***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: OBJECTIVE Physical exercise has been consistently documented as a complementary therapy in the treatment of depressive disorders . However , despite a higher prevalence among women compared to men , the trials developed in women are scarce . In addition , the optimal dosage of exercise capable of producing benefits that reduce depressive symptoms remains unclear . This clinical trial is design ed to measure the effect of a structured physical exercise program as a complement to antidepressant medication in the treatment of women with depression . METHODS From July 2013 to May 2014 , we implemented a r and omized controlled trial ( HAPPY BRAIN study ) . A total of 26 women ( aged 50.16 ± 12.08 ) diagnosed with clinical depression were r and omized either to a supervised aerobic exercise group ( 45 - 50 min/week three times a week for four months ) plus pharmacotherapy ( intervention group ) , or only antidepressant medication ( control group ) . RESULTS The exercise group presented a decrease in BDI-II and DASS-21 total score scales . Relatively to DASS-21 , it showed a significant decrease in anxiety and stress . The exercise group when compared to a control group showed improvement in relation to physical functioning parameters between baseline and post-intervention . Moreover , anthropometric parameters presented only significant differences between groups in fat mass percentage . Nonetheless , no differences were found between groups in weight , body mass index , waist circumference , and self-esteem . CONCLUSION Our results showed that supervised structured aerobic exercise training could be an effective adjuvant therapy for treating women with depression , reducing depressive symptomatology and improving physical fitness . A key factor of this improvement included strict control of exercise workload parameters and adjustment to each subject 's capacity . In our study , due to the sample size there is an increase in the probability of type II errors Objective : To determine whether falls can be prevented with minimally supervised exercise targeting potentially remediable fall risk factors , i.e. , poor balance , reduced leg muscle strength , and freezing of gait , in people with Parkinson disease . Methods : Two hundred thirty-one people with Parkinson disease were r and omized into exercise or usual-care control groups . Exercises were practice d for 40 to 60 minutes , 3 times weekly for 6 months . Primary outcomes were fall rates and proportion of fallers during the intervention period . Secondary outcomes were physical ( balance , mobility , freezing of gait , habitual physical activity ) , psychological ( fear of falling , affect ) , and quality -of-life measures . Results : There was no significant difference between groups in the rate of falls ( incidence rate ratio [ IRR ] = 0.73 , 95 % confidence interval [ CI ] 0.45–1.17 , p = 0.18 ) or proportion of fallers ( p = 0.45 ) . Preplanned subgroup analysis revealed a significant interaction for disease severity ( p < 0.001 ) . In the lower disease severity subgroup , there were fewer falls in the exercise group compared with controls ( IRR = 0.31 , 95 % CI 0.15–0.62 , p < 0.001 ) , while in the higher disease severity subgroup , there was a trend toward more falls in the exercise group ( IRR = 1.61 , 95 % CI 0.86–3.03 , p = 0.13 ) . Postintervention , the exercise group scored significantly ( p < 0.05 ) better than controls on the Short Physical Performance Battery , sit-to-st and , fear of falling , affect , and quality of life , after adjusting for baseline performance . Conclusions : An exercise program targeting balance , leg strength , and freezing of gait did not reduce falls but improved physical and psychological health . Falls were reduced in people with milder disease but not in those with more severe Parkinson disease . Classification of evidence : This study provides Class III evidence that for patients with Parkinson disease , a minimally supervised exercise program does not reduce fall risk . This study lacked the precision to exclude a moderate reduction or modest increase in fall risk from exercise . Trial registration : Australian New Zeal and Clinical Trials Registry ( ACTRN12608000303347 ) Background : Exercise can be beneficial for cardiopulmonary , musculoskeletal or neurological systems , and other factors including mood , and may be beneficial in reducing fall risks , dementia and variables associated with quality of life ( QOL ) . Parkinson 's disease ( PD ) produces progressive motor and cognitive deterioration that may leave those inflicted unable to participate in st and ard exercise programs . Alternative forms of exercise such as yoga may be successful in improving physical function , QOL and physiological variables for overall well-being . Aim : This r and omized controlled pilot study investigated the effectiveness of yoga intervention on physiological and health-related QOL measures in people with PD . Methods and Material s : Thirteen people with stage 1 - 2 PD were r and omized to either a yoga ( n = 8) or a control group ( n = 5 ) . The yoga group participated in twice-weekly yoga sessions for 12 weeks . Participants were tested at baseline , and at 6 and 12 weeks using the Unified Parkinson 's Disease Rating Scale ( UPDRS ) , clinical measures of health-related QOL and physiological measures . Results : Significant improvement in UPDRS scores ( P = .006 ) , diastolic blood pressure ( P = 0.036 ) and average forced vital capacity ( P = 0.03 ) was noted in the yoga group over time . Changes between groups were also noted in two SF-36 subscales . Positive trends of improvement were noted in depression scores ( P = 0.056 ) , body weight ( P = 0.056 ) and forced expiratory volume ( P = 0.059 ) . Yoga participants reported more positive symptom changes including immediate tremor reduction . Conclusions : The results suggest that yoga may improve aspects of QOL and physiological functions in stages 1 - 2 PD . Future larger studies are needed to confirm and extend our findings of the effects of yoga in PD BACKGROUND Regular physical exercise may improve a variety of physiological and psychological factors in depressive persons . However , there is little experimental evidence to support this assumption for adolescent population s. We conducted a r and omized controlled trial to investigate the effect of physical exercise on depressive state , the excretions of stress hormones and physiological fitness variables in adolescent females with depressive symptoms . METHODS Forty-nine female volunteers ( aged 18 - 20 years ; mean 18.8 + /- 0.7 years ) with mild-to-moderate depressive symptoms , as measured by the Centre for Epidemiologic Studies Depression ( CES-D ) scale , were r and omly assigned to either an exercise regimen or usual daily activities for 8 weeks . The subjects were then crossed over to the alternate regimen for an additional 8-week period . The exercise program consisted of five 50-min sessions per week of a group jogging training at a mild intensity . The variables measured were CES-D rating scale , urinary cortisol and epinephrine levels , and cardiorespiratory factors at rest and during exercise endurance test . RESULTS After the sessions of exercise the CES-D total depressive score showed a significant decrease , whereas no effect was observed after the period of usual daily activities ( ANOVA ) . Twenty-four hour excretions of cortisol and epinephrine in urine were reduced due to the exercise regimen . The training group had a significantly reduced resting heart rate and increased peak oxygen uptake and lung capacity . CONCLUSIONS The findings of this study suggest that a group jogging exercise may be effective in improving depressive state , hormonal response to stress and physiological fitness of adolescent females with depressive symptoms Background Depression is a disabling , prevalent condition . Physical activity programs may assist depression management in older people , ameliorate co-morbid conditions and reduce the need for antidepressants . The UPLIFT pilot study assessed the feasibility of older depressed people attending a community-based progressive resistance training ( PRT ) program .  The study also aim ed to determine whether PRT improves depressive status in older depressed patients . Methods A r and omised controlled trial was conducted . People aged ≥ 65 years with depressive symptoms were recruited via general practice s. Following baseline assessment , subjects were r and omly allocated to attend a local PRT program three times per week for 10 weeks or a brief advice control group . Follow-up assessment of depressive status , physical and psychological health , functional and quality of life status occurred post intervention and at six months . Results Three hundred and forty six people responded to the study invitation , of whom 22 % had depressive symptoms ( Geriatric Depression Scale , GDS-30 score ≥ 11 ) . Thirty two people entered the trial . There were no significant group differences on the GDS at follow-up . At six months there was a trend for the PRT intervention group to have lower GDS scores than the comparison group , but this finding did not reach significance ( p = 0.08 ) . More of the PRT group ( 57 % ) had a reduction in depressive symptoms post program , compared to 44 % of the control group . It was not possible to discern which specific components of the program influenced its impact , but in post hoc analyses , improvement in depressive status appeared to be associated with the number of exercise sessions completed ( r = -0.8 , p < 0.01 ) . Conclusion The UPLIFT pilot study confirmed that older people with depression can be successfully recruited to a community based PRT program . The program can be offered by existing community-based facilities , enabling its ongoing implementation for the potential benefit of other older people BACKGROUND Although exercise has been shown to relieve depression , little is known about its mechanism or dose-response characteristics . We hypothesized that high intensity progressive resistance training ( PRT ) would be more effective than either low intensity PRT or st and ard care by a general practitioner ( GP ) in depressed elderly persons , and that high intensity PRT would provide superior benefits in quality of life , sleep quality , and self-efficacy . METHODS Sixty community-dwelling adults > 60 years with major or minor depression were r and omized to supervised high intensity PRT ( 80 % maximum load ) or low intensity PRT ( 20 % maximum load ) 3 days per week for 8 weeks , or GP care . RESULTS A 50 % reduction in the Hamilton Rating Scale of Depression score was achieved in 61 % of the high intensity , 29 % of the low intensity , and 21 % of the GP care group ( p = .03 ) . Strength gain was directly associated with reduction in depressive symptoms ( r = 0.40 , p = .004 ) , as was baseline social support network type ( F = 3.52 , p = .015 ) , whereas personality type , self-efficacy , and locus of control were unrelated to the antidepressant effect . Vitality quality -of-life scale improved more in the high intensity group than in the others ( p = .04 ) . Sleep quality improved significantly in all participants ( p < .0001 ) , with the greatest relative change in high intensity PRT ( p = .05 ) . CONCLUSIONS High intensity PRT is more effective than is low intensity PRT or GP care for the treatment of older depressed patients Inactivity is a prevalent problem in the population affected with multiple sclerosis ( MS ) . Thus , there is a need to develop and test physical activity ( PA ) interventions that can be widely disseminated . We conducted a formative evaluation as part of a r and omized controlled trial of a pamphlet-based PA intervention  among 30 women with MS .  Pamphlets were customized to sub-sets of participants who shared similar symptoms and barriers to PA . Mixed methods were used to examine the intervention 's influence on self-efficacy , social support , processes of change and stages of change placement , as well as explore participants ' perceived barriers , motivators and strategies for engaging in a PA program . Results indicated that the intervention group significantly improved stages of change placement ( F = 16.64 , P < 0.01 ) and social support ( F = 4.08 , P = 0.05 ) in comparison to the control group . Fatigue , pain and lack of time were the commonly cited barriers to engage in the PA program ; whereas the pamphlets , phone calls and action planning were cited as motivators . Participants used fatigue management strategies , enlisted social support and modified their environment to routinely engage in the PA program . Strategies were identified to improve the PA intervention in future research BACKGROUND Studies of physical exercise in patients with Alzheimer 's disease ( AD ) are few and results have been inconsistent . OBJECTIVE To assess the effects of a moderate-to-high intensity aerobic exercise program in patients with mild AD . METHODS In a r and omized controlled trial , we recruited 200 patients with mild AD to a  supervised exercise group  ( 60-min sessions three times a week for 16 weeks ) or to a control group . Primary outcome was changed from baseline in cognitive performance estimated by Symbol Digit Modalities Test ( SDMT ) in the intention-to-treat ( ITT ) group . Secondary outcomes included changes in quality of life , ability to perform activities of daily living , and in neuropsychiatric and depressive symptoms . RESULTS The ITT analysis showed no significant differences between intervention and control groups in change from baseline of SDMT , other cognitive tests , quality of life , or activities of daily living . The change from baseline in Neuropsychiatric Inventory differed significantly in favor of the intervention group ( mean : -3.5 , 95 % confidence interval ( CI ) -5.8 to -1.3 , p = 0.002 ) . In subjects who adhered to the protocol , we found a significant effect on change from baseline in SDMT as compared with the control group ( mean : 4.2 , 95 % CI 0.5 to 7.9 , p = 0.028 ) , suggesting a dose-response relationship between exercise and cognition . CONCLUSIONS This is the first r and omized controlled trial with 
    Output:
    
Exercise is an efficacious and safe add-on therapeutic intervention showing a medium-sized effect on QoL and a large effect on mood in patients with chronic brain disorders , with a positive dose – response correlation .
Exercise also improved several cognitive domains with small but significant effects