***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: Evidence suggests that bladder control problems develop or worsen as a result of fractured neck of femur ( # NOF ) and its subsequent management . The primary aim of this study was to reduce the prevalence and severity of post surgery continence problems among patients , aged from 60-years , undergoing surgery for # NOF , using a best practice “ case-management model ” multifactorial intervention .  Eligible consenting patients admitted with # NOF were r and omized to intervention or control group . Self-report question naires compared pre-surgery , post surgery , and follow-up continence status between groups . This pilot r and omized controlled trial , which included 45 eligible patients aged 60 to 93-years , found no evidence that the intervention was effective in reducing prevalence of post-surgery incontinence in this acute setting . Staff surveys highlighted the need for open communication between the research team and hospital staff . Unclear results were attributed to the small sample size . A central outcome was evidence that intervention to improve continence management for  older people post-surgery is imperative . Focused assessment and treatment for those most at risk of incontinence after # NOF would be more acceptable to staff and a more efficient use of re sources . A simple screening tool would ensure that those most at risk are detected , and targeted for care To comprehend the results of a r and omised controlled trial ( RCT ) , readers must underst and its design , conduct , analysis , and interpretation . That goal can be achieved only through total transparency from authors . Despite several decades of educational efforts , the reporting of RCTs needs improvement . Investigators and editors developed the original CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to help authors improve reporting by use of a checklist and flow diagram . The revised CONSORT statement presented here incorporates new evidence and addresses some criticisms of the original statement . The checklist items pertain to the content of the Title , Abstract , Introduction , Methods , Results , and Discussion . The revised checklist includes 22 items selected because empirical evidence indicates that not reporting this information is associated with biased estimates of treatment effect , or because the information is essential to judge the reliability or relevance of the findings . We intended the flow diagram to depict the passage of participants through an RCT . The revised flow diagram depicts information from four stages of a trial ( enrolment , intervention allocation , follow- up , and analysis ) . The diagram explicitly shows the number of participants , for each intervention group , included in the primary data analysis . Inclusion of these numbers allows the reader to judge whether the authors have done an intention- to-treat analysis . In sum , the CONSORT statement is intended to improve the reporting of an RCT , enabling readers to underst and a trial 's conduct and to assess the validity of its results AIMS To investigate whether a nutritional intervention in older women and men with femoral neck fracture had an effect on postoperative complications during hospitalization and on nutritional status at a four-month follow-up . METHODS The design was a r and omized controlled trial . The present study sample consisted of 157 patients aged 70 years and above with femoral neck fracture . The nutritional intervention included , among other things , a nutritional journal to detect nutrition deficiencies and protein-enriched meals for at least four days postoperatively . Further , at least two nutritional and protein drinks were served each day during the whole hospitalization and other factors that would influence the patient 's nutrition were also considered and dealt with . Postoperative complications were registered and patients were assessed using the Mini Nutritional Assessment ( MNA ) scale , including body mass index ( BMI ) , on admission and at a four-month follow-up . RESULTS Malnutrition was common and low MNA scores were associated with postoperative complications such as delirium and decubitus ulcers . There were significantly fewer days of delirium in the intervention group , seven patients in the intervention group developed decubitus ulcers vs. 14 patients in the control group and the total length of hospitalization was shorter . There were no detectable significant improvements regarding nutritional parameters between the intervention and the control group at the four-month follow-up but men improved their mean BMI , body weight and MNA scores in both the intervention and the control groups while women deteriorated in both groups . CONCLUSIONS Malnutrition was common among older people with hip fractures admitted to hospital . The nutritional intervention might have contributed to the patients suffering fewer days with delirium , fewer decubitus ulcers and shorter hospitalization but did not improve the long-term nutritional status , at least not in women . RELEVANCE TO CLINICAL PRACTICE This nutritional intervention , which was included in a multifactorial multidisciplinary intervention , is inexpensive and relatively easy to implement . It has significant effects on complications but no long-term effect on nutritional parameters , at least not in women Abstract Objective : To evaluate the effect of intensive geriatric rehabilitation on demented patients with hip fracture . Design : Preplanned sub analysis of r and omised intervention study . Settting : Jyväskylä Central Hospital , Finl and . Participants : 243 independently living patients aged 65 years or older admitted to hospital with hip fracture . Intervention : After surgery patients in the intervention group ( n=120 ) were referred to the geriatric ward whereas those in the control group were discharged to local hospitals . Main outcome measures : Length of hospital stay , mortality , and place of residence three months and one year after surgery for hip fracture . Results : The median length of hospital stay of hip fracture patients with moderate dementia ( mini mental state examination score 12 - 17 ) was 47 days in the intervention group ( n=24 ) and 147 days in the control group ( n=12 , P=0.04 ) . The corresponding figures for patients with mild dementia ( score 18 - 23 ) were 29 days in the intervention group ( n=35 ) and 46.5 days in the control group ( n=42 , P=0.002 ) . Three months after the operation , in the intervention group 91 % ( 32 ) of the patients with mild dementia and 63 % ( 15 ) of the patients with moderate dementia were living independently . In the control group , the corresponding figures were 67 % ( 28 ) and 17 % ( 2 ) . There were no significant differences in mortality or in the lengths of hospital stay of severely demented patients and patients with normal mini mental state examination scores . Conclusions : Hip fracture patients with mild or moderate dementia can often return to the community if they are provided with active geriatric rehabilitation Background : Exercise is an important strategy with potential to improve recovery in older adults following a hip fracture . Purpose : The purpose of this study was to test the impact of a self-efficacy based intervention , the Exercise Plus Program , and the different components of the intervention , on self-efficacy , outcome expectations , and exercise behavior among older women post-hip fracture . Methods : Participants were r and omized to one of four groups : exercise plus , exercise only , plus only ( i.e. , motivation ) , or routine care . Data collection was done at baseline ( within 22 days of fracture ) , 2 , 6 , and 12 months post-hip fracture . Results : A total of 209 women were recruited with an average age of 81.0 years ( SD=6.9 ) . The majority was White ( 97.1 % ) , was widowed ( 57.2 % ) , and had a high school education ( 66.7 % ) . Generalized Estimating Equations were used to perform repeated measures analyses . No differences in trajectories of recovery were observed for self-efficacy or outcome expectations . A statistically significant difference in the overall trajectory of time in exercise was seen ( p<.001 ) , with more time spent exercising in all three treatment groups . Conclusions : The study demonstrated that it was possible to engage these women in a home-based exercise program and that the plus only , exercise only , and the exercise plus groups all increased exercise OBJECTIVE To investigate the short- and long-term effects of a multidisciplinary postoperative rehabilitation programme in patients with femoral neck fracture . DESIGN AND SUBJECTS A r and omized controlled trial in patients ( n = 199 ) with femoral neck fracture , aged > or= 70 years . METHODS The primary outcomes were : living conditions , walking ability and activities of daily living performance on discharge , 4 and 12 months postoperatively . The intervention consisted of staff education , individualized care planning and rehabilitation , active prevention , detection and treatment of postoperative complications . The staff worked in teams to apply comprehensive geriatric assessment , management and rehabilitation . A geriatric team assessed those in the intervention group 4 months postoperatively , in order to detect and treat any complications . The control group followed conventional postoperative routines . RESULTS Despite shorter hospitalization , significantly more people from the intervention group had regained independence in personal activities of daily living performance at the 4- and 12-month follow-ups ; odds ratios ( 95 % confidence interval ( CI ) ) 2.51 ( 1.00 - 6.30 ) and 3.49 ( 1.31 - 9.23 ) , respectively . More patients in the intervention group had also regained the ability to walk independently indoors without walking aids by the end of the study period , odds ratio ( 95 % confidence interval ) 3.01 ( 1.18 - 7.61 ) . CONCLUSION A multidisciplinary postoperative intervention programme enhances activities of daily living performance and mobility after hip fracture , from both a short-term and long-term perspective Background It is not known whether postoperative occupational therapy is of value for hip fracture patients .In this r and omized trial we evaluated the effects of an individualized , postoperative , occupational training ( OT ) program on the  patient 's self-reported health-related quality of life ( HRQL ) and self-reported abilities to perform activities of daily living ( ADL ) and instrumental activities of daily living ( IADL ) . Patients and methods 100 eligible patients ( aged ≥ 65 years ) were r and omized 50:50 to an OT or control group  ( termed the C group : conventional care ) . The OT group received individualized OT from day 3 or 4 after surgery and until discharge , and also a home visit . The patients answered the Swedish Health-Related Quality of Life question naire ( SWED-QUAL ) and the modified Disability Rating Index ( DRI ) three times : 3–4 days after surgery , at discharge , and at follow-up after 2 months . Results We found no statistically significant differences between the groups at discharge and at follow-up regarding mean SWED-QUAL scores . However , on comparing each group over time , 2 monthsafter the fracture the OT group had regained their self-reported pre-fracture HRQL status in 10 of 12 SWED-QUAL subscales , and the C group in 6 subscales . Statistically significant differences ( p < 0.05 ) were found between the groups after 2 months regarding self-reported IADL ( moving around indoors , performance of light housework , and getting in and out of a car ) . Interpretation Our findings indicate that the individualized occupational training  improved the ability to perform IADL and appeared to speed up the recovery in some HRQL areas Objective : To compare ambulation outcomes between home and institutional rehabilitation of patients with hip fracture . Design : R and omized controlled clinical equivalence trial . Setting : The Queen Elizabeth Hospital in Hong Kong . Subjects : Eighty-one patients with hip fracture . Intervention : Study group patients ( 40 ) were discharged directly home from the acute hospital and visited by a physiotherapist an average of 4.6 times . The control group subjects ( 41 ) were discharged to a rehabilitation centre for further treatment lasting on average 36.2 days ( SD 14.6 ) and they received physiotherapy daily . Main outcome measures : Ambulation ability measured on a categorical scale . Results : The mean age of the subjects was 75 years ( SD 8.3 years ) . Females comprised 60 % of all the subjects and majority were retired or home makers . Both groups of patients improved in their ambulation ability during their rehabilitation period but neither group achieved their pre-ambulatory status by the time of completion of the study . The study group achieved significantly higher ambulation scores ( p < 0.05 ) for community and household ambulation compared with the control group by the end of the study , a year after operation . Conclusion : Five visits by a physiotherapist in the patient 's home after discharge from an acute hospital after surgical treatment for hip fracture yielded better results in ambulation ability than one month of conventional institution-based rehabilitation OBJECTIVE To evaluate the effects of a 3-month home-based physical therapy ( PT ) program for patients with hip fracture after surgery . DESIGN R and omized controlled trial . SETTING Home . PARTICIPANTS Twenty-five patients recently discharged from an acute orthopedic department . INTERVENTIONS Patients were r and omized to the home-based PT group ( n=13 ) , where they received home-based PT 8 times from discharge to month 3 postdischarge , or to the control group ( n=12 ) . The home-based PT program included exercises for muscle strengthening , range of motion ( ROM ) , balance , and functional training . Patients in the control group were instructed to practice the exercise program given at bedside before discharge . MAIN OUTCOME MEASURES Patients were evaluated for hip ROM , strength , walking velocity , Harris hip score , and health-related quality of life ( HRQOL ) at the week of discharge and at 1 , 3 , and 6 months after discharge . RESULTS The baseline characteristics showed no difference between the 2 groups . Harris score of the home-based PT group progressed from 58.6+/-8.5 to 90.1+/-5.4 at month 3 , whereas Harris score of the control group progressed from 54.6+/-14.5 to 77 
    Output:
    
Some outcomes may be amenable to psychosocial treatments ; however , there is insufficient evidence to recommend practice changes .