***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: Abstract The evaluation of a 13-month maintenance program ( MP ) for 39 severe COPD patients with FEV1%pred 44(7)% who , as result of two different 8-week leg exercise training ( LET ) programs , one supervised at the hospital ( group S ; n = 20 ) and the other self-monitored ( SM ; n = 19 ) , had achieved different levels of exercise tolerance . After LET , patients in group S had a higher maximal oxygen uptake and endurance time than patients in the SM group [ O2max 1.43(0.30 ) l · min−1 ] vs l.25(0.27 ) l · min−1 and endurance-time 16(4 ) min vs 12 ( 5 ) min , respectively ) . During the MP patients were advised to walk vigorously at least 4 km/day , 4 times/wk . After the MP , while endurance time remained higher than at baseline , it had decreased ( p < 0.01 ) immediately after LET in both groups and no differences were evident between groups ( 11(4 ) min and 10(4 ) , respectively ) . In contrast , Chronic Respiratory Diseases Question naire scores , which had improved significantly after LET in both groups , remained high . Long-term effects of MP were independent of the training strategy or whether physiological improvements had been obtained with the initial LET . SM exercise programs do not seem capable of maintaining physiological improvements in exercise tolerance , though “ quality of life ” can be maintained [ Purpose ] Fragmentary studies on characteristics of respiratory muscles are being done to increase respiratory capacity by classifying exercises into voluntary respiratory exercise which relieves symptoms and prevents COPD and exercise using breathing exercise equipment . But this study found changes on respiratory pattern through changes on the activity pattern of agonist and synergist respiratory muscles and studied what effect they can have on body function improvement . [ Subjects and Methods ] Fifteen subjects in experimental group I that respiratory exercise of diaphragm and 15 subjects in experimental group II that feedback respiratory exercise were r and omly selected among COPD patients to find the effective intervention method for COPD patients . And intervention program was conducted for 5 weeks , three times a week , once a day and 30 minutes a session . They were measured with BODE index using respiratory muscle activity , pulmonary function , the six-minute walking test , dyspnea criteria and BMI Then the results obtained were compared and analyzed . [ Results ] There was a significant difference in sternocleidomastoid muscle and scalene muscle and in 6-minute walk and BODE index for body function . Thus the group performing feedback respiratory had more effective results for mild COPD patients . [ Conclusion ] Therefore , the improvement was significant regarding the activity of respiratory muscles synergists when breathing before doing breathing exercise . Although , it is valuable to reduce too much mobilization of respiratory muscles synergists through the proper intervention it is necessary to study body function regarding improvement of respiratory function for patients with COPD STUDY OBJECTIVES The purpose of this study was to compare the effects of endurance training only to endurance plus strength ( combined ) training in a r and omized trial of patients with COPD . METHODS Twenty-four patients completed the study : 11 patients in the  combined training group ( FEV(1 ) 45 + /- 5 % predicted ) , and 13 patients in the endurance training group  ( FEV(1 ) 40 + /- 4 % predicted ) [ mean + /- SE ] . Muscle strength , quality of life , exercise performance , and quadriceps fatigability were measured before and after rehabilitation . RESULTS Combined training led to significant improvements in quadriceps ( 23.6 % ) , hamstring ( 26.7 ) , pectoralis major ( 17.5 % ) , and latissimus dorsi ( 20 % ) muscle strength . Endurance training alone did not produce significant improvements in muscle strength : quadriceps ( 1.1 % decrease ) , hamstring ( 12.2 % increase ) , pectoralis major ( 7.8 % increase ) , and latissimus dorsi ( 2.8 % decrease ) . The increase in strength after training was significantly greater in the combined group compared to the endurance group for the quadriceps and latissimus dorsi muscles but not for the hamstring and pectoralis major muscles . Six-minute walk distance , endurance exercise time , and quality of life ( as measured by the Chronic Respiratory Question naire ) significantly increased in both groups after rehabilitation with no significant differences in the extent of improvement between groups . The extent of improvement in quadriceps fatigability after training ( assessed by quadriceps twitch force before and after exercise ) was not significantly different between groups . CONCLUSION Strength training can lead to significant improvement in muscle strength in elderly patients with COPD . However , this improvement in muscle strength does not translate into additional improvement in quality of life , exercise performance or quadriceps fatigability compared to that achieved by endurance exercise alone Background . Data on the use and efficacy of complementary and alternative medicine ( CAM ) in patients with asthma are limited , and there is a lack of studies documenting the use of CAM in patients with chronic obstructive pulmonary disease ( COPD ) in Turkey . Aim . To determine the prevalence of CAM usage in patients with asthma and COPD and to assess the clinical and demographic factors associated with the use of CAM . Material s and methods . A total of 521 patients ( 313 with asthma and 208 with COPD ) were r and omly enrolled into this cross-sectional survey . A face-to-face interview was conducted using a structured question naire . Results . One hundred sixty-three patients ( 52 % ) with asthma and 70 patients ( 33 % ) with COPD were reported to be using some form of CAM  ( p < 0.001 ) . The most popular modalities were herbal remedies ( 46 % and 28 % in the two groups , respectively ) and animal products ( 28 % and 5 % in the two groups , respectively ) . CAM-practicing asthma patients were typically younger with longer duration of disease and higher income than the CAM-practicing COPD patients . For the patients , the main source of information on CAM practice s was their relatives and friends . Only a small number of the patients consulted with their physicians about CAM . The main reasons to use CAM for patients with asthma and COPD were harmlessness and symptomatic relief , respectively .  CAM-related adverse effects and difficulties to obtain CAM  were significantly higher in patients with asthma than in patients with COPD . Conclusion . There is a high prevalence of CAM usage in patients with asthma and COPD in Turkey . Hence , becoming familiar with CAM therapy and inquiring about patient practice of CAM as part of the routine medical history will allow the physicians to provide reliable information to their patients on these medical practice In patients with chronic obstructive pulmonary disease ( COPD ) the intensity of aerobic training is limited by dyspnea . Improving strength of the inspiratory muscles could enhance aerobic exercise training by reducing exercise-related dyspnea . We examined effects of home-based inspiratory muscle training ( IMT ) and cycle ergometry training ( CET ) in 53 patients with moderate to severe COPD ( FEV(1)% pred , 50 + /- 17 [ mean + /- SD ] ) . Patients were r and omly assigned to 4 mo of training in one of four groups : IMT , CET , CET + IMT , or health education ( ED ) . Patients were encouraged to train to the limits of their dyspnea . Inspiratory muscle strength and endurance increased in IMT and CET + IMT groups compared with CET and ED groups ( p < 0 . 01 ) . Peak oxygen uptake increased and heart rate , minute ventilation , dyspnea , and leg fatigue decreased at submaximal work rates in the CET and CET + IMT groups compared with the IMT and ED groups ( p < 0 . 01 ) . There were no differences between the CET and CET + IMT groups . Home-based CET produced a physiological training effect and reduced exercise-related symptoms while IMT increased respiratory muscle strength and endurance . The combination of CET and IMT did not produce additional benefits in exercise performance and exercise-related symptoms . This is the first study to demonstrate a physiological training effect with home-based exercise training Background Hypertension is a risk factor for cardiovascular disease , and the prevalence of hypertension tends to increase with age . Current treatments for hypertension have side effects and poor adherence . Qigong has been studied as an alternative therapy for hypertension ; however , the types of qigong used in those studies were diverse , and there have not been many well- design ed r and omized controlled trials . Our objectives are the following : 1 ) To evaluate the effects of qigong on blood pressure , health status and hormone levels for pre- or mild hypertension . 2 ) To test the method ological appropriateness of this clinical trial and calculate a sample size for future r and omized trials . Methods Forty subjects with pre- or mild hypertension will be r and omized to either the qigong exercise group or the non-treated group . Participants in the qigong group will conduct qigong exercises 5 times per week for 8 weeks , and participants in the non-treated group will maintain their current lifestyle , including diet and exercise . The use of antihypertensive medication is not permitted . The primary endpoint is a change in patient blood pressure . Secondary endpoints are patient health status ( as measured by the SF-36 and the MYMOP2 question naires ) and changes in hormone levels , including norepinephrine , epinephrine , and cortisol . Discussion This study will be the first r and omized trial to investigate the effectiveness of qigong exercises for the treatment of pre- and mild hypertension . The results of this study will help to establish the optimal approach for the care of adults with pre- or mild hypertension . Trial registration Clinical Research Information Service Objectives . To evaluate the sustaining effects of Tai Chi Qigong ( TCQ ) in improving the psychosocial health in chronic obstructive pulmonary disease ( COPD ) patients in the sixth month . Background . COPD affects both physical and emotional aspects of life . Measures to minimize patients ' suffering need to be implemented . Methods . 206 COPD patients were r and omly assigned into three groups : TCQ group , exercise group , and control group . The TCQ group completed a three-month TCQ program , the exercise group practice d breathing and walking exercise , and the control group received usual care . Results . Significant group-by-time interactions in quality of life ( QOL ) using St. George 's respiratory question naire ( P = 0.002 ) and the perceived social support from friends using multidimensional scale of perceived social support ( P = 0.04 ) were noted . Improvements were observed in the TCQ group only . Conclusions . TCQ has sustaining effects in improving psychosocial health ; it is also a useful and appropriate exercise for COPD patients Complementary and alternative medicine ( CAM ) use by Australians is substantial and increasing , but little is known about its use by the elderly . We here present the findings for the elderly cohort in our recently conducted national survey on  CAM use by adult Australians . In May and June 2005 , computer-assisted telephone interviews , using r and om-digit telephone dialing , were employed to gather data on CAM use in the last 12 months . Of 1067 adult participants interviewed , 178 were 65 or older . More than half of these ( 57.8 % ; 95 % CI , 50.7%-64.9 % ) had used at least one of 17 common forms of CAM and 60.4 % of the CAM users had consulted CAM practitioners . Clinical nutrition , chiropractic , massage therapy , meditation , and herbal medicine were the most common forms of CAM used by the elderly . A higher proportion of the elderly had always used both CAM and conventional medical treatments  ( 37.9 % ) than had those aged 18 - 34 ( 15.7 % ) and 35 - 64 ( 26.9 % ) . Elderly CAM users ( 60.2 % ) were more likely than younger users to discuss their use with their doctors . Of those who did not do so , 24.1 % were not asked by their doctors and 16.0 % considered that their doctor would disapprove . In conclusion , we found that a substantial proportion of older Australians  use CAM .  The elderly are also more likely than younger adults to discuss their use of CAM with their doctors , but doctors need to play a more active role in initiating such communication Aerobic exercise training is used for rehabilitation in patients with chronic obstructive pulmonary disease ( COPD ) , although it has little effect on muscle weakness and atrophy . Resistance training may be a useful addition to aerobic programs for these patients . The purpose of the present study was to investigate the effects of resistance training in addition to aerobic training on functional outcomes in patients with COPD . Seventeen COPD patients enrolled in an aerobic-based program that met twice a week were assigned to a 12-week control/aerobic [ CON : n=8 ; 63 ( 8) years ; mean ( SD ) ] or a resistance/aerobic group [ RES : n=9 ; 61 ( 7 ) years ] . RES trained an additional twice a week on 12 resistance machines , performing three sets of 8–12 repetitions at 32–64 % of their one-repetition maximum ( 1-RM ) lifts . RES ( P<0.05 ) increased upper ( 36 % ) and lower ( 36 % ) body strength , as well as lean body mass ( 5 % ) , while CON showed little to no change . The 12-min walk distance increased ( P<0.05 ) in only the RES [ 676 ( 219 ) to 875 ( 172 ) m ] . Measurements of three of the eight tasks of activities of daily living improved in RES ( P<0.0 
    Output:
    
Results : This systematic review and meta- analysis will provide a high- quality synthesis and evaluate the efficacy and safety based on current relevant literature evidence of Liuzijue Qigong intervention for COPD patient .
Conclusion : Our systematic review will provide evidence to determine whether Liuzijue Qigong is an effective and safe approach to prevention and treatment of COPD patients