beats/min, p<0.001, dz=1.2) during exercise, and rating of perceived exertion at the end of exercise (15.4±1.6 vs 14.5±1.2, p<0.01, dz=0.85). Plasma [β-hydroxybutyrate] remained higher after KE vs placebo ingestion before the time-trial (3.5±1.0 vs 0.3±0.2 mM, p<0.0001, dz=3.1), but performance was not different (KE: 16:25±2:50 vs placebo: 16:06±2:40 min:s, p=0.20; dz=0.31). We conclude that acute ingestion of a relatively large KE bolus dose increased markers of cardiorespiratory stress during submaximal exercise in endurance-trained participants. Novelty bullets: •Limited studies have yielded equivocal data regarding exercise responses after acute ketone body supplementation. •Using a randomized, double-blind, placebo-controlled, counterbalanced design, we found that ingestion of a large bolus dose of a commercial ketone monoester supplement increased markers of cardiorespiratory stress during cycling at ventilatory threshold intensity in endurance-trained adults.

Caffeinated Chewing Gum Improves Bicycle Motocross Time-Trial Performance

2020 ◽  
Vol 30 (6) ◽  
pp. 427-434 ◽  
Author(s):  
Amin Daneshfar ◽  
Carl J. Petersen ◽  
Majid S. Koozehchian ◽  
Daniel E. Gahreman
Keyword(s):  
Perceived Exertion ◽  
Weight Ratio ◽  
Time Trial ◽  
Rating Of Perceived Exertion ◽  
Repeated Measure ◽  
Chewing Gum ◽  
Placebo Condition ◽  
Double Blind ◽  
Measure Analysis ◽  
Repeated Measure Analysis

This study aimed to identify the acute effects of caffeinated chewing gum (CAF) on bicycle motocross (BMX) time-trial (TT) performance. In a randomized, placebo-controlled, double-blind cross-over design, 14 male BMX riders (age = 20.0 ± 3.3 years; height = 1.78 ± 0.04 m; body mass = 72 ± 4 kg), consumed either (300 mg; 4.2 ± 0.2 mg/kg) caffeinated (300 mg caffeine, 6 g sugars) or a placebo (0 mg caffeine, 0 g sugars) gum, and undertook three BMX TTs. Repeated-measure analysis revealed that CAF has a large ergogenic effect on TT time, F(1, 14) = 33.570, p = .001, ; −1.5% ± 0.4 compared with the placebo. Peak power and maximal power to weight ratio also increased significantly compared with the placebo condition, F(1, 14) = 54.666, p = .001, ; +3.5% ± 0.6, and F(1, 14) = 57.399, p = .001, ; +3% ± 0.3, respectively. Rating of perceived exertion was significantly lower F(1, 14) = 25.020, p = .001, in CAF (6.6 ± 1.3) compared with the placebo (7.2 ± 1.7). Administering a moderate dose (300 mg) of CAF could improve TT time by enhancing power and reducing the perception of exertion. BMX coaches and riders may consider consuming CAF before a BMX race to improve performance and reduce rating of perceived exertion.

Drink-Flavor Change’s Lack of Effect on Endurance Cycling Performance in Trained Athletes

2007 ◽  
Vol 17 (4) ◽  
pp. 315-327 ◽  
Author(s):  
Ben Desbrow ◽  
Clare Minahan ◽  
Michael Leveritt
Keyword(s):  
Perceived Exertion ◽  
Time Trial ◽  
Cycling Performance ◽  
Rating Of Perceived Exertion ◽  
Controlled Trials ◽  
Exercise Protocol ◽  
Male Athletes ◽  
Subsequent Performance ◽  
Sports Drink ◽  
Endurance Cycling

This study investigated whether a change in beverage favor during endurance cycling improves subsequent performance. Eight trained male athletes (age 24.3 ± 3.9 y, weight 74.7 ± 6.0 kg, peak O2 uptake [VO2peak] 65.4 ± 5.4 mL·kg−1·min−1; mean ± SD) undertook 3 trials, with training and diet being controlled. Trials consisted of 120 min of steady-state (SS) cycling at ~70% VO2peak, immediately followed by a 7-kJ/kg time trial (TT). During exercise subjects were provided with fluids every 20 min. After 80 min of SS cycling subjects either continued drinking the same-favor sports drink or changed to an alternate favor—either an alternate-favor sports drink (AFSD) or cola. All beverages were carbohydrate and volume matched. Changing drink favor caused no significant change in TT time (sports drink 27:16 ± 03:12, AFSD 27:06 ± 03:16, cola 27:03 ± 02:42; min: s). The various favors produced no treatment effects on heart rate, blood glucose, or rating of perceived exertion throughout the SS exercise protocol. The influence of other taste variables such as palatability, bitterness, or timing of favor change on endurance-exercise performance requires more rigorous investigation.

Improved Cycling Time-Trial Performance after Ingestion of a Caffeine Energy Drink

2009 ◽  
Vol 19 (1) ◽  
pp. 61-78 ◽  
Author(s):  
John L. Ivy ◽  
Lynne Kammer ◽  
Zhenping Ding ◽  
Bei Wang ◽  
Jeffrey R. Bernard ◽  
...  
Keyword(s):  
Perceived Exertion ◽  
Time Trial ◽  
Endurance Performance ◽  
Energy Drink ◽  
Rating Of Perceived Exertion ◽  
Double Blind ◽  
Time Trial Performance ◽  
Cycling Time Trial ◽  
Cycling Time ◽  
Trial Performance

Context:Not all athletic competitions lend themselves to supplementation during the actual event, underscoring the importance of preexercise supplementation to extend endurance and improve exercise performance. Energy drinks are composed of ingredients that have been found to increase endurance and improve physical performance.Purpose:The purpose of the study was to investigate the effects of a commercially available energy drink, ingested before exercise, on endurance performance.Methods:The study was a double-blind, randomized, crossover design. After a 12-hr fast, 6 male and 6 female trained cyclists (mean age 27.3 ± 1.7 yr, mass 68.9 ± 3.2 kg, and VO2 54.9 ± 2.3 ml · kg–1 · min–1) consumed 500 ml of either flavored placebo or Red Bull Energy Drink (ED; 2.0 g taurine, 1.2 g glucuronolactone, 160 mg caffeine, 54 g carbohydrate, 40 mg niacin, 10 mg pantothenic acid, 10 mg vitamin B6, and 10 μg vitamin B12) 40 min before a simulated cycling time trial. Performance was measured as time to complete a standardized amount of work equal to 1 hr of cycling at 70% Wmax.Results:Performance improved with ED compared with placebo (3,690 ± 64 s vs. 3,874 ± 93 s, p < .01), but there was no difference in rating of perceived exertion between treatments. β-Endorphin levels increased during exercise, with the increase for ED approaching significance over placebo (p = .10). Substrate utilization, as measured by open-circuit spirometry, did not differ between treatments.Conclusion:These results demonstrate that consuming a commercially available ED before exercise can improve endurance performance and that this improvement might be in part the result of increased effort without a concomitant increase in perceived exertion.

scholarly journals Mitochondria-targeted antioxidant supplementation improves 8 km time trial performance in middle-aged trained male cyclists

2020 ◽  
Author(s):  
Sophie Broome ◽  
Andrea Braakhuis ◽  
Cameron Mitchell ◽  
Troy Merry
Keyword(s):  
Perceived Exertion ◽  
Average Power ◽  
Time Trial ◽  
Cycling Performance ◽  
Middle Aged ◽  
Clinical Trial Registry ◽  
Double Blind ◽  
Nutritional Strategy ◽  
Exercise Induced ◽  
Respiratory Gases

Abstract BackgroundExercise increases skeletal muscle ROS production, which may contribute to the onset of muscular fatigue and impair athletic performance. Mitochondria-targeted antioxidants such as MitoQ are becoming popular amongst active individuals as they are designed to accumulate within mitochondria and may provide targeted protection against exercise-induced oxidative stress. However, the effect of MitoQ supplementation on cycling performance is currently unknown. Here we investigate whether MitoQ supplementation can improve cycling performance measured as time to complete an 8 km time trial.MethodIn a randomised, double-blind, placebo-controlled crossover study, 19 middle-aged (age: 44 ± 4 years) recreationally trained (VO2peak: 58.5 ± 6.2 ml·kg·min− 1, distance cycled per week during six months prior to study enrollment: 158.3 ± 58.4 km) male cyclists completed 45 min cycling at 70% VO2peak followed by an 8 km time trial after 28 days of supplementation with MitoQ (20 mg/day) and a placebo. Free F2-isoprostanes were measured in plasma samples collected at rest, after 45 min cycling at 70% VO2peak and after completion of the time trial. Respiratory gases and measures of rate of perceived exertion (RPE) were also collected.ResultsMean completion time for the time trial was 1.3% faster with MitoQ (12.91 ± 0.94 min) compared to placebo (13.09 ± 0.95 min, P = 0.04 95% CI [0.05, 2.64], d = 0.2). There was no difference in RPE during the time trial between conditions (P = 0.82) despite average power output during the time trial being higher following MitoQ supplementation (280 ± 53 W) compared to placebo (270 ± 51 W, P = 0.04). Plasma F2-isoprostanes were lower on completion of the time trial following MitoQ supplementation (35.89 ± 13.6 pg/ml) compared to placebo (44.7 ± 16.9 pg/ml P = 0.03).ConclusionThese data suggest that MitoQ supplementation may be an effective nutritional strategy to attenuate exercise-induced increases in oxidative damage to lipids and improve cycling performance.Trial registrationThis study was registered with the Australia New Zealand Clinical Trial Registry (ACTRN12619000451101) on 19th March 2019.

Impact of sodium citrate ingestion during recovery after dehydrating exercise on rehydration and subsequent 40-km cycling time-trial performance in the heat

2018 ◽  
Vol 43 (6) ◽  
pp. 571-579 ◽  
Author(s):  
Silva Suvi ◽  
Martin Mooses ◽  
Saima Timpmann ◽  
Luule Medijainen ◽  
Daria Narõškina ◽  
...  
Keyword(s):  
Water Intake ◽  
Perceived Exertion ◽  
Sodium Citrate ◽  
Lactate Concentration ◽  
Blood Lactate Concentration ◽  
Time Trial ◽  
Cycling Performance ◽  
Double Blind ◽  
Warm Environment ◽  
The Impact

The purpose of this study was to assess the impact of sodium citrate (CIT) ingestion (600 mg·kg−1) during recovery from dehydrating cycling exercise (DE) on subsequent 40-km cycling performance in a warm environment (32 °C). Twenty male nonheat-acclimated endurance athletes exercised in the heat until 4% body mass (BM) loss occurred. After 16 h recovery with consumption of water ad libitum and prescribed diet (evening meal 20 kcal·kg−1, breakfast 12 kcal·kg−1) supplemented in a double-blind, randomized, crossover manner with CIT or placebo (PLC), they performed 40-km time-trial (TT) on a cycle ergometer in a warm environment. During recovery greater increases in BM and plasma volume (PV) concomitant with greater water intake and retention occurred in the CIT trial compared with the PLC trial (p < 0.0001). During TT there was greater water intake and smaller BM loss in the CIT trial than in the PLC trial (p < 0.05) with no between-trial differences (p > 0.05) in sweat loss, PV decrement, ratings of perceived exertion, or TT time (CIT 68.10 ± 3.28 min, PLC 68.11 ± 2.87 min). At the end of TT blood lactate concentration was higher (7.58 ± 2.44 mmol·L−1 vs 5.58 ± 1.32 mmol·L−1; p = 0.0002) and rectal temperature lower (39.54 ± 0.50 °C vs 39.65 ± 0.52 °C; p = 0.033) in the CIT trial than in the PLC trial. Compared with pre-DE time point, PV had decreased to a lower level in the PLC trial than in the CIT trial (p = 0.0001). In conclusion, CIT enhances rehydration after exercise-induced dehydration but has no impact on subsequent 40-km cycling TT performance in a warm uncompensable environment.

scholarly journals Caffeine but not acetaminophen increases 4-km cycling time-trial performance

2019 ◽  
Author(s):  
Fabiano Tomazini ◽  
Ana Carla S. Mariano ◽  
Victor A. Andrade-Souza ◽  
Viviane C. Sebben ◽  
Carlos A. B. de Maria ◽  
...  
Keyword(s):  
Oxygen Uptake ◽  
Body Mass ◽  
Perceived Exertion ◽  
Lactate Concentration ◽  
Time Trial ◽  
Rating Of Perceived Exertion ◽  
Plasma Lactate ◽  
Double Blind ◽  
Cycling Time Trial ◽  
Cycling Time

AbstractAcetaminophen has been combined with caffeine for therapeutic purpose, but the effect of co-ingestion of acetaminophen and caffeine on exercise performance has not been investigated. The aim of this study was to determine the effect of isolated and combined ingestion of caffeine and acetaminophen on performance during a 4-km cycling time-trial. In a double-blind, crossover design, eleven men, accustomed to cycling recreationally, completed a 4-km cycling time-trial one hour after the ingestion of cellulose (PLA), acetaminophen (20 mg·kg−1body mass, ACT), caffeine (5 mg·kg−1body mass, CAF) or combined acetaminophen and caffeine (20 and 5 mg·kg−1body mass, respectively, ACTCAF). The perception of pain and rating of perceived exertion were recorded every 1-km, and electromyography and oxygen uptake were continually recorded and averaged each 1-km. Plasma lactate concentration was measured before and immediately after the trial. The time and mean power during the 4-km cycling time-trial was significantly improved (P< 0.05) in CAF (407.9 ± 24.5 s, 241.4 ± 16.1 W) compared to PLA (416.1 ± 34.1 s, 234.1 ± 19.2 W) and ACT (416.2 ± 26.6 s, 235.8 ± 19.7 W). However, there was no difference between ACTCAF (411.6 ± 27.7 s, 238.7 ± 18.7 W) and the other conditions (P> 0.05). The perception of pain, rating of perceived exertion, electromyography, oxygen uptake, and plasma lactate were similar across the conditions (P> 0.05). In conclusion, caffeine but not acetaminophen increases power output ultimately increasing performance during a 4-km cycling time-trial.

Effect of Various Carbohydrate-Electrolyte Fluids on Cycling Performance and Maximal Voluntary Contraction

2010 ◽  
Vol 20 (2) ◽  
pp. 104-114 ◽  
Author(s):  
Matthew S. Ganio ◽  
Jennifer F. Klau ◽  
Elaine C. Lee ◽  
Susan W. Yeargin ◽  
Brendon P. McDermott ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Maximal Voluntary Contraction ◽  
Perceived Exertion ◽  
Cycling Performance ◽  
Voluntary Contraction ◽  
Rating Of Perceived Exertion ◽  
Total Work ◽  
Double Blind ◽  
Repeated Measures Design ◽  
The Central Nervous System

The purpose of this study was to compare the effects of a carbohydrate-electrolyte plus caffeine, carnitine, taurine, and B vitamins solution (CE+) and a carbohydrate-electrolyte-only solution (CE) vs. a placebo solution (PLA) on cycling performance and maximal voluntary contraction (MVC). In a randomized, double-blind, crossover, repeated-measures design, 14 male cyclists (M ± SD age 27 ± 6 yr, VO2max 60.4 ± 6.8 ml · kg−1 · min−1) cycled for 120 min submaximally (alternating 61% ± 5% and 75% ± 5% VO2max) and then completed a 15-min performance trial (PT). Participants ingested CE+, CE, or PLA before (6 ml/kg) and every 15 min during exercise (3 ml/kg). MVC was measured as a single-leg isometric extension (70° knee flexion) before (pre) and after (post) exercise. Rating of perceived exertion (RPE) was measured throughout. Total work accumulated (KJ) during PT was greater (p < .05) in CE+ (233 ± 34) than PLA (205 ± 52) but not in CE (225 ± 39) vs. PLA. MVC (N) declined (p < .001) from pre to post in PLA (988 ± 213 to 851 ± 191) and CE (970 ± 172 to 870 ± 163) but not in CE+ (953 ± 171 to 904 ± 208). At Minutes 60, 90, 105, and 120 RPE was lower in CE+ (14 ± 2, 14 ± 2, 12 ± 1, 15 ± 2) than in PLA (14 ± 2, 15 ± 2, 14 ± 2, 16 ± 2; p < .001). CE+ resulted in greater total work than PLA. CE+, but not PLA or CE, attenuated pre-to-post MVC declines. Performance increases during CE+ may have been influenced by lower RPE and greater preservation of leg strength during exercise in part as a result of the hypothesized effects of CE+ on the central nervous system and skeletal muscle.

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