***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 — Exercise training reduces the symptoms of chronic heart failure . Which exercise intensity yields maximal beneficial adaptations is controversial . Furthermore , the incidence of chronic heart failure increases with advanced age ; it has been reported that 88 % and 49 % of patients with a first diagnosis of chronic heart failure are > 65 and > 80 years old , respectively . Despite this , most previous studies have excluded patients with an age > 70 years . Our objective was to compare training programs with moderate versus high exercise intensity with regard to variables associated with cardiovascular function and prognosis in patients with postinfa rct ion heart failure . Methods and Results — Twenty-seven patients with stable postinfa rct ion heart failure who were undergoing optimal medical treatment , including & bgr;-blockers and angiotensin-converting enzyme inhibitors ( aged 75.5±11.1 years ; left ventricular [ LV ] ejection fraction 29 % ; & OV0312;o2peak 13 mL · kg−1 · min−1 ) were r and omized to either moderate continuous training ( 70 % of highest measured heart rate , ie , peak heart rate ) or aerobic interval training ( 95 % of peak heart rate ) 3 times per week for 12 weeks or to a control group that received st and ard advice regarding physical activity . & OV0312;o2peak increased more with aerobic interval training than moderate continuous training ( 46 % versus 14 % , P<0.001 ) and was associated with reverse LV remodeling . LV end-diastolic and end-systolic volumes declined with aerobic interval training only , by 18 % and 25 % , respectively ; LV ejection fraction increased 35 % , and pro-brain natriuretic peptide decreased 40 % . Improvement in brachial artery flow-mediated dilation ( endothelial function ) was greater with aerobic interval training , and mitochondrial function in lateral vastus muscle increased with aerobic interval training only . The MacNew global score for quality of life in cardiovascular disease increased in both exercise groups . No changes occurred in the control group . Conclusions — Exercise intensity was an important factor for reversing LV remodeling and improving aerobic capacity , endothelial function , and quality of life in patients with postinfa rct ion heart failure . These findings may have important implication s for exercise training in rehabilitation programs and future studies Introduction Low-to-moderate intensity exercise improves muscle contractile properties and endurance capacity in multiple sclerosis ( MS ) . The impact of high intensity exercise remains unknown . Methods Thirty-four MS patients were r and omized into a sedentary control group ( SED , n = 11 ) and 2 exercise groups that performed 12 weeks of a high intensity interval ( HITR , n = 12 ) or high intensity continuous cardiovascular training ( HCTR , n = 11 ) , both in combination with resistance training . M.vastus lateralis fiber cross sectional area ( CSA ) and proportion , knee-flexor/extensor strength , body composition , maximal endurance capacity and self-reported physical activity levels were assessed before and after 12 weeks . Results Compared to SED , 12 weeks of high intensity exercise  increased mean fiber CSA ( HITR : + 21±7 % , HCTR : + 23±5 % ) . Furthermore , fiber type I CSA increased in HCTR ( + 29±6 % ) , whereas type II ( + 23±7 % ) and IIa ( + 23±6 % , ) CSA increased in HITR . Muscle strength improved in HITR and HCTR ( between + 13±7 % and + 45±20 % ) and body fat percentage tended to decrease ( HITR : -3.9±2.0 % and HCTR : -2.5±1.2 % ) . Furthermore , endurance capacity ( Wmax + 21±4 % , time to exhaustion + 24±5 % , VO2max + 17±5 % ) and lean tissue mass ( + 1.4±0.5 % ) only increased in HITR . Finally self-reported physical activity levels increased 73±19 % and 86±27 % in HCTR and HITR , respectively . Conclusion High intensity cardiovascular exercise combined with resistance training was safe , well tolerated and improved muscle contractile characteristics and endurance capacity in MS . Trial Registration Clinical Trials.gov Abstract Purpose A better underst and ing of how people with multiple sclerosis ( pwMS ) recover from exercise may help inform interventions . Methods We explored physiological and perceptual responses following exercise of different intensities , using a crossover exposure-response design , in 14 adults with multiple sclerosis ( MS ) and 9 controls . A cycling exercise test determined maximum capacity ( Wpeak ) . Participants then performed 20-min exercise sessions relative to Wpeak ( r and om order separated by 7 days ) : ( 1 ) 45 % and ( 2 ) 60 % continuous cycling and ( 3 ) 90 % intermittent cycling ( 30 s cycling , 30 s rest ) . During a 45-min recovery period , tympanic temperature ( Temp ° C ) , exertion in breathing ( RPEbr ) and legs ( RPEleg ) , and cortical excitability ( MEParea ) were measured . Results Eleven pwMS and eight controls completed the study . Controls performed better on the exercise test ( p < 0.05 ) , thus more absolute work during subsequent sessions . PwMS took longer to recover RPEleg with recovery time increasing with intensity ( 45%-6 min ; 60%-15 min ; 90%-35 min ) and correlating with Temp ° C . MEParea was significantly depressed in both groups at 45 % and 60 % ( p < 0.001 ) , in the MS group this also correlated with RPEleg . Conclusions Feelings of leg exertion may persist after exercise in some pwMS , especially at high intensities . This may relate to body temperature and , after continuous exercise , cortical excitability . These results support considering the recovery period post exercise and provide an insight into potential correlates of post-exercise fatigue . Implication s for Rehabilitation A better underst and ing of how pwMS recover following exercise may help inform exercise prescription a long side fatigue management . This study showed that , in pwMS , the time taken to recover from feelings of leg fatigue increased with the intensity of the exercise session rather that total work performed and was related to increase in body temperature . The results of this relatively small study support the need to consider a recovery period after exercise and provide an insight into potential physiological Introduction The prevalence of impaired glucose tolerance ( IGT ) is higher in persons with multiple sclerosis ( MS ) compared to healthy controls , indicating metabolic deficits that may increase comorbidity . In other population s , IGT can , at least partly , be reversed by intense physical exercise , but this is never investigated before in MS . Aim To investigate the effect of high intensity aerobic and resistance training on glucose tolerance and skeletal muscle GLUT4 content in MS . Methods Thirty-four persons with MS ( aged 45 ± 3 years , EDSS 2.5 ± 1.07 ) were r and omized into three groups , including a ( 1 ) sedentary control group ( SED , n = 11 ) , ( 2 ) 12-week high intensity interval plus resistance training group ( HITR , n = 12 ) , or ( 3 ) 12-week high intensity continuous aerobic training plus resistance training group ( HCTR , n = 11 ) . Before and after 12 weeks , glucose tolerance and skeletal muscle GLUT4 content were determined by an oral glucose tolerance test and analysis of a m.vastus lateralis biopsy , respectively . Results There were no significant changes for subjects of SED . From pre- to post-intervention , total area under the glucose curve ( tAUC ) decreased significantly in both HITR ( −6.9 ± 6.2 % ) and HCTR ( −11.0 ± 7.7 % ) ( P < 0.05 ) . Insulin tAUC decreased ( −12.3 ± 14.7 % ) within HCTR and muscle GLUT4 content increased ( + 6.6 ± 4.5 % ) in HITR . Conclusion Twelve weeks of high intensity aerobic exercise in combination with resistance training improved glucose tolerance in persons with MS Background Poststroke guidelines recommend moderate-intensity , continuous aerobic training ( MCT ) to improve aerobic capacity and mobility after stroke . High-intensity interval training ( HIT ) has been shown to be more effective than MCT among healthy adults and people with heart disease . However , HIT and MCT have not been compared previously among people with stroke . Objective The purpose of this study was to assess the feasibility and justification for a definitive r and omized controlled trial ( RCT ) comparing HIT and MCT in people with chronic stroke . Design A preliminary RCT was conducted . Setting The study was conducted in a cardiovascular stress laboratory and a rehabilitation research laboratory . Patients Ambulatory people at least 6 months poststroke participated . Intervention Both groups trained 25 minutes , 3 times per week , for 4 weeks . The HIT strategy involved 30-second bursts at maximum-tolerated treadmill speed alternated with 30- to 60-second rest periods . The MCT strategy involved continuous treadmill walking at 45 % to 50 % of heart rate reserve . Measurements Measurements included recruitment and attendance statistics , qualitative HIT acceptability , adverse events , and the following blinded outcome variables : peak oxygen uptake , ventilatory threshold , metabolic cost of gait , fractional utilization , fastest treadmill speed , 10-Meter Walk Test , and Six-Minute Walk Test . Results During the 8-month recruitment period , 26 participants consented to participate . Eighteen participants were enrolled and r and omly assigned to either the HIT group ( n=13 ) or the MCT group ( n=5 ) . Eleven out of the 13 HIT group participants attended all sessions . Participants reported that HIT was acceptable and no serious adverse events occurred . St and ardized effect size estimates between groups were moderate to very large for most outcome measures . Only 30 % of treadmill speed gains in the HIT group translated into overground gait speed improvement . Limitations The study was not design ed to definitively test safety or efficacy . Conclusions Although further protocol optimization is needed to improve overground translation of treadmill gains , a definitive RCT comparing HIT and MCT appears to be feasible and warranted UNLABELLED Poststroke hemiparesis often leads to a vicious cycle of limited activity , deconditioning , and poor cardiovascular health . Accumulating evidence suggests that exercise intensity is a critical factor determining gains in aerobic capacity , cardiovascular protection , and functional recovery after stroke . High-intensity interval training ( HIT ) is a strategy that augments exercise intensity using bursts of concentrated effort alternated with recovery periods . However , there was previously no stroke-specific evidence to guide HIT protocol selection . PURPOSE This study aim ed to compare within-session exercise responses among three different HIT protocol s for persons with chronic ( > 6 months after ) stroke . METHODS Nineteen ambulatory persons with chronic stroke performed three different 1-d HIT sessions in a r and omized order , approximately 1 wk apart . HIT involved repeated 30-s bursts of treadmill walking at maximum tolerated speed , alternated with rest periods . The three HIT protocol s were different on the basis of the length of the rest periods , as follows : 30 s ( P30 ) , 60 s ( P60 ) , or 120 s ( P120 ) . Exercise tolerance , oxygen uptake ( V˙O2 ) , HR , peak treadmill speed , and step count were measured . RESULTS P30 achieved the highest mean V˙O2 , HR , and step count but with reduced exercise tolerance and lower treadmill speed than P60 or P120 ( P30 : 70.9 % V˙O2peak , 76.1 % HR reserve ( HRR ) , 1619 steps , 1.03 m·s(-1 ) ; P60 : 63.3 % V˙O2peak , 63.1 % HRR , 1370 steps , 1.13 m·s(-1 ) ; P120 : 47.5 % V˙O2peak , 46.3 % HRR , 1091 steps , 1.10 m·s(-1 ) ) . P60 achieved treadmill speed and exercise tolerance similar to those in P120 , with higher mean V˙O2 , HR , and step count . CONCLUSIONS For treadmill HIT in chronic stroke , a combination of P30 and P60 may optimize aerobic intensity , treadmill speed , and stepping repetition , potentially leading to greater improvements in aerobic capacity and gait outcomes in future studies BACKGROUND AND PURPOSE Assessment of the quality of r and omized controlled trials ( RCTs ) is common practice in systematic review s. However , the reliability of data obtained with most quality assessment scales has not been established . This report describes 2 studies design ed to investigate the reliability of data obtained with the Physiotherapy Evidence Data base ( PEDro ) scale developed to rate the quality of RCTs evaluating physical therapist interventions . METHOD In the first study , 11 raters independently rated 25 RCTs r and omly selected from the PEDro data base . In the second study , 2 raters rated 120 RCTs r and omly selected from the PEDro data base , and disagreements were resolved by a third rater ; this generated a set of individual rater and consensus ratings . The process was repeated by independent raters to create a second set of individual and consensus ratings . Reliability of ratings of PEDro scale items was calculated using multirater kappas , and reliability of the total ( summed ) score was calculated using int 
    Output:
    
HIIT appears to be safe and effective in increasing fitness in people with MS and low levels of disability .