***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: Objectives . To evaluate the reporting quality of published r and omized clinical trials ( RCTs ) in the Tai Chi literature following the publication of the CONSORT guidelines in 2001 . Data Sources . The OVID MEDLINE and PUBMED data bases . Review Methods . To survey the general characteristics of Tai Chi RCTs in the literature , we included any report if ( i ) it was an original report of the trial ; ( ii ) its design was RCT ; ( iii ) one of the treatments being tested was Tai Chi ; and ( iv ) it was in English . In addition , we assessed the reporting quality of RCTs that were published between 2002 and 2007 , using a modified CONSORT checklist of 40 items . The adequate description of Tai Chi interventions in these trials was examined against a 10-item checklist adapted from previous review s. Results . The search yielded 31 Tai Chi RCTs published from 2002 to 2007 and only 11 for 1992–2001 . Among trials published during 2002–2007 , the most adequately reported criteria were related to background , participant eligibility and interpretation of the study results . Nonetheless , the most poorly reported items were associated with r and omization allocation concealment , implementation of r and omization and the definitions of period of recruitment and follow-up . In addition , only 23 % of RCTs provided adequate details of Tai Chi intervention used in the trials . Conclusion . The findings in this review indicated that the reporting quality of Tai Chi intervention trials is sub-optimal . Substantial improvement is required to meet the CONSORT guidelines and allow assessment of the quality of evidence . We believe that not only investigators , but also journal editors , review ers and funding agencies need to follow the CONSORT guidelines to improve the st and ards of research and strengthen the evidence base for Tai Chi and for complementary and alternative medicine PURPOSE Tai Chi exercise , an ancient Chinese martial art , has drawn more and more attention for its health benefits . The purpose of the study was to identify the effects of a Sun-style Tai Chi exercise on arthritic symptoms ( joint pain and stiffness ) , motivation for performing health behaviors , and the performance of health behaviors among older women with osteoarthritis . METHODS Total of 72 women with the mean age of 63 years old were recruited from out patients clinic or public health centers according to the inclusion criteria and assigned r and omly to either the Tai Chi exercise group or the control . A Sun-style Tai Chi exercise has been provided three times a week for the first two weeks , and then once a week for another 10 weeks . In 12 weeks of study period , 22 subjects in the Tai Chi exercise group and 21 subjects in the control group completed the posttest measure with the dropout rate of 41 % . Outcome variables included arthritic symptoms measured by K-WOMAC , motivation for health behavior , and health behaviors . RESULTS At the completion of the 12 week Tai Chi exercise , the Tai Chi group perceived significantly less joint pain ( t=-2.19 , p=0.03 ) and stiffness ( t=-2.24 , p=0.03 ) , perceived more health benefits ( t=2.67 , p=0.01 ) , and performed better health behaviors ( t=2.35 , p=0.02 ) , specifically for diet behavior ( t=2.06 , p=0.04 ) and stress management ( t=2.97 , p=0.005 ) . CONCLUSION A Sun-style Tai Chi exercise was found as beneficial for women with osteoarthritis to reduce their perceived arthritic symptoms , improve their perception of health benefits to perform better health behaviors We investigated the effects of a multi-station proprioceptive exercise program on functional capacity , perceived knee pain , and sensoriomotor function . Twenty-two patients ( aged 41 - 75 years ) with grade 2 - 3 bilateral knee osteoarthrosis were r and omly assigned to two groups : treatment ( TR ; n = 12 ) and non-treatment ( NONTR ; n = 10 ) . TR performed 11 different balance/coordination and proprioception exercises , twice a week for 6 weeks . Functional capacity and perceived knee pain during rest and physical activity was measured . Also knee position sense , kinaesthesia , postural control , isometric and isokinetic knee strength ( at 60 , 120 and 180 ° ·s(-1 ) ) measures were taken at baseline and after 6 weeks of training . There was no significant difference in any of the tested variables between TR and NONTR before the intervention period . In TR perceived knee pain during daily activities and functional tests was lessened following the exercise program ( p < 0.05 ) . Perceived knee pain was also lower in TR vs. NONTR after training ( p < 0.05 ) . The time for rising from a chair , stair climbing and descending improved in TR ( p < 0.05 ) and these values were faster compared with NONTR after training ( p < 0.05 ) . Joint position sense ( degrees ) for active and passive tests and for weight bearing tests improved in TR ( p < 0.05 ) and the values were lower compared with NONTR after training ( p < 0.05 ) . Postural control ( ' eyes closed ' ) also improved for single leg and t and em tests in TR ( p < 0.01 ) and these values were higher compared with NONTR after training . The isometric quadriceps strength of TR improved ( p < 0.05 ) but the values were not significantly different compared with NONTR after training . There was no change in isokinetic strength for TR and NONTR after the training period . The results suggest that using a multi-station proprioceptive exercise program it is possible to improve postural control , functional capacity and decrease perceived knee pain in patients with bilateral knee osteoarthrosis . Key PointsIt is possible to improve postural control , functional capacity and decrease perceived knee pain in patients with bilateral knee osteoarthrosis with a pure proprioceptive/ balance exercise program used in the present study .The exercise regime used in the present study was as effective as previous studies , but of much shorter duration and utilized unsophisticated , inexpensive equipment which is available in most physiotherapy departments . Therefore , the incorporation of this exercise program into clinical practice is readily feasible OBJECTIVE The Arthritis , Diet , and Activity Promotion Trial ( ADAPT ) was a r and omized , single-blind clinical trial lasting 18 months that was design ed to determine whether long-term exercise and dietary weight loss are more effective , either separately or in combination , than usual care in improving physical function , pain , and mobility in older overweight and obese adults with knee osteoarthritis ( OA ) . METHODS Three hundred sixteen community-dwelling overweight and obese adults ages 60 years and older , with a body mass index of > or = 28 kg/m(2 ) , knee pain , radiographic evidence of knee OA , and self-reported physical disability , were r and omized into healthy lifestyle ( control ) , diet only , exercise only , and diet plus exercise groups . The primary outcome was self-reported physical function as measured with the Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) . Secondary outcomes included weight loss , 6-minute walk distance , stair-climb time , WOMAC pain and stiffness scores , and joint space width . RESULTS Of the 316 r and omized participants , 252 ( 80 % ) completed the study .  Adherence was as follows : for healthy lifestyle , 73 % ; for diet only , 72 % ; for exercise only , 60 % ; and for diet plus exercise , 64 % . In the diet plus exercise group , significant improvements in self-reported physical function ( P < 0.05 ) , 6-minute walk distance ( P < 0.05 ) , stair-climb time ( P < 0.05 ) , and knee pain ( P < 0.05 ) relative to the healthy lifestyle group were observed . In the exercise group , a significant improvement in the 6-minute walk distance ( P < 0.05 ) was observed . The diet-only group was not significantly different from the healthy lifestyle group for any of the functional or mobility measures . The weight-loss groups lost significantly ( P < 0.05 ) more body weight ( for diet , 4.9 % ; for diet plus exercise , 5.7 % ) than did the healthy lifestyle group ( 1.2 % ) . Finally , changes in joint space width were not different between the groups . CONCLUSION The combination of modest weight loss plus moderate exercise provides better overall improvements in self-reported measures of function and pain and in performance measures of mobility in older overweight and obese adults with knee OA compared with either intervention alone OBJECTIVE To evaluate the effects of isokinetic exercise versus a program of patient education on pain and function in older persons with knee osteoarthritis . DESIGN A r and omized , comparative clinical trial , with interventions lasting 8 weeks and evaluations of 12 weeks . SETTING An outpatient Veterans Affairs Medical Center clinic and an affiliated university hospital . PATIENTS One hundred thirteen men and women between 50 and 80 years old with diagnosed osteoarthritis of the knee ; 98 completed the entire assigned treatment . INTERVENTION Patients received either a regimen of isokinetic exercise of the quadriceps muscle three times weekly over 8 weeks or a series of 4 discussion s and lectures led by health care professionals . MAIN OUTCOME MEASURES Variables studied for change were isokinetic and isometric quadriceps strength , pain and function determined by categorical and visual analog scales , and overall status using physician and patient global evaluations by the Arthritis Impact Scale , version 2 , Western Ontario McMaster 's Arthritis Index , and Medical Outcome Study Short Form 36 . RESULTS Both treatment groups showed significant strength gains ( p < .05 ) , which occurred over a wider velocity spectrum for the exercise group . Exercised patients also had improved pain scores for more of the variables measured than those receiving education . Both groups had positive functional outcomes and slightly improved measures of overall status . CONCLUSIONS Isokinetic exercise is an effective and well-tolerated treatment for knee osteoarthritis , but a much less costly education program also showed some benefits OBJECTIVE To assess the effectiveness of physical therapy , given either as an individually attended treatment or in a small group format , in terms of pain , physical function , and health related quality of life for patients with osteoarthritis ( OA ) of the knee . METHODS After 2 baseline assessment s , 126 patients were r and omized into one of 3 allocation arms : individual treatments ( n = 43 ) , small group format program ( n = 40 ) , and waiting list control ( n = 43 ) . After re assessment at 8 weeks , patients allocated to waiting list control were r and omized into one of the 2 active treatment arms . Assessment s included both self-report measures ( WOMAC , SF-36 ) and objective measures of physical performance ( gait analysis and muscle strength ) . RESULTS Both physical therapy treatment allocations result ed in significant improvements in pain , physical function , and health related quality of life above the control group ( st and ardized response mean 0.36 to 0.65 ) . Improvements in the self-report measures were substantiated by significant correlated improvements in knee extensor strength and fast walking speed ( rho 0.36 - 0.42 ) . There were no significant differences in effectiveness between the 2 physical therapy allocations for any of the measured outcomes . Improvements gained were maintained for at least 2 months . Responsiveness to treatment was modified by loss of medial joint space width , the interaction being significant for physical function , gait , and knee extensor strength . CONCLUSION Physical therapy , either as an individually delivered treatment or in a small group format , is an effective intervention for patients with knee OA . Responsiveness to this 8 week intervention was modified by loss of medial joint space width Objectives To evaluate the effectiveness of two primary care strategies for delivering evidence based care to people aged 55 or over with knee pain :  enhanced pharmacy review and community physiotherapy . Design Pragmatic multicentre r and omised clinical trial . Setting 15 general practice s in North Staffordshire . Participants 325 adults aged 55 years or over ( mean 68 years ) consulting with knee pain ; 297 ( 91 % ) reached six month follow-up . Interventions Enhanced pharmacy review ( pharmacological management in accordance with an algorithm ) ; community physiotherapy ( advice about activity and pacing and an individualised exercise programme ) ; control ( advice leaflet reinforced by telephone call ) . Main outcome measure Change in Western Ontario and McMaster Universities osteoarthritis index ( WOMAC ) at 3 , 6 , and 12 months . Results Mean baseline WOMAC pain score was 9.1 ( SD 3.7 ) , and mean baseline function score was 29.9 ( SD 12.8 ) . At three months , the mean reductions in pain scores were 0.41 ( SD 2.8 ) for control , 1.59 ( 3.2 ) for pharmacy , and 1.56 ( 3.4 ) for physiotherapy ; reductions in function scores were 0.80 ( 8.5 ) , 2.61 ( 9.8 ) , and 4.79 ( 10.8 ) . Compared with control , mean differences in change scores for physiotherapy were 1.15 ( 95 % confidence interval 0.2 to 2.1 ) for pain and 3.99 ( 1.2 to 6.8 ) for function ; those for pharmacy were 1.18 ( 0.3 to 2.1 ) for pain and 1.80 ( −0.8 to 4.5 ) for function . These differences were not sustained to six or 12 months . Significantly fewer participants in the physiotherapy group reported consulting their general pract 
    Output:
    
The main conclusions drawn were : ( i ) despite recommendations for the use of exercise programs as pain therapy in patients with hip and knee osteoarthritis , very few r and omized clinical studies were conducted ; ( ii ) the structure of the exercise programs ( content , duration , frequency and duration of the session ) is very heterogeneous ; ( iii ) on overall , exercise programs based on Tai Chi have better results than mixed exercise programs , but without clear differences