***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 
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    ***EXAMPLES*** 
    Input: BACKGROUND Intensive exercise training can lead to improvement in strength and functional performance in older people living at home and nursing home residents . There is little information whether intensive physical exercise may be applicable and effective in elderly patients suffering from the acute sequelae of injurious falls or hip surgery . OBJECTIVE To assess the feasibility , safety and efficacy of intensive , progressive physical training in rehabilitation after hip surgery . DESIGN Prospect i ve , r and omised , placebo-controlled intervention study of a 3-months training intervention and a 3-months ' follow-up . SETTING Physical training 6 - 8 weeks after hip surgery . SUBJECTS Twenty-eight ( 15 intervention , 13 control ) elderly patients with a history of injurious falls admitted to acute care or inpatient rehabilitation because of acute fall-related hip fracture or elective hip replacement . METHODS Progressive resistance and functional training to improve strength and functional performance . RESULTS No training-related medical problems occurred in the study group . Twenty-four patients ( 86 % ) completed all assessment s during the intervention and follow-up period . Adherence was excellent in both groups ( intervention : 93 , 0+/-13 , 5 % versus control : 96 , 7+/-6 , 2 % ) . Training significantly increased strength , functional motor performance and balance and reduced fall-related behavioural and emotional problems . Some improvements in strength persisted during 3-months follow-up while other strength variables and functional performances were lost after cessation of training . Patients in the control group showed no change in strength , functional performance and emotional state during intervention and follow-up . CONCLUSIONS Progressive resistance training and progressive functional training are safe and effective methods to increase strength and functional performance during rehabilitation in patients after hip surgery and a history of injurious falls . Because part of the training improvements were lost after stopping the training , a continuing training regime should be established Postoperative length of stay ( LOS ) may be affected by more intensive physical therapy following surgery . This study was design ed to assess whether LOS could be affected by weekend physical therapy following surgery in patients who had undergone total hip arthroplasty ( THA ) or total knee arthroplasty ( TKA ) . Weekend coverage for these patients was made possible by increased staffing in the Physical Therapy Department . The study group consisted of 84 patients who had undergone THA or TKA and had physical therapy treatment the weekend following surgery . The Control group consisted of 53 patients who had undergone THA or TKA prior to the implementation of the weekend intervention program .  A retrospective chart audit was used to obtain pertinent information about control group patients . In the total sample mean LOS following weekend therapy ( 10.84 days ) was significantly different ( p < 0.05 ) from mean LOS prior to implementation of the study ( 12.28 days ) . Significant decreases in postoperative LOS were also found within the two subgroups of patients who had undergone THA and TKA . The results indicate that physical therapy treatment the weekend following THA or TKA significantly decreases postoperative LOS when physical therapy re sources are increased to accommo date this increase in coverage OBJECTIVE To compare treadmill training with partial body-weight support ( TT-BWS ) and conventional physical therapy ( PT ) in ambulatory patients with hip arthroplasty . DESIGN R and omized controlled trial . SETTING Rehabilitation center . PARTICIPANTS Eighty patients with a fully loadable implant who could walk independently with crutches after unilateral total hip arthroplasty were r and omized to receive either TT-BWS ( treatment group ) or conventional PT ( controls ) , for 10 working days . INTERVENTIONS Each patient received 45 minutes of individualized PT , either treadmill training plus PT in the experimental or PT alone in the control group . MAIN OUTCOME MEASURES The Harris score , recorded by blind assessors , served as the primary outcome measure . Secondary outcome measures were the hip extension deficit , gait velocity , gait symmetry , affected hip abductor power ; hip abductor amplitude of electromyographic activation ; and the interval from surgery to ab and oning crutches . RESULTS At the end of training , the treatment group 's Harris score was 13.6 points higher ( P<.0001 ) than the control group 's score . Further , hip extension deficit was 6.8 degrees less ( P<.0001 ) , gait symmetry was 10 % greater ( P=.001 ) , affected hip abductor was stronger ( Medical Research Council grade s 4.24 vs 3.73 ; P<.0001 ) , and the amplitude of gluteus medius activity was 41.5 % greater ( P=.001 ) than those measures for controls . Gait velocity did not differ in the 2 groups . These significant differences in favor of the treatment group persisted at 3 and 12 months . The treatment group ab and oned crutches sooner than the control group ( 3 vs 8wk ) . In the treatment group , 39 patients finished treatment , 35 appeared at 3 , and 26 at 12 months for follow-up . In the control group , the corresponding numbers were 40 , 35 , and 24 patients , respectively . CONCLUSION TT-BWS is more effective than conventional PT at restoring symmetrical independent walking after hip replacement The ability to develop muscle force rapidly may be a very important factor to prevent a fall and to perform other tasks of daily life . However , information is still lacking on the range of training-induced neuromuscular adaptations in elderly humans recovering from a period of disuse . Therefore , the present study examined the effect of three types of training regimes after unilateral prolonged disuse and subsequent hip-replacement surgery on maximal muscle strength , rapid muscle force [ rate of force development ( RFD ) ] , muscle activation , and muscle size .  Thirty-six subjects ( 60 - 86 yr ) were r and omized to a 12-wk rehabilitation program consisting of either 1 ) strength training ( 3 times/wk for 12 wk ) , 2 ) electrical muscle stimulation ( 1 h/day for 12 wk ) , or 3 ) st and ard rehabilitation ( 1 h/day for 12 wk ) . The nonoperated side did not receive any intervention and thereby served as a within-subject control . Thirty subjects completed the trial . In the strength-training group , significant increases were observed in maximal isometric muscle strength ( 24 % , P < 0.01 ) , contractile RFD ( 26 - 45 % , P < 0.05 ) , and contractile impulse ( 27 - 32 % , P < 0.05 ) . No significant changes were seen in the two other training groups or in the nontrained legs of all three groups . Mean electromyogram signal amplitude of vastus lateralis was larger in the strength-training than in the st and ard-rehabilitation group at 5 and 12 wk ( P < 0.05 ) . In contrast to traditional physiotherapy and electrical stimulation , strength training increased muscle mass , maximal isometric strength , RFD , and muscle activation in elderly men and women recovering from long-term muscle disuse and subsequent hip surgery . The improvement in both muscle mass and neural function is likely to have important functional implication s for elderly individuals This preliminary study examined , in a restricted r and omized trial , the effects of a 6-week arm-crank rehabilitation training program in elderly osteoarthrosis patients after total hip arthroplasty , first on physiological and perceptual responses and second on physical function . Two groups of patients were studied : a training group ( N = 7 , mean age = 74.9 yr , st and ard deviation [ SD ] = 5.0 yr ) who followed a training program in addition to traditional rehabilitation , and a control group who followed traditional rehabilitation only ( N = 7 mean age = 75.4 yr , SD = 5.1 yr ) . At the beginning of the training program , the heart rate and the perceived exertion were not significantly correlated during the exercise session . However , at the end of the training program , five patients had a significant heart rate/perceived exertion relationship ( p < 0.05 ) . Furthermore , positive effects of the arm-crank rehabilitation training program were observed on cardioventilatory and functional responses in the training group compared with the control group . These results suggest that after an habituation period , most of our elderly osteoarthrosis patients experienced physical sensations that were connected to physiological responses . Therefore , perceived exertion could be useful in these patients to regulate exercise intensity , especially at the end of and after the rehabilitation period To determine the effect of minimal exercise on functional fitness following total hip replacement in elderly women , 20 women ( 13 exercisers , 7 controls ) who had undergone unilateral or bilateral hip replacement surgery for primary osteoarthritis were studied . An exercise treadmill test with respiratory gas and blood lactate analyses , and a field test of walking speed on a measured course , were administered before and after a twice weekly exercise programme of three months ' duration . Markers of cardiorespiratory fitness , including peak achieved oxygen uptake ( VO2 ) and ventilatory and lactate thresholds were measured . Maximum self-selected walking speed was also measured over a flat course . Peak VO2 increased in the exercise group when compared to baseline ( P < 0.05 ) but did not differ from the control group . The exercise group significantly improved their walking speed by 10.1 % compared with non-exercising controls ( 1.41 vs 1.20 m/sec , P < 0.05 ) , and increased VO2 at lactate threshold . The improvements occurred despite the twice weekly exercise sessions being below the recommended frequency of exercise for improving cardiorespiratory fitness .  Minimal exercise in elderly women after hip surgery can substantially improve submaximal exercise capacity , as well as walking speed Providing physical therapy service on Sundays is a much debated topic among hospital administrators . The purpose of this study was to determine if 7 days per week of physical therapy coverage results in shorter lengths of stay and differing discharge status than 6 days per week . A total of 140 subjects with hip or knee arthroplasty participated ; there were 80 in the 6-day groups and 60 in the 7-day groups . Data on postoperative length of stay , discharge destination , and discharge disposition were collected by retrospective medical record review . The Mann-Whitney U test was used to test for differences in length of stay data , and the chi-squared test was used to test for differences in discharge disposition and discharge destination . No significant differences in postoperative length of stay , discharge destination , nor discharge disposition existed between the 6- and 7-day physical therapy coverage hip or knee arthroplasty groups . However , the power of the statistical tests applied was low . This study provides no evidence that 7-day per week physical therapy results in shortened postoperative length of stay , differing discharge destination , nor differing discharge disposition for patients undergoing hip or knee arthroplasty OBJECTIVE To investigate the influence of an arm-interval exercise program for the upper limbs on health status and walking ability in elderly patients after total hip arthroplasty . DESIGN A r and omized controlled investigation . After surgery , a control group started a general rehabilitation program , and a training group combined it with an arm-interval exercise program . SUBJECTS Fourteen patients ( age 75.1 + /- 4.8 years ) were r and omly assigned to the control group ( n = 7 ) and the training group ( n = 7 ) . METHODS A Western Ontario and MacMaster University ( WOMAC ) Osteoarthritis Index was completed and an incremental exercise test on an arm crank ergometer was also performed 1 month before ( T(-1 ) ) and 2 months after surgery ( T2 ) . Moreover , a 6-minute  walk test was performed at T2 . RESULTS Both groups significantly improved all dimensions of WOMAC , except in WOMAC physical function subscale in the control group . The training group covered a significantly longer distance in the walking test than the control group and also presented significantly higher VO2 peak value at T2 . Correlation analyses indicate that VO2 peak value and the distance covered in the 6-minute walking test were significantly associated with functional status . After calculating the ratio distance covered/score at WOMAC physical function , we observed a significantly higher ratio value in the training group than in the control group . CONCLUSION Preliminary results indicate that the improvement in physical fitness and functional status of the training group seems to be associated with better health status Organized physiotherapy starting two months after uncomplicated total hip replacements for primary arthrosis did not improve the rehabilitation . Six months after surgery there were no significant differences between 14 patients with and 16 patients without physiotherapy regarding improvement of passive hip motion , or hip or knee muscle strength of the operated limb . Neither were there any differences in walking ability or activities of daily living OBJECTIVE To assess the efficacy of a home exercise program in increasing hip muscle strength , walking speed , and function in patients more than 1.5 years after total hip replacement ( THR ) . DESIGN R and omized controlled trial . SETTING Kinesiology laboratory . PARTICIPANTS Fifty-three patients with unilateral THR were r and omly assigned to the training ( n=26 ) and control ( n=27 ) groups . Patients in the training group were further divided into exercise-high ( n=13 ) and exercise-low ( n=13 ) compliance groups according to their practice ratio ( high , > or = 50 % ) . INTERVENTION The training group underwent a 12-week home program that included hip flexion range of motion exercises for both hip joints ; strengthening exercises for bilateral hip flexors , extensors , and abductors ; and a 30-minute walk every day . The control group did not receive any training . MAIN OUTCOME MEASURES Strength of bilateral hip muscles , free and fast walking speeds while walking over 3 different terrains , and functional performance were assessed by using a dynamometer , videotape analysis , and the functional activity part of 
    Output:
    
Results indicate that physiotherapy exercise after discharge following total hip replacement has the potential to benefit patients .
Conclusion Insufficient evidence exists to establish the effectiveness of physiotherapy exercise following primary hip replacement for osteoarthritis .