***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: PURPOSE The purpose s of this study were to assess a ) the effectiveness of Masai Barefoot Technology ( MBT ) shoe in reducing  knee pain in persons with knee osteoarthritis ( OA ) and ( b ) changes in balance , ankle and knee ROM , and ankle strength compared with a high-end walking shoe for 12 wk . METHODS The research design was a r and omized controlled trial ( 123 subjects , knee OA ) . Subjects were r and omized to a MBT ( N = 57 ) or a control shoe ( N = 66 ) . A Western Ontario and McMaster Universities ( WOMAC ) OA index , BMI , balance , active ROM , and ankle torque were quantified at week 0 , 3 , 6 , 9 , and 12 . Two- sample t-tests were done for between-group comparisons . RESULTS There was no significant difference between groups in total pain score . A significant reduction over the 12-wk period was found for both shoe conditions ( -42/500 or 25.6 % MBT , -46.2 or 27.1 % control ) . There was no significant group difference in pain during walking ( t = -1.09 , P = 0.28 ) . Pain during walking was significantly reduced by 5.2/100 mm in the MBT and 9.7/100 mm in the control group . Total pain showed a significant reduction for the MBT -27.4/500 ( -16.6 % ) and the control group -28.9/500 ( -17.0 % ) between baseline and week 3 . Between week 3 and 6 , there was a significant reduction for the MBT group only ( -27.2/500 or -20.0 % ) . There was a significant increase in the static balance between baseline and 12 wk in the MBT group only , although the difference between groups was not significant . DISCUSSION The results indicate that special shoe interventions can reduce pain in subjects with moderate knee OA Background Research es on the results of surgical treatment of thoracolumbar spine fractures are infrequent . The aim of this study was to determine midterm outcomes of surgical treatment of these fractures in a prospect i ve survey . Methods A case series study on pediatric patients with the diagnosis of thoracic and /or lumbar vertebral fractures was conducted over a ten-year period . Surgically treated patients were evaluated in the follow-up period , based on back pain , independent function , neurological status , and radiographic indices . Results There were 102 pediatric individuals , 61 boys and 41 girls , aged 3–17 years ( mean 12 years of age ) with thoracic and /or lumbar spinal fractures . Motor vehicle accident was the most common mechanism of injury ( 45.0 % ) . L1 was the most frequent level of fractured vertebra ( 24.4 % ) , and pelvic fracture was the most common associated orthopedic injury ( 21.5 % ) . Totally , 20 patients underwent surgery , but only fifteen ( 14 boys and one girl ) participated in follow-up ( mean 49 months ; range 12–81 months ) . Posterior spinal fusion and instrumentation was accomplished in 12 cases . Three patients were operated by anterior approach and fusion followed by posterior fusion and instrumentation because of delay in diagnosis . There were no major perioperative complications . Two cauda equina syndromes and two incomplete spinal cord injuries improved back to normal . Five cases ( 33.3 % ) reported occasional back pain , and all patients were functionally independent . Radiographic indices improved significantly . Conclusions Spinal fusion and instrumentation in pediatric patients with unstable thoracolumbar vertebral fractures with or without spinal cord injuries have favorable radiographic and functional outcomes BACKGROUND To compare kinematics , kinetics and muscle activity during  st and ing and walking for healthy subjects using an  unstable test shoe  ( Masai Barefoot Technology , MBT ) and a stable control shoe . METHODS Eight subjects volunteered for this study . During quiet st and ing , center of pressure excursion and muscle activity were determined . During walking , lower extremity kinematics , kinetics , and muscle electromyographic ( EMG ) signals were determined . Data were collected for the two shoe conditions after a 2week accommodation period . Statistics included repeated measures ANOVAs ( alpha = 0.05 ) and post hoc tests where appropriate . FINDINGS During quiet st and ing , the center of pressure excursion was significantly and substantially greater in the unstable compared to the control shoe . Electromyographic intensity increased in the unstable test shoe for all tested muscles , but only significantly for the tibialis anterior . During locomotion , kinematics were similar in the two shoe conditions except for the initial plantar-dorsiflexion , which showed a significant more dorsiflexed position during the first half of stance in the unstable test shoe compared to the stable control shoe . The angular impulses did not show any significant differences between the two shoe conditions for all three joints but some trends towards a reduction for the knee and hip joint . There were no significant differences in electromyographic activities between the control and the unstable shoe . However , several muscles showed some trends . INTERPRETATION The unstable shoe produced changes and trends in kinematic , kinetic and electromyographic characteristics that seemed to be advantageous for the locomotor system . Further studies should investigate muscle strength , dynamic stability , pain reduction for arthritic knees and injury prevention for high performance athletes when using the unstable shoes Proprioceptive training has been shown to reduce the incidence of ankle sprains in different sports . It can also improve rehabilitation after anterior cruciate ligament ( ACL ) injuries whether treated operatively or nonoperatively . Since ACL injuries lead to long absence from sports and are one of the main causes of permanent sports disability , it is essential to try to prevent them . In a prospect i ve controlled study of 600 soccer players in 40 semiprofessional or amateur teams , we studied the possible preventive effect of a gradually increasing proprioceptive training on four different types of wobble-boards during three soccer seasons . Three hundred players were instructed to train 20 min per day with 5 different phases of increasing difficulty . The first phase consisted of balance training without any balance board ; phase 2 of training on a rectangular balance board ; phase 3 of training on a round board ; phase 4 of training on a combined round and rectangular board ; phase 5 of training on a so-called BABS board .  A control group of 300 players from other , comparable teams trained “ normally ” and received  no special balance training . Both groups were observed for three whole soccer seasons , and possible ACL lesions were diagnosed by clinical examination , KT-1000 measurements , magnetic resonance imaging or computed tomography , and arthroscopy . We found an incidence of 1.15 ACL injuries per team per year in the control group and 0.15 injuries per team per year in the proprioceptively trained group ( P<0.001 ) . Proprioceptive training can thus significantly reduce the incidence of ACL injuries in soccer players The incidence of Achilles tendinopathy is very high in young female gymnasts ( 17.5 % ) . According to literature , ecography screenings show the tendons thickening , but at the same time it does not reveal a direct link to the clinical picture . The neovessels are involved in the pathophysiological process of Achilles tendinopathy . For this reason , we wanted to verify there between perfusion tendon values and the type of sport activity . We performed a clinical observational study monitoring the  oximetry of the Achilles tendon  and the epidemiological data of 52 elite female ( artistic and rhythmic ) gymnasts versus 21 age-matched controls .  Analyzing the main limb , we revealed statistically higher oximetry values in the artistic gymnasts group ( 69.5 % ) compared to the rhythmic gymnasts group ( 67.1 % ) ( t = 2.13 ; p = 0.01 ) and the sedentary group ( 66.2 % ) ( t = 2.70 ; p = 0.004 ) , but we did not find any differences between rhythmic gymnasts group and the sedentary group ( t = 0.68 ; p = 0.24 ) . The multiple logistic regression model highlighted that the oximetry value of the main limb is not influenced by age , knowledge of the main limb , years of general and gymnastic sports activity ( p > 0.05 ) . We discovered an increase of Achilles tendon perfusion in the main limb in the artistic gymnast group . We hypothesize that specific figures of artistic sports activity are responsible for muscle overload and gastrocnemius-soleus group and , at the same time , these figures cause hyperperfusion of the tendon . Prospect i ve longitudinal studies could explain if this could become a predictive sign of the next Achilles tendinopathy onset Objective : The objectives of this study were to assess the effect of unstable s and als on ( 1 ) low back pain ( LBP ) in golfers with undiagnosed moderate LBP , ( 2 ) static and dynamic balance , and ( 3 ) golf performance . Design : This was a 6-week prospect i ve study where subjects were r and omized to a control group and an intervention group . Setting : Baseline measurements were recorded in the Human Performance Laboratory . Participants : Forty male golfers with nonspecific moderate LBP . Intervention : The intervention group wore unstable shoes for 6 weeks , and the control group wore their regular golf shoes . Main Outcome Measures : Low back pain , timed balance , and golf performance were assessed at baseline and at 6 weeks . Changes were compared through independent sample s t tests . Results : ( 1 ) There was a significant difference between groups in the change of perceived LBP scores in the laboratory ( test group : −17.5/100 mm , control : −3.6/100 mm ) and in the comparison of the first week entries to the last week entries recorded in logbooks ( test group : −10.7/100 mm , control group : + 2.6/100 mm ) . ( 2 ) There was no significant change in the static or dynamic balance times . ( 3 ) There was no significant change in golf performance between the intervention and control groups . Conclusion : The results indicate that unstable s and als can be used to reduce moderate lower back pain in this population of golfers without negatively affecting performance BACKGROUND The age-associated loss of physical function engenders gait patterns which jeopardise the knee and hip to osteoarthritis . Masai Barefoot Technology ( MBT ) shoes have been shown to provide a facility to address specific needs for load modification in terms of musculoskeletal disease prevention in people with restricted proprioceptive or strength abilities . Therefore , a readjustment of lower extremity joint loading profiles in the elderly was hypothesised when using this type of footwear . AIM The aim of this study was to evaluate the effects of MBT shoes on gait kinematics and kinetics in both an elderly and young cohort during walking . DESIGN This was a cross-sectional study . SETTING A 3-dimensional motion analysis laboratory . POPULATION Eleven healthy elderly men and 11 healthy young men . METHODS A conventional sport shoe served as control situation to MBT . Subjects were advised to walk eight trials per shoe at a criterion speed of 1.5 ± 0.1 m·s(-1 ) in block-r and omised order . Peak joint angles , moments and powers at the ankle , knee and hip were calculated through an inverse dynamic model . Data were compared by a two-way repeated measure ANOVA ( α=0.05 ) . RESULTS MBT  reduced external ankle joint moments and powers independent of age . At the hip , MBT footwear led to decreases in external hip flexion moments and concentric hip power output during early and late stance . Herein , no age-by-condition effects were present . Moreover , MBT  reduced external knee flexion moments and concentric knee extensor powers at loading response , with the greater changes observed in the elderly . Additionally , a main effect of condition showing a general decrease in  the MBT situation , but no interaction effect was noted for first peak external knee adduction moments . CONCLUSION These results suggest that MBT shoes diminish joint loads among age groups , whereas compared to young adults , the elderly , in particular , benefited from MBT footwear with regard to relief stress on the knee joint region . CLINICAL REHABILITATION IMPACT Based on these findings , the use of MBT shoes may attenuate the risk of developing knee and hip osteoarthritis in the elderly and may play an important role regarding pain avoidance and /or disability Abstract Purpose Economic crisis time gives to efficient procedures an important role in healthy system . Total hip replacement is a common bilateral orthopedic procedure , but there exists an important controversy to perform it in single or two stages . Our aim is to report our clinical and radiological short-term complications of bilateral uncemented total hip arthroplasty in a single time . Material s and methods We have retrospectively review ed the patients treated between 2000 and 2011 in our center by bilateral uncemented total hip replacement in a single time .  We have review ed the medical history and analyzed by age , diagnosis and ASA parameters related to the procedure , hospital stay , transfusion requirements and clinical complications . Radiological evaluation was made with anteroposterior hip radiograph evaluation ( acetabular radiolucencies and stem migration ) . Functional assessment was carried out by the Merle D’Aubigné score . Results Seventeen patients with mean age of 47.4 ( 18–68 ) years were review ed with a mean follow-up of 44.3 ( 6–172 ) months . ASA distribution : 29.4 % grade I ; 52.9 % grade II and 17.6 % grade III . Merlé D’Aubigné score improved from 11.01 to 16.45 . Hospital stay was 6 days . Transfusion requirements were two hematic concentrates for each patient . Two external popliteal sciatic nerve neurap 
    Output:
    
Unstable footwears were shown to immediately alter the stability in gait during daily-life activities .
The center of body pressure is moved posteriorly with a consequent posterior displacement of the upper part of body in order to regain an appropriate body balance , and these postural changes are associated with an overall increase in the activity of lumbar erector spine muscles , as well as certain lower limb muscles .
Current literature provides enough cues to conclude for a beneficial role of MBT shoes in the postural and proprioceptive recovery , but from the same literature can not be drown clear and appropriate guidance to determine more in detail their indication for specific pathological conditions or for particular phases of the musculoskeletal recovery process