***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: To comprehend the results of a r and omised controlled trial ( RCT ) , readers must underst and its design , conduct , analysis , and interpretation . That goal can be achieved only through total transparency from authors . Despite several decades of educational efforts , the reporting of RCTs needs improvement . Investigators and editors developed the original CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to help authors improve reporting by use of a checklist and flow diagram . The revised CONSORT statement presented here incorporates new evidence and addresses some criticisms of the original statement . The checklist items pertain to the content of the Title , Abstract , Introduction , Methods , Results , and Discussion . The revised checklist includes 22 items selected because empirical evidence indicates that not reporting this information is associated with biased estimates of treatment effect , or because the information is essential to judge the reliability or relevance of the findings . We intended the flow diagram to depict the passage of participants through an RCT . The revised flow diagram depicts information from four stages of a trial ( enrolment , intervention allocation , follow- up , and analysis ) . The diagram explicitly shows the number of participants , for each intervention group , included in the primary data analysis . Inclusion of these numbers allows the reader to judge whether the authors have done an intention- to-treat analysis . In sum , the CONSORT statement is intended to improve the reporting of an RCT , enabling readers to underst and a trial 's conduct and to assess the validity of its results BACKGROUND Greater thoracic kyphosis is associated with increased biomechanical loading of the spine which is potentially problematic in individuals with osteoporotic vertebral fractures . Conservative interventions that reduce thoracic kyphosis warrant further investigation . This study aim ed to investigate the effects of therapeutic postural taping on thoracic posture . Secondary aims explored the effects of taping on trunk muscle activity and balance . METHODS Fifteen women with osteoporotic vertebral fractures participated in this within-participant design study . Three taping conditions were r and omly applied : therapeutic taping , control taping and no taping .  Angle of thoracic kyphosis was measured after each condition . Force plate-derived balance parameters and trunk muscle electromyographic activity ( EMG ) were recorded during three static st and ing tasks of 40s duration . RESULTS There was a significant main effect of postural taping on thoracic kyphosis ( p=0.026 ) , with a greater reduction in thoracic kyphosis after taping compared with both control tape and no tape . There were no effects of taping on EMG or balance parameters . CONCLUSIONS The results of this study demonstrate that the application of postural therapeutic tape in a population with osteoporotic vertebral fractures induced an immediate reduction in thoracic kyphosis . Further research is needed to investigate the underlying mechanisms associated with this decrease in kyphosis Background It is possible that cross-over studies included in current systematic review s are being inadequately assessed , because the current risk of bias tools do not consider possible biases specific to cross-over design . We performed this study to evaluate whether this was being done in  cross-over studies included in Cochrane  Systematic Review s ( CSRs ) . Methods We search ed the Cochrane Library ( up to 2013 issue 5 ) for CSRs that included at least one cross-over trial . Two authors independently undertook the study selection and data extraction . A r and om sample of the CSRs was selected and we evaluated whether the cross-over trials in these CSRs were assessed according to criteria suggested by the Cochrane h and book . In addition we reassessed the risk of bias of these cross-over trials by a checklist developed form the Cochrane h and book . Results We identified 688 CSRs that included one or more cross-over studies . We chose a r and om sample of 60 CSRs and these included 139 cross-over studies . None of these CSRs undertook a risk of bias assessment specific for cross-over studies . In fact items specific for cross-over studies were seldom considered anywhere in quality assessment of these CSRs . When we reassessed the risk of bias , including the 3 items specific to cross-over trials , of these 139 studies , a low risk of bias was judged for appropriate cross-over design in 110(79 % ) , carry-over effects in 48(34 % ) and for reporting data in all stages of the trial in 114(82 % ) . Assessment of biases in cross-over trials could affect the GRADE assessment of a review ’s findings . Conclusion The current Cochrane risk of bias tool is not adequate to assess cross-over studies . Items specific to cross-over trials leading to potential risk of bias are generally neglected in CSRs . A proposed check list for the evaluation of cross-over trials is provided OBJECT External supports serve as a traditional treatment option for  osteoporotic vertebral fractures ( OVFs ) . However , the role of external supports in the treatment of OVF remains inconclusive . The purpose of this study was to determine the role of a rigid external support in the healing of OVFs by prospect ively evaluating union ( fracture settling ) rates and prognostic variables for patients suffering from an incident OVF . METHODS Fifty-five patients with acute back pain were enrolled in this study after being diagnosed with an OVF based on MRI findings . Patients were treated using a plastic thoracolumbosacral orthosis ( TLSO ) and underwent follow-up at 2 , 3 , and 6 months . Vertebrae were referred to as " settled " when there was no dynamic mobility on sitting lateral and supine lateral radiographs . At the time of the 3- and 6-month follow-up visits , the patients were divided into 2 groups , the " settled group " and the " unsettled group . " Patients in these groups were compared with regard to clinical and radiographic features . RESULTS Of the 55 patients enrolled , 53 patients were followed up for 6 months . There were 14 men and 39 women with an average age of 75.3 years .  Fracture settling of the affected vertebra was defined in 54.7 % of the patients at 2 months , in 79.2 % at 3 months , and in 88.7 % at 6 months . All 5 components of the Japanese Orthopaedic Association Back Pain Evaluation Question naire improved significantly both at 3 months and 6 months . Patients in the unsettled group exhibited a statistically greater likelihood of having fractures at the thoracolumbar junction , Type A3 fractures , and fractures with a diffuse low-intensity area on T2-weighted MRI studies at 3 months . In contrast , at 6 months , the only statistically significant difference between the groups was patient age . CONCLUSIONS The biomechanical disadvantages of OVFs ( location , type , and size ) adversely influencing the fracture healing were overcome by the treatment using a TLSO within 6 months . The authors ' findings show that a TLSO plays a biomechanical role in the healing of OVFs OBJECTIVE To assess the changes in static and dynamic balance and movement strategies in patients with severe osteoporotic vertebral compression fracture while wearing and not wearing the Knight-Taylor ( K-T ) spinal brace .  SUBJECTS 47 patients with severe osteoporotic vertebral compression fracture , which was confirmed on radiographs and with bone density measurements obtained by dual energy X-ray absorption . INTERVENTION Patients were r and omly subjected to computerized dynamic posturography , which contained sensory organization tests , motor control balance test at 75 % limit of stability ( LOS ) in 8 movement directions , and left/right rhythmic weight shift test ( L/R RWS ) , while wearing and not wearing the K-T spinal brace , respectively . RESULTS Patients wearing the spinal brace had significantly increased average stability , significantly increased average maximal stability under the swayed vision with fixed support surface condition and under the eye open with swayed support surface condition , significantly increased ankle strategy and decreased average velocity of COG target sway under the eye open with swayed support surface condition , significantly reduced the frequency of falls under the eye closed with swayed support surface condition and swayed vision with swayed support surface condition , and significantly decreased in the percentage of directional control with no difference of reaction time in the LOS test , and an increase in the on-axis velocity in the L/R RWS test . CONCLUSIONS The K-T spinal brace efficiently enables the subjects to maintain static and dynamic motor balance . Its use decreases the fall frequency but limits the directional control in severe osteoporotic patients with vertebral compression fracture Summary In a prospect i ve cohort study of 395 geriatric out patients , mortality after 3 years was associated with prevalent vertebral fractures at baseline . The mortality risk was independently associated with the presence of three or more vertebral fractures at baseline . In the surviving patients , the risk of incident fractures was noteworthy , occurring in 26 % of these patients . Introduction The purpose of this study is to determine mortality rate and the incidence of vertebral fractures in a geriatric outpatient group , during a 3-year follow-up period , in a teaching hospital in Amsterdam , The Netherl and s. Methods This study includes a prospect i ve cohort study of 395 geriatric patients who had their baseline visit at a diagnostic day hospital in 2007 and 2008 . They were invited for follow-up 3 years later . Lateral X-rays of the lumbar spine and chest were performed at baseline and after 3 years ; vertebral fractures were scored in all patients according to the semi-quantitative method of Genant . Results After 3 years , mortality was 46 % and associated with prevalent vertebral fractures at baseline ( odds ratio ( OR ) , 1.83 ; 95 % CI , 1.23–2.74 ) . The presence of three or more vertebral fractures at baseline was an independent risk factor for mortality ( OR , 3.32 ; 95 % CI , 1.56–7.07 ) . Other independently associated risk factors were greater age , higher co-morbidity score , and having more prescriptions . Higher cognitive capacity protected against mortality after 3 years . In 72 patients , radiography was repeated . Nineteen patients ( 26 % ) had an incident radiographic vertebral fracture : 16 in those with a prevalent fracture , and 3 in those without a prevalent vertebral fracture at baseline . Conclusions In geriatric out patients , mortality after 3 years was associated with prevalent vertebral fractures at baseline , and the mortality risk was independently associated with 3 or more vertebral fractures at baseline . In survivors , the risk of incident fractures was noteworthy , since these occurred in 26 % of the patients , particularly in those with a prevalent vertebral fracture Objectives : We conducted a prospect i ve r and omized study to evaluate the efficacy of two newly developed spinal orthoses in patients with vertebral fractures . Design : We conducted a prospect i ve , r and omized , cross-over study to evaluate the efficacy of two newly developed spinal orthoses in patients with osteoporotic vertebral fractures . Measurements include trunk muscle strength , angle of kyphosis , body height , body sway , and parameters of quality -of-life such as pain , well-being , and limitations of daily living . Results : Wearing the orthosis Spinomed during a 6-mo period ( results of Spinomed active are given in parentheses ) was associated with a 72 % ( 64 % ) increase in back extensor strength ( P < 0.01 ) , a 44 % ( 56 % ) increase in abdominal flexor strength ( P < 0.01 ) , an 11 % ( 11 % ) decrease in the angle of kyphosis ( P < 0.01 ) , a 23 % ( 20 % ) decrease in body sway ( P = 0.03 and P = 0.02 ) , a 19 % ( 18 % ) increase in vital capacity ( P < 0.01 and P = 0.03 ) , a 41 % ( 47 % ) decrease in average pain ( P < 0.01 ) , an 18 % ( 18 % ) increase in well-being ( P < 0.01 ) , and a 49 % ( 54 % ) decrease in limitations of daily living ( P < 0.01 ) , respectively . The overall tolerability of the orthoses was good ; no adverse effects were reported and the dropout rate with 7 % was rather low . Conclusions : The use of an orthosis increases trunk muscle strength and therefore improves posture in patients with vertebral fractures caused by osteoporosis . In addition , a better quality -of-life is achieved by pain reduction , decreased limitations of daily living , and improved well-being . Thereby , the use of an orthosis may represent an efficacious nonpharmacologic treatment option for spinal osteoporosis Pfeifer M , Begerow B , Minne HW : Effects of a new spinal orthosis on posture , trunk strength , and quality of life in women with postmenopausal osteoporosis : A r and omized trial . Am J Phys Med Rehabil 2004;83:177–186 . Objective One fourth of women ≥50 yrs of age in the general population have one or more vertebral fractures . The orthotic treatment modality in the management of vertebral fractures caused by osteoporosis remains subjective because no objective data from clinical trials are available . The objective of this research was to evaluate the efficacy of a newly developed spinal orthosis in patients with osteoporotic vertebral fractures . Design We conducted a study that measured trunk muscle strength , angle of kyphosis , body height , body sway , and variables of quality of life such as pain , well-being , and limitations of daily living . Results Wearing the orthosis for 6-mo period was associated with a 73 % increase in back extensor strength , a 5 
    Output:
    
A wide range of outcomes assessing impairments , activities and participation were assessed but the findings were mixed .