***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: Context Osteogenesis imperfecta ( OI ) is associated with reduced muscle size , dynamic muscle function , and mobility . Objective To assess the effect of whole body vibration ( WBV ) on bone density and geometry , muscle size and function , mobility , and balance in children with OI . Design R and omized controlled pilot trial . Setting Tertiary pediatric research center . Participants Twenty-four children ( 5 to 16 years ) with OI types 1 , 4 , and limited mobility [ Child Health Assessment Question naire ( CHAQ ) score ≥ 0.13 ] recruited in sex- and pubertal stage-matched pairs . Incident fractures in two boys ( WBV arm ) led to exclusion of two prepubertal pairs . Intervention Five months of WBV training ( 3 × 3 minutes twice daily ) or regular care . Main Outcome Measures Bone and muscle variables measured by dual-energy X-ray absorptiometry ( spine , hip , total body ) and peripheral quantitative computed tomography ( tibia ) . Mobility assessed by 6-minute walk tests and CHAQ ; dynamic muscle function by mechanography . Results All participants had reduced walking distances and muscle function ( P < 0.001 ) . Body mass index z score was associated with higher CHAQ scores ( ρ + 0.552 ; P = 0.005 ) and lower walking and two-leg jumping performance ( ρ - 0.405 to -0.654 , P < 0.05 ) . The WBV and control groups did not differ in the 5-month changes in bone . Total lean mass increased more in the WBV group [ + 1119 g ( + 224 to + 1744 ) ] compared with controls [ + 635 g ( -951 to + 1006 ) ] , P = 0.01 , without improving mobility , muscle function , or balance . Conclusions The increase in lean mass without changes in muscle function or bone mass suggests reduced biomechanical responsiveness of the muscle-bone unit in children with OI Background and Purpose : Infants with Down syndrome ( DS ) are consistently late walkers . The purpose of this investigation was to test the effects of individualized , progressively more intense treadmill training on developmental outcomes in infants with DS . Subjects : Thirty infants born with DS were r and omly assigned to receive lower-intensity , generalized treadmill training or higher-intensity , individualized training implemented by their parents in their homes . Methods : Research staff members monitored implementation of training , physical growth , and onset of motor milestones of all infants on a monthly basis . Results : Infants in the higher-intensity , individualized training group increased their stepping more dramatically over the course of training . Infants in the higher-intensity training group attained most of the motor milestones at an earlier mean age . Discussion and Conclusion : Treadmill training of infants with DS is an excellent supplement to regularly scheduled physical therapy intervention for the purpose of reducing the delay in the onset of walking INTRODUCTION Whole-body vibration exposure may translate into improved bone mass in young adult women . The primary focus of this study was to examine the effects of grade d whole-body vibration or vibration exposure plus resistance training on bone mineral density ( BMD ) , hematological measures for bone remodeling , and exercise metabolism in young women . METHODS There were 51 healthy active women [ mean ( SD ) age , 21.02 ( 3.39 ) yr ; height , 165.66 ( 6.73 ) cm ; body mass 66.54 ( 13.39 ) kg ] who participated in the intervention . Subjects were r and omly assigned to whole-body vibration ( WBV ) , whole-body vibration plus resistance training ( WBV+RT ) , or control ( CONT ) groups for 16 wk . RESULTS A repeated-measure ANOVA found no significant ( P < 0.05 ) group differences in BMD at the completion of 16 wk . A significant within group change was apparent for the WBV ( 2.7 % femoral neck ) and WBV+RT ( femoral neck 1.9 % ; vertebra 0.98 % ) . WBV and WBV+RT experienced a significant ( P < 0.05 ) 60 % and 58 % increase in adiponectin , 48 % and 30 % in transforming growth factor-beta1 , and 17 % and 34 % in nitric oxide with an accompanying 50 % and 36 % decrease in osteopontin , 19 % and 34 % in interleukin-1beta , and 38 % and 39 % in tumor necrosis factor-alpha . CONCLUSIONS The results indicate grade d whole-body vibration exposure may be effective in improving BMD by increasing bone deposition while also decreasing bone resorption . Whole-body vibration may also provide an efficient stratagem for young women to achieve peak bone mass and help stave off osteoporosis later in life and provide a novel form of physical training Summary Adolescents with Down syndrome ( DS ) have poorer bone health than their peers without DS . Twenty-five adolescents with DS were r and omly assigned to whole-body vibration training ( WBV ) or control groups . The results indicate that a 20-week WBV might be useful to improve subtotal bone mineral content and density in adolescents with DS . Introduction This study aims to determine the effects of 20 weeks of whole body vibration training ( WBV ) on bone mineral content ( BMC ) , density ( BMD ) , and structure variables in adolescents with Down syndrome ( DS ) . Methods This r and omized controlled trial of 25 adolescents ( 12–18 years ) with DS ( 8 females ) generated 2 non-equal groups , WBV group ( n = 11 ) and CON group ( n = 14 ) . Using an efficacy analysis , the primary outcomes were BMC and BMD by dual-energy X-ray absorptiometry and the secondary were bone structure variables by peripheral quantitative computed tomography . A synchronous vibration platform ( PowerPlate ® ) was used ( 3/week , 10 repetitions ( 30–60 s ) 1-min rest , frequency of 25–30 Hz , and peak-to-peak displacement of 2 mm ( peak acceleration 2.5–3.6 g ) ) . Results WBV group improved whole body BMC 2.8 % , 95 % CI [ 3.5 , 2.1 ] , subtotal area , BMC , and BMD by 2.8 , 4.8 , and 2 % , respectively , 95 % confidence intervals ( CIs ) [ 3.4 , 2.1 ] , [ 6.5 , 3.1 ] , and [ 2.8 , 1.1 ] , respectively ( all , p < 0.05 ) , showing group by time interactions in BMC and BMD ( both p < 0.05 ) . Lumbar spine BMC and BMD also increased in the WBV group by 6.6 and 3.3 % both p < 0.05 , 95 % CIs [ 8.6 , 4.7 ] , and [ 4.9 , 1.7 ] , respectively . Regarding bone structure , WBV group showed improvements in tibial BMC at 4 % ( 2.9 % , 95 % CI [ 3.0 , 2.8 ] ) and in volumetric BMD ( vBMD ) , cortical vBMD , and cortical thickness at 66 % of the radius ( by 7.0 , 2.4 , and 10.9 % ; 95 % CIs [ 7.4 , 6.7 ] , [ 2.6 , 2.3 ] , and [ 12.4 , 9.3 ] , respectively ) ( all , p < 0.05 ) . Conclusions A 20-week WBV , with this protocol , might be useful to improve subtotal BMC and BMD in adolescents with DS Objective The purpose of this study was to determine whether whole-body vibration training could improve st and ing balance and muscle strength in children with Down syndrome . Design This study was a r and omized controlled trial study ing 30 children ( 8–10 yrs old ) with Down syndrome . They were assigned r and omly using sealed envelopes , with 15 children allocated to the control group ( 9 boys , 6 girls ) and another 15 children allocated to the study group ( 8 boys , 7 girls ) . The control group received a design ed physical therapy program , whereas the study group received the same program given to the control group in addition to whole-body vibration training . Both groups received the treatment sessions three times per week for 6 successive months . Measurement of stability indices by using the Biodex Stability System as well as muscle strength of the knee flexors and extensors by using a h and held dynamometer was done before and after the 6 mos of the treatment program . Results Each group demonstrated significant improvements in stability indices and muscle strength after treatment ( P < 0.05 ) , with significantly greater improvements seen in the study group when compared with the control group ( P < 0.05 ) . Conclusions Whole-body vibration may be a useful intervention modality to improve balance and muscle strength in children with Down syndrome Objective : To evaluate the effect of whole body vibration on the mobility of long-term immobilized children and adolescents with a severe form of osteogenesis imperfecta . Osteogenesis imperfecta is a hereditary primary bone disorder with a prevalence from 1 in 10000 to 1 in 20000 births . Most of these children are suffering from long-term immobilization after recurrent fractures . Due to the immobilization they are affected by loss of muscle ( sarcopenia ) and secondary loss of bone mass . Subjects : Whole body vibration was applied to eight children and adolescents ( osteogenesis imperfecta type 3 , N=5 ; osteogenesis imperfecta type 4 , N=3 ) over a period of six months . Interventions and results : Whole body vibration was applied by a vibrating platform ( Galileo Systems ) constructed on a tilting-table . Success of treatment was assessed by measuring alterations of the tilting-angle and evaluating the mobility ( Brief Assessment of Motor Function ) . All individuals were characterized by improved muscle force documented by an increased tilting-angle ( median = 35 degrees ) or by an increase in ground reaction force ( median at start=30.0 [ N/kg ] ( 14.48—134.21 ) ; median after six months = 146.0 [ N/kg ] ( 42.46—245.25 ) . Conclusions : Whole body vibration may be a promising approach to improve mobility in children and adolescents severely affected with osteogenesis imperfecta BACKGROUND AND PURPOSE Assessment of the quality of r and omized controlled trials ( RCTs ) is common practice in systematic review s. However , the reliability of data obtained with most quality assessment scales has not been established . This report describes 2 studies design ed to investigate the reliability of data obtained with the Physiotherapy Evidence Data base ( PEDro ) scale developed to rate the quality of RCTs evaluating physical therapist interventions . METHOD In the first study , 11 raters independently rated 25 RCTs r and omly selected from the PEDro data base . In the second study , 2 raters rated 120 RCTs r and omly selected from the PEDro data base , and disagreements were resolved by a third rater ; this generated a set of individual rater and consensus ratings . The process was repeated by independent raters to create a second set of individual and consensus ratings . Reliability of ratings of PEDro scale items was calculated using multirater kappas , and reliability of the total ( summed ) score was calculated using intraclass correlation coefficients ( ICC [ 1,1 ] ) . RESULTS The kappa value for each of the 11 items ranged from.36 to.80 for individual assessors and from.50 to.79 for consensus ratings generated by groups of 2 or 3 raters . The ICC for the total score was.56 ( 95 % confidence interval=.47-.65 ) for ratings by individuals , and the ICC for consensus ratings was.68 ( 95 % confidence interval=.57-.76 ) . DISCUSSION AND CONCLUSION The reliability of ratings of PEDro scale items varied from " fair " to " substantial , " and the reliability of the total PEDro score was " fair " to " good . 
    Output:
    
The studies included in this systematic review showed that WBV training has positive effects on bone mineral density ( BMD ) , body composition and balance .