***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: Regular exercise reduces functional loss associated with multiple sclerosis ( MS ) . However , the impact of exercise on inflammatory mediators associated with disease activity remains relatively unexplored . The purpose of this study was to determine whether ambulatory MS subjects would respond similarly to aerobic cycle training compared with matched controls on circulating immune variables , interleukin (IL)-6 , tumor necrosis factor (TNF)-alpha and interferon (IFN)-gamma .  Eleven MS and 11 non-MS control subjects ( 8 women and 3 men in both groups ) matched in age , height , body mass , body fat , and peak O(2 ) uptake completed the study . Subjects completed 30 min of cycle ergometry at 60 % of peak O(2 ) uptake , 3 day/wk for 8 wk . Plasma cytokine concentrations were determined before and after exercise at weeks 0 , 4 , and 8 . MS and control subjects showed a similar cytokine responses to exercise .  IL-6 at rest tended to decrease ( P = 0.08 ) with training in both groups . Resting plasma TNF-alpha tended to be higher in MS compared with controls throughout the study ( P = 0.08 ) . MS subjects showed elevated resting TNF-alpha in MS at the end of the 8-wk program ( P = 0.04 ) , whereas resting TNF-alpha remained unchanged in controls ( P > 0.05 ) . Resting plasma IFN-gamma at rest was elevated in MS subjects ( P = 0.008 ) and unchanged in controls at the end of the intervention ( P > 0.05 ) . The response of plasma IL-6 , TNF-alpha , and IFN-gamma after a single bout of exercise was similar between MS and control subjects ( P > 0.05 ) . Additional research to underst and the impact of exercise on immune variables in MS is warranted Interleukin-6 ( IL-6 ) is a cytokine that can mediate numerous biological actions including fatigue . Circulating IL-6 increases during prolonged exercise , and furthermore , the signalling receptors sIL-6R and sgp130 are also increased . The variability of the response of these markers to exercise is unknown ; therefore , we examined the changes in these markers to a preloaded time trial bout of running . Nine males performed three identical trials where participants ran at 60 % $ $ v\dot{V}{\text{O } } _ { { 2 { \text{max } } } } $ $ for 2 h interspersed with 30 s at 90 % $ $ v\dot{V}{\text{O } } _ { { 2 { \text{max } } } } $ $ every 10 min , followed by a 5-km time trial . Blood sample s were drawn at baseline , following the 2-h bout , post time trial , 1 h post time trial and the following morning . Results showed that between-subject variability ( CVg ) was greater than within-subject variation ( CVi ) for the three markers . IL-6 , sIL-6R and sgp130 demonstrated a CVi of 15.3–25.5 % , 15.0–17.6 % and 6.2–9.4 % variation , respectively , across the time points . When the data from the second and third trials were analysed independently , CVi was reduced which is supported by the time trial results for which CVi improve ( 4.7–2.4 % ) . In conclusion , the results indicate that a large variation in response to exercise can be reduced following a habituation trial Prolonged strenuous exercise is followed by a temporary functional immune impairment . Low numbers of CD4 + T helper ( Th ) and CD8 + T cytotoxic ( Tc ) cells are found in the circulation . These cells can be divided according to their cytokine profile into type 1 ( Th1 and Tc1 ) , which produce interferon-gamma and interleukin (IL)-2 , and type 2 ( Th2 and Tc2 ) cells , which produce IL-4 . The question addressed in the present study was whether exercise affected the relative balance between the circulating levels of these cytokine-producing T cells .  Nine male runners performed treadmill running  for 2.5 h at 75 % of maximal oxygen consumption . The intracellular expression of cytokines was detected following stimulation with ionomycin and phorbol 12-myristate 13-acetate in blood obtained before , during , and after exercise . The percentage of type 1 T cells in the circulation was suppressed at the end of exercise and 2 h after exercise , whereas no changes were found in the percentage of type 2 T cells . Plasma epinephrine correlated negatively with the percentage of circulating CD8 + T cells producing IL-2 , whereas peak IL-6 correlated with the percentage of CD8 + IL-4-producing T cells in the circulation . Peak plasma IL-6 correlated with plasma cortisol postrunning . In conclusion , the postexercise decrease in T lymphocyte number is accompanied by a more pronounced decrease in type 1 T cells , which may be linked to high plasma epinephrine . Furthermore , IL-6 may stimulate type 2 T cells , thereby maintaining a relatively unaltered percentage of these cells in the circulation compared with total circulating lymphocyte number As interleukin-6 ( IL-6 ) , its soluble receptor ( sIL-6R ) , and the IL-6/sIL-6R complex is transiently elevated in response to prolonged moderate-intensity exercise , this study investigated how these levels would be modulated by an acute bout of high-intensity intermittent ( HIIT ) exercise in comparison to continuous moderate-intensity exercise ( MOD ) . This study also investigated the expression of the differentially spliced sIL-6R ( DS-sIL-6R ) in response to exercise . Eleven healthy males completed two exercise trials matched for external work done ( 582 ± 82 kJ ) . During MOD , participants cycled at 61.8 (2.6)% VO2peak for 58.7 ( 1.9 ) min , while HIIT consisted of ten 4-min intervals cycling at 87.5 (3.4)% $ $ \dot{V}{{\hbox{O}}_{2{\rm{peak } } } } $ $ separated by 2-min rest . Blood sample s were collected pre-exercise , post-exercise , and 1.5 , 6 , and 23 h post-exercise . Plasma IL-6 , sIL-6R , IL-6/sIL-6R complex , and DS-sIL-6R levels were measured by enzyme-linked immunosorbent assay . HIIT caused a significantly greater increase in IL-6 than MOD ( P = 0.018 ) . Both MOD and HIIT result ed in an increase in sIL-6R and IL-6/sIL-6R complex ( P < 0.001 ) , however , this was not significantly different between trials . Soluble IL-6R peaked at 6 h post-exercise in both trials . DS-sIL-6R increased significantly with exercise ( P = 0.02 ) , representing 0.49 % of the total sIL-6R increase . This investigation has demonstrated that the IL-6 response is greater after intermittent high-intensity exercise than comparable moderate-intensity exercise ; however , increased IL-6/sIL-6R complex nor sIL-6R was different between HIIT and MOD . The current study has shown for the first time that elevated sIL-6R after HIIT exercise is derived from both proteolytic cleavage and differential splicing BACKGROUND AND PURPOSE Patients with multiple sclerosis ( MS ) tend to have movement difficulties , and the effect of physiotherapy for this group of patients has been subjected to limited systematic research . In the present study physiotherapy based on the Bobath concept , applied to MS patients with balance and gait problems , was evaluated . The ability of different functional tests to demonstrate change was evaluated . METHOD A single-subject experimental study design with ABAA phases was used , and two patients with relapsing-remitting MS in stable phase were treated . Tests were performed 12 times , three at each phase : A ( at baseline ) ; B ( during treatment ) ; A ( immediately after treatment ) ; and A ( after two months ) . The key feature of treatment was facilitation of postural activity and selective control of movement . Several  performance and self report measures and interviews  were used . RESULTS After intervention , improved balance was shown by the Berg Balance Scale ( BBS ) in both patients , and improved quality of gait was indicated by the Rivermead Visual Gait Assessment ( RVGA ) . The patients also reported improved balance and gait function in the interviews and scored their condition as ' much improved ' . Gait parameters , recorded by an electronic walkway , changed , but differently in the two patients . Among the physical performance tests the BBS and the RVGA demonstrated the highest change , while no or minimal change was demonstrated by the Rivermead Mobility Index ( RMI ) and Ratings of Perceived Exertion ( RPE ) . CONCLUSION The findings indicate that balance and gait can be improved after physiotherapy based on the Bobath concept , but this should be further evaluated in larger controlled trials of patients with MS Low- grade systemic inflammation is suggested to play a role in the development of several chronic diseases including cancer . Higher levels of physical activity and lower adiposity have been associated with reduced levels of markers of systemic inflammation , such as C-reactive protein ( CRP ) ; however , reductions in CRP have not been consistently observed in r and omized controlled trials of exercise . Purpose : To examine the effect of a 12-month aerobic exercise intervention on CRP levels  in men and women . Methods : One hundred two men and 100 women , sedentary and of ages 40 to 75 years , with mean body mass index ( BMI ) of 29.9 and 28.7 kg/m2 , respectively , were r and omly assigned to a 12-month moderate-to-vigorous aerobic exercise intervention ( 6 d/wk , 60 min/d , 60 - 85 % maximum heart rate ) or control group .  Fasting blood sample s were collected at baseline and at 12 months . CRP levels were measured by high-sensitivity latex-enhanced nephelometry . Results : At baseline , CRP was 1.16 and 2.11 mg/L for men and women , respectively , and CRP was correlated with percent body fat ( r = 0.48 , P ≤0.001 ) , BMI ( r = 0.37 , P ≤ 0.001 ) , and aerobic fitness ( r = −0.49 , P ≤ 0.001 ) . No intervention effects were observed for CRP in men or women , or when stratified by baseline BMI ( < 30 versus ≥30 kg/m2 ) , baseline CRP ( <3 versus ≥3 mg/L ) , or change in body weight , body composition , or aerobic fitness . Conclusion : A 12-month moderate-to-vigorous aerobic exercise intervention did not affect CRP levels  in previously sedentary men or women with average-risk CRP values at baseline . ( Cancer Epidemiol Biomarkers Prev 2008;17(7):1714–8 In recent years it has become clear that multiple sclerosis ( MS ) patients benefit from physical exercise as performed in aerobic training but little is known about the effect on functional domains and physiological factors mediating these effects . We studied immunological , endocrine and neurotrophic factors as well as coordinative function and quality of life during an 8-week aerobic bicycle training in a waitlist control design . In the immune-endocrine study ( 1 ) 28 patients were included , the coordinative extension study ( 2 ) included 39 patients .  Training was performed at 60 % VO(2)max after determining individual exertion levels through step-by-step ergometry .  Metabolic ( lactate ) , endocrine ( cortisol , adrendocortico-releasing hormone , epinephrine , norepinephrine ) , immune ( IL-6 , soluble IL-6 receptor ) , and neurotrophic ( brain-derived neurotrophic factor ( BDNF ) , nerve growth factor ( NGF ) ) parameters were compared from a pre study and a post study endurance test at 60 % VO(2)max for 30 min . In study ( 1 ) , lowered lactate levels despite higher workload levels indicated a training effect . Disease-specific quality of life ( as measured by the Hamburg Quality of Life Question naire for Multiple Sclerosis , HAQUAMS ) significantly increased in the training group . No significant training effects were seen for endocrine and immune parameters or neurotrophins . In study ( 2 ) , two out of three coordinative parameters of the lower extremities were significantly improved . In summary , low-level aerobic training in MS improves not only quality of life but also coordinative function and physical fitness Background : There is evidence to support both the use of intravenous methylprednisolone ( IVMP ) in multiple sclerosis ( MS ) relapse and physiotherapy in the management of MS , but no studies have investigated the combination of steroids and rehabilitation together . Objectives : To evaluate the benefits of IVMP with planned , comprehensive multidisciplinary team ( MDT ) care compared to IVMP with st and ard care . Methods : In this r and omised controlled trial , patients confirmed to have had a definite MS relapse severe enough to warrant IVMP ( 1 g daily for three days ) were r and omised to two groups . The control group was managed according to the st and ard ward routine ; the treatment group received planned coordinated multidisciplinary team assessment and treatment . Baseline assessment s , including demographics and Exp and ed Disability Status Scale ( EDSS ) were carried out on both groups . The primary outcome measures were Guy ’s Neurological Disability Scale ( GNDS ) , and Amended Motor Club Assessment ( AMCA ) . The secondary measures were the Barthel Index ( BI ) , Human Activity Profile ( HAP ) , and Short Form Item 36 Health Survey ( SF-36 ) 
    Output:
    
The results revealed that with physical activity there seems to have a modulation on anti-inflammatory cytokines which improve physical and cardiorespiratory performance .
Physical activity influences the quality of life and it seems to stimulate the presence of anti-inflammatory cytokines .
With light physical activity the cellular activity is lower , while with moderate activity there seems to have more capacity to help in the resolution of an inflammatory situation