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OBJECTIVE:To evaluate the effects ofZingiber cassumunar (Plai cream) in either 7% or 14%concentration on delayed onset muscle soreness (DOMS). METHODS: Seventy-ifve untrained healthy volunteers (28 males and 47 females), performed 4 sets of 25 eccentric repetitions of the dominant quadriceps muscle on an isokinetic dynamometry machine. Participants were then randomized into 3 groups: 14% Plai cream, 7% Plai cream and placebo cream. Two grams of the cream (strips of 5-cm long) were gently rubbed into the quadriceps muscles for 5 min immediately folowing the exercise and every 8 h thereafter for 7 d in al groups. Muscle soreness, muscle strength, jump height, thigh circumference and creatine kinase were measured before and after eccentric exercise. RESULTS:Compared to the placebo cream the 14% Plai cream substantialy reduced muscle soreness over the 7 d by –82% (95% CI = –155% to –6%,P = 0.03), but had similar muscle soreness effects to 7% Plai cream (–34%, –96% to 27%,P = 0.2). Compared to the placebo cream the 7% Plai cream resulted in a smal non-signiifcant reduction in muscle soreness levels over the folowing 7 d (–40%,–116% to 36%,P = 0.3). Compared to placebo cream there was little effect of Plai cream (7% or 14%) on muscle strength, jump height, thigh circumference or creatine kinase concentration. CONCLUSION:Using 14% Plai cream over a 7-day period substantialy reduced muscle soreness symptoms compared to 7% Plai cream or a placebo cream. The authors suggest that the administration of 14% Plai cream is a useful altative in the management of DOMS. TRIAL REGISTRATION: Thai Clinical Trial Registry TCTR20140215001.