***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: This study aim ed to investigate the biological response to hypoxia as a stimulus , as well as exercise- and vibration-induced shear stress , which is known to induce angiogenesis . Twelve male cyclists ( 27.8 + /- 5.4 yr ) participated in this study . Each subject completed four cycle training sessions under normal conditions ( NC ) without vibration , NC with vibration , normobaric hypoxic conditions ( HC ) without vibration , and HC with vibration . Each session lasted 90 min , and sessions were held at weekly intervals in a r and omized order . Five blood sample s ( pretraining and 0 h post- , 0.5 h post- , 1 h post- , and 4 h posttraining ) were taken from each subject at each training session . Hypoxia was induced by a normobaric hypoxic chamber with an altitude of 2,500 m. The mechanical forces ( cycling with or without vibration ) were induced by a cycling ergometer . The parameters VEGF , endostatin , and matrix metalloproteinases ( MMPs ) were analyzed using the ELISA method . VEGF showed a significant increase immediately after the exercise only with exogenously induced vibrations , as calculated with separate ANOVA analysis . Endostatin increased after training under all conditions . Western blot analysis was performed for the determination of endostatin corresponding to the 22-kDa cleavage product of collagen XVIII . This demonstrated elevated protein content for endostatin at 0 h postexercise . MMP-2 increased in three of the four training conditions . The exception was NC with vibration . MMP-9 reached its maximum level at 4 h postexercise . In conclusion , the results support the contention that mechanical stimuli differentially influence factors involved in the induction of angiogenesis . These findings may contribute to a broader underst and ing of angiogenesis Background Benefits of community-based whole-body vibration ( WBV ) as a mode of exercise training for people with chronic obstructive pulmonary disease ( COPD ) have not been investigated . The low skill dem and of WBV may enhance habitual sustainability to physical activity by people with COPD , provided efficacy of WBV can be established . The purpose of this trial was to compare a community-based WBV intervention with a sham WBV ( SWBV ) intervention and monitor exacerbations , exercise tolerance , and functional performance of the lower limbs of people with COPD . Methods Community-dwelling adults with a GOLD clinical diagnosis of COPD were recruited to the trial . This was a Phase II efficacy trial with crossover to sham intervention interspersed with two-week washout . Each six-week intervention consisted of two sessions per week of either WBV or SWBV . The interventions were completed in the home of each participant under supervision . The outcome measures were selected psychological ( perceived dyspnoea ) and physiological ( heart rate and oxygen saturation ) responses to exercise , simulated activities of daily living ( timed-up- and got test and 5-chair st and s test ) , and selected kinematic variables of gait across the 14-week trial . Results Sixteen adults with stable COPD were recruited to the trial .  No exacerbations were reported during the WBV or SWBV interventions . After WBV , performance of activities of daily living ( ADLs ) and gait improved ( p ≤ 0.05 ) , while there was no change after SWBV ( p > 0.05 ) . Despite five withdrawals during the washout period , a 100 % compliance to each six-week intervention was noted . Conclusions Results showed that WBV did not exacerbate symptoms of COPD that can be associated with physical inactivity . The WBV intervention improved tests to simulate ADLs such as rising from a chair , turning , and walking gait with greater effect than a SWBV intervention . If a placebo effect was systemic to the WBV intervention , the effect was negligible . As a st and alone community-based intervention , WBV was an efficacious mode of exercise training for people with stable COPD that did not negatively effect exercise tolerance or exacerbate the disease , while concurrently improving functional performance of the lower limbs . Trial registration Australian and New Zeal and Clinical Trials Registry ACTRN12612000508875 Background Exercise intolerance is a common development in patients with chronic obstructive pulmonary disease ( COPD ) . There is little data on the use of an isolated program using vibration platform training on functional capacity in these patients , which is an area that deserves investigation . Aim To investigate the effect of training on a vibrating platform ( whole-body vibration [ WBV ] ) on functional performance and quality of life of subjects with COPD . Methods A r and omized controlled crossover pilot study with eleven subjects with COPD ( forced expiratory volume in 1 second [FEV1]% predicted = 14.63±11.14 ; forced vital capacity [FVC]% predicted = 48.84±15.21 ; FEV1/FVC = 47.39±11.63 ) underwent a 12-week WBV training program . Participants were r and omized into the intervention group ( IG ) undergoing three sessions per week for a total of 12 weeks and control group ( CG ) without intervention . We evaluated the 6-minute walk test ( 6MWT ) , distance walked ( DW ) , duration of the walk ( TW ) , and index of perceived exertion ( IPE ) , quality of life using St George ’s Respiratory Question naire ( SGRQ ) and developed a 12-week program of training on a vibrating platform . Results The mean age was 62.91±8.82 years old ( 72.7 % male ) .  The DW increased at the end of training with a difference between groups of 75 m ; all domains of the SGRQ improved at the end of training . The effect size Cohen ’s d ranged from small to large for all the measured results . Conclusion These preliminary results suggest that WBV may potentially be a safe and feasible way to improve functional capacity in the 6MWT of patients with COPD undergoing a training program on the vibrating platform as well as in all domains of the SGRQ quality of life . However , further studies with a larger number of patients are needed to establish the long-term effect on functional capacity and quality of life in these patients OBJECTIVES To investigate the effects of 24 weeks of whole-body-vibration ( WBV ) training on knee-extension strength and speed of movement and on counter-movement jump performance in older women . DESIGN A r and omized , controlled trial . SETTING Exercise Physiology and Biomechanics Laboratory , Leuven , Belgium . PARTICIPANTS Eighty-nine postmenopausal women , off hormone replacement therapy , aged 58 to 74 , were r and omly assigned to a WBV group ( n=30 ) , a resistance-training group ( RES , n=30 ) , or a control group ( n=29 ) . INTERVENTION The WBV group and the RES group trained three times a week for 24 weeks . The WBV group performed unloaded static and dynamic knee-extensor exercises on a vibration platform , which provokes reflexive muscle activity . The RES group trained knee-extensors by performing dynamic leg-press and leg-extension exercises increasing from low ( 20 repetitions maximum ( RM ) ) to high ( 8RM ) resistance . The control group did not participate in any training . MEASUREMENTS Pre- , mid- ( 12 weeks ) , and post- ( 24 weeks ) isometric strength and dynamic strength of knee extensors were measured using a motor-driven dynamometer . Speed of movement of knee extension was assessed using an external resistance equivalent to 1 % , 20 % , 40 % , and 60 % of isometric maximum . Counter-movement jump performance was determined using a contact mat . RESULTS Isometric and dynamic knee extensor strength increased significantly ( P<.001 ) in the WBV group ( mean+/-st and ard error 15.0+/-2.1 % and 16.1+/-3.1 % , respectively ) and the RES group ( 18.4+/-2.8 % and 13.9+/-2.7 % , respectively ) after 24 weeks of training , with the training effects not significantly different between the groups ( P=.558 ) . Speed of movement of knee extension significantly increased at low resistance ( 1 % or 20 % of isometric maximum ) in the WBV group only ( 7.4+/-1.8 % and 6.3+/-2.0 % , respectively ) after 24 weeks of training , with no significant differences in training effect between the WBV and the RES groups ( P=.391 ; P=.142 ) . Counter-movement jump height enhanced significantly ( P<.001 ) in the WBV group ( 19.4+/-2.8 % ) and the RES group ( 12.9+/-2.9 % ) after 24 weeks of training . Most of the gain in knee-extension strength and speed of movement and in counter-movement jump performance had been realized after 12 weeks of training . CONCLUSION WBV is a suitable training method and is as efficient as conventional RES training to improve knee-extension strength and speed of movement and counter-movement jump performance in older women . As previously shown in young women , it is suggested that the strength gain in older women is mainly due to the vibration stimulus and not only to the unloaded exercises performed on the WBV platform The physiological response of humans to vibration has intrigued research ers for some time , and recently in relation to its potential as a non‐pharmacological means to improve peripheral blood flow . A new vibration device [ Arapal Technologies Ltd ( ATL ) , Christchurch , New Zeal and ] for pain relief that purportedly delivers multidirectional vibration waveforms , has been developed . The aim of the study was to quantify the effect of 30 min of mechanical vibration ( 60 Hz ) using two ATL massage devices concurrently upon local peripheral blood flow in healthy humans . On the basis of past work it was expected that acute exposure of the body to the vibratory stimulus would increase local peripheral blood flow . In a r and omized cross‐over design , mean blood flow ( MBF ) to the calf was measured using venous occlusion plethysmography before , during 3 min and after 30 min exposure to the vibratory devices or placebo ( non‐vibratory ) devices . Statistical analysis revealed no consistent differences between conditions and considerable individual variability . The MBF increase tended to be higher in the vibration condition than the placebo condition ( P = 0·16 , 95 % likely range = −14·4 % to 82·2 % ) , the mean increase from resting blood flow at the post‐test was 26 ± 49 % in the vibration condition and 12 ± 39 % in the placebo condition . It took approximately 22 min of exposure to the vibratory stimulus to elicit peak blood flow ( 18 min with the placebo ) . Improvements in local blood flow may be beneficial in the therapeutic alleviation of pain or other symptoms result ing from acute or chronic musculoskeletal injuries Background Patients with stable COPD show improvements in exercise capacity and muscular function after the application of whole body vibration . We aim ed to evaluate whether this modality added to conventional physiotherapy in exacerbated hospitalised COPD patients would be safe and would improve exercise capacity and quality of life . Methods 49 hospitalised exacerbated COPD patients were r and omized ( 1:1 ) to undergo physiotherapy alone or physiotherapy with the addition of whole body vibration . The primary endpoint was the between-group difference of the 6-minute walking test ( day of discharge – day of admission ) . Secondary assessment s included chair rising test , quality of life , and serum marker analysis . Results Whole body vibration did not cause procedure-related adverse events . Compared to physiotherapy alone , it led to significantly stronger improvements in 6-minute walking test ( 95.55 ± 76.29 m vs. 6.13 ± 81.65 m ; p = 0.007 ) and St. Georges Respiratory Question naire ( -6.43 ± 14.25 vs. 5.59 ± 19.15 , p = 0.049 ) . Whole body vibration increased the expression of the transcription factor peroxisome proliferator receptor gamma coactivator-1-α and serum levels of irisin , while it decreased serum interleukin-8 . Conclusion Whole body vibration during hospitalised exacerbations did not cause procedure-related adverse events and induced clinical ly significant benefits regarding exercise capacity and health-related quality of life that were associated with increased serum levels of irisin , a marker of muscle activity . Trial registration German Clinical Trials Register DRKS00005979 . Registered 17 March 2014 BACKGROUND Interval ( IT ) and continuous training ( CT ) represent well-established exercise modalities in patients with moderate to severe chronic obstructive pulmonary disease ( COPD ) . However , their effects and feasibility in patients with end-stage COPD remain unclear . METHODS Sixty patients ( 53 ± 6 years , 53 % women ) being evaluated for lung transplantation where r and omly assigned either to IT ( n = 30 , cycling at 100 % peak work rate for 30 seconds alternating with 30 seconds of rest ) or CT ( n = 30 , cycling at 60 % of peak work rate ) during a 3-week inpatient rehabilitation program . Both exercise protocol s yielded an equivalent amount of total work . Patients had a mean forced expiratory volume at 1 second ( FEV(1 ) ) of 25 % ± 8 % of predicted value . RESULTS Patients in both groups achieved similar clinical ly relevant improvements in 6-minute walking distance of 35 ± 29 meters for IT and 36  
    Output:
    
However , no significant difference was found between the two groups regarding forced expired volume in 1 second ( FEV1 ) ( % predicated ) , change of FEV1 ( % predicated ) , sit-to-st and test , 6-MWD ( % predicated ) , change of 6-MWD ( % predicated ) , St George 's Respiratory Question naire score , COPD Assessment Test score , and change of COPD Assessment Test score .
Conclusion WBVT has beneficial effects on functional exercise capacity for COPD patients