Research Proposal Assignment: Vitamin C supplementation & Recovery from DOMS after Eccentric Exercise

Question

Task: Research Proposal Assignment Title: Vitamin C supplementation and recovery from delayed onset muscle soreness (DOMS) after eccentric exercise. SECTION 1 (2000 words): Section 1 should be a review of the current evidence base surrounding your topic.

SECTION 2 (1000 words): Section 2 should evaluate the potential clinical implications of your project. How might the results change or not injury management / clinical practice /prevention (depending on your topic theme).

Answer

Research Proposal AssignmentSection 1
Research Question
How would intake of Vitamin C supplements help mitigate aspects of delayed onset muscle soreness (DOMS) suffered from undertaking eccentric exercises

Literature Review
Importance of Eccentric exercises
Eccentric exercises are considered within daily workout routines where specific activities include body movements associated with lengthening muscles simultaneously those are being contracted. One of the significant examples when an individual undergoes or instead tends to display eccentric muscle movement is when that individual lowers its arm during a bicep curl, as shown in the figure below.

Figure 1: Lengthening of muscles during a bicep curl
(Source: coreconcepts.com, 2020)

According to Frizziero et al. (2016), eccentric exercises are performed in gyms or by athletes. Therefore, suggest that these exercises certainly have benefits associated when regular adopted as a normal workout routine. Trainees perform eccentric exercises to gain faster development of muscles through development in both size and strength, as muscles are said to grow bigger in size when eccentric movement lengthens every tissue within those muscles. Eccentric exercises are also significant in increasing metabolism rate through rapid burning of body calories during the resting phase after performing those exercises in a controlled manner. With the increase in tissue size and muscle strengths, eccentric exercises are also significant in bringing in more flexibility within individuals with the most negligible risks of injuries.

Health benefits of including Vitamin C in daily diets
In the words of Raman (2020), Vitamin C is considered a powerful antioxidant that helps improve the body's natural defence system. With the controlled intake of Vitamin C supplements, an individual can strengthen their immune system in natural ways. The chances of suffering from choric diseases such as heart disease can be reduced. The research further states that Vitamin C supplements reduce systolic and diastolic blood pressures by 3.8mmHg and 1.5mmHg, respectively, in healthy adults. Vitamin C also helps adults who suffer from high blood pressure by reducing their systolic and diastolic blood pressures by 4.9mmHg and 1.7mmHg. From the aspects mentioned above, it can be said that controlled intake of Vitamin C, which is 75 mg for women and 90 mg for men, can help people to manage their blood pressure levels (ods.od.nih.gov, 2021).

As opined by Brzezi?ska et al. (2021) opined that regular intake of Vitamin C in a controlled manner helps individuals reduce the level of uric acid within the blood that helps prevent them from gout attacks of arthritis faced by adults. Moreover, Vitamin C is responsible for the effective absorption of iron from daily diets and is considered the best alternative component for people who are recommended to intake meat-free diets, as meat is a significant source of iron (Wan et al., 2019).

Occurrence and symptoms of delayed onset muscle soreness (DOMS) from eccentric exercises
Frizziero et al. (2016) mentioned that eccentric professional’s athletes and sportspersons perform exercises; therefore, these exercises are said to be of high intensity by nature. According to Olson (2019), eccentric or similar high-intensity exercises cause tiny tears in the muscle that is hard to see from bare eyes, as those are microscopic by nature. The human body is said to respond to this damage by increasing inflammation on that affected area, and this process of inflammation results in delayed onset of pain in muscles.

Figure 2: Eccentric and concentric muscle movements
(Source: Nosaka, 2015)

It is evident for beginners in such exercises, and with time, their body adapts with highly intensified workout routines. However, when the soreness or muscle pain continues to remain in an individual after doing such eccentric exercises for an experienced period, that individual is said to suffer from delayed onset of muscle soreness (Kim, Kim, & Lee, 2017).

Figure 3: DOMS due to Eccentric muscle movements
(Source: Sonkodi, Berkes, &Koltai, 2020)

Prolonged DOMS within individuals leads them to suffer from having tender muscles, reduced range of movement due to pain and stiffness, swelling in affected muscles, short-term loss of muscle strength, and muscle fatigue to some extent. The situations might worsen, and individuals are often prescribed to go through serious medical check-ups. It can be seen when the existence of DOMS within them lasts longer than seven days, their urine becomes abnormally dark, and severe swelling in leg and hands muscles is witnessed.

Intake of Vitamin C in mitigating delayed onset muscle soreness (DOMS) from eccentric exercises
According to Sonkodi, Berkes, &Koltai (2020), Vitamin C supplements are preferred within diets to meet the requirement of antioxidants within the human body. The intake of substance rich in antioxidants helps to assist the cells to heal that might have been damaged in some way possible. From the aspects mentioned above, eccentric exercises were found to have negative impacts on human muscles, as they are said to inject pain within individuals due to muscle tear and continuous repair from continuous eccentric and concentric movements. Therefore, the addition of Vitamin C supplements within diets of individuals performing eccentric exercises on a regular basis will help them in the natural development of antioxidants in their bodies. The development of antioxidants shall heal the cell damage and muscle tear when the body is at rest. Thus, it can be said that Vitamin C helps develop antioxidants in the human body that shall provide them with ease and relaxation from DOMS due to prolonged eccentric exercises. The study undertaken by Lee (2021) suggests that a team headed by Dr Declan Connolly at the University of Vermont's Human Performance Laboratory carried out tests in 2006 based on the role of Vitamin C in preventing DOMS. During the test period of eight days, human subjects were said to undergo intense eccentric exercises provided with a daily dosage of Vitamin C or placebo.

The results did not meet its expectations. However, a session carried out by professionals of the University of North Carolina in 2006 by providing those supplements for two weeks before and four days after an eccentric exercise, the rate of muscle soreness was reduced without affecting muscle function among the test subjects (Foroohi, 2017).

Rationale
The rationale of the study is that with time, people are becoming cautious with their health and diet intake, due to which most of them are found to be indulging in activities associated with eccentric movement of muscles. Due to eccentric movement of muscles during exercises, swelling or somewhat muscle soreness is identified, which can become causes of delayed onset muscle soreness due to prolonged symptoms from eccentric exercises. Medical treatments are said to exist for such health problems; however, precautions and changes in diet intake might help provide them with quick relief in those situations. Therefore, the study is being carried out to identify the role of Vitamin C and how adopting such antioxidants shall help prevent DOMS among people from eccentric exercises.

Literature Gap
The gap within the identified literature is associated with limited research regarding excessive intake of Vitamin C for a presentation from DOMS. The reason for the development of the gap depicted above is that there was a lack of research study available regarding the influence of excessive Vitamin C and another antioxidant. Therefore, the literature lacks details regarding whether Vitamin C consumed in more quantities will have fastened the recovery process from DOMS or instead will worsen the prevailing negative consequence from eccentric exercises.

Aim
The research study aims to identify how undertaking Vitamin C supplements might provide relief from delayed onset muscle soreness (DOMS) that is generally developed due to eccentric exercises.

Objectives
• To identify and understand the need for eccentric exercise for healthier living.
• To identify and evaluate health benefits of Vitamin C intake in daily diets
• To assess the occurrence and symptoms of DOMS from eccentric exercises
• To identify and analyse the reasons for taking Vitamin C supplements for mitigating negative consequence of DOMS from eccentric exercises

Proposed Method of Data Collection Collection of Data
The choice of research strategy shall be of a secondary-research type to identify findings from the secondary sources of information regarding aspects associated with eccentric exercises, its impact associated with DOMS, and Vitamin C supplements to help reduce the consequences faced by DOMS. Data shall be collected based on themes prepared for identifying findings from scholarly journals, articles, and websites (Safi, Thiessen, &Schmailzl, 2018). Therefore, the use of qualitative data collection via themes is suitable for the chosen research strategy based on specific inclusion and exclusion criteria that will be mentioned further in the study.

Protocols of Testing - Inclusion / exclusion criteria

Table 1: Inclusion and Exclusion criteria
Ethical considerations
Ethics statement – Declaration of Helsinki
The World Medical Association (WMA) had developed a statement of ethical principles to guide physicians and other medical professionals within studies associated with human subjects (wma.net, 2013). This statement is known as the Declaration of Helsinki, which that states the researcher in the medical profession must protect the life, health, privacy and dignity of considered human subjects within respective studies. The statement further guides that it is significant for researchers in having scientific knowledge regarding experiments conducted within the study. Aspects associated with the welfare of animals and environmental conservation is other constituents of the Declaration of Helsinki.

Indicating how Consent will be taken
Secondary sources of information undertaken by the previous researcher within a similar field of research of a particular research study must be acknowledged and appropriately referenced, which is included in one way of undertaking consents to use findings from previous studies. Access, permission and consent of data collected will be used following the requirement of the data source, GDPR, and standard law duty of confidentiality (st-andrews.ac.uk, 2021). For the particular research, the research will sign terms of use, have a comprehensive plan for data management and security, be used from a secure portal, and raw data will be converted to anonymous form before the study's release. The aspects mentioned above shall be followed in order to meet the criteria of undertaking consent for the study.

Ethical considerations applicable for study
One of the significant ethical considerations is the re-identification of data before releasing the same to the researcher. Secondary sources of data within the study shall not be re-identified after the outcomes from the analysis are developed, as these might be involved with reviewing studies that have used human participants (paolatubaro, 2015). Data used within the research will not result in any kind of damage or distress within societies.

Statistical considerations
Analysis of Data
In order to analyse the collected data from different secondary sources of information, the thematic analysis will be considered. This choice of data analysis technique shall help closely identify the specific topics, ideas, theories, and assumptions from the collected data based on themes created from the study's research objectives (Terry et al., 2017). It will help in the development of knowledge and increase outcomes of aspects learned from the assessment of findings from secondary sources of information.

Statistical Test
Section 2
Clinical implications
Point of the research project idea
The point of research idea based on the identification of benefits associated with vitamin C intake in reducing the causes and effects of DOMS due to eccentric exercises is to provide knowledge of acute prevention to readers of the study. With the help of research, readers associated with high-intensified practices that include continuous eccentric and concentric muscle movements can know how regular intake of Vitamin C might help reduce the causes of muscle soreness that they might be facing from exercises (Raman, 2020). The research also enumerates how muscle development within the human body is associated with the intake of antioxidants such as Vitamin C.

Potential clinical implications
• As mentioned above, eccentric exercises are significant for professional athletes and sportspersons since they require that level of muscle flexibility and strength for regularly meeting their daily activities.
• The individuals associated with regular exercises, such as sportsperson and athletes, shall relate to how devastating the pain after the exercises can be in terms of swelling or muscle soreness (Frizziero et al., 2016).
• The development of DOMS is common in people who focus on regular eccentric exercises as they are frequented in tensing their muscle while their muscle lengthens.
• With informed knowledge, people associated with eccentric exercises can consider taking Vitamin C regularly within diets, following the constraints of an adequate intake level suitable for both male and female adults.
• People who are facing high blood pressure and still prefer exercises to keep them fit must also develop knowledge regarding the benefits of Vitamin C as an effective source of antioxidants.
• Individuals who already have an adequate level of Vitamin C within their respective diets without knowing the consequences of DOMS will become more aware and continue doing the same to prevent them from muscle soreness.
• It is not essential for individuals to go through eccentric exercises, which might be experiencing muscle soreness. Still, people that indulge in activities associated with continuous eccentric and concentric muscle movements are also likely to suffer from DOMS. Therefore, readers falling within such a category as mentioned above will also develop knowledge regarding deformity. Thus, they will consider including diets rich in Vitamin C to prevent them from the negative consequences of muscle soreness.
• With the development of various other nutrients in the human body, Vitamin C helps improve immunity within people and is often preferred by people within their diets that are suffering from dementia or other memory or thinking incapability (Brzezi?ska et al., 2021).
• The research will also reduce the level of stress that is developed before the start of eccentric exercise regarding the extreme pain that might be felt after the exercise among people. The knowledge regarding the elimination of muscle soreness from intake of Vitamin C before and after the exercise might be helpful in assuring beginners to undertake high-intensified exercises.

Impact of research on clinical practice
With the help of research, readers associated with athletic activities must now become familiar with how rough and severe their training and exercising activities were. With this, they can reduce those on significant levels. The research can be made helpful within the clinical practice where professionals can now explain the patients suffering from DOMS and the essential benefits of Vitamin C, which help prevent the disease. With the help of this research, individuals shall be frequented with the idea of muscle pain and soreness and how those can be eliminated (Visconti et al., 2020). The idea of how antioxidants work within the human body when undertaken through regular diets before and after workouts shall also be familiarised among people who do not have much knowledge and experience in medicines and health care. Ideas regarding approaches used in injury management can be linked with the study's findings so that appropriate measures can be undertaken before and after injuries to eliminate the chances of negative consequences after an individual deal with a particular injury.

The development of knowledge will certainly make people aware of the symptoms of DOMS and muscle pain from eccentric so that they can avoid activities that might put them in those situations. Moreover, clinical practitioners can guide parents on how much Vitamin C supplements can be provided to their children in regular diets so that children associated with sports ambition are prevented from DOMS from the initial phases of their lives.

How might it support or not current clinical practice in Sports Therapy?
The research study will serve in fulfilling its purpose of awareness within the field of health care and help trainers in gyms and coaches in sports academy in the development of better sportspersons and athletes (Davis, Alabed, & Chico, 2020). The knowledge regarding the use of Vitamin C for reducing muscle pain and soreness shall help professionals within the sports profession create better diet charts that will guide the overall development of a healthy human body when associated with eccentric workouts before sports events. Therefore, it can be said that this research and other studies within a similar topic area will help in building knowledge regarding health management among people in the sports profession that have comparatively less experience than that in medical and health care professions.?

Reference List
Brzezi?ska, O., Styrzy?ski, F., Makowska, J., &Walczak, K. (2021).
Role of Vitamin C in Prophylaxis and Treatment of Gout—A Literature Review. Nutrients, 13(2), 701.
coreconcepts.com., (2020). Eccentric Concentration for Positive Muscle Growth. Retrieved 9 June 2021, from https://www.coreconcepts.com.sg/article/negative-reps-for-positive-muscle-growth/ Davis, H. L., Alabed, S., & Chico, T. J. A. (2020). Effect of sports massage on performance and recovery: a systematic review and meta-analysis. BMJ Open Sport & Exercise Medicine, 6(1), e000614.

Foroohi, S. (2017). Effect of vitamin C on delayed onset muscle soreness indexes. Journal of Physical Activity and Hormones, 1(1), 51-62.

Frizziero, A., Vittadini, F., Fusco, A., Giombini, A., &Masiero, S. (2016). Efficacy of eccentric exercise in lower limb tendinopathies in athletes.J Sports Med Phys Fitness, 56(11), 1352-1358.

Garg, R. (2016). Methodology for research I. Indian journal of anaesthesia, 60(9), 640.

Kim, J., Kim, J., & Lee, J. (2017). Effect of compression garments on delayed-onset muscle soreness and blood inflammatory markers after eccentric exercise: a randomized controlled trial. Journal of exercise rehabilitation, 13(5), 541.

Lee, M., (2021).Vitamin C for Muscle Soreness | Livestrong.com. Retrieved 9 June 2021, from https://www.livestrong.com/article/442120-vitamin-c-for-muscle-soreness/

Nosaka, K., (2015). Health Check: why do my muscles ache the day after exercise?. Retrieved 9 June 2021, from https://theconversation.com/health-check-why-do-my-muscles-ache-the-day-after-exercise-41820 ods.od.nih.gov., (2021). Office of Dietary Supplements - Vitamin C. Retrieved 9 June 2021, from https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/

Olson, G., (2019). Delayed Onset Muscle Soreness (DOMS): Symptoms, Causes, Treatment. Retrieved 9 June 2021, from https://www.healthline.com/health/doms#symptoms paolatubaro, V. (2015). Research ethics in secondary data: what issues?. Retrieved 9 June 2021, from https://databigandsmall.com/2015/10/18/research-ethics-in-secondary-data-what-issues/#:~:text=Data%20must%20be%20de%2Didentified,in%20any%20damage%20or%20distress Raman, R., (2020) 7 Impressive Benefits of Vitamin C Supplements. Retrieved 9 June 2021, from https://www.healthline.com/nutrition/vitamin-c-benefits

Safi, S., Thiessen, T., &Schmailzl, K. J. (2018). Acceptance and resistance of new digital technologies in medicine: qualitative study. Research proposal assignmentJMIR research protocols, 7(12), e11072.

Sonkodi, B., Berkes, I., &Koltai, E. (2020). Have we looked in the wrong direction for more than 100 years? Delayed onset muscle soreness is, in fact, neural microdamage rather than muscle damage. Antioxidants, 9(3), 212. st-andrews.ac.uk., (2021). Secondary data - Research - University of St Andrews. Retrieved 9 June 2021, from https://www.st-andrews.ac.uk/research/integrity-ethics/humans/ethical-guidance/secondary-data/ Terry, G., Hayfield, N., Clarke, V., & Braun, V. (2017).Thematic analysis.The Sage handbook of qualitative research in psychology, 17-37.

Visconti, L., Forni, C., Coser, R., Trucco, M., Magnano, E., & Capra, G. (2020). Comparison of the effectiveness of manual massage, long-wave diathermy, and sham long-wave diathermy for the management of delayed-onset muscle soreness: a randomized controlled trial. Archives of physiotherapy, 10(1), 1-7.

Wan, D., Wu, Q., Ni, H., Liu, G., Ruan, Z., & Yin, Y. (2019). Treatments for iron deficiency (ID): prospective organic iron fortification. Current pharmaceutical design, 25(3), 325-332.

wma.net., (2013). Declaration of Helsinki | World Medical Association Declaration of Helsinki - Ethical Principles for Medical Research Involving Human Subjects. Retrieved 9 June 2021, from https://www.wma.net/wp-content/uploads/2016/11/DoH-Oct2013-JAMA.pdf