***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 : Regular aerobic exercise in patients with cystic fibrosis ( CF ) improves aerobic conditioning and delays disease progression , result ing in better quality of life . The purpose of this study was to evaluate the effect of an aerobic exercise program based on verbal and written guidelines on maximum exercise capacity using a cardiopulmonary exercise test , quality of life , and the self-reported aerobic exercise practice of children and adolescents with CF . METHODS : This r and omized controlled trial followed guidelines for physical exercise in a CF center . Subjects were assigned to 2 groups : intervention ( group 1 ) , with 17 subjects ; and control ( group 2 ) , also with 17 subjects . Data were collected from October 2010 to October 2011 , and the study population comprised 7–20-y-old children and adolescents with CF . The intervention consisted of h and ing out a manual with guidelines for aerobic physical exercises and reinforcing recommendations in telephone calls every 2 weeks . RESULTS : Thirty-four subjects were included in the study , 20 of whom were boys ( 58.5 % ) . The groups were similar at baseline . In group 1 , 6 subjects ( 35.2 % ) reported practicing physical exercises regularly . The mean age was 13.4 ± 2.8 y , the  mean percent-of-predicted FEV1 was 95.5 ± 17.9 % , and the mean peak oxygen uptake ( V̇O2 ) relative to body mass was 34.9 ± 9.0 mL/kg/min . In group 2 , 4 subjects ( 23.5 % ) reported practicing physical exercises regularly . The mean age was 12.7 ± 3.3 y , the mean percent-of-predicted FEV1 was 100.1 ± 21.2 % , and the mean peak V̇O2 was 33.2 ± 8.2 mL/kg/min . In group 1 , there was a significant increase in physical exercise practice as reported by subjects after 3 months of intervention compared with group 2 ( P = .01 ) . No statistically significant differences were found for the other variables . CONCLUSIONS : Verbal and written guidelines for aerobic exercise , together with supervision over the telephone , had a positive impact on the self-reported regular physical exercise practice of children and adolescents . However , no improvement was found in lung function and maximum exercise capacity or domains of the quality of life question naire STUDY OBJECTIVE Exercise has the potential to improve the ability of a patient with cystic fibrosis ( CF ) to cope with the physical dem and s of everyday life , and may improve prognosis . The purpose of this study was to compare the effects of a home-based , semi-supervised , upper-body strength-training regimen with a similarly structured aerobic training regimen . DESIGN Data were collected during a 1-year r and omized clinical trial . SETTING Counselors conducted in-home visits with the participants once per week for the first 8 weeks followed by monthly visits for the remainder of the study . PATIENTS Sixty-seven patients with CF , aged 8 to 18 years , participated in the trial . INTERVENTION Participants in both exercise conditions were encouraged to exercise at least three times per week for 1 year . Each child in the aerobic group was given a stair-stepping machine , and each child in the upper-body strength training group was given an upper-body-only weight-resistance machine . MEASURES AND RESULTS Aerobic fitness , pulmonary function , quality of life , and strength were measured at baseline , at 6 months , and at 12 months . Strength training increased the maximum weight lifted for biceps curls significantly more than aerobic training ( p < 0.02 ) . However , this differential did not remain significant after control for increase in height . Both training procedures were associated with increased strength ( p < 0.002 ) and physical work capacity ( PWC ) [ p < 0.033 ] . CONCLUSIONS We concluded that strength and aerobic training may increase upper-body strength , and that both types of training may increase PWC for children with CF . Future trials should be conducted with no-training control subjects and larger sample s to increase statistical power QUESTION Does exercise using a gaming console result in similar cardiovascular dem and and energy expenditure as formally prescribed exercise in adults with cystic fibrosis ? How do these patients perceive gaming console exercise ? DESIGN R and omised cross-over trial with concealed allocation and intention-to-treat analysis . PARTICIPANTS 19 adults with cystic fibrosis admitted to hospital for treatment of a pulmonary exacerbation . INTERVENTION Participants underwent two 15-minute exercise interventions on separate days ; one involving a gaming console and one a treadmill or cycle ergometer . OUTCOME MEASURES Cardiovascular dem and was measured using heart rate and rating of perceived exertion ( RPE ) . Energy expenditure was estimated using a portable activity monitor . Perception ( enjoyment , fatigue , workload , effectiveness , feasibility ) was rated using a horizontal 10-cm visual analogue scale . RESULTS There was no significant difference in average heart rate ( mean difference 3 beats/min , 95 % CI -3 to 9 ) or energy expenditure ( 0.1 MET , 95 % CI -0.3 to 0.5 ) between the two interventions . Both interventions provided a ' hard ' workout ( RPE ∼15 ) . Gaming console exercise was rated as more enjoyable ( mean difference 2.6 cm , 95 % CI 1.6 to 3.6 ) than formal exercise but they did n't differ significantly in fatigue ( -1.0 cm , 95 % CI -2.4 to 0.3 ) , perceived effectiveness ( -0.4 cm , 95 % CI -1.2 to 0.3 ) , or perceived feasibility for inclusion in routine management ( 0.2 cm , 95 % CI -0.7 to 1.1 ) . CONCLUSION Gaming console exercise provides a similar cardiovascular dem and as traditional exercise modalities . It is feasible that adults with cystic fibrosis could include gaming console exercise in their exercise program . TRIAL REGISTRATION ACTRN12610000861055 Little is known about the long-term persistence of positive effects induced by a physical conditioning programme in cystic fibrosis . Therefore , this study determined the effects of a 6-month conditioning programme on peak oxygen uptake ( primary outcome ) and other markers of fitness , physical activity , anthropometry , lung function and quality of life ( secondary outcomes ) , 18 and 24 months after the programme was initiated . Patients with cystic fibrosis aged 12–40 yrs were r and omly assigned to an  intervention ( n = 23 ) and a  control ( n = 15 ) group . The intervention group consented to add 3 h of sports per week for ≥6 months to their previous activities . Controls were asked to maintain their level of activity for 12 months . Patients were seen at baseline and after 3 , 6 , 12 , 18 and 24 months . There was no significant difference between groups at baseline . The intervention induced positive effects on peak oxygen uptake ( difference in changes from baseline to the 18- and 24-month assessment s between groups : 3.72±1.23 mL·min−1·kg−1 ; p<0.01 ) , maximal workload ( 0.37±0.11 W·kg−1 ; p<0.01 ) , vigorous physical activity ( 1.63±0.82 h·week−1 ; p<0.05 ) , forced vital capacity ( 6.06±2.87 % predicted ; p<0.05 ) and perceived health ( 9.89±4.72 ; p<0.05 ) . A home-based partially supervised physical conditioning programme  can improve physical fitness , lung function and perceived health long after the intervention has ended BACKGROUND : Xbox Kinect has been proposed as an exercise intervention in cystic fibrosis ( CF ) , but its potential has not been compared with st and ard training modalities . METHODS : Using a crossover design , subjects were r and omized to 2 intervention groups : Xbox Kinect and a traditional stationary cycle . Heart rate , SpO2 , dyspnea , and fatigue were measured . Subject satisfaction was tested . RESULTS : Thirty subjects with CF ( 11 males , mean ± SD age of 12 ± 2.5 y , mean ± SD FEV1 of 73 ± 16 % of predicted ) were enrolled . Xbox Kinect provided a cardiovascular dem and similar to a stationary cycle , although the modality was different ( interval vs continuous ) . Maximum heart rates were similar ( P = .2 ) . Heart rate target was achieved more frequently with a stationary cycle ( P = .02 ) . Xbox Kinect  caused less dyspnea ( P = .001 ) and fatigue ( P < .001 ) and was more enjoyable than a stationary cycle ( P < .001 ) . CONCLUSIONS : Subjects preferred Xbox Kinect for its interactivity . Xbox Kinect has the potential to be employed as an exercise intervention in young subjects with CF , but investigation over longer periods is needed Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more BACKGROUND Children 's physical activity patterns are characterized by short-term anaerobic activities . Anaerobic exercise performance in children with cystic fibrosis ( CF ) has received little attention compared to aerobic performance . This study investigated the effects of anaerobic training in children with CF . DESIGN AND METHODS Twenty patients were r and omly assigned to the training group ( TG ) [ 11 patients ; mean ( + /- SD ) age , 13.6 + /- 1.3 years ; mean FEV(1 ) , 75.2 + /- 20.7 % predicted ] or the control group ( CG ) [ 9 patients ; mean age , 14.2 + /- 2.1 years ; FEV(1 ) , 82.1 + /- 19.1 % predicted ] . The TG trained 2 days per week for 12 weeks , with each session lasting 30 to 45 min . The training program consisted of anaerobic activities lasting 20 to 30 s. The control subjects were asked not to change their normal daily activities . Body composition , pulmonary function , peripheral muscle force , habitual physical activity , aerobic and anaerobic exercise performance , and quality of life were reevaluated at the end of the training program , and again after a 12-week follow-up period . RESULTS Patients in the TG significantly improved their anaerobic performance , aerobic performance , and quality of life . No significant changes were seen in other parameters , and no improvements were found in CG . After the follow-up period , only anaerobic performance and quality of life in TG were significantly higher compared to pretraining values . CONCLUSIONS Anaerobic training has measurable effects on aerobic performance ( although not sustained ) , anaerobic performance , and health-related quality of life in children with CF . Therefore , anaerobic training could be an important component of therapeutic programs for CF patients Bronchial hygiene therapy is a st and ard part of the treatment of patients with cystic fibrosis ( CF ) . Coughing alone promotes sputum expectoration and is probably the primary effective component of st and ard bronchial hygiene therapy . The purpose of this study was to determine whether substituting regular exercise , which also promotes coughing , for two of three daily bronchial hygiene treatments would affect the expected improvements in pulmonary function and exercise response in hospitalized patients with CF . Seventeen patients with CF hospitalized ( means length of stay = 13.0 + /- 2.6 days ) for an acute exacerbation of their pulmonary disease participated in the study . The patients were r and omly assigned to either a group that participated in two cycle ergometer exercise sessions and one bronchial hygiene treatment session per day ( EX Group [ n = 9 ] ) or a group that participated in three bronchial hygiene treatment sessions per day ( PD Group [ n = 8 ] ) . Pulmonary functions and responses to a progressive , incremental cycle ergometer exercise test were measured on admission and before discharge . Bronchial hygiene therapy consisted of postural drainage , in six positions , with chest percussion and vibration . Therapeutic exercise was of moderate intensity and was individually adjusted based on the patient 's heart rate and arterial oxygen saturation response to the admission exercise test . Coughing was encouraged during and after all treatments . Pulmonary function and exercise response were significantly improved over the period of hospitalization in both groups ; the improvements were the same in the two groups . These results indicate that , in some hospitalized patients with CF , exercise therapy may be substituted for at least part of the st and ard protocol of bronchial hygiene therapy PURPOSE The purpose of our study was to assess the effects of an 8-wk intrahospital combined circuit weight and aerobic training program performed by children with cystic fibrosis ( of low-moderate severity and stable clinical condition ) on the following outcomes : cardiorespiratory fitness ( VO2peak ) and muscle strength ( five-repetition maximum ( 5RM ) bench press , 5RM leg press , and 5RM seated row ) ( primary outcomes ) and pulmonary function ( forced vital capacity , forced expiratory volume in 1 s ) , weight , body composition , functional mobility ( Timed Up and Down Stairs and 3-m Timed Up and Go tests ) , and quality of life ( secondary outcomes ) . We also determined the effects of a detraining period ( 4 wk ) on the aforementioned outcomes . MET 
    Output:
    
There was also wide variation in the quality of the included studies .This systematic review shows very low- to low- quality evidence from both short- and long-term studies that in people with cystic fibrosis  aerobic or anaerobic physical exercise training ( or a combination of both ) has a positive effect on aerobic exercise capacity , pulmonary function and health-related quality of life .
Exercise training is already part of regular outpatient care offered to most people with cystic fibrosis , and since there is some evidence for beneficial effects on aerobic fitness and no negative side effects exist , there is no reason to actively discourage this .
The benefits from including physical exercise training in an individual 's regular care may be influenced by the type and duration of the training programme .