***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 AND PURPOSE This prospect i ve , multicenter study was performed to determine the frequency of symptomatic complications up to 30 months after stroke using prespecified definitions of complications . METHODS We recruited 311 consecutive stroke patients admitted to hospital . Research nurses review ed their progress on a weekly basis until hospital discharge and again at 6 , 18 , and 30 months after stroke . RESULTS Complications during hospital admission were recorded in 265 ( 85 % ) of stroke patients . Specific complications were as follows : neurological-recurrent stroke ( 9 % of patients ) , epileptic seizure ( 3 % ) ; infections-urinary tract infection ( 24 % ) , chest infection ( 22 % ) , others ( 19 % ) ; mobility related-falls ( 25 % ) , falls with serious injury ( 5 % ) , pressure sores ( 21 % ) ; thromboembolism-deep venous thrombosis ( 2 % ) , pulmonary embolism ( 1 % ) ; pain-shoulder pain ( 9 % ) , other pain ( 34 % ) ; and psychological-depression ( 16 % ) , anxiety ( 14 % ) , emotionalism ( 12 % ) , and confusion ( 56 % ) . During follow-up , infections , falls , " blackouts , " pain , and symptoms of depression and anxiety remained common . Complications were observed across all 3 hospital sites , and their frequency was related to patient dependency and duration after stroke . CONCLUSIONS Our prospect i ve cohort study has confirmed that poststroke complications , particularly infections and falls , are common . However , we have also identified complications relating to pain and cognitive or affective symptoms that are potentially preventable and may previously have been underestimated Background and Purpose — Drop foot after stroke may be addressed using an ankle foot orthosis ( AFO ) or a foot drop stimulator ( FDS ) . The Functional Ambulation : St and ard Treatment versus Electric Stimulation Therapy ( FASTEST ) trial was a multicenter , r and omized , single-blinded trial comparing FDS and AFO for drop foot among people ≥3 months after stroke with gait speed ⩽0.8 m/s . Methods — Participants ( n=197 ; 79 females and 118 males ; 61.14±11.61 years of age ; time after stroke 4.55±4.72 years ) were r and omized to 30 weeks of  either FDS or a st and ard AFO . Eight dose-matched physical therapy sessions were provided to both groups during the first 6 weeks of the trial . Results — There was significant improvement within both groups from baseline to 30 weeks in comfortable gait speed ( 95 % confidence interval for mean change , 0.11–0.17 m/s for FDS and 0.12–0.18 m/s for AFO ) and fast gait speed . However , no significant differences in gait speed were found in the between-group comparisons . Secondary outcomes ( st and ard measures of body structure and function , activity , and participation ) improved significantly in both groups , whereas user satisfaction was significantly higher in the FDS group than in the control group . Conclusions — Using either an FDS or an AFO for 30 weeks yielded clinical ly and statistically significant improvements in gait speed and other functional outcomes . User satisfaction was higher in the FDS group . Although both groups did receive intervention , this large clinical trial provides evidence that FDS or AFO with initial physical therapy sessions can provide a significant and clinical ly meaningful benefit even years after stroke . Clinical Trial Registration Information— URL : http://www . clinical trials.gov . Unique Identifier : NCT01138995 Background Falls are common in stroke survivors returning home after rehabilitation , however there is currently a lack of evidence about preventing falls in this population . This paper describes the study protocol for the FLASSH ( FaLls prevention After Stroke Survivors return Home ) project . Methods and design This r and omised controlled trial aims to evaluate the effectiveness of a multi-factorial falls prevention program for stroke survivors who are at high risk of falling when they return home after rehabilitation . Intervention will consist of a home exercise program as well as individualised falls prevention and injury minimisation strategies based on identified risk factors for falls . Additionally , two sub- studies will be implemented in order to explore other key areas related to falls in this population . The first of these is a longitudinal study evaluating the relationship between fear of falling , falls and function over twelve months , and the second evaluates residual impairment in gait stability and obstacle crossing twelve months after discharge from rehabilitation . Discussion The results of the FLASSH project will inform falls prevention practice for stroke survivors . If the falls prevention program is shown to be effective , low cost strategies to prevent falls can be implemented for those at risk around the time of discharge from rehabilitation , thus improving safety and quality of life for stroke survivors . The two sub- studies will contribute to the overall underst and ing and management of falls risk in stroke survivors . Trial registration This trial is registered with the Australian and New Zeal and Clinical Trials Registry ( ACTRN012607000398404 ) Objectives To investigate if repeated verbal instructions about physical activity to patients with ischaemic stroke could increase long term physical activity . Design Multicentre , multinational , r and omised clinical trial with masked outcome assessment . Setting Stroke units in Denmark , China , Pol and , and Estonia . Participants 314 patients with ischaemic stroke aged ≥40 years who were able to walk—157 ( mean age 69.7 years ) r and omised to the intervention , 157 ( mean age 69.4 years ) in the control group . Interventions Patients r and omised to the intervention were instructed in a detailed training programme before discharge and at five follow-up visits during 24 months . Control patients had follow-up visits with the same frequency but without instructions in physical activity . Main outcome measures Physical activity assessed with the Physical Activity Scale for the Elderly ( PASE ) at each visit . Secondary outcomes were clinical events . Results The estimated mean PASE scores were 69.1 in the intervention group and 64.0 in the control group ( difference 5.0 ( 95 % confidence interval −5.8 to 15.9 ) , P=0.36 . The intervention had no significant effect on mortality , recurrent stroke , myocardial infa rct ion , or falls and fractures . Conclusion Repeated encouragement and verbal instruction in being physically active did not lead to a significant increase in physical activity measured by the PASE score . More intensive strategies seem to be needed to promote physical activity after ischaemic stroke . Trial registration Clinical Trials Background and Purpose — The optimal organization of rehabilitation services after discharge from a stroke unit has not been determined . This study sought to evaluate the effect of early supported discharge and continued rehabilitation at home ( ESD ) , in terms of patient outcome 5 years after stroke and changes in selected data over time . Methods — Eighty-three patients from Southwest Stockholm , mildly or moderately impaired 5 to 7 days after acute stroke , were enrolled in a r and omized controlled trial . The core components of the ESD service were initial treatment in a stroke unit and the involvement of an outreach team to deliver and coordinate home-based rehabilitation in partnership with the patient . At the 5-year follow-up , measures used to assess patient outcome included survival , motor capacity , dysphasia , activities of daily living ( ADL ) , social activities , subjective dysfunction , and self-reported falls . Results — Fifty-four patients ( 30 in the intervention group and 24 in the control group ) were evaluated 5 years after stroke , at which time a significantly larger proportion of patients in the intervention group were independent in extended ADL and active in household activities . Conclusions — This ESD service has a beneficial effect on extended ADL 5 years after stroke for mildly to moderately impaired patients BACKGROUND Locomotor training , including the use of body-weight support in treadmill stepping , is a physical therapy intervention used to improve recovery of the ability to walk after stroke . The effectiveness and appropriate timing of this intervention have not been established . METHODS We stratified 408 participants who had had a stroke 2 months earlier according to the extent of walking impairment -- moderate ( able to walk 0.4 to < 0.8 m per second ) or severe ( able to walk < 0.4 m per second)-- and r and omly assigned them to one of three training groups . One group received training on a treadmill with the use of body-weight support 2 months after the stroke had occurred ( early locomotor training ) , the second group received this training 6 months after the stroke had occurred ( late locomotor training ) , and the third group participated in an exercise program at home managed by a physical therapist 2 months after the stroke ( home-exercise program ) . Each intervention included 36 sessions of 90 minutes each for 12 to 16 weeks . The primary outcome was the proportion of participants in each group who had an improvement in functional walking ability 1 year after the stroke . RESULTS At 1 year , 52.0 % of all participants had increased functional walking ability . No significant differences in improvement were found between early locomotor training and home exercise ( adjusted odds ratio for the primary outcome , 0.83 ; 95 % confidence interval [ CI ] , 0.50 to 1.39 ) or between late locomotor training and home exercise ( adjusted odds ratio , 1.19 ; 95 % CI , 0.72 to 1.99 ) . All groups had similar improvements in walking speed , motor recovery , balance , functional status , and quality of life . Neither the delay in initiating the late locomotor training  nor the severity of the initial impairment affected the outcome at 1 year . Ten related serious adverse events were reported ( occurring in 2.2 % of participants undergoing early locomotor training , 3.5 % of those undergoing late locomotor training , and 1.6 % of those engaging in home exercise ) . As compared with the home-exercise group , each of the groups receiving locomotor training had a higher frequency of dizziness or faintness during treatment ( P=0.008 ) . Among patients with severe walking impairment , multiple falls were more common in the group receiving early locomotor training than in the other two groups ( P=0.02 ) . CONCLUSIONS Locomotor training , including the use of body-weight support in stepping on a treadmill , was not shown to be superior to progressive exercise at home managed by a physical therapist . ( Funded by the National Institute of Neurological Disorders and Stroke and the National Center for Medical Rehabilitation Research ; LEAPS Clinical Trials.gov number , NCT00243919 . ) QUESTIONS Is treadmill walking with body weight support during inpatient rehabilitation detrimental to walking quality compared with assisted overground walking ? Does it result in better walking capacity , perception of walking or community participation ? DESIGN Analysis of secondary outcomes of a r and omised trial with concealed allocation , assessor blinding and intention-to-treat analysis . PARTICIPANTS 126 patients unable to walk within 4 weeks of a stroke who were undergoing inpatient rehabilitation . INTERVENTION The experimental group undertook up to 30 minutes of treadmill walking with body weight support via an overhead harness per day while the control group undertook up to 30 minutes of overground walking . OUTCOME MEASURES The secondary outcomes were walking quality and capacity , walking perception , community participation and falls . RESULTS Six months after entering the study , there was no difference between the groups of independent walkers in terms of speed ( MD 0.10 m/s , 95 % CI -0.06 to 0.26 ) or stride ( MD 6 cm , 95 % CI -7 to 19 ) . The independent walkers in the experimental group walked 57 m further ( 95 % CI 1 to 113 ) in the 6 min walk than those in the control group . The experimental group ( walkers and non-walkers ) rated their walking 1 point out of 10 ( 95 % CI 0.1 to 1.9 ) higher than the control group . There was no difference between the groups in community participation or number of falls . CONCLUSION Treadmill training with body weight support results in better walking capacity and perception of walking compared to overground walking without deleterious effects on walking quality BACKGROUND AND PURPOSE This study describes the methodology , patient outcome , and use of hospital and rehabilitation services at 3 months of a population -based r and omized controlled trial . The purpose was to evaluate rehabilitation at home after early supported discharge from the Department of Neurology , Huddinge Hospital , for moderately disabled stroke patients in southwest Stockholm . METHODS The patients were eligible if they were continent , independent in feeding , had mental function within normal limits , and had impaired motor function and /or aphasia 1 week after stroke . Patients were r and omized either to early supported discharge with continuity of rehabilitation at home for 3 to 4 months or to routine rehabilitation service  in a hospital , day care , and /or outpatient care . The home rehabilitation team consisted of two physical therapists , two occupational therapists , and one speech therapist ; one of the therapists was assigned as case manager for the patient . The rehabilitation program at home emphasized a task- and context -oriented approach . The activities were chosen on the basis of the patient 's personal interests . Spouses were offered education and individual counseling . A total of 81 patients were followed up for a minimum of 3 months . Patient outcome was assessed by the Frenchay Social Activity Index , Extended Katz Index , Barthel Index , Lindmark Motor Capacity Assessment , Nine-Hole Peg Test , walking speed over 10 m , reported falls , and subjective dysfunction according to the Sickness Impact Profile . Patient use of hospital and home rehabilitation service and patient satisfaction with care were studied . RESULTS Overall there were no statistical significant differences in outcome . Multivariate logistic regression analysis suggested a systematic positive effect for the home rehabilitation group in social activity , activities of daily living , motor capacity , manual dexterity , and walking . A considerable difference 
    Output:
    
There is currently insufficient evidence that exercises or prescription of single lens glasses to multifocal users prevent falls or decrease the number of people falling after being discharged from rehabilitation following their stroke .