***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: Abstract Objective : To evaluate the effectiveness of combinations of three methods to promote physical activity . Design : R and omised controlled trial . Baseline assessment with post-intervention follow up at 12 weeks and 1 year . Setting : One urban general practice , 1995 - 7 . Participants : 523 adults aged 40 to 64 years , r and omised to four intervention groups and a control group . Interventions : Brief ( one interview ) or intensive ( six interviews over 12 weeks ) motivational interviewing based on the stages of change model of behaviour change , with or without financial incentive ( 30 vouchers entitling free access to leisure facilities ) . Main outcome measures : Physical activity score ; sessions of moderate and vigorous activity in the preceding four weeks . Results : Response rate was 81 % at 12 weeks and 85 % at one year . More participants in the intervention group reported increased physical activity scores at 12 weeks than controls ( 38 % v 16 % , difference 22 % , 95 % confidence interval for difference 13 % to 32 % ) , with a 55 % increase observed in those offered six interviews plus vouchers . Vigorous activity increased in 29 % of intervention participants and 11 % of controls ( difference 18 % , 10 % to 26 % ) , but differences between the intervention groups were not significant . Short term increases in activity were not sustained , regardless of intensity of intervention . Conclusions : The most effective intervention for promoting adoption of exercise was the most intensive . Even this did not promote long term adherence to exercise . Brief interventions promoting physical activity that are used by many schemes in the United Kingdom are of question able effectiveness . Key messages Schemes promoting physical activity are currently popular in general practice in Britain , but few have been rigorously evaluated and their effectiveness is unknown . In this study , the most effective intervention for promoting adoption of physical activity was the most intensive , involving six motivational interviews and a financial incentive A comparatively brief intervention ( one interview ) was only effective in the short term in around a third of participants Short term increases in physical activity were not maintained at one year follow up and even the most intensive intervention was ineffective in promoting long term adherence to increased physical activity . National and local government , health authorities , and primary healthcare teams should be cautious about current and future expenditure on , and implementation of , exercise prescription or referral Background and Purpose — A new gait training strategy for patients with stroke seeks to increase walking speed through treadmill training . This study compares the effects of structured speed-dependent treadmill training ( STT ) ( with the use of an interval paradigm to increase the treadmill speed stepwise according to principles of sport physiology ) with limited progressive treadmill training ( LTT ) and conventional gait training ( CGT ) on clinical outcome measures for patients with hemiparesis . Methods — Sixty ambulatory poststroke patients were each r and omly selected to receive 1 of the 3 different gait therapies : 20 subjects were treated with STT , 20 subjects were trained to walk on a treadmill with a 20 % increase of belt speed over the treatment period ( LTT ) , and 20 subjects were treated with CGT . Treatment outcomes were assessed on the basis of overground walking speed , cadence , stride length , and Functional Ambulation Category scores . Results — After a 4-week training period , the STT group scored significantly higher than the LTT and CGT groups for overground walking speed ( STT versus LTT , P < 0.001 ; STT versus CGT , P < 0.001 ) , cadence ( STT versus LTT , P = 0.007 ; STT versus CGT , P < 0.001 ) , stride length ( STT versus LTT , P < 0.001 ; STT versus CGT , P < 0.001 ) , and Functional Ambulation Category scores ( STT versus LTT , P = 0.007 ; STT versus CGT , P < 0.001 ) . Conclusions — Structured STT in poststroke patients result ed in better walking abilities than LTT or CGT . This gait training strategy provides a dynamic and integrative approach for the treatment of gait dysfunction after stroke Abstract The evaluation of a 13-month maintenance program ( MP ) for 39 severe COPD patients with FEV1%pred 44(7)% who , as result of two different 8-week leg exercise training ( LET ) programs , one supervised at the hospital ( group S ; n = 20 ) and the other self-monitored ( SM ; n = 19 ) , had achieved different levels of exercise tolerance . After LET , patients in group S had a higher maximal oxygen uptake and endurance time than patients in the SM group [ O2max 1.43(0.30 ) l · min−1 ] vs l.25(0.27 ) l · min−1 and endurance-time 16(4 ) min vs 12 ( 5 ) min , respectively ) . During the MP patients were advised to walk vigorously at least 4 km/day , 4 times/wk . After the MP , while endurance time remained higher than at baseline , it had decreased ( p < 0.01 ) immediately after LET in both groups and no differences were evident between groups ( 11(4 ) min and 10(4 ) , respectively ) . In contrast , Chronic Respiratory Diseases Question naire scores , which had improved significantly after LET in both groups , remained high . Long-term effects of MP were independent of the training strategy or whether physiological improvements had been obtained with the initial LET . SM exercise programs do not seem capable of maintaining physiological improvements in exercise tolerance , though “ quality of life ” can be maintained The purpose of this study was to determine the effect of intensity-controlled , grade d dance exercise and selected components of behavior modification on exercise adherence in overweight middle-aged women . Thirty-eight moderately overweight women , aged 35 to 58 , participated in a 16 1/2-week dance exercise program . Participants were r and omly assigned to an experimental group ( n = 20 ) that received intensity-controlled , grade d exercise and individual and group reinforcement , or to a control group ( n - 18 ) that exercised at a moderate intensity typical of commercial fitness classes and received no special reinforcement . Before exercise training began and at the completion of 16 1/2 weeks , a structured , open-ended interview was conducted . Ninety-four percent of the women in both groups adhered to the program , an exceptionally high adherence rate for this population . Eight participantidentified factors seemed to have influenced exercise adherence : group homogeneity , carpooling and social networks , pleasurable feelings associated with increased energy and fitness , leader with a health-related background , time limitation of exercise program , commitment to an established goal , desire to change body image , and desire to change health status and improve physical health BACKGROUND In patients with intermittent claudication , a supervised walking exercise program increases peak exercise performance and community-based functional status .  Patients with peripheral arterial disease also have muscle weakness in the affected extremity that may contribute to the walking impairment . However , the potential benefits of training modalities other than walking exercise , such as strength training , have not been critically evaluated in this patient population . The present study tested the hypothesis that a strength training program would be as effective as treadmill walking exercise and that combinations of strengthening and walking exercise would be more effective than either alone in improving exercise performance . METHODS AND RESULTS Twenty-nine patients with disabling claudication were r and omized to 12 weeks of supervised walking exercise on a treadmill ( 3 h/wk at a work intensity sufficient to produce claudication ) , strength training ( 3 h/wk of resistive training of five muscle groups of each leg ) , or a nonexercising control group . Grade d treadmill testing was performed to maximally tolerated claudication pain to define changes in peak exercise performance . After 12 weeks , patients in the treadmill training program had a 74 + /- 58 % increase in peak walking time as well as improvements in peak oxygen consumption ( VO2 ) and the onset of claudication pain . Patients in the strength-trained group had a 36 + /- 48 % increase in peak walking time but no change in peak VO2 or claudication onset time . Control subjects had no changes in any of these measures over the 12-week period . After the first 12 weeks , patients in the initial walking exercise group continued for 12 more weeks of supervised treadmill training . This result ed in an additional 49 + /- 53 % increase in peak walking time ( total of 128 + /- 99 % increase over the 24 weeks ) . After the initial 12 weeks , patients in the strength-trained group began 12 weeks of supervised treadmill training , and patients in the control group participated in a 12-week combined program of strengthening and treadmill walking exercise . The combined strength and treadmill training program and treadmill training after 12 weeks of strength training result ed in increases in peak exercise performance similar to those observed with 12 weeks of treadmill training alone . CONCLUSIONS A supervised treadmill walking exercise program is an effective means to improve exercise performance in patients with intermittent claudication , with continued improvement over 24 weeks of training . In contrast , 12 weeks of strength training was less effective than 12 weeks of supervised treadmill walking exercise . Finally , strength training , whether sequential or concomitant , did not augment the response to a walking exercise program BACKGROUND Project ACTIVE was a r and omized clinical trial comparing two physical activity interventions , lifestyle and traditional structured exercise . The two interventions were evaluated and compared in terms of cost effectiveness and ability to enhance physical activity among sedentary adults . DESIGN This was a r and omized clinical trial . SETTING / PARTICIPANTS The study included 235 sedentary but healthy community-dwelling adults . INTERVENTION A center-based lifestyle intervention that consisted of behavioral skills training was compared to a structured exercise intervention that included supervised , center-based exercise . MAIN OUTCOME MEASURES The main outcome measures of interest included cost , cardiorespiratory fitness , and physical activity . RESULTS Both interventions were effective in increasing physical activity and fitness . At 6 months , the costs of the lifestyle and structured interventions were , respectively , $ 46.53 and $ 190.24 per participant per month . At 24 months these costs were $ 17.15 and $ 49.31 per participant per month . At both 6 months and 24 months , the lifestyle intervention was more cost-effective than the structured intervention for most outcomes measures . CONCLUSIONS A behaviorally-based lifestyle intervention approach in which participants are taught behavioral skills to increase their physical activity by integrating moderate-intensity physical activity into their daily lives is more cost-effective than a structured exercise program in improving physical activity and cardiorespiratory health . This study represents one of the first attempts to compare the efficiency of intervention alternatives for improving physical activity among healthy , sedentary adults STUDY OBJECTIVES To determine whether long-term treatment with exercise therapy results in more favorable , disease-specific , health-related quality of life ( HRQL ) compared with short-term treatment with exercise therapy ; and to determine whether there are gender differences in disease-specific HRQL  among individuals r and omized into the two treatment groups . DESIGN R and omized clinical trial . SETTING Center-based exercise therapy unit at a university . PARTICIPANTS One hundred forty patients with COPD ; 118 completed trial . INTERVENTIONS Short-term exercise therapy ( 3 months ) ; long-term exercise therapy ( 18 months ) . MEASUREMENTS Chronic Disease Respiratory Question naire ( CRQ ) . RESULTS After 3 months of treatment , there were significant improvements in all CRQ scores for men and women ( p < 0.01 ) , and for the total sample ( p < 0.01 ) . At 18 months , individuals r and omized into the long-term group had significantly more favorable scores than the short-term group for dyspnea ( p = 0.03 ) , fatigue ( p < 0.01 ) , emotional function ( p = 0.04 ) , and mastery ( p = 0.04 ) . However , these effects were moderated by gender . That is , men in the long-term group reported significantly more favorable scores than men in the short-term group for dyspnea ( 0.04 ) , fatigue ( p < 0.001 ) , emotional function ( p = 0.02 ) , and mastery ( p = 0.02 ) . At the 18-month assessment , there were no differences between long-term and short-term exercise therapy for women on any of the subscales of the CRQ . CONCLUSIONS Taken collectively , the CRQ data demonstrate that long-term exercise therapy has little added benefit for women over short-term exercise therapy ; however , men derive significant benefits from extended training Objectives 1 . To assess the long-term effectiveness of a comprehensive cardiac rehabilitation programme on quality of life and survival in patients with a large spectrum of cardiovascular diseases ( myocardial infa rct ion , acute coronary syndrome , percutaneous transluminal coronary angioplasty and coronary artery bypass grafting ) . 2 . To establish the degree of correlation between expected improvement of health-related quality of life and improvement in physical function attributable to rehabilitation in the intervention group , in comparison with similar changes in the conventional care group . Design R and omized , controlled , parallel-group design ( intervention/conventional care ) . Setting Akershus County , southeast of Oslo City , Norway . Participants 500 patients , men and women , aged 40 - 85 years , who have sustained at least one of the above-mentioned cardiovascular diseases . Interventions 8 weeks of supervised , structured physical training of three periods of 20 min per week , targeting a heart rate of 60 - 70 % of the individual 's maximum ; home-based physical exercise training with the same basic schedule as in the supervised period ; quantification of patients ' compliance with the exercise programme by the use of wristwatches , information 
    Output:
    
Notably home based programs appeared to have a significantly higher adherence rate than center based programs .
AUTHORS ' CONCLUSIONS In the short-term , center based programs are superior to home based programs in patients with PVD .
There is a high possibility of a training effect however as the center based groups were trained primarily on treadmills ( and the home based were not ) and the outcome measures were treadmill based .
There is conflicting evidence which is better in patients with COPD .
Home based programs appear to be superior to center based programs in terms of the adherence to exercise ( especially in the long-term )