***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 AND PURPOSE To establish prevalence of urinary symptoms among community-dwelling stroke survivors and how these symptoms affected lives of these survivors compared with a nonstroke population . METHODS The present study was a community-based postal survey in Leicestershire community , UK ( that excluded institutional setting s ) , that was design ed to track stroke , urinary , and bowel symptoms and the effect of such symptoms on relationships , social life , daily activities , and overall quality of life . Subjects included 14 600 people who were living in the community and < /=40 years of age , r and omly selected from the Leicestershire Health Authority Register . RESULTS A 70 % response rate was achieved with the return of 10 226 question naires . Prevalence of reported stroke was 4 % ( n=423 ) . Prevalence of urinary symptoms was 34 % ( n=3197 ) . Overall , stroke survivors had a higher prevalence of symptoms than the nonstroke population ( 64 % to 32 % , respectively ) . These symptoms were reported to have more of an effect on the lives of the stroke survivors compared with the nonstroke population even when adjusted for age and sex differences . This reported impact was not related to the stroke per se but to the severity of the urinary symptoms . CONCLUSIONS These data show a high prevalence of urinary symptoms among community-dwelling stroke survivors . These symptoms were reported to have considerable impact on the lives of stroke survivors , which needs to be taken into account in future research and clinical practice Objective : To examine the effects of pelvic floor muscle training ( PFMT ) on the contractility of pelvic floor muscle and lower urinary tract symptoms in female stroke patients . Design : R and omized , single-blind controlled study . Setting : Outpatient rehabilitation hospital . Subjects : Thirty one female patients who were more than three months post-stroke and stress urinary incontinence . Interventions : The subjects were r and omized to either a PFMT group ( n = 16 ) , or a control group ( n = 15 ) . Both groups received general rehabilitation exercise for 6 weeks , but the PFMT group additionally received PFMT for 6 weeks . Main measures : Vaginal function test using a perineometer ( maximal vaginal squeeze pressure ) and intra-vaginal electromyography ( activity of pelvic floor muscle ) , and urinary symptoms and quality of life using a Bristol Female Lower Urinary Tract Symptom question naire . Results : After intervention , the maximal vaginal squeeze pressures for the PFMT and control groups were 18.35 ( 5.24 ) and 8.46 ( 3.50 ) mmHg , respectively . And the activities of pelvic floor muscle of the PFMT and control groups was 12.09 ( 2.24 ) ㎶ and 9.33 ( 3.40 ) ㎶ , respectively . After intervention , the changes of scores for inconvenience in the activity of daily living of the PFMT and control groups were −15.00 ( 6.25 ) and −0.17 ( 1.59 ) , respectively . In addition , the changes of score for lower urinary tract symptom was improved more in the PFMT group ( -4.17 ( 4.00 ) ) than in the control group ( -0.25 ( 1.29 ) ) ( P < 0.05 ) . Conclusions : These findings suggest that PFMT is beneficial for the management of urinary incontinence in female stroke patients BACKGROUND Lower urinary tract symptoms ( LUTS ) have a significant impact on quality of life ( QoL ) in post‑stroke patients . AIM The aim of this study was to evaluate the effect of pelvic floor muscle training ( PFMT ) on QoL parameters in men with post‑stroke LUTS . DESIGN R and omized , controlled and single‑blinded trial . SETTING Out patients , University Hospital . POPULATION Thirty‑one men , median age 68 ( interquartile range 60 - 74 ) years , with post‑stroke LUTS were included . Thirty participants completed the study . METHODS The participants r and omized to the treatment group were treated in a systematic , controlled and intensive PFMT program over 3 months ( 12 weekly sessions ) . The participants r and omized to the control group did not receive specific LUTS treatment . The effect was measured on the 36-Item Short Form Health Survey ( SF-36 ) and the Nocturia Quality ‑of‑Life ( N‑QoL ) Question naire . RESULTS The results on SF-36 indicated significant improvement within pre- and post‑test in the domains emotional role ( median 77 to 100 , P=0.03 ) and vitality ( median 65 to 70 , P=0.03 ) in the treatment group , but not the control group . There were no statistically significant differences between groups at pre‑test , post‑test or 6-month follow‑up . The results on N‑QoL indicated statistically significant differences between pre- and post‑test in the bother/concern domain in both groups and in sleep/energy for the control group , but not the treatment group . There were no statistically significant differences between groups . CONCLUSIONS PFMT may improve the emotional health and vitality domains of QoL in men with mild to moderate post‑stroke and LUTS ; however the improvements in the treatment group were not significantly better than for the control group . PFMT did not improve nocturia‑related QoL. CLINICAL REHABILITATION IMPACT This study is the first to evaluate the effect of PFMT on QoL parameters in men with mild to moderate post‑stroke and LUTS . The results indicate some short‑term effect on SF-36 but none on N‑QoL. However , further studies with larger sample sizes and with less restrictive inclusion and exclusion criteria are requested CONTEXT Menopausal hormone therapy has long been credited with many benefits beyond the indications of relieving hot flashes , night sweats , and vaginal dryness , and it is often prescribed to treat urinary incontinence ( UI ) . OBJECTIVE To assess the effects of menopausal hormone therapy on the incidence and severity of symptoms of stress , urge , and mixed UI in healthy postmenopausal women . DESIGN , SETTING , AND PARTICIPANTS Women 's Health Initiative multicenter double-blind , placebo-controlled , r and omized clinical trials of menopausal hormone therapy in 27,347 postmenopausal women aged 50 to 79 years enrolled between 1993 and 1998 , for whom UI symptoms were known in 23,296 participants at baseline and 1 year . INTERVENTIONS Women were r and omized based on hysterectomy status to active treatment or placebo in either the estrogen plus progestin ( E + P ) or estrogen alone trials . The E + P hormones were 0.625 mg/d of conjugated equine estrogen plus 2.5 mg/d of medroxyprogesterone acetate ( CEE + MPA ) ; estrogen alone consisted of 0.625 mg/d of conjugated equine estrogen ( CEE ) . There were 8506 participants who received CEE + MPA ( 8102 who received placebo ) and 5310 who received  CEE alone ( 5429 who received placebo ) . MAIN OUTCOME MEASURES Incident UI at 1 year among women without UI at baseline and severity of UI at 1 year among women who had UI at baseline . RESULTS Menopausal hormone therapy increased the incidence of all types of UI at 1 year among women who were continent at baseline . The risk was highest for stress UI ( CEE + MPA : relative risk [ RR ] , 1.87 [ 95 % confidence interval { CI } , 1.61 - 2.18 ] ; CEE alone : RR , 2.15 [ 95 % CI , 1.77 - 2.62 ] ) , followed by mixed UI ( CEE + MPA : RR , 1.49 [ 95 % CI , 1.10 - 2.01 ] ; CEE alone : RR , 1.79 [ 95 % CI , 1.26 - 2.53 ] ) . The combination of CEE + MPA had no significant effect on developing urge UI ( RR , 1.15 ; 95 % CI , 0.99 - 1.34 ) , but CEE alone increased the risk ( RR , 1.32 ; 95 % CI , 1.10 - 1.58 ) . Among women experiencing UI at baseline , frequency worsened in both trials ( CEE + MPA : RR , 1.38 [ 95 % CI , 1.28 - 1.49 ] ; CEE alone : RR , 1.47 [ 95 % CI , 1.35 - 1.61 ] ) . Amount of UI worsened at 1 year in both trials ( CEE + MPA : RR , 1.20 [ 95 % CI , 1.06 - 1.36 ] ; CEE alone : RR , 1.59 [ 95 % CI , 1.39 - 1.82 ] ) . Women receiving menopausal hormone therapy  were more likely to report that UI limited their daily activities ( CEE + MPA : RR , 1.18 [ 95 % CI , 1.06 - 1.32 ] ; CEE alone : RR , 1.29 [ 95 % CI , 1.15 - 1.45 ] ) and bothered or disturbed them ( CEE + MPA : RR , 1.22 [ 95 % CI , 1.13 - 1.32 ] ; CEE alone : RR , 1.50 [ 95 % CI , 1.37 - 1.65 ] ) at 1 year . CONCLUSIONS Conjugated equine estrogen alone and CEE + MPA increased the risk of UI  among continent women and worsened the characteristics of UI among symptomatic women after 1 year . Conjugated equine estrogen with or without progestin should not be prescribed for the prevention or relief of UI ABSTRACT Purpose : To study the prevalence of depression at 12 months after stroke and to analyze factors associated with depression . Methods : This prospect i ve cross-sectional study was conducted among nine tertiary hospitals in Thail and . Stroke patients from the Thai Stroke Rehabilitation Registry who were admitted in inpatient rehabilitation wards were recruited for evaluation at the 12-month follow-up time point . Hospital Anxiety and Depression Scale ( HADS )  was used to evaluate depression in stroke . A score of ≥11 was considered as having depression . Univariate and multivariate analysis was used to investigate factors related with depression in stroke . Results : Two hundred stroke patients with a mean age of 62.1±12.5 years were recruited . Approximately 60 % were male . The number of stroke patients with depression at the 12-month follow-up was 42 ( 21.0 % , 95%CI 15.9%–27.2 % ) . Mean HADS score at 12-month follow-up was not significantly different from those at discharge . However , 28 ( 16.5 % ) stroke patients who did not have depression at discharge developed depression during the 12-month period . From multivariate analysis , complications and urinary incontinence were found to be significantly associated with depression after stroke with adjusted odds ratio of 3.65 ( 95%CI 1.11–12.06 ) and 4.82 ( 95%CI 1.74–13.38 ) , respectively . Conclusion : Depression is a common complication after stroke . This study found one-fifth of stroke survivors  developed depression at the 12-month follow-up . Complications at discharge and urinary incontinence were significantly correlated with depression in multivariate analysis . Further study concerning interventions in decreasing depression should be performed in order to improve the quality of life of those stroke patients This pilot multicentered , r and omized , parallel , sham-controlled trial is intended to evaluate the effectiveness and safety of electroacupuncture therapy for poststroke patients with urinary incontinence . Forty stroke survivors aged > 19 years will be recruited in 2 hospitals in the Republic of Korea . Patients who experienced stroke within 2 years and satisfy criteria of urinary frequencies ≥2 with either 3 to 4 points on the Patient Perception of Intensity of Urgency Scale or 13 points or more on the Korean version of the International Prostate Symptom Scale ( K-IPSS ) will be identified , along with other eligibility criteria . Patients will be r and omly allocated to either a treatment or control group to receive 10 sessions of electroacupuncture or sham therapies , respectively . Patients and outcome assessors will be blinded . The primary outcome is the change of Total Urgency and Frequency Score between the baseline and the trial endpoint . The K-IPSS , the International Consultation on Incontinence Question naire for Urinary Incontinence Short Form , and the Lower Urinary Tract Symptoms Outcome Score will be evaluated for effectiveness assessment . Adverse events will be reported after every session . The Blinding Index will also be calculated . Data will be statistically analyzed with 0.05 significance levels by 2-sided testing Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Background Urinary incontinence following acute stroke is common , affecting between 40%-60 % of people in hospital after a stroke . Despite the availability of clinical guidelines for urinary in 
    Output:
    
There is insufficient evidence to guide continence care of adults in the rehabilitative phase after stroke .
More appropriately powered , multicentre trials of interventions are required to provide robust evidence for interventions to improve urinary incontinence after stroke