***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: The clinical and physiological effects of a medically supervised , indoor physical training programme were investigated in 36 asthmatic subjects aged 16 - 40 years . After clinical evaluation , lung function assessment , and progressive incremental exercise testing subjects were r and omly allocated to control and training groups . The measurements were repeated after a six week run in period and after a further three months in which those in the training group underwent an indoor training programme . The measurements made at three months were compared with those at the end of the run in period . There was no significant change in anthropometric characteristics , blood lipid profiles , or the provocative concentration of histamine causing a 20 % fall in FEV1 ( histamine PC20 ) in the group who underwent training . After training there were significant increases in mean maximal oxygen uptake ( ml kg-1 min-1 ) from 23 ( 5 ) to 28 ( 6 ) , oxygen pulse ( ml/beat ) from 8.8 ( 2.3 ) to 10.8 ( 2.4 ) , and anaerobic threshold ( 1/min ) from 1.11 ( 0.27 ) to 1.38 ( 0.33 ) . These changes were significantly greater in the group undergoing training than in the control group . There was also a significant fall in breathlessness scores ( Borg ratings ) , blood lactate , carbon dioxide output , and minute ventilation during submaximal exercise in the training group , with no change in the control group . The subject 's motivation , the initial level of fitness , and the symptom score at the time of training were the most important factors influencing improvements in cardiorespiratory fitness . Thus submaximal physical exercise of controlled intensity , sustained for three months , produced significant improvements in fitness and cardiorespiratory performance that should be advantageous to the exercising asthmatic patient . The availability of medical supervision throughout the exercise programme appears to have contributed to the successful outcome Introduction Patients with chronic obstructive pulmonary disease ( COPD ) exhibit aerobic function , autonomic nervous system , and mucociliary clearance alterations . These parameters can be attenuated by aerobic training , which can be applied with continuous or interval efforts . However , the possible effects of aerobic training , using progressively both continuous and interval sessions ( ie , linear periodization ) , require further investigation . Aim To analyze the effects of 12-week aerobic training using continuous and interval sessions on autonomic modulation , mucociliary clearance , and aerobic function in patients with COPD . Methods Sixteen patients with COPD were divided into an aerobic ( continuous and interval ) training group ( AT ) ( n=10 ) and a control group ( CG ) ( n=6 ) . An incremental test ( initial speed of 2.0 km·h−1 , constant slope of 3 % , and increments of 0.5 km·h−1 every 2 minutes ) was performed . The training group underwent training for 4 weeks at 60 % of the peak velocity reached in the incremental test ( vVO2peak ) ( 50 minutes of continuous effort ) , followed by 4 weeks of sessions at 75 % of vVO2peak ( 30 minutes of continuous effort ) , and 4 weeks of interval training ( 5 × 3-minute effort at vVO2peak , separated by 1 minute of passive recovery ) . Intensities were adjusted through an incremental test performed at the end of each period . Results The AT presented an increase in the high frequency index ( ms2 ) ( P=0.04 ) , peak oxygen uptake ( VO2peak ) ( P=0.01 ) , vVO2peak ( P=0.04 ) , and anaerobic threshold ( P=0.02 ) . No significant changes were observed in the CG ( P>0.21 ) group . Neither of the groups presented changes in mucociliary clearance after 12 weeks ( AT : P=0.94 and CG : P=0.69 ) . Conclusion Twelve weeks of aerobic training ( continuous and interval sessions ) positively influenced the autonomic modulation and aerobic parameters in patients with COPD .  However , mucociliary clearance was not affected by aerobic training Objective To evaluate an entirely outpatient-based program of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease COPD , using St . George ’s Respiratory question naire ( SGRQ ) , the 6-minutes walking test ( 6-MWT ) and BODE index as the primary outcome measures . Methods A prospect i ve , parallel-group controlled study of an outpatient rehabilitation program in 80 patients with COPD ( 67 men and 13 women ; mean age 64.8 ± 10.6 years ; FEV1 , 42.8 % ± 7.6 % of the predicted value . The active group ( n = 40 ) took part in a 14-week rehabilitation program [ 3 h/wk , 1.5 h of education and exercise and 1.5 h of cycling ] . The control group ( n = 40 ) was review ed routinely as medical out patients . The following evaluations were carried out at study entry and after14 weeks : ( 1 ) pulmonary function studies ; ( 2 ) 6-minutes walking test 6MWT ; ( 3 ) quality of life ; and ( 4 ) BODE index . Results The following patients completed the study : 35 patients ( 87.5 % ) from the active group ( mean age , 63.7 ± 11.9 years ; mean forced expiratory volume in one second ( FEV1 ) , 41.9 ± 2.6 % of the predicted value ) ; and 36 patients ( 88 % ) from the control group ( mean age , 65.9 ± 10.3 years ; mean FEV1 , 43.33 ± 3.6 % of the predicted value ) . We found no changes in pulmonary function parameters in the active group and the control one at 14weeks . On the other h and , there were significant changes within the components of the SGRQ ( 12.3 for the score total ) for the patients of the active group but not for the patients of the control one ( only 1.5 for the score total ) , we observed also a significant increase in the distance of the 6-MWT in the patients of the active group but not for the patients of the control one , and finally a decrease of two points ( from 6 to 4 ) was noted in the score of the active group ’s BODE index without any change in the control group ’s one . Conclusion An outpatient-based of 14-week rehabilitation program  significantly improved the quality of life and exercise tolerance without any change in the pulmonary function in patients with moderate COPD , and there was also a large decrease in the risk of death in rehabilitated patients as measured using the BODE index Background Chronic obstructive pulmonary disease ( COPD ) is a common cause of morbidity and mortality affecting a large number of individuals in both developed and developing countries and it represents a significant financial burden for patients , families and society . Pulmonary rehabilitation ( PR ) is a multidisciplinary program that integrates components of exercise training , education , nutritional support , psychological support and self-care , result ing in an improvement in dyspnea , fatigue and quality of life . Despite its proven effectiveness and the strong scientific recommendations for its routine use in the care of COPD , PR is generally underutilized and strategies for increasing access to PR are needed . Home-based self-monitored pulmonary rehabilitation is an alternative to outpatient rehabilitation . In the present study , patients with mild , moderate and severe COPD su bmi tted to either an outpatient or at-home PR program for 12 weeks were analyzed . Methods Patients who fulfilled the inclusion criteria were r and omized into three distinct groups : an  outpatient group who performed all activities at the clinic  , a home-based group who performed the activities at home and a control group . PR consisted of a combination of aerobic exercises and strengthening of upper and lower limbs 3 times a week for 12 weeks . Results There was a significant difference in the distance covered on the six-minute walk test ( p < 0.05 ) and BODE index ( p < 0.001 ) in the outpatient and at-home groups after participating in the rehabilitation program compared to baseline . Conclusion A home-based self-monitoring pulmonary rehabilitation program is as effective as outpatient pulmonary rehabilitation and is a valid alternative for the management of patients with COPD .RiassuntoRazionaleLa broncopneumopatia cronica ostruttiva ( BPCO ) è una causa frequente di morbilità e mortalità che colpisce un’ampia quota di popolazione sia nel mondo industrializzato che nei Paesi in via di sviluppo e rappresenta un peso economico di rilievo per pazienti , familiari e collettività . La riabilitazione respiratoria ( PR ) è un programma multidisciplinare che inegra componenti di riallenamento all’esercizio fisico , educazionale , supporto nutrizionale , supporto psicologico ed autoaiuto , che porta ad un miglioramento della dispnea , della affaticabilità e della qualità della vita . Nonostante la provata efficacia e le forti raccom and azioni delle società scientifiche al suo impiego routinario nel trattamento della BPCO , la PR è generalmente sottoutilizzata e si rendono perciò necessarie strategie per aumentarne l’utilizzo . La PR effettuata a domicilio ed auto-monitorata dal paziente stesso è un’alternativa alla classica riabilitazione ambulatoriale . In questo studio sono stati valuati pazienti con BPCO di grado lieve , moderato e grave sottoposti a un programma di PR ambulatoriale o domiciliare . MetodiI pazienti eligibili allo studio sono stati r and omizzati in tre gruppi : un gruppo ambulatoriale che effettuava tutte le attività in ospedale , un gruppo domiciliare che effettuava il programma a domicilio ed un gruppo di controllo . Il programma di PR consisteva in una combinazione di esercizi aerobici e di rafforzamento della muscolatura degli arti superiori e inferiori per 3 volte la settimana per 12 settimane . RisultatiSia nel gruppo che ha partecipato al PR ambulatoriale che in quello domiciliare si sono rilevate differenze significative rispetto alle misure di base nella distanza coperta con il test del cammino di 6 minuti ( p < 0.05 ) che nell’indice BODE ( p < 0.001 ) . Conclusion iUn programma di riabilitazione respiratoria automonitorato eseguito a domicilio ha efficacia sovrapponibile ad un programma ambulatoriale e può perciò essere considerato una valida alternativa nella gestione del paziente con BPCO This study poses two questions : 1 ) is there an abnormality in isokinetic skeletal muscle strength and endurance in mild chronic obstructive pulmonary disease ( COPD ) ? and 2 ) what is the effect of a r and omized , controlled , 12 week hospital outpatient weight training programme in terms of skeletal muscle function and exercise tolerance ? Upper and lower limb isokinetic maximum and sustained muscle function were compared in 43 COPD patients ( age 49+/-11 yrs ) , mean forced expiratory volume in one second ( FEV1 ) 77+/-23 % pred and 52 healthy , sedentary subjects ( age 51 ( 10 ) yrs ) , mean FEV1 109+/-16 % pred . The 43 COPD patients were r and omly allocated into training ( n=26 ) and control ( n=17 ) groups . Isokinetic and isotonic muscle function , whole body endurance , maximal exercise capacity and lung function were measured . The COPD patients had reduced isokinetic muscle function ( with the exception of sustained upper limb strength ) as compared with healthy sedentary subjects . Muscle function improved after weight training in the COPD patients . Whole body endurance during treadmill walking also improved with no change in maximal oxygen consumption . A deficit in skeletal muscle function can be identified in patients with mild chronic obstructive pulmonary disease which can not be explained by factors such as hypoxaemia and malnutrition . Intervention with weight training is effective in countering this deficit which the authors conclude is probably due to muscle deconditioning Global asthma control levels are suboptimal . The influence of regular exercise on asthma control is unclear . We assessed the effects of a 12-week supervised exercise intervention followed by 12 weeks of self-administered exercise on adults with partially controlled asthma ( n = 21 ) and matched controls ( n = 15 ) . Assessment s were conducted at baseline and week 12 for both the exercise and control group , and again at week 24 for the exercise group . There was a significant treatment effect on asthma control in the exercise group , as measured by the Asthma Control Question naire ( ACQ ) , from baseline to week 12 , compared with the control group . A clinical ly significant improvement ( 0.5 increase in ACQ score ) was observed for asthma quality of life and ACQ in the exercise group from baseline to week 12 . There was a significant improvement in aerobic fitness from baseline to week 24 in the exercise group . In conclusion , a 12-week supervised exercise intervention led to improvements in asthma control and quality of life in partially controlled asthmatics motivated to exercise . These improvements were maintained , while aerobic fitness and perceived asthma control significantly improved over an additional 12 weeks of self-administered exercise . These findings indicate that a structured exercise intervention can improve asthma control Most pulmonary rehabilitation ( PR ) programs do not currently incorporate IMT in their PR programs for COPD patients . The aim of the present study was to assess the influence of adding IMT to the patients already involved in a rehabilitation program . Thirty-four patients with significant COPD were recruited for the study . All patients participated in a general exercise reconditioning ( GER ) program for 12 weeks . The patients were then r and omized to receive IMT or sham IMT 
    Output:
    
No specific adjustments to exercise prescription were described .
There was a lack of tailoring of exercise programmes and limited effects were found .