***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 effect of exercise on specific impairments and activity limitations in people with hip osteoarthritis ( OA ) is limited . Objective The study objective was to evaluate the long-term effect of exercise therapy and patient education on range of motion ( ROM ) , muscle strength , physical fitness , walking capacity , and pain during walking in people with hip OA . Design This was a secondary outcome analysis of a r and omized clinical trial . Setting The setting was a university hospital . Participants One hundred nine people with clinical ly and radiographically evident hip OA were r and omly allocated to receive both exercise therapy and patient education ( exercise group ) or patient education only ( control group ) . Intervention All participants attended a patient education program consisting of 3 group meetings led by 2 physical therapists . Two other physical therapists were responsible for providing the exercise therapy program , consisting of 2 or 3 weekly sessions of strengthening , functional , and stretching exercises over 12 weeks . Both interventions were conducted at a sports medicine clinic . Measurements Outcome measures included ROM , isokinetic muscle strength , predicted maximal oxygen consumption determined with the Astr and bicycle ergometer test , and distance and pain during the Six-Minute Walk Test ( 6MWT ) . Follow-up assessment s were conducted 4 , 10 , and 29 months after enrollment by 5 physical therapists who were unaware of group allocations . Results No significant group differences were found for ROM , muscle strength , predicted maximal oxygen consumption , or distance during the 6MWT over the follow-up period , but the exercise group had less pain during the 6MWT than the control group at 10 months ( mean difference=−8.5 mm ; 95 % confidence interval=−16.1 , −0.9 ) and 29 months ( mean difference=−9.3 mm ; 95 % confidence interval=−18.1 , −0.6 ) . Limitations Limitations of the study were reduced statistical power and 53 % rate of adherence to the exercise therapy program . Conclusions The previously described effect of exercise on self-reported function was not reflected by beneficial results for ROM , muscle strength , physical fitness , and walking capacity , but exercise in addition to patient education result ed in less pain during walking in the long term OBJECTIVE To investigate the effect of a neuro-muscular exercise ( NEMEX ) therapy program compared with instructions in optimized analgesics and anti-inflammatory drug use ( PHARMA ) , on measures of knee-joint load in people with mild to moderate knee osteoarthritis ( OA ) . We hypothesized that knee joint loading during walking would be reduced by NEMEX and potentially increased by PHARMA . DESIGN Single-blind , r and omized controlled trial ( RCT ) comparing NEMEX therapy twice a week with PHARMA . Participants with mild-to-moderate medial tibiofemoral knee OA were r and omly allocated ( 1:1 ) to one of two 8-week treatments . Primary outcome was change in knee load during walking ( Knee Index , a composite score from all three planes based on 3D movement analysis ) after 8 weeks of intervention . Secondary outcomes were frontal plane peak knee adduction moment ( KAM ) , Knee Injury and Osteoarthritis Outcome Scores ( KOOS ) and functional performance tests . RESULTS Ninety three participants ( 57 % women , 58 ± 8 years with a body mass index [ BMI ] of 27 ± 4 kg/m2 ( mean ± st and ard deviation [ SD ] ) ) were r and omized to NEMEX group ( n = 47 ) or PHARMA ( n = 46 ) ; data from 44 ( 94 % ) and 41 ( 89 % ) participants respectively , were available at follow-up . 49 % of the participants in NEMEX and only 7 % in PHARMA demonstrated good compliance . We found no difference in the primary outcome as evaluated by the Knee Index -0.07 [ -0.17 ; 0.04 ] Nm/%BW HT . Secondary outcomes largely supported this finding . CONCLUSIONS We found no difference in the primary outcome ; knee joint load change during walking from a NEMEX program vs information on the recommended use of analgesics and anti-inflammatory drugs . Clinical Trials.gov Identifier : NCT01638962 ( July 3 , 2012 ) . Ethical Committee : S-20110153 Background Osteoarthritis ( OA ) is a leading cause of disability in the United States . Although no disease-modifying therapies exist , patients with knee OA who increase walking may reduce risk of functional limitations . Objective The objective of the study is to evaluate the impact of a mobile app ( OA GO ) plus wearable activity monitor/pedometer ( Jawbone UP 24 ) used for 90 days on the mobility of patients with knee OA treated with hylan G-F 20 .  Methods Patients with knee OA aged 30 to 80 years who were eligible to receive hylan G-F 20 and were familiar with smartphone technology were enrolled in this r and omized , multicenter , open-label study . Patients who had a body mass index above 35 kg/m2 were excluded . All patients received a single 6-mL injection of hylan G-F 20 and wore the Jawbone monitor . The patients were then r and omized 1:1 to Jawbone and OA GO ( Group A ; n=107 ) with visible feedback ( unblinded ) or Jawbone only ( Group B ; n=104 ) with no visible feedback ( blinded ) . The primary endpoint was mean change from baseline in steps per day at day 90 between Groups A and B. Results Baseline characteristics were similar between groups . There were significant differences between the increases in least squares ( LS ) mean number of steps per day ( 1199 vs 467 , P=.03 ) and the mean percentage change ( 35.8 % vs 11.5 % , P=.02 ) from baseline in favor of Group A over Group B. There was a greater reduction in pain from baseline during the 6-minute walk test in Group A versus Group B. ( LS mean change : −55.3 vs −33.8 , P=.007 ) . Most patients ( 65.4 % ) and surveys of physicians ( 67.3 % ) reported they would be likely or very likely to use/recommend the devices . Patient Activity Measure-13 scores improved from baseline ( LS mean change for Groups A and B : 5.0 vs 6.9 ) , with no significant differences between groups . The occurrence of adverse events was similar in the 2 groups . Conclusions Use of a novel smartphone app in conjunction with a wearable activity monitor provided additional improvement on mobility parameters such as steps per day and pain with walking in the 6-minute walk test in patients with knee OA who were treated with hylan G-F 20 . Results also highlight the amenability of patients and physicians to using mobile health technology in the treatment of OA and suggest further study is warranted Knee osteoarthritis is a common joint problem leading to an increase of pain and a loss of function in older individuals . The main objective of this study was to evaluate if a participant who was r and omly assigned to his preferred group improved his adherence to an effective walking program  compared to a participant who did not receive his preferred group . This was a 9-month pilot r and omized clinical trial , based on a patient treatment preferences design . The 69 eligible participants had a diagnosis of knee osteoarthritis . Participants were r and omized to one of two groups : a supervised community-based or unsupervised walking program , based on the Ottawa Panel guidelines . At 6 months , participants who expressed a preference , either for the supervised or unsupervised program , and who were assigned to their preferred choice of program showed significantly higher adherence to walking sessions ( supervised 60.7 ± 12.3 % , P < 0.0001 ; unsupervised 43.1 ± 12.1 % , P = 0.03 ) , compared to the participants who did not obtain their preferred choice of program . After 9 months , significant improvements were shown according to the level of stiffness evaluated with the WOMAC ( P = 0.01 ) and the functional status assessed with the Timed Up and GO Test ( P = 0.04 ) , among the adherent participants who obtained their preference , as compared to those who did not receive their preference . We show this approach promotes long-term adherence to a community-based walking program , while ensuring the maintenance of clinical benefits of walking , among older adults susceptible to avoid or not properly engage in physical activity OBJECTIVE ( 1 ) Do treatment effects differ between participants receiving manual therapy ( MT ) with exercise compared to subjects who do n't , ( 2 ) are treatment effects sustained better when participants receive booster sessions compared to those who do n't over a one year period in subjects with knee osteoarthritis ( KOA ) ? DESIGN Multi-center , 2 × 2 factorial r and omized clinical trial . 300 participants with knee OA were r and omized to four groups : exercise-no boosters ( Ex ) , exercise-with boosters ( Ex+B ) , manual therapy+exercise-no boosters ( MT+Ex ) , manual therapy+exercise-with boosters ( MT+Ex+B ) . The primary outcome was the Western Ontario and McMaster osteoarthritis index ( WOMAC ) at 1 year . Secondary outcomes included knee pain , physical performance tests , and proportions of participants meeting treatment responder criteria . RESULTS There were no differences between groups on the WOMAC at 1 year or on any performance-based measures . Secondary analyses indicated a ) better scores on the WOMAC and greater odds of being a treatment responder at 9 weeks for participants receiving MT , b ) greater odds of being a treatment responder at 1 year for participants receiving boosters . Exploratory interaction analysis suggested knee pain decreases for participants receiving boosters and increases for participants not receiving boosters from 9 weeks to 1 year . CONCLUSIONS MT or use of boosters with exercise did not result in additive improvement in the primary outcome at 1 year . Secondary outcomes suggest MT may have some short term benefit , and booster sessions may improve responder status and knee pain at 1 year . However , the role of booster sessions remains unclear in sustaining treatment effects and warrants further study . CLINICAL TRIALS gov ( NCT01314183 ) Objective : To evaluate the effects of a dance-based aquatic exercise program on functionality , cardiorespiratory capacity , postexercise heart rate , and fatigue in obese postmenopausal women with knee osteoarthritis . Methods : A r and omized controlled trial was performed . In all , 34 obese women diagnosed with knee osteoarthritis participated . Women were r and omly allocated to an experimental group ( n = 17 ) or a control group ( n = 17 ) . Participants in the experimental group were included in an 8-week dance-based aquatic exercise program conducted in community swimming pools . Those in the control group underwent a global aquatic exercise program . The primary outcome measure was functionality assessed with the Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) . Secondary outcomes were cardiorespiratory capacity evaluated with the 6-minute walk test , and postexercise heart rate and fatigue assessed using a visual analog scale . Variables were measured at baseline , after the intervention , and at 3-month follow-up . Results : A between-group analysis showed significant postintervention differences in functionality ( aggregate postintervention WOMAC score of 37.30 ± 16.61 vs 41.83 ± 13.69 ; P = 0.048 ) in favor of the experimental group . In addition , significant between-group differences were found after the 8 weeks in cardiorespiratory capacity , postexercise heart rate , and fatigue . Follow-up continued to show significant differences between groups in function ( aggregate WOMAC score of 38.60 ± 13.61 vs 42.60 ± 9.05 ; P = 0.038 ) , postexercise heart rate , and fatigue . Conclusions : An 8-week dance-based exercise program  significantly improved function and cardiorespiratory capacity , and decreased postexercise heart rate and fatigue . Most of these improvements were maintained at 3-month follow-up in obese postmenopausal women Objective The aim of this study was to investigate the effects of high-velocity ( HV ) and low-velocity ( LV ) resistance training on gait kinematics and kinetics in patients with hip osteoarthritis . Design This was a single-blind , r and omized controlled trial . Forty-six women with hip osteoarthritis were r and omly allocated to the HV ( n = 23 ) or LV ( n = 23 ) training group . The participants underwent an 8-week home-based the HV or LV resistance-training program , involving the hip and knee muscles . Outcome measures included gait kinematics and kinetics using 3-dimensional analyses , muscle strength and power , the Harris Hip Score , and hip pain using the visual analog scale . Results There was no significant difference in changes for any of the outcome measures between groups . After the training session , muscle power , walking speed , and cadence significantly increased only in the HV group , whereas stride length and the peak hip extension angle during gait significantly increased , and pain on the visual analog scale and the peak ankle dorsiflexion moment during gait significantly decreased only in the LV group . Muscle strength and Harris Hip Score significantly increased in both groups . Conclusions The results of this study may indicate that the potential effect of resistance training on abnormal gait pattern depends on movement velocities during training Background Pronated foot posture is associated with many clinical and biomechanical outcomes unique to medial compartment knee osteoarthritis ( OA ) . Though shoe-worn insole treatment , including lateral wedges , is commonly studied in this patient population , their effects on the specific subgroup of people with medial knee OA and concomitant pronated feet are unknown . The purpose of this study was to evaluate 
    Output:
    
Exercise is the most common treatment evaluated and should be accompanied with education to effectuate a behavioural change in physical activity of people with OA .
No new insights in the field of braces ( or orthoses ) and in the field of acupuncture were found