***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 People with idiopathic Parkinson ’s disease ( PD ) frequently have low activity levels , poor mobility and reduced quality of life . Although increased physical activity may improve mobility , balance and wellbeing , adherence to exercises and activity programs over the longer term can be challenging , particularly for older people with progressive neurological conditions such as PD . Physical activities that are engaging and enjoyable , such as dancing , might enhance adherence over the long term . The objective of this study was to evaluate the feasibility of a r and omized controlled trial of Irish set dancing compared with routine physiotherapy for people with mild to moderately severe PD . Methods Twenty-four people with idiopathic PD referred for movement rehabilitation were r and omized to receive  st and ard physiotherapy exercises or Irish set dancing classes  once per week plus a weekly home program for 6 months ( 12 in each group ) . The feasibility and safety of the proposed RCT protocol was the main focus of this evaluation . The primary outcome was motor disability measured by the motor component of the UPDRS , which was assessed prior to and after therapy by trained assessors blinded to group assignment . The Timed Up and Go , the Berg Balance Scale and the modified Freezing of Gait Question naire were secondary measures . Quality of life of the people with PD was evaluated using the PDQ-39 . Results Both the Irish set dancing and physiotherapy exercise program were shown to be feasible and safe . There were no differences between groups in the rate of adverse events such as falls , serious injuries , death or rates of admission to hospital . The physiotherapists who provided usual care remained blind to group allocation , with no change in their st and ard clinical practice . Compliance and adherence to both the exercise and dance programs were very high and attrition rates were low over the 6 months of therapy . Although improvements were made in both groups , the dance group showed superior results to st and ard physiotherapy in relation to freezing of gait , balance and motor disability . Conclusions Irish dancing and physiotherapy were both safe and feasible in this sample from Venice , with good adherence over a comparatively long time period of 6 months . A larger multi-centre trial is now warranted to establish whether Irish set dancing is more effective than routine physiotherapy for enhancing mobility , balance and quality of life in people living with idiopathic PD.Trial registration EudraCT number 2012 - 005769 - A previous r and omized , controlled trial of tai chi showed improvements in objective ly measured balance and other motor-related outcomes in patients with Parkinson 's disease . This study evaluated whether patient-reported outcomes could be improved through exercise interventions and whether improvements were associated with clinical outcomes and exercise adherence . In a secondary analysis of the tai chi trial , patient-reported and clinical outcomes and exercise adherence measures were compared between tai chi and resistance training and between tai chi and stretching exercise . Patient-reported outcome measures were perceptions of health-related benefits result ing from participation , assessed by the Parkinson 's Disease Question naire ( PDQ-8 ) and Vitality Plus Scale ( VPS ) . Clinical outcome measures included motor symptoms , assessed by a modified Unified Parkinson 's Disease Rating Scale – Motor Examination ( UPDRS-ME ) and a 50-foot speed walk . Information on continuing exercise after the structured interventions were terminated was obtained at a 3-month postintervention follow-up .  Tai chi participants reported significantly better improvement in the PDQ-8 ( −5.77 points , P = 0.014 ) than did resistance training participants and in PDQ-8 ( −9.56 points , P < 0.001 ) and VPS ( 2.80 points , P = 0.003 ) than did stretching participants . For tai chi , patient-reported improvement in the PDQ-8 and VPS was significantly correlated with their clinical outcomes of UPDRS-ME and a 50-foot walk , but these correlations were not statistically different from those shown for resistance training or stretching . However , patient-reported outcomes from tai chi training were associated with greater probability of continued exercise behavior than were either clinical outcomes or patient-reported outcomes from resistance training or stretching . Tai chi improved patient-reported perceptions of health-related benefits , which were found to be associated with a greater probability of exercise adherence . The findings indicate the potential of patient perceptions to drive exercise behavior after structured exercise programs are completed and the value of strengthening such perceptions in any behavioral intervention AIM The Patient Education Programme for Parkinson 's disease ( PEPP ) was assessed in a recent r and omised controlled trial ( RCT ) . In this study , a trend was identified towards significant improvement of patients ' quality of life ( Qol ) as well as a significant reduction of caregivers ' psychosocial burden and need for help . This study is aim ed at evaluating the effectiveness of the PEPP in clinical practice as compared with the RCT in an academic setting . The second aim is to assess its effectiveness in clinical practice at 6-month follow-up . METHODS Fifty-five patients and 50 caregivers from nine clinical setting s participated in the PEPP consisting of eight weekly sessions of 90 min .  Self-report question naires were used to assess patients ' Qol ( PDQ-39 ) and caregivers ' psychosocial burden and need for help ( BELA-A-k ) at baseline , directly after the programme and at 6-month follow-up . To compare the baseline data and short-term effects , data were used from an RCT study which included 64 Parkinson 's disease patients and 46 caregivers . RESULTS Compared with the RCT control group , significant effects , after Bonferoni adjustment , were found for patients ' Qol as well as for caregivers ' psychosocial burden and need for help . No significant changes were found between baseline scores compared with 6-month follow-up . Scores returned to baseline levels at 6-month follow-up . CONCLUSIONS Effects from the RCT study were replicated and the effect on patients ' Qol was now significant . However , at 6-month follow-up , scores returned to baseline levels , indicating the need for some form of a booster session Introduction Physical rehabilitation is commonly used in patients with Parkinson ’s disease ( PD ) to improve their health and alleviate the symptoms . Objective We compared the effects of three programs , strength training ( ST ) , aerobic training ( AT ) , and physiotherapy , on motor symptoms , functional capacity , and electroencephalographic ( EEG ) activity in PD patients . Methods Twenty-two patients were recruited and r and omized into three groups : AT ( 70 % of maximum heart rate ) , ST ( 80 % of one repetition maximum ) , and physiotherapy ( in groups ) . Subjects participated in their respective interventions twice a week for 12 weeks . The assessment s included measures of disease symptoms ( Unified Parkinson ’s Disease Rating Scale [ UPDRS ] ) , functional capacity ( Senior Fitness Test ) , and EEG before and after 12 weeks of intervention . Results The PD motor symptoms ( UPDRS-III ) in the group of patients who performed ST and AT improved by 27.5 % ( effect size [ES]=1.25 , confidence interval [CI]=−0.11 , 2.25 ) and 35 % ( ES=1.34 , CI=−0.16 , 2.58 ) , respectively , in contrast to the physiotherapy group , which showed a 2.9 % improvement ( ES=0.07 , CI=−0.85 , 0.99 ) . Furthermore , the functional capacity of all three groups improved after the intervention . The mean frequency of the EEG analysis mainly showed the effect of the interventions on the groups ( F=11.50 , P=0.0001 ) . Conclusion ST and AT in patients with PD are associated with improved outcomes in disease symptoms and functional capacity Objective : To investigate the feasibility and effectiveness of six weeks of home-based treadmill training in people with mild Parkinson ’s disease . Design : Pilot r and omized controlled trial of a six-week intervention followed by a further six weeks follow-up . Setting : Home-based treadmill training with outcome measures taken at a hospital clinic . Participants : Twenty cognitively intact participants with mild Parkinson ’s disease and gait disturbance . Two participants from the treadmill training group and one from the control group dropped out . Interventions : The treadmill training group undertook a semi-supervised home-based programme of treadmill walking for 20–40 minutes , four times a week for six weeks . The control group received usual care . Main outcome measures : The feasibility of the intervention was assessed by recording exercise adherence and acceptability , exercise intensity , fatigue , muscle soreness and adverse events . The primary outcome measure of efficacy was walking capacity ( 6-minute walk test distance ) . Results : Home-based treadmill training was feasible , acceptable and safe with participants completing 78 % ( SD 36 ) of the prescribed training sessions . The treadmill training group did not improve their walking capacity compared to the control group . The treadmill training group showed a greater improvement than the control group in fatigue at post test ( P = 0.04 ) and in quality of life at six weeks follow-up testing ( P = 0.02 ) . Conclusions : Semi-supervised home-based treadmill training is a feasible and safe form of exercise for cognitively intact people with mild Parkinson ’s disease . Further investigation regarding the effectiveness of home-based treadmill training is warranted This r and omized controlled clinical trial was conducted to compare the effects of movement rehabilitation strategies and exercise therapy in hospitalized patients with idiopathic Parkinson 's disease . Participants were r and omly assigned to a group that received movement strategy training or musculoskeletal exercises during 2 consecutive weeks of hospitalization . The primary outcome was disability as measured by the Unified Parkinson 's Disease Rating Scale , UPDRS ( motor and ADL components ) . Secondary outcomes were balance , walking speed , endurance , and quality of life . Assessment s were carried out by blinded testers at baseline , after the 2 weeks of treatment and 3 months after discharge . The movement strategy group showed improvements on several outcome measures from admission to discharge , including the UPDRS , 10 m walk , 2 minute walk , balance , and PDQ39 . However , from discharge to follow up there was significant regression in performance on the 2 minute walk and PDQ39 . For the exercise group , quality of life improved significantly during inpatient hospitalization and this was retained at follow-up . Inpatient rehabilitation produces short term reductions in disability and improvements in quality of life in people with Parkinson 's disease OBJECTIVES To assess the validity of the Parkinson 's Disease Quality of  Life  ( PDQL ) question naire , a patient-specific multi-dimensional quality of life measure , in a community-based sample of patients with Parkinson 's disease ( PI ) ) using st and ardized measures of disease severity , depressive symptomatology and cognitive function . DESIGN A group of 194 patients with probable PD were r and omly selected from a community-based register and were invited to self-complete the 37-item PDQL .  Disease severity was measured by the disease-specific Webster scale , cognition by the  CAMCOG neuropsychological test  and depressive symptomatology by the self-report 15-item GDS-15 geriatric depression scale . RESULTS A total of 136 patients returned completed PDQL question naires . Significant differences ( P < 0.05 ) emerged between the pooled PDQL score of patients grouped on the basis of disease severity . Depressive symptoms and cognition were also associated with poorer perceived quality of life as measured by the PDQL . CONCLUSIONS The results of this study are indicative of the validity of the PDQL as an important additional measurement which reflects the impact of PD from the patient perspective . It shows poorer quality of life to be associated with increasing age , disease severity more severe depressive symptomatology and impaired cognitive functioning . However , the responsiveness of this instrument in the evaluation of care in PD remains to be determined Background Exercise confers short-term benefits for individuals with Parkinson disease ( PD ) . Objective The purpose of the study was to compare short- and long-term responses among 2 supervised exercise programs and a home-based control exercise program . Design The 16-month r and omized controlled exercise intervention investigated 3 exercise approaches : flexibility/balance/function exercise ( FBF ) , supervised aerobic exercise ( AE ) , and home-based exercise ( control ) . Setting This study was conducted in outpatient clinics . Patients The participants were 121 individuals with PD ( Hoehn & Yahr stages 1–3 ) . Interventions The FBF program ( individualized spinal and extremity flexibility exercises followed by group balance/functional training ) was supervised by a physical therapist . The AE program ( using a treadmill , bike , or elliptical trainer ) was supervised by an exercise trainer . Supervision was provided 3 days per week for 4 months , and then monthly ( 16 months total ) . The control group participants exercised at home using the National Parkinson Foundation Fitness Counts program , with 1 supervised , clinic-based group session per month . Measurements Outcomes , obtained by blinded assessors , were determined at 4 , 10 , and 16 months . The primary outcome measures were overall physical function ( Continuous Scale — Physical Functional Performance [ CS-PFP ] ) , balance ( Functional Reach Test [ FRT ] ) , and walking economy ( oxygen uptake [ mL/kg/min ] ) . Secondary outcome measures were symptom severity ( Unified Parkinson 's Disease Rating Scale [ UPDRS ] activities of daily living [ ADL ] and motor subscales ) and quality of life ( 39-item Parkinson 's Disease Quality of Life Scale [ PDQ-39 ] ) . Results Of the 121 participants , 86.8 % , 82.6 % , and 79.3 % completed 4 , 10 , and 16 months , respectively , of the intervention . At 4 months , improvement in 
    Output:
    
Physical-exercise-based rehabilitation programs realized 2 - 4 times a week , 60 min each session , for 6 - 12 weeks , and follow-up of 3 months promotes significant positive effects on quality of life in Parkinson 's disease patients at mild to moderate stages and disease duration around 6 years