***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 
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    Input: Aims /hypothesisGait characteristics and balance are altered in diabetic patients . Little is known about possible treatment strategies . This study evaluates the effect of a specific training programme on gait and balance of diabetic patients . Methods This was a r and omised controlled trial ( n = 71 ) with an intervention ( n = 35 ) and control group ( n = 36 ) . The intervention consisted of physiotherapeutic group training including gait and balance exercises with function-orientated strengthening ( twice weekly over 12 weeks ) . Controls received no treatment . Individuals were allocated to the groups in a central office . Gait , balance , fear of falls , muscle strength and joint mobility were measured at baseline , after intervention and at 6-month follow-up . Results The trial is closed to recruitment and follow-up . After training , the intervention group increased habitual walking speed by 0.149 m/s ( p < 0.001 ) compared with the control group . Patients in the intervention group also significantly improved their balance ( time to walk over a beam , balance index recorded on Biodex balance system ) , their performance-oriented mobility , their degree of concern about falling , their hip and ankle plantar flexor strength , and their hip flexion mobility compared with the control group . After 6 months , all these variables remained significant except for the Biodex sway index and ankle plantar flexor strength . Two patients developed pain in their Achilles tendon : the progression for two related exercises was slowed down . Conclusions /interpretationSpecific training can improve gait speed , balance , muscle strength and joint mobility in diabetic patients . Further studies are needed to explore the influence of these improvements on the number of reported falls , patients ’ physical activity levels and quality of life . Trial registration : Clinical Trials.gov NCT00637546 Funding : This work was supported by the Swiss National Foundation ( SNF ) : OBJECTIVE To determine the effect of a specific exercise regimen on clinical measures of postural stability and confidence in a population with peripheral neuropathy ( PN ) . DESIGN Prospect i ve , controlled , single blind study . SETTING Outpatient clinic of a university hospital . PARTICIPANTS Twenty subjects with diabetes mellitus and electrodiagnostically confirmed PN . INTERVENTION Ten subjects underwent a 3-week intervention exercise regimen design ed to increase rapidly available distal strength and balance . The other 10 subjects performed a control exercise regimen . MAIN OUTCOME MEASURES Unipedal stance time , functional reach , t and em stance time , and score on the activities-specific balance and confidence ( ABC ) scale . RESULTS The intervention subjects , but not the control subjects , showed significant improvement in all 3 clinical measures of balance and nonsignificant improvement on the ABC scale . CONCLUSION A brief , specific exercise regimen improved clinical measures of balance in patients with diabetic PN . Further studies are needed to determine if this result translates into a lower fall frequency in this high-risk population There is insufficient evidence to support the use of exercise in the management of  chronic disablement in people with inflammatory peripheral neuropathy . Therefore , our study aim ed to determine the feasibility and effectiveness of a physiotherapist prescribed community based exercise programme for reducing chronic disablement in patients with stable motor neuropathy . We assessed the effects of a 12 week unsupervised , community based strengthening , aerobic and functional exercise programme on activity limitation and other measures of functioning in 16 people with stable motor neuropathy and 10 healthy control subjects . Fourteen of 16 patients and 8 out of 10 healthy control subjects completed the study and exercised safely in the community with no adverse events . Significant improvements were seen in all measures of activity limitation and in wider measures of health including anxiety , depression and fatigue in the patient group . Improvements were sustained at six months after completion of the exercise programme , except for depression . Ten patients continued to exercise regularly at six months . These findings demonstrate that individually prescribed community based exercise is feasible and acceptable for people with stable motor neuropathy and participation in exercise may be successful in reducing chronic disablement . Future r and omised controlled trials are needed to examine the efficacy of this complex community based intervention BACKGROUND Lymphoma patients undergoing therapy must cope with the side-effects of the disease itself , therapy and associated immobility . Peripheral neuropathy ( PNP ) , loss of balance control and weakness not only diminishes patients ' quality of life ( QOL ) , it can also affect planning and the dosage of therapy . Exercise may enable patients to reverse these declines , improving their performance level and QOL . PATIENTS AND METHODS We carried out a r and omized , controlled trial , assigning 61 lymphoma patients either to a  control group ( CG ; N=31 ) or to a 36-week intervention ( IG ; N=30 ) , consisting of sensorimotor- , endurance- and strength training twice a week . Primary end point was QOL ; secondary end points included movement coordination , endurance , strength and therapy-induced side-effects . RESULTS Intergroup comparison revealed improved QOL- ( ΔT1-T0 ; P=0.03 ) and PNP-related deep sensitivity in the IG : 87.5 % were able to reduce the symptom , compared with 0 % in the CG ( P<0.001 ) . Significant differences in the change of balance control could be found between the groups , with the IG improving while the CG steadily declined ( monopedal static ΔT3-T0 ; P=0.03 ; dynamic ΔT3-T0 ; P=0.007 ; perturbed mono-ΔT3-T0 ; P=0.009 and bipedal ΔT3-T0 ; P=0.006 ) , failed attempts ( monopedal static ΔT3-T0 ; P=0.02 , dynamic ΔT3-T0 ; P<0.001 and perturbed ΔT3-T0 ; P=0.006 ) and improved time to regain balance ( ΔT3-T0 ; P=0.04 ) . Moreover , the change in the aerobic performance level ( ΔT3-T0 ; P=0.05 ) and additional amount of exercise carried out per week [ metabolic equivalent ( MET ) ; P=0.02 ] differed significantly across groups . CONCLUSIONS Exercise , especially sensorimotor training , is a feasible and promising method to support cancer patients during therapy . It improves patients QOL , reduces restrictions from side-effects such as PNP and improves patients ' balance control , physical performance level and mobility . GERMAN CLINICAL TRIALS REGISTER NUMBER DRKS00003894 This study was design ed to determine whether a 6-month Tai Chi exercise program can improve self-reported physical functioning limitations among healthy , physically inactive older individuals . Ninety-four community residents ages 65 to 96 ( M age = 72.8 years , SD = 5.1 ) volunteered to participate in the study . Participants were r and omly assigned to either a 6-month experimental ( Tai Chi ) group ( n = 49 ) , which exercised twice per week for 60 min , or a wait-list control group ( n = 45 ) . A 6-item self-report physical functioning scale , assessing the extent of behavioral dysfunction caused by health problems , was used to evaluate change in physical functioning limitations as a result of Tai Chi intervention . Results indicated that compared to the control group , participants in the Tai Chi group experienced significant improvements in all aspects of physical functioning over the course of the 6-month intervention . Overall , the experimental group had 65 % improvement across all 6 functional status measures ranging from daily activities such as walking and lifting to moderate-vigorous activities such as running . It was concluded that the 6-month Tai Chi exercise program was effective for improving functional status in healthy , physically inactive older adults . A self-paced and self-controlled activity such as Tai Chi has the potential to be an effective , low-cost means of improving functional status in older persons OBJECTIVE To assess the efficacy of a balance rehabilitation treatment by using both a powered platform on which subjects st and and specific physical exercises ( EXs ) . DESIGN Crossover trial . SETTING Physical and rehabilitation medicine department in Italy . PARTICIPANTS Patients ( N=33 ) with balance disorders ( 14 vestibular origin , 19 peripheral neuropathy origin ) . INTERVENTIONS Patients underwent powered platform then EX treatment ( n=17 ) ; the other 16 received the same treatments in reverse order . powered platform consisted of balancing on a sinusoidally oscillating powered platform ( in anteroposterior and laterolateral directions in separate trials ) with eyes open and closed . A physical therapist administered Cawthorne-Cooksey EXs for patients with vestibular disorders and modified Frenkel EXs for patients with neuropathy . Treatment lasted 1 hour a day for 10 consecutive days , except for the weekend . MAIN OUTCOME MEASURES Body sway area , subjective score of stability , balance and gait scores , and amplitude of head displacement while balancing on the oscillating powered platform were recorded before , ( t0 ) after the first ( t1 ) , and after the second treatment ( t2 ) , regardless of the powered platform or EX order . RESULTS On average , all participants improved balance regardless of the order of treatments , and more so at t2 than t1 . Improvement was observed by using instrumental evaluations and balance and gait scales . In both patient groups , powered platform treatment proved to be as effective as EX in improving balance . This effect was stronger in patients with vestibular disorders , independently of order of treatment . CONCLUSIONS Balance rehabilitation with either EX or powered platform is effective in patients with balance disorders of vestibular or neuropathic origin . These findings point to the value of either or both physical EXs and powered platform in increasing stability and potentially decrease the risk of falling in patients with neuropathy , for whom few results are documented in the literature BACKGROUND Diabetes is the most important cause of peripheral neuropathy ( DPN ) . No definitive treatment for DPN has been established , and very few data on the role of exercise training on DPN have been reported . AIM OF THE STUDY We sought to examine the effects of long-term exercise training on the development of DPN in both Types 1 and 2 diabetic patients . PARTICIPANTS AND METHODS Seventy-eight diabetic patients without signs and symptoms of peripheral DPN were enrolled , r and omized , and subdivided in two groups : 31 diabetic participants [ 15 f , 16 m ; 49+/-15.5 years old ; body mass index ( BMI ) = 27.9+/-4.7 ] , who performed a prescribed and supervised 4 h/week brisk walking on a treadmill at 50 % to 85 % of the heart rate reserve ( exercise group : EXE ) , and a  control group of 47 diabetic participants ( CON ; 24 f , 23 m ; 52.9+/-13.4 years old ; BMI = 30.9+/-8.4 ) .  Vibration perception threshold ( VPT ) , nerve distal latency ( DL ) , nerve conduction velocity ( NCV ) , and nerve action potential amplitude ( NAPA ) in the lower limbs were measured . RESULTS We found significant differences on Delta ( delta ) in NCV for both peroneal and sural motor nerve between the EXE and CON groups during the study period ( P<.001 , for both ) . The percentage of diabetic patients that developed motor neuropathy and sensory neuropathy during the 4 years of the study was significantly higher in the CON than the EXE group ( 17 % vs. 0.0 % , P<.05 , and 29.8 % vs. 6.45 % , P<.05 , respectively ) . In addition , the percentage of diabetic patients who developed increased VPT ( 25 V ) during the study was significantly higher in the CON than the EXE group ( 21.3 % vs. 12.9 % , P<.05 ) . Change on Hallux VPT from baseline to the end of the study was significantly different between the EXE and CON groups ( P<.05 ) ; no significant change in Malleolus VPT between the two groups occurred . CONCLUSIONS This study suggests , for the first time , that long-term aerobic exercise training can prevent the onset or modify the natural history of DPN Background : Pain is a common symptom in peripheral neuropathies . The factors determining why some peripheral neuropathies are painful and others are not are incompletely understood . Pro-inflammatory cytokines have been implicated to play a crucial role in the generation of pain . Objective : To investigate whether cytokine profiles differ between patients with painful or painless neuropathy . Methods : In this prospect i ve study , we analyzed blood mRNA and protein levels  of the pro-inflammatory cytokines interleukin-2 ( IL-2 ) and tumor necrosis factor-α ( TNF ) and the anti-inflammatory cytokines IL-4 and IL-10  in 32 patients with painful neuropathy , 20 patients with painless neuropathy , and 38 healthy control subjects , using quantitative real-time PCR and ELISA . Results : Patients with a painful neuropathy had about twofold higher IL-2 mRNA ( p = 0.001 ) and TNF mRNA ( p < 0.0001 ) and protein levels ( p = 0.009 ) than healthy control subjects and about twofold higher IL-2 and TNF mRNA ( p = 0.03 ; p = 0.001 ) and protein levels ( p = 0.04 ; p = 0.04 ) than patients with painless neuropathy . In contrast , mRNA levels of the anti-inflammatory cytokine IL-10 were about twofold higher in patients with painless neuropathy than in patients with painful neuropathy ( p = 0.001 ) and controls ( p 
    Output:
    
Current data suggests that exercise is a feasible , safe , and promising supportive measure for neuropathic patients .
This is best documented for patients with diabetic peripheral neuropathy ( DPN ) , suggesting that endurance training has the potential to prevent the onset of and reduce the progression of DPN .
In general , balance exercises  showed the highest effect on the motor as well as sensory symptoms in all types of PNP .
Conclusion Overall , balance training  appears to be the most effective exercise intervention  .
Studies focusing exclusively on strength , or a combination of endurance and strength , appear to have a lower impact .
For metabolically-induced neuropathies , endurance training also plays an important role .