***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 The introduction of antiretroviral therapy ( ART ) has dramatically reduced the mortality rate of people living with HIV ( PLHIV ) . However , complications of both HIV and ART , such as peripheral neuropathy currently affect PLHIV . The purpose of this study was to establish the prevalence of peripheral neuropathy of the lower extremity and , its association with demographic and health status , characteristics among people on ART in Rw and a. Methods A cross sectional study was conducted among 507 women and men aged between 18 and 60 years , on ART , r and omly selected from eight selected ART clinics in Rw and a.  Brief Peripheral Neuropathy Screen was used to assess peripheral neuropathy . Results Peripheral neuropathy prevalence was 59 % overall , mean age of the participants was 39.7 ( ±9.2 ) and a slightly older age was associated with peripheral neuropathy ; [ 42(±9.2 ) vs 37 ( ±8.8 ) ( p < 0.001 ) ] . 78 % of participants living in urban setting s compared to 40 % in rural setting s reported peripheral neuropathy , 69 % of participants with higher levels of education ( secondary level and above ) reported lower extremity neuropathy . The three factors were significantly associated with peripheral neuropathy in multivariable model analysis : older age [ aOR = 1.1 , 95 % CI ( 1.0 , 1.2 ) , p < 0.001 ] , primary education level [ aOR = 0.6 95 % Cl ( 0.3 , 1.0 ) , p = 0.04 ] and urban setting [ aOR = 0.1 , 95 % CI ( 0.06 , 0.3 ) , p < 0.001 ] , after adjusting for other factors . None of the health status characteristics namely ; the level of CD4 cell count , duration of HIV infection and duration on ART , was independently associated with peripheral neuropathy . Conclusions The prevalence of peripheral neuropathy among PLHIV on ART in Rw and a is high . It is unclear why urban setting has an effect on PN levels in this cross sectional study , but does suggest that unidentified social and lifestyles factors may have a role in subjective symptoms and objective signs , of PN Aim To clinical ly evaluate the effectiveness of acupuncture when used in the management of chemotherapy-induced peripheral neuropathy ( PN ) . Background During cancer treatment , certain chemotherapies can cause varying degrees of PN . Patients ’ quality of life can be seriously impaired through loss of sensation , pain or mobility problems . Conventional medications routinely used to manage neuropathic symptoms have poor side-effect profiles and there is little or no evidence justifying their use to treat chemotherapy-related neurotoxicities . There are studies suggesting that acupuncture may be an effective therapy in treating PN across a number of different aetiologies . Design A retrospective service evaluation . Method Patients ( n=18 ) were referred for acupuncture by the medical staff and /ornurse specialists or they self-referred for treatment . A course of six weekly acupuncture sessions was offered to them , and their details were recorded on an evaluation form prior to session one . Points were selected by acupuncturists , based on patient presentation , and needles remained in situ for 30–45 min . Treatments took place in outpatient clinics , chemotherapy day case ward or a drop-in clinic based in a physiotherapy gym . The evaluation form was completed at the end of session 6 by a therapist who had not been involved in patient care . Results 82 % ( n=14 ) of patients reported an improvement in symptoms following their course of acupuncture ; one patient with advanced disease died during the 6 weeks . Some patients derived additional benefits from the treatment including a reduction in analgesic use and improved sleeping patterns . The most common acupoints used were SP6 ( n=18 ) , ST36 ( n=18 ) and LV3 ( n=14 ) . Conclusion Although these results are encouraging , they are uncontrolled . They suggest that acupuncture could be an option for these patients and controlled trials using vali date d patient-reported outcome measures are justified Objective To evaluate the effect of 8-week moderate intensity aerobic ( heart-rate reserve 40–60 % ) exercise on neuropathy quality of life in type 2 diabetes . Methods A single blind , parallel-group , r and omized controlled trial was carried out in a tertiary setting . People with type 2 diabetes were eligible for the study if they had clinical neuropathy which was defined by a minimum score of seven on the Michigan diabetic neuropathy score . Following which , the patients were r and omly assigned to an 8-week program by a computer-generated r and om number tables to intervention or control group . Repeated measure analysis of variance was used for data analysis ( p < 0.05 was considered significant ) . Results There were 47 participants in the control group and 40 participants in the study group after r and omization but 37 from the control group and 29 from the intervention group completed the final analysis . The two groups had a significant difference , pre – post intervention in scores of pain ( F = 7 , p = 0.01 ) , sensory symptoms ( F = 4.60 , p = 0.04 ) , restricted activities of daily living ( F = 4.97 , p = 0.03 ) , disruptions in social relationships ( F = 5.43 , p = 0.02 ) , specific impact on quality of life ( F = 9.28 , p < 0.001 ) overall quality of life ( F = 28.72 , p < 0.001 ) , and total score ( F = 31.10 , p < 0.001 ) . Degrees of freedom for all the components were 1 , 62 . Conclusion Moderate intensity aerobic exercise is cornerstone in improving the quality of life of individuals with peripheral neuropathy in type 2 diabetes OBJECTIVE Labor pain and its management is a major concern for childbearing women , their families and health care providers . This study aim ed to investigate the effects of two non-pharmacological methods such as birth ball and heat therapy on labor pain relief . MATERIAL & METHODS This r and omized control trial was undertaken on 90 primiparous women aged 18 - 35 years old who were r and omly assigned to two intervention ( birth ball and heat ) and control groups .  The pain score was recorded by using Visual Analogue Scale ( VAS ) before the intervention and every 30 min in three groups until cervical dilatation reached 8 cm . RESULTS The mean pain severity score in the heat therapy group was less than that of in control group at 60 and 90 min after intervention ( p < 0.05 ) . In addition there were significantly differences between the pain scores in the birth ball group after all three investigated times in comparison to control group . CONCLUSION Both heat therapy and birth ball can use as inexpensive complementary and low risk treatment for labor pain PURPOSE The aim of this study was to determine the effects of Tai Chi exercise on glucose control , neuropathy scores , balance , and quality of life in patients with type 2 diabetes and neuropathy . METHODS A pretest-posttest design with a nonequivalent control group was utilized to recruit 59 diabetic patients with neuropathy from an outpatient clinic of a university hospital . A st and ardized Tai Chi for diabetes program was provided , which comprised 1 hour of Tai Chi per session , twice a week for 12 weeks . Outcome variables were fasting blood glucose and glycosylated hemoglobin for glucose control , the Semmes-Weinstein 10-g monofilament examination scores and total symptom scores for neuropathy , single leg stance for balance , and the Korean version of the SF-36v2 for quality of life . Thirty-nine patients completed the posttest measures after the 12-week Tai Chi intervention , giving a 34 % dropout rate . RESULTS The mean age of the participants was 64 years , and they had been diagnosed with type 2 diabetes for more than 12 years . The status was significantly better for the participants in the Tai Chi group ( n=20 ) than for their control ( i.e. , nonintervention ) counterparts ( n=19 ) in terms of total symptom scores , glucose control , balance , and quality of life . CONCLUSION Tai Chi improved glucose control , balance , neuropathic symptoms , and some dimensions of quality of life in diabetic patients with neuropathy . Further studies with larger sample s and long-term follow-up are needed to confirm the effects of Tai Chi on the management of diabetic neuropathy , which may have an impact on fall prevention in this population [ Purpose ] The aim of this double-blind , r and omized and placebo-controlled study is to investigate the effects of Transcutaneous Electrical Nerve Stimulation for reducing the side effects of Chemotherapy-induced Peripheral Neuropathy in cancer patients undergoing chemotherapy with oxaloplatin or paclitaxel . [ Subjects and Methods ] Twenty-four patients were r and omly allocated into two groups : active or placebo stimulation . All patients were assessed for pain , numbness/tingiling , frequency of symptoms , and quality of life . The transcutaneous Electrical Nerve Stimulation device was applied daily with modulating frequencies ranging between 7 Hz and 65 Hz in distal limb regions during three cycles of chemotherapy ( 45 days ) . The other stimulation parameters were : pulse duration of 200 μsec , intensity at the highest tolerable level , and increases in intensity when it diminished . [ Results ] The data showed no difference between active or placebo groups in terms of pain , numbness/tingling , frequency of symptoms or impact on daily life activities . [ Conclusion ] These results suggest that Transcutaneous Electrical Nerve Stimulation applied in the frequency variation mode was not proven to be effective to improve the symptoms of Chemotherapy-induced Peripheral Neuropathy during chemotherapy cycles . There was no worsening of symptoms in subsequent cycles of the onset of symptoms of the disease OBJECTIVE —The purpose of this study was to determine the efficacy of anodyne monochromatic infrared photo energy ( MIRE ) in-home treatments over a 90-day period to improve peripheral sensation and self-reported quality of life in individuals with diabetes . RESEARCH DESIGN AND METHODS —This was a double-blind , r and omized , sham-controlled clinical trail . We r and omly assigned 69 individuals with diabetes and a vibration perception threshold ( VPT ) between 20 and 45 V to two treatment groups : active or sham treatment . Sixty patients ( 120 limbs ) completed the study .  Anodyne units were used at home every day for 40 min for 90 days . We evaluated nerve conduction velocities , VPT , Semmes-Weinstein monofilaments ( SWM ) ( 4- , 10- , 26- , and 60-g monofilaments ) , the Michigan Neuropathy Screening Instrument ( MNSI ) , a 10-cm visual analog pain scale , and a neuropathy-specific quality of life instrument . We used a nested repeated- measures multiple ANOVA design . Two sites ( great toe and fifth metatarsal ) were tested on both the left and right feet of each patient , so two feet were nested within each patient and two sites were nested within each foot . To analyze the ordinal SWM scores , we used a nonparametric factorial analysis for longitudinal data . RESULTS —There were no significant differences in measures for quality of life , MNSI , VPT , SWM , or nerve conduction velocities in active or sham treatment groups ( P > 0.05 ) . CONCLUSIONS —Anodyne MIRE therapy was no more effective than sham therapy in the treatment of sensory neuropathy in individuals with diabetes BACKGROUND AND PURPOSE The effects of a home exercise program for persons with chronic peripheral neuropathies ( CPN ) have not been documented . We compared changes in impairment and health-related quality of life ( HRQL ) between exercise and control groups , investigated the relationship between HRQL and measures of impairment , and contrasted the HRQL of individuals with CPN to that previously described for the general population . SUBJECTS Twenty-eight subjects with CPN , aged 23 to 84 years ( mean = 56.2 , SD = 14.9 ) , completed the study . METHODS Impairment measures included average muscle score ( AMS ) , h and grip force , walking time , and forced vital capacity . The HRQL instrument measured the eight scales of the Medical Outcomes Study 36-Item Short-Form Health Survey ( SF-36 ) and the component scales . The exercise group ( n = 14 ) completed a 6-week home exercise program . The control group ( n = 14 ) did not participate in a home exercise program . RESULTS There was an increase in the AMS in the exercise group compared with the control group . No other between-group differences were found . The exercise group improved in scores on the role limitation scales of the SF-36 . The AMS and walking time were moderately correlated with the physical function scale of the SF-36 ( r = .55 and -.62 , respectively ) . The SF-36 scores of individuals with CPN were lower than scores previously described for the general population . CONCLUSION AND DISCUSSION The home exercise program appears to be an important component of the treatment of persons with CPN . Compared with the general population , patients with CPN appear to have a lower HRQL , but some areas appear to improve following a home exercise program Purpose Muscle pain is a natural consequence of intense and prolonged exercise and has been suggested to be a limiter of performance . Transcutaneous electrical nerve stimulation ( TENS ) and interferential current ( IFC ) have been shown to reduce both chronic and acute pain in a variety of conditions . This study sought to ascertain whether TENS and IFC could reduce exercise-induced pain ( EIP ) and whether this would affect 
    Output:
    
This review identified that a number of self-management strategies that were initiated by patients , including heat , exercise , meditation , and transcutaneous electrical nerve stimulation ( TENS ) therapy , may reduce self-reported PN symptoms .
As the available studies were of low quality , these strategies warrant further investigation with more homogeneous sample s , using more rigorously design ed trials and larger sample s. Patients experiencing PN may find a range of self-initiated strategies beneficial in reducing PN symptoms and improving quality of life .