***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 There is increasing scientific knowledge about the interaction between physiological ( musculoskeletal , neuromuscular , cognitive and sensory ) systems and their influence on balance and walking impairments in Parkinson ’s disease . We have developed a new conceptual framework for balance training , emphasising specific components of balance control related to Parkinson ’s disease symptoms by using highly challenging , progressive and varying training conditions . The primary aim of this proposed r and omised controlled trial will be to investigate the short-term and long-term effects of a 10-week balance training regime in elderly with Parkinson ’s disease . Methods / Design Eighty participants with mild to moderate idiopathic Parkinson ’s disease will be recruited and r and omly allocated to an intervention group receiving balance training or a control group whose participants will continue to receive their usual care . The intervention will consist of a 10-week group training regime ( 1-hour training , three times per week ) , which will be led by two physiotherapists to ensure training progression and safety . The conceptual framework will be applied by addressing specific balance components ( sensory integration , anticipatory postural adjustments , motor agility , stability limits ) through varying training conditions and structured progression . Assessment will be conducted through a multi-dimensional battery of outcomes , prior to and immediately after the 10-week intervention , and at 9 and 15 months ’ follow-up after entering the study . Primary outcome measures will be balance performance ( assessed using the Mini Balance Evaluation Systems Test ) , change in gait velocity ( m/s ) between single and dual task walking , and fear of falling ( evaluated using the Fall Efficacy Scale International ) . Discussion This study has the potential to provide new insight and knowledge of the effects of specific , varied and challenging balance training on a wide health spectrum in elderly with PD . If found to be effective , this pragmatic approach with translation of theory into practice , can be implemented in existing outpatient care . Trial registration 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 - OBJECTIVE The goal of this pilot study was to determine the effects of short duration , intensive tango lessons on functional mobility in people with Parkinson disease . DESIGN This study employed a within-subject , prospect i ve , repeated measures design . SUBJECTS/ PATIENTS Fourteen people with idiopathic Parkinson disease participated . SETTING All balance and gait assessment s were performed in a laboratory , but dance classes took place in a large , open classroom . INTERVENTIONS Participants completed ten 1.5-h long Argentine tango dance lessons within 2 weeks . Their balance , gait and mobility were assessed before and after the training sessions . MAIN OUTCOME MEASURES Measures included the Berg Balance Scale , the Unified Parkinson Disease Rating Scale , gait velocity , functional ambulation profile , step length , stance and single support percent of gait , Timed Up and Go , and the 6 min walk . RESULTS Participants significantly improved on the Berg Balance Scale ( effect size (ES)=0.83 , p=0.021 ) , Unified Parkinson Disease Rating Scale Motor Subscale III ( ES=-0.64 , p=0.029 ) , and percent of time spent in stance during forward walking ( ES=0.97 , p=0.015 ) . Non-significant improvements were noted on the Timed Up and Go ( ES=-0.38 , p=0.220 ) and 6 min walk ( ES=0.35 , p=0.170 ) . CONCLUSIONS Frequent social dance lessons completed within a short time period appear to be appropriate and effective for these individuals with mild-moderately severe Parkinson disease Background and Purpose — Additional exercise therapy has been shown to have a positive impact on function after acute stroke and research is now focusing on methods to increase the amount of therapy that is delivered . This r and omized controlled trial examined the impact of additional family-mediated exercise ( FAME ) therapy on outcome after acute stroke . Methods — Forty participants with acute stroke were r and omly assigned to either a control group who received routine therapy with no formal input from their family members or a FAME group , who received routine therapy and additional lower limb FAME therapy for 8 weeks . The primary outcome measure used was the lower limb section of the Fugl-Meyer Assessment modified by Lindmark . Other measures of impairment , activity , and participation were completed at baseline , postintervention , and at a 3-month follow-up . Results — Statistically significant differences in favor of the FAME group were noted on all measures of impairment and activity postintervention ( P<0.05 ) . These improvements persisted at the 3-month follow-up but only walking was statistically significant ( P<0.05 ) . Participants in the FAME group were also significantly more integrated into their community at follow-up ( P<0.05 ) . Family members in the FAME group reported a significant decrease in their levels of caregiver strain at the follow-up when compared with those in the control group ( P<0.01 ) . Conclusions — This evidence -based FAME intervention can serve to optimize patient recovery and family involvement after acute stroke at the same time as being mindful of available re sources OBJECTIVE To determine the effects of participation in a 2-year community-based dance class on disease severity and functional mobility in people with Parkinson disease ( PD ) . DESIGN R and omized controlled trial . SETTING S/LOCATION Dance classes took place in a community-based location . Outcome measures were collected in a university laboratory . PATIENTS Ten individuals with PD were r and omly assigned to the Argentine tango ( AT ) group ( n=5 [ 4 men ] ; mean age±st and ard deviation , 69.6±6.6 years ) or the control group ( n=5 [ 4 men ] ; mean age±st and ard deviation , 66±11.0 years ) . INTERVENTIONS The AT group participated in a community-based AT class for 1 hour twice weekly for 2 years . Control group participants were given no prescribed exercise . Blinded assessment s occurred at baseline and 12 and 24 months . OUTCOME MEASURES Movement Disorder Society-Unified Parkinson Disease Rating Scale ( MDS-UPDRS ) III , Mini-Balance Evaluation Systems Test ( Mini-BESTest ) , gait velocity ( forward and backward ) , Timed Up and Go and dual-task Timed Up and Go , Six-Minute Walk Test ( 6MWT ) , MDS-UPDRS II , MDS-UPDRS I , and Freezing of Gait Question naire . RESULTS There were no differences between groups at baseline . A significant group-by-time interaction ( F [2,8]=17.59 ; p<0.0001 ) was noted for the MDS-UPDRS III , with the AT group having lower scores at 12 and 24 months than the controls . Significant interactions were also noted for the Mini-BESTest , MDS-UPDRS II and I , and 6MWT . CONCLUSION This is believed to be one of the longest- duration studies to examine the effects of exercise on PD . Participation in community-based dance classes over 2 years was associated with improvements in motor and nonmotor symptom severity , performance on activities of daily living , and balance in a small group of people with PD . This is noteworthy given the progressive nature of PD and the fact that the control group declined on some outcome measures over 2 years OBJECTIVE To determine the effects of a 12-month community-based tango dance program on activity participation among individuals with Parkinson 's disease ( PD ) . DESIGN R and omized controlled trial with assessment at baseline , 3 , 6 , and 12 months . SETTING Intervention was administered in the community ; assessment s were completed in a university laboratory . PARTICIPANTS Volunteers with PD ( n=62 ) enrolled in the study and were r and omized to a treatment group ; 10 participants did not receive the allocated intervention , and therefore the final analyzed sample included 52 participants . INTERVENTIONS Participants were r and omly assigned to the tango group , which involved 12 months of twice-weekly Argentine tango dance classes , or to the no intervention control group ( n=26 per group ) . MAIN OUTCOME MEASURE Current , new , and retained participation in instrumental , leisure , and social activities , as measured by the Activity Card Sort ( with the dance activity removed ) . RESULTS Total current participation in the tango group was higher at 3 , 6 , and 12 months compared with baseline ( Ps≤.008 ) , while the control group did not change ( Ps≥.11 ) . Total activity retention ( since onset of PD ) in the tango group increased from 77 % to 90 % ( P=.006 ) over the course of the study , whereas the control group remained around 80 % ( P=.60 ) . These patterns were similar in the separate activity domains . The tango group gained a significant number of new social activities ( P=.003 ) , but the control group did not ( P=.71 ) . CONCLUSIONS Individuals with PD who participated in a community-based Argentine tango class  reported increased participation in complex daily activities , recovery of activities lost since the onset of PD , and engagement in new activities . Incorporating dance into the clinical management of PD may benefit participation and subsequently quality of life for this population Partnered tango dance can improve balance and gait in individuals with Parkinson ’s disease ( PD ) .  Partnered dance may allow these individuals to challenge balance more than nonpartnered dance . Alternatively , partnered practice could reduce balance gains because the participant may rely on the partner as a balance aid when challenged . The authors compared the effects of partnered and nonpartnered dance on balance and mobility in 39 people ( 11 women ) with mild-moderate PD ( Hoehn and Yahr stages I-III ) . Participants were r and omly assigned to  partnered or nonpartnered tango and attended 1-hour classes twice per week , completing 20 lessons within 10 weeks . Balance and gait were evaluated in the weeks immediately before , immediately after , and 1 month after the intervention . Both groups significantly improved on the Berg Balance Scale , comfortable and fast-as-possible walking velocity , and cadence . Improvements were maintained at the 1-month follow-up . The nonpartnered class improved as much as the partnered class ; however , partnered participants expressed more enjoyment and interest in continuing This study explored the viability and efficacy of integrating cadence-matched , salient music into a walking intervention for patients with Parkinson 's disease ( PD ) . Twenty-two people with PD were r and omised to a  control  ( CTRL , n = 11 ) or  experimental  ( MUSIC , n = 11 ) group . MUSIC subjects walked with an individualised music playlist three times a week for the intervention period . Playlists were design ed to meet subject 's musical preferences . In addition , the tempo of the music closely matched ( ±10–15 bpm ) the subject 's preferred cadence . CTRL subjects continued with their regular activities during the intervention . The effects of training accompanied by “ walking songs ” were evaluated using objective measures of gait score . The MUSIC group improved gait velocity , stride time , cadence , and motor symptom severity following the intervention . This is the first study to demonstrate that music listening can be safely implemented amongst PD patients during home exercise Recent research has shown that dance , specifically tango , may be an appropriate and effective strategy for ameliorating functional mobility deficits in people who are frail and elderly . Individuals with Parkinson 's disease ( PD ) experience declines in functional mobility that may be even more pronounced than those experienced by frail elderly individuals without PD . The purpose of this study was to compare the effects of two movement programs : tango classes or exercise classes .  Nineteen subjects with PD were r and omly assigned to a  tango group or a  group exercise class  representative of the current classes offered in our geographical area for individuals with PD . Subjects completed a total of 
    Output:
    
Consequently , there is a relatively high dem and of planning skills for the leader and the responsiveness to somatosensory cues for the follower .
This finding is important in light of the decline of spatial cognition in neurodegenerative disease ( Possin , 2010 ) .
These interactions resemble those with caregiver-mediated exercises after stroke ( Galvin et al. , 2011 ; Vloothuis et al. , 2014 ) and may improve not only the functional mobility of patients but also decrease feelings of caregiver burden through mechanisms of empowerment and self-management .