***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 Although the acute effect of intermittent pneumatic compression ( IPC ) therapy had been documented for patients with symptomatic peripheral arterial obstructive disease ( PAOD ) , its efficacy in improving quality of life ( QOL ) , especially for those with infrapopliteal diffuse lesions , remains unclear . METHODS AND RESULTS Thirty-one patients with infrapopliteal diffuse or multiple segmental lesions were enrolled in the study . Based on receipt of IPC therapy ( 3 h daily for 3 months ) , patients were allocated to a study ( n=23 ) or control ( n=8 ) group . The 6-min walking test , transcutaneous oxygen tension ( TcPO₂ ) , and QOL evaluated with the Short-Form 36 question naire were measured at the beginning and end of the study . In the QOL analysis , scores for physical functioning , physical and emotional role functioning , bodily pain , and general and mental health showed significant changes after IPC therapy . In the 6-min walking test , duration , and the initial and absolute claudication distances were significantly increased in the study group . The TcPO₂ also significantly increased in the distal end of the target limb after IPC therapy . CONCLUSIONS Patients at high risk for amputation with infrapopliteal diffuse or multiple segmental lesions can improve their walking ability , TcPO₂ of the target limb and QOL after IPC therapy BACKGROUND Traditional teaching assumes that the distal arterial tree is maximally dilated in patients with critical limb ischemia ( CLI ) .  Endovascular or arterial bypass procedures are the commonly used interventions to increase distal perfusion . However , other forms of treatment such as spinal cord stimulation or intermittent pneumatic compression ( IPC ) have been shown to improve limb salvage rates . This prospect i ve study was design ed to determine if the use of IPC increases popliteal , gastrocnemial , collateral arterial , and skin blood flow in patients with CLI . METHODS Twenty limbs with CLI in 20 patients ( mean age , 74 years ) were evaluated with duplex ultrasound scans and laser Doppler fluxmetry in the semi-erect position before , during , and after IPC . One pneumatic cuff was applied on the foot and the other on the calf . The maximum inflation pressure was 120 mm Hg and was applied for 3 seconds at three cycles per minute . All patients had at least two-level disease by arteriography . Fourteen limbs were characterized as inoperable , and six were considered marginal for reconstruction . Flow volumes were measured in the popliteal , medial gastrocnemial , and a genicular collateral artery . Skin blood flux was measured on the dorsum of the foot at the same time . RESULTS Significant flow increase during the application of IPC was found in all three arteries ( 18/20 limbs ) compared with baseline values ( P < .02 ) . The highest change was seen in the popliteal , followed by the gastrocnemial and the collateral artery . After the cessation of IPC , the flow returned to baseline . This was attributed to the elevation of time average velocity , as the diameter of the arteries remained unchanged . The skin blood flux increased significantly as well ( P < .03 ) . In the two limbs without an increase in the arterial or skin blood flow , significant popliteal vein reflux was found . Both limbs were amputated shortly after . CONCLUSIONS IPC increases axial , muscular , collateral , and skin blood flow in patients with CLI and may be beneficial to those who are not c and i date s for revascularization . Patients with significant venous reflux may not benefit from IPC . This supports the theory that one of the mechanisms by which IPC  enhances flow is by increasing the arteriovenous pressure gradient The SF-36 Health Survey is the most widely used self-report measure of functional health . It is commonly used in both r and omized controlled trials ( RCT ) and non-controlled evaluation of medical or other health services . However , determining a clinical ly significant change in SF-36 outcomes from pre-to-post-intervention , in contrast to statistically significant differences , is often not a focus of medical outcomes research . We propose use of the Reliable Change Index ( RCI ) in combination with SF-36 norms as one method for research ers , provider groups , and health care policy makers to determine clinical ly significant healthcare outcomes when the SF-36 is used as a primary measure . The RCI is a statistic that determines the magnitude of change score necessary of a given self-report measure to be considered statistically reliable . The RCI has been used to determine clinical ly significant change in mental health and behavioral medicine outcomes research , but is not widely applied to medical outcomes research . A usable table of RCIs for the SF-36 has been calculated and is presented . Instruction and a case illustration of how to use the RCI table is also provided . Finally , limitations and caution ary guidelines on using SF-36 norms and the RCI to determine clinical ly significant outcome are discussed BACKGROUND Patients with chronic critical limb ischemia following a failed bypass graft or with non-reconstructable distal disease diagnosed angiographically , have a very poor prognosis . This is a prospect i ve pilot study to assess the influence of the ArtAssist Device on pedal blood flow and amputation rate . METHODS Thirty-three legs in 25 patients were evaluated . Ten legs presented with rest pain , and 23 legs with tissue loss . Nine legs had previously undergone bypass surgery .  RESULTS At a mean follow-up of 3 months , 14 ( 42 % ) legs were amputated , and 19 ( 58 % ) were saved . Eleven of the amputated legs were in patients with chronic renal failure , a known risk factor . The amputation rate , excluding this group , was 13.6 % ( 3/22 ) . Toe pressures measured initially and after 3 months on the pump showed a significant improvement ( p=0.03 ) . Forty percent of patients presenting with rest pain improved , while 26 % of foot ulcers healed on the pump . Mortality rate was 12 % . CONCLUSIONS The results from this prospect i ve study are encouraging but need to be vali date d in a larger prospect i ve r and omized study 
    Output:
    
No difference in all-cause mortality was found .
Complications included pain associated with compression , as well as skin abrasion and contact rash as a result of the cuff rubbing against the skin .
In conclusion , the limited available results suggest that IPC may be associated with improved limb salvage , wound healing and pain management .