***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 Many patients with Parkinson 's disease ( PD ) lead a sedentary lifestyle . Promotion of physical activities may beneficially affect the clinical presentation of PD , and perhaps even modify the course of PD . However , because of physical and cognitive impairments , patients with PD require specific support to increase their level of physical activity . Methods We developed the ParkFit Program : a PD-specific and multifaceted behavioral program to promote physical activity . The emphasis is on creating a behavioral change , using a combination of accepted behavioral motivation techniques . In addition , we design ed a multicentre r and omized clinical trial to investigate whether this ParkFit Program increases physical activity levels over two years in sedentary PD patients . We intended to include 700 sedentary patients . Primary endpoint is the time spent on physical activities per week , which will be measured every six months using an interview-based 7-day recall . Results In total 3453 PD patients were invited to participate . Ultimately , 586 patients - with a mean ( SD ) age of 64.1 ( 7.6 ) years and disease duration of 5.3 ( 4.5 ) years - entered the study . Study participants were younger , had a shorter disease duration and were less sedentary compared with eligible PD patients not willing to participate . Discussion The ParkFit trial is expected to yield important new evidence about behavioral interventions to promote physical activity in sedentary patients with PD . The results of the trial are expected in 2012.Trial registration http:// clinical trials.gov ( nr NCT00748488 ) This pilot study examines the effects of Tai Chi on balance , gait and mobility in people with Parkinson disease ( PD ) . Thirty-three people with PD were r and omly assigned to either a Tai Chi group or a control group . The Tai Chi group participated in 20 1-h long training sessions completed within 10 - 13 weeks ; whereas , the control group had two testing sessions between 10 and 13 weeks apart without interposed training . The Tai Chi group improved more than the control group on the Berg Balance Scale , UPDRS , Timed Up and Go , t and em stance test , six-minute walk , and backward walking . Neither group improved in forward walking or the one leg stance test . All Tai Chi participants reported satisfaction with the program and improvements in well-being .  Tai Chi appears to be an appropriate , safe and effective form of exercise for some individuals with mild-moderately severe PD Freezing is a disabling symptom in patients with Parkinson 's disease . We investigated the effectiveness of a new rehabilitation strategy based on treadmill training associated with auditory and visual cues .  Forty Parkinsonian patients with freezing were r and omly assigned to two groups : Group 1 underwent a rehabilitation program based on treadmill training associated with auditory and visual cues , while Group 2 followed a rehabilitation protocol using cues and not associated with treadmill . Functional evaluation was based on the Unified Parkinson 's Disease Rating Scale Motor Section ( UPDRS III ) , Freezing of Gait Question naire ( FOGQ ) , 6-minute walking test ( 6MWT ) , gait speed , and stride cycle . Patients in both the groups had significant improvements in all variables considered by the end of the rehabilitation program ( all P = 0.0001 ) . Patients treated with the protocol including treadmill , had more improvement than patients in Group 2 in most functional indicators ( P = 0.007 , P = 0.0004 , P = 0.0126 , and P = 0.0263 for FOGQ , 6MWT , gait speed , stride cycle , respectively ) . The most striking result was obtained for 6MWT , with a mean increase of 130 m in Group 1 compared with 57 m in Group 2 . Our results suggest that treadmill training associated with auditory and visual cues might give better results than more conventional treatments . Treadmill training probably acts as a supplementary external cue Background Although physical therapy and falls prevention education are argued to reduce falls and disability in people with idiopathic Parkinson 's disease , this has not yet been confirmed with a large scale r and omised controlled clinical trial . The study will investigate the effects on falls , mobility and quality of life of ( i ) movement strategy training combined with falls prevention education , ( ii ) progressive resistance strength training combined with falls prevention education , ( iii ) a generic life-skills social program ( control group ) . Methods / Design People with idiopathic Parkinson 's disease who live at home will be recruited and r and omly allocated to one of three groups . Each person shall receive therapy in an out-patient setting in groups of 3 - 4 . Each group shall be scheduled to meet once per week for 2 hours for 8 consecutive weeks . All participants will also have a structured 2 hour home practice program for each week during the 8 week intervention phase . Assessment s will occur before therapy , after the 8 week therapy program , and at 3 and 12 months after the intervention . A falls calendar will be kept by each participant for 12 months after outpatient therapy . Consistent with the recommendations of the Prevention of Falls Network Europe group , three falls variables will be used as the primary outcome measures : the number of fallers , the number of multiple fallers and the falls rate . In addition to quantifying falls , we shall measure mobility , activity limitations and quality of life as secondary outcomes . Discussion This study has the potential to determine whether outpatient movement strategy training combined with falls prevention education or progressive resistance strength training combined with falls prevention education are effective for reducing falls and improving mobility and life quality in people with Parkinson 's disease who live at home . Trial registration Australia and New Zeal and Clinical Trials Register ( ANZCTR ) : BACKGROUND The conduct of r and omized , controlled trials of nonpharmacologic treatments presents specific challenges that are not adequately addressed in trial reports . OBJECTIVE To develop an extension of the CONSORT ( Consoli date d St and ards of Reporting Trials ) Statement for trials of nonpharmacologic treatments . DESIGN A consensus meeting was organized to develop an extension of the CONSORT Statement that addresses r and omized trials of nonpharmacologic treatments . To prepare for the meeting , a survey was conducted to identify the specific issues for discussion . SETTING Consensus meeting in Paris , France . PARTICIPANTS A total of 33 experts attended the meeting . The experts were method ologists ( n = 17 ) ; surgeons ( n = 6 ) ; editors ( n = 5 ) ; and clinicians involved in rehabilitation ( n = 1 ) , psychotherapy ( n = 2 ) , education ( n = 1 ) , and implantable devices ( n = 1 ) . MEASUREMENTS Experts indicated which of the 22 items on the CONSORT checklist should be modified or which additional items should be added specifically for nonpharmacologic treatments . During a 3-day consensus meeting , all items were discussed and additional method ological issues related to nonpharmacologic research were identified . RESULTS The consensus was that 11 items on the CONSORT checklist needed some modifications for nonpharmacologic trials : item 1 ( title and abstract ) , item 3 ( participants ) , item 4 ( interventions ) , item 7 ( sample size ) , item 8 ( r and omization ) , item 11 ( blinding ) , item 12 ( statistical methods ) , item 13 ( participant flow ) , item 15 ( baseline data ) , item 20 ( discussion : interpretation ) , and item 21 ( generalizability ) . In addition , the meeting participants added 1 item related to implementation of the intervention . LIMITATION Evidence was not always available to support the inclusion of each checklist item . CONCLUSION The methods and processes used to develop this extension could be used for other reporting guidelines . The use of this extension to the CONSORT Statement should improve the quality of reporting r and omized , controlled trials assessing nonpharmacologic treatments AIM To investigate the effects of an aerobic training in subjects with Parkinson 's disease ( PD ) as compared to a medical Chinese exercise ( Qigong ) . METHODS DESIGN r and omized controlled trial with a cross over design . SETTING PD out- patients referred to a Neurorehabilitation facility for the management of motor disability . SUBJECTS 26 PD patients in Hoehn and Yahr stage II to III under stable medication were r and omly allocated to either Group AT1+QG2 ( receiving 20 aerobic training sessions followed by 20 ' ' Qigong ' ' group sessions with 2 month interval between the interventions ) , or Group QG1+AT2 ( performing the same treatments with an inverted sequence ) . MAIN OUTCOME MEASURES clinical effects of treatment were sought through the Unified Parkinson 's Disease Rating Scale ( UPDRS ) , Brown 's Disability Scale ( B'DS ) , six-Minute Walking Test ( 6MWT ) , Borg scale for breathlessness , Beck Depression Inventory ( BDI ) and Parkinson 's Disease Question naire-39 items ( PDQ-39 ) . A spirometry test and maximum cardiopulmonary exercise test ( CPET ) were also performed to determine the pulmonary function , the metabolic and cardio-respiratory requests at rest and under exercise . All measures were taken immediately before and at the completion of each treatment phase . RESULTS The statistical analysis focusing on the evolution of motor disability and quality of life revealed a significant interaction effect between group and time for the 6MWT ( time x group effect : F : 5.4 P=0.002 ) and the Borg scale ( time x group effect : F : 4.2 P=0.009 ) . Post hoc analysis showed a significant increase in 6MWT and a larger decrease in Borg score after aerobic training within each subgroup , whereas no significant changes were observed during Qigong . No significant changes over time were detected through the analysis of UPDRS , B'DS , BDI and PDQ-39 scores . The analysis of cardiorespiratory parameters showed significant interaction effects between group and time for the Double Productpeak ( time x group effect : F : 7.7 P=0.0003 ) , the VO(2peak ) ( time x group effect : F : 4.8 P=0.007 ) , and the VO(2)/kg ratio ( time x group effect : F : 4.3 P=0.009 ) , owing to their decrease after aerobic training to an extent that was never observed after Qigong treatment . CONCLUSIONS Aerobic training exerts a significant impact on the ability of moderately disabled PD patients to cope with exercise , although it does not improve their self-sufficiency and quality of life Background . Rehabilitation treatments have acute beneficial effects in Parkinson ’s disease ( PD ) patients , but whether the effects persist over time is unclear . Objective . To assess whether an intensive rehabilitation treatment ( IRT ) is effective in improving motor performance compared with a control group in a 12-month follow-up , to investigate whether a second cycle administered after 1 year has the same efficacy as the first treatment , and to determine whether IRT reduces the need for increasing levodopa dosage . Methods . A total of 50 PD patients were r and omly assigned to 2 groups ; 25 participants had 4 weeks of inpatient physical therapy that included treadmill and stabilometric platform training . At discharge , these patients were invited to continue doing the learned exercises . After 12 months , the same treatment was repeated . The control group of 25 patients received only pharmacological treatment and was invited to practice generic physical exercise at home . The rating scales used for the clinical evaluation were the Unified Parkinson ’s Disease Rating Scale Sections II and III ( UPDRS II and III ) and total ( UPDRS tot ) . Results . The authors found that the beneficial effects of IRT persisted over time . A second rehabilitation cycle administered after 1 year was as effective as the first treatment . At the end of the study , daily medication dosage was reduced in treated patients , whereas it was significantly increased in control patients . Conclusion . These findings suggest that the natural worsening of symptoms associated with PD can be effectively counteracted by a properly design ed IRT BACKGROUND Several previous studies have examined the health of carers , but they have usually focused on elderly subjects and have often not had representative control sample s. AIM To determine whether caring for a partner with Parkinson 's disease is associated with a worsening social , psychological and physical well-being than people with partners who do not suffer with Parkinson 's disease . METHOD One hundred and fifty-four carer spouses of subjects with Parkinson 's disease , and 124 non-carer spouses of r and omly selected population controls recruited from a national case-control study of early-onset Parkinson 's disease in the Republic of Irel and , between 1992 - 1994 , were studied . Outcome was measured along three dimensions : social functioning , assessed by the frequency of social contacts , outings and holidays ; psychological well-being , measured by the General Health Question naire ; and physical health , measured by the career 's use of medical services , medications and episodes of chronic illness . RESULTS Carer spouses were less likely to get out of the house once a week at least ( odds ratio 1.79 , 95 % confidence intervals 1.00 - 3.20 ) or to have had a holiday in the last year ( odds ratio 1.71 , 95 % confidence intervals 1.01 - 2.90 ) . Contact with friends and neighbours decreased with increasing care provision . For spouses providing a lot of care , there was an almost fivefold increase in psychiatric morbidity ( odds ratio 4.86 , 95 % confidence intervals 1.5 - 15.9 ) after adjusting for other variables . Most of the medical outcomes were less favourable among carers , but only the use of tranquilizers ( odds ratio 3.73 , 95 % confidence intervals 1.18 - 11.8 ) and episodes of chronic illness ( odds ratio 2.96 , 95 % confidence intervals 1.27 - 6.94 ) were significant . CONCLUSIONS Overall , career spouses have slightly worse social , psychological and physical profiles . For social outcomes , increasing care provision is associated 
    Output:
    
There is insufficient evidence to support or refute the effectiveness of one physiotherapy intervention over another in PD.This review shows that a wide range of physiotherapy interventions to treat PD have been tested .