***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: OBJECTIVE To test whether training on a high-frequency ( 28Hz ) vibrating platform improves muscle power and bone characteristics in postmenopausal women . DESIGN R and omized controlled trial with 6-month follow-up . SETTING Outpatient clinic in a general hospital in Italy . PARTICIPANTS Twenty-nine postmenopausal women ( intervention group , n=14 ; matched controls , n=15 ) . INTERVENTION Participants stood on a ground-based oscillating platform for three 2-minute sessions for a total of 6 minutes per training session , twice weekly for 6 months . The controls did not receive any training . Both groups were evaluated at baseline and after 6 months . MAIN OUTCOME MEASURES Muscle power , calculated from ground reaction forces produced by l and ing after jumping as high as possible on a forceplate , cortical bone density , and biomarkers of bone turnover . RESULTS Over 6 months , muscle power improved by about 5 % in women who received the intervention , and it remained unchanged in controls ( P=.004 ) . Muscle force remained stable in both the intervention and control groups . No significant changes were observed in bone characteristics . CONCLUSION Reflex muscular contractions induced by vibration training improve muscle power in postmenopausal women Forty-eight community living women 66–87 years old volunteered to participate in a 12-month prospect i ve , r and omized , controlled , trial . The aim was to determine if a combined weight-bearing training program twice a week would be beneficial to bone mineral density and neuromuscular function . The participants were pairwise age-matched and r and omly assigned to either an exercise group ( n=24 ) or a control group ( n=24 ) . Twenty-one subjects in the intervention group and 19 in the control group completed the study . The exercise program lasted for 50 min and consisted of a combination of strengthening , aerobic , balance and coordination exercises . The mean percentage of scheduled sessions attended for the exercise group was 67 % . At the completion of the study , the intervention group showed significant increments in bone mineral density of the Ward ’s triangle ( 8.4 % , P<0.01 ) as well as improvement in maximum walking speed ( 11.4 % , P<0.001 ) and isometric grip strength ( 9.9 % , P<0.05 ) , as compared to the control group . The conclusion was that a combined weight-bearing training program might reduce fracture risk factors by improving bone density as well as muscle strength and walking ability . This program could be suitable for older community living women in general , and might , therefore , have important implication s for fracture prevention Summary The purpose of this study was to determine the optimal intensity of exercise necessary to prevent the postmenopausal bone loss on the basis of anaerobic threshold ( AT ) . Thirty-three postmenopausal women were r and omized to control ( group C : n=12 ) or two exercise groups ( group H and group M ) . All women performed a treadmill exercise test , and the AT was measured by expired gas analysis . The exercise regimen consisted mainly of walking at a speed that kept the exercise heart rate above the AT ( group H : n=12 ) or below the AT ( group M : n=9 ) . Exercise was performed for 30 minutes , three times a week for 7 months . The bone mineral density ( BMD ) of the lumbar vertebrae was measured using dual energy X-ray absorptiometry . The BMD level in group C decreased by 1.7±2.7 % , but there was a significant increase of 1.1±2.9 % in group H. In group M there was a decrease of 1.0±3.1 % which did not differ from group C. In group C , serum osteocalcin and urinary hydroxyproline excretion were significantly increased , but no changes were seen in either of the exercise groups . Urinary calcium significantly decreased in the exercise groups . We conclude that short-term ( 7 months ) exercise with intensity above the AT is safe and effective in preventing postmenopausal bone loss This paper reports the results of a study of the gait of 102 patients with osteoarthritis of the knee . Functional status was measured by a 6-min test of walking distance ; the stride characteristics associated with the walk test were assessed . Stride characteristics were measured by a Stride Analyzer . Patients were r and omized to an 8-week educational and walking program ( the intervention group ) or to a weekly telephone survey ( the control group ) . The intervention group patients had a 15 % increase in walking distance ( P < 0.0001 ) and increases of 9.1 % in stride length at free walking speeds ( P < 0.007 ) and 17 % in stride length at fast walking speeds ( P < 0.01 ) compared to the control group . The results of this study have shown that the walking and educational program was effective in improving gait function in patients with osteoarthritis of the knee OBJECTIVE To investigate the effect of a 2-year vigorous , combined high-impact , strength , and endurance training program on bone mineral density ( BMD ) determined by dual-energy x-ray absorptiometry ( DXA ) , quantitative computed tomography ( QCT ) , and ultrasound in early postmenopausal women with osteopenia . DESIGN Nonr and omized controlled trial , reporting 1-year data . SETTING Community . PARTICIPANTS Early postmenopausal ( 1 - 8y postmenopausal ) osteopenic women ( DXA T score at lumbar spine or total hip between -1 and -2.5 st and ard deviations ) . The exercise group ( n=59 ; mean age , 55.1+/-3.4y ) and control group ( n=41 ; mean age , 55.9+/-3.1y ) were recruited from community registers . INTERVENTION Fourteen months of exercise training , with 2 joint sessions and 2 additional home training sessions . Exercise and control groups were supplemented individually with calcium and cholecalciferol up to 1500 mg of calcium and 500IU of vitamin D per day . MAIN OUTCOMES MEASURES BMD at the lumbar spine and total hip measured by DXA , isometric maximum strength , and maximal oxygen consumption ( VO2max ) during a stepwise running test to exhaustion . RESULTS Bone density increased significantly at the lumbar spine for the exercise group ( 1.3 % , P<.001 ) and decreased in the control group ( -1.2 % , P<.01 ) . Differences at the total hip ( -0.3 % , not significant vs -0.8 % , P<.05 ) and the femoral neck ( -0.8 % , P<.05 vs -1.8 % , P<.001 ) were nonsignificant . Changes in isometric maximum strength were significant for each region ( grip strength , trunk flexors and extensors , hip flexors , leg adductors and abductors , arm flexors and extensors ) in the exercise group ( 11%-39 % ) compared with nonrelevant changes ( -1.1 % to 3.9 % ) in the control group . Between-group differences were significant ( P<.01-.001 ) for all strength parameters . VO2max increased significantly by 11 % ( P<.001 ) in the exercise group but decreased in the control group by 4 % ( P<.05 ) while showing significant between-group differences . CONCLUSION High-intensity exercise training can have a positive influence on bone density in early postmenopausal osteopenic women Many studies have been done involving exercise , impact loading , and the effect on BMD . In some of these studies , particularly those involving outpatient activity , compliance and the specific parameters of an individual 's impact loading have been difficult to monitor effectively . In this study , an individual , home-use platform was used to record daily , specific , and reproducible impact forces generated during a  heel drop exercise . At three centers over 24 months , we conducted a r and omized , prospect i ve study of 157 osteoporotic and osteopenic women , aged 60 - 85 years . A total of 99 patients used the home Osteocare device  ( OrthoGenesis Incorporated , Northborough , Massachusetts USA ) to generate a reproducible and specific daily impact program ( active group ) . Controls ( 32 ) performed a similar motion on the unit but without trying to trigger an impact force ( sham group ) , and 26 patients did no prescribed heel drop exercise  (  control group ) . All groups had the same calcium and vitamin D supplementation .  Hip DXA was performed at baseline and every 6 months during the entire study duration . Compliance with the 3 - 5 min routine was high , and patients were able to consistently achieve the specific targeted impact range . Pooled BMD results showed no significant differences between groups in overall BMD measurements . However , a classification model that looked at individual site-specific BMD changes showed that more than 75 % of the active group responded ( versus 62 % for both the sham and the control groups ) by maintaining or increasing site-specific hip BMD over the 2-year trial . In fact , at the end of the study , 45 % of the actives were gainers versus 12 % and 22 % in the sham and control groups , respectively . This study suggests that hip BMD may be maintained through a brief , safe , at-home , monitored impact loading program The effect of two structured exercise programmes on the bone mass of 48 healthy postmenopausal white women aged 50 - 62 was studied after one year . Volunteers were r and omised to group 1 ( control ) , group 2 ( aerobic exercise ) , or group 3 ( aerobic and strengthening exercises ) . Before and after the training programme each subject had evaluations of bone mass ( determined by neutron activation analysis and expressed as calcium bone index ) and maximum oxygen uptake attained on a multistage exercise treadmill test . After one year both exercise groups had higher levels of fitness and greater bone mass than controls . Mean values ( 2 SEM ) for changes in the calcium bone index were -0.011 ( 0.037 ) , 0.039 ( 0.035 ) , and 0.066 ( 0.036 ) for groups 1 , 2 , and 3 , respectively . Analysis of variance on the observed data and analysis of covariance adjusting changes to the initial mean value for the whole group showed significant differences between each exercise group and the controls but no difference between the exercise groups themselves . Both exercise groups showed a significant improvement in maximum oxygen uptake . This study suggests that exercise may modify bone loss in healthy postmenopausal women PURPOSE The purpose of this study was to compare the effects of a high-load ( 80 % , 1-repetition maximum ( RM ) , 8 reps ) and a high-repetition ( 40 % , 1-RM , 16 reps ) resistance training protocol on muscular strength and bone mineral density ( BMD ) in early postmenopausal , estrogen-deficient women . The 6-month programs were matched initially for training volume ( 3 sets , 3 d x wk(-1 ) ) for 12 exercises selected to specifically load the spine and hip . METHODS Subjects included 25 women ( 41 - 60 yr ) who were matched by spine BMD then r and omly assigned to either the high-load ( HL , N = 10 ) , high-repetition ( HR , N = 7 ) , or control ( C , N = 8) groups . Dietary calcium intakes were supplemented to approximately 1500 mg x d(-1 ) . Total body , spine , and hip BMD ( DXA , Lunar Model DPX-IQ ) , upper and lower body muscular strength , and biochemical markers of bone turnover were measured at baseline and after 6 months of training . RESULTS There were no group differences in the baseline measures . Both training groups showed similar increases in biceps ( 20 % ) and rectus femoris ( 28 - 33 % ) cross-sectional areas , in lower body strength ( approximately 30 % ) and in hip strength ( 37 - 40 % ) . HL showed greater improvements in upper body strength ( HL 25 % , HR 16 % ) . Neither training group experienced significant increases in spine or hip BMD , although the HL total body BMD tended to decrease ( -1.1%+/-0.4 , P = 0.054 ) after training . Osteocalcin tended to increase ( P = 0.08 ) in all groups after training , and the % change in osteocalcin was positively related to % changes in the total hip ( r = 0.41 , P = 0.048 ) and the trochanter ( r = 0.42 , P = 0.04 ) BMD . CONCLUSION The high-load and high-repetition resistance training protocol s were both effective in improving muscular strength and size in postmenopausal women , indicating low-intensity resistance training can be beneficial for the muscular fitness in women for whom high-intensity exercise is contraindicated OBJECTIVE to evaluate the effects of brisk walking on bone mineral density in women who had suffered an upper limb fracture . DESIGN r and omized placebo-controlled trial . Assessment s of bone mineral density were made before and at 1 and 2 years after intervention . St and ardized and vali date d measures of physical capacity , self-rated health status and falls were used . SETTING district general hospital outpatient department . SUBJECTS 165 women drawn from local accident and emergency departments with a history of fracture of an upper limb in the previous 2 years . Women were r and omly allocated to intervention ( self-paced brisk walking ) or placebo ( upper limb exercises ) groups . INTERVENTION both groups were seen at 3-monthly intervals to assess progress , measure physical capacity and maintain enthusiasm . The brisk-walking group were instructed to progressively increase the amount and speed of walking in a manner that suited them . The upper limb exercise placebo group were asked to carry out a series of exercises design ed 
    Output:
    
REVIEW ER 'S CONCLUSIONS Aerobics , weight bearing and resistance exercises are all effective in increasing the BMD of the spine in postmenopausal women .
Walking is also effective on the hip .