***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: Evidence -based practice involves the use of evidence from systematic review s and r and omised controlled trials , but the extent of this evidence in physiotherapy has not previously been surveyed . The aim of this survey is to describe the quantity and quality of r and omised controlled trials and the quantity of systematic review s relevant to physiotherapy . The Physiotherapy Evidence Data base ( PEDro ) was search ed . The quality of trials was assessed with the PEDro scale . The search identified a total of 2,376 r and omised controlled trials and 332 systematic review s. The first trial was published in 1955 and the first review was published in 1982 . Since that time , the number of trials and review s has grown exponentially . The mean PEDro quality score has increased from 2.8 in trials published between 1955 and 1959 to 5.0 for trials published between 1995 and 1999 . There is a substantial body of evidence about the effects of physiotherapy . However , there remains scope for improvements in the quality of the conduct and reporting of clinical trials To compare the effectiveness of a creative dance and a movement exploration program in relation , to balance performance 26 mildly and moderately mentally retarded boys and girls ( ages 8 to 13 years ) were r and omly assigned to one of the programs . Mean ages of the subjects in the dance and movement exploration groups were 10.5 yr . and 11.1 yr . , respectively . Each group received 24 lessons of 30 min . each , in the 8-wk . program . Pre- and posttest distance on six balance-beam tasks and stabilometer performance subjected to multivariate analysis of covariance indicated no significant differences PURPOSE Maintaining balance in humans involves continuous changes in parameters . The aim of this study was to assess the effect of hippotherapeutic exercises on development of the sense of balance in boys aged 15 to 17 years with mild intellectual disability . METHODS The study examined 50 r and omly chosen boys aged 15 to 17 years with mild intellectual disability from the special education centre in Leżajsk , Pol and . The study participants were divided into two groups : experimental group , who participated for 3 months in hippotherapeutic classes and the control group , with  boys attending outdoor or indoor physical education classes .  Before and after completion of the study , both experimental and control groups were diagnosed by means of Accu SwayPlus force plate . The force plate was used to determine alterations in the position of the centre of pressure ( COP ) on the platform in the frontal and sagittal planes in relaxed st and ing position with feet spread to the shoulder width and with eye control with respect to the base of support ( BOS ) . The description was based on mean displacement of the centre of gravity ( COG ) , mean velocity of displacements of the COG , mean radial displacement and total length of the COP pathway . RESULTS In the experimental group , equestrian exercises induced a series of significant changes that pointed to the improved balance reactions . The character of these changes in the positions analysed was similar : values of body sway in the sagittal plane and their range and mean displacements decreased statistically significantly after training . The same tendency was observed for mean radial displacements in the free open position and with closed support surface . Furthermore , the velocity of displacement and the length of the COP 's projection pathway on the support surface in the free open position was also reduced . All significant changes and trends found for the experimental group , which occurred after 3 month of hippotherapeutic classes , suggest improved parameters of balance . CONCLUSIONS The lack of changes in balance parameters in the control group shows that the hippotherapeutic classes significantly develop balance abilities in boys aged 15 to 17 years with mild intellectual disability [ Purpose ] The aim of this study was to assess the effects of 8 weeks of Wii Fit balance game training on the balance abilities of students with intellectual disabilities . [ Subjects and Methods ] Twenty-four students with intellectual disabilities were selected and r and omly divided into Wii Fit balance game training , physical education , and sedentary activity groups . The Wii Fit balance game training group received two 40-minute Wii Fit balance game training sessions per week for a total of 8 weeks . Kruskal-Wallis one-way analysis of variance and the Wilcoxon signed rank test were used to compare differences . [ Results ] After eight weeks of training , the Wii Fit balance game training group showed significant differences between the pre- and post-training parameters , including the duration of st and ing on one leg with the eyes closed , average anteroposterior movement speed , swing area per unit time , and speed strength index . The physical education group showed significant differences between the pre- and post-training speed strength index values . The sedentary activity group did not show any significant differences between the pre- and post-training parameters . [ Conclusion ] Wii Fit balance game training can improve static balance and lower extremity muscle strength in students with intellectual disabilities Purpose : The Pediatric Balance Scale ( PBS ) , a modification of Berg 's Balance Scale , was developed as a balance measure for school‐age children with mild to moderate motor impairments . The purpose of this study was to determine the test‐retest and interrater reliability of the PBS . Methods : To determine test‐retest reliability , 20 children ( aged five to 15 years ) with known balance impairments were tested by one examiner on the PBS . Ten pediatric physical therapists independently scored 10 r and omly selected videotaped test sessions . Results : There was no significant difference in total test scores [ intraclass correlation coefficient ( ICC ) model 3,1 = 0.998 ] or individual items ( Kappa Coefficients , k = 0.87 to 1.0 ; Spearman Rank Correlation Coefficients , r = 0.89 to 1.0 ) measured by one therapist on two occasions . No significant difference among ratings by different physical therapists was found on the PBS for total test score ( ICC 3,1 = 0.997 ) . Conclusion : The PBS has been demonstrated to have good test‐retest and interrater reliability when used with school‐age children with mild to moderate motor impairments . ( Pediatr Phys Ther 2003;15:114‐128 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 . Quantification of dynamic balance is often necessary to assess a patient 's level of injury or ability to function in order to initiate an appropriate plan of care . Some therapists use the star-excursion test in an attempt to quantify dynamic balance . This test requires the patient to balance on one leg while reaching with the other leg . For the purpose of this study , the reach was performed in four directions . No previous research ers have attempted to evaluate the reliability of this test . Twenty healthy subjects between the ages of 18 and 35 years participated in this study . During two testing sessions , each subject was required to perform five reaching trials in four directions . Reliability estimates , calculated using the intraclass correlation coefficient ( 2 , 1 ) , ranged from 0.67 to 0.87 . Six duplicate practice sessions were suggested to increase this range above 0.86 . Task complexity may account for the moderate reliability estimates . Subjects should engage in a learning period before being evaluated on the star-excursion test The aim of our study was to investigate the effect of a combined strength and proprioception training ( CSPT ) program on muscle strength and postural balance in children with intellectual disability ( ID ) . The maximum voluntary contraction ( MVC ) and postural parameters ( CoPVm , CoPLX , CoPLY ) of 20 children with ID were recorded before and after 8 weeks of a CSPT program . The participants were divided into two groups : an experimental group who attended a CSPT program and a control group who continued with daily activities . In the trained group , the MVC increased significantly ( p<0.001 ) after the training period and the postural parameters decreased significantly in Double-Leg Stance ( DLS ) and One-Leg Stance ( OLS ) during the firm surface condition as well as in the DLS during the foam surface condition ; in both eyes open ( EO ) and eyes closed ( EC ) conditions . A CSPT program improves postural balance in children with ID could be due to the enhancement in muscle strength and proprioceptive input integration The aim of this study was to assess the effects of a hippotherapy program on static balance and strength in adolescents with intellectual disability ( ID ) . Nineteen adolescents with moderate ID were assigned either an experimental group ( n=10 ) or a control group ( n=9 ) . The experimental group attended a 10-week hippotherapy program . To assess static balance , three tasks of increasing difficulty ( Double-Leg Stance with opened or closed eyes , and One-Leg Stance with opened eyes ) were performed while st and ing on an EPS pressure platform ( Loran Engineering S.r . I. , Bologna , Italy ) . The strength measurements consisted of three maximal isometric half-squats from the seating position ( knee joint at 90 ° ) . The hippotherapy intervention program result ed in significant improvements in strength parameters , and on the more complex balance task ( i.e. st and ing on one leg ) . In conclusion , this study provides evidence that hippotherapy can be used as an effective intervention for improving balance and strength in individuals with ID , and could thus influence functional activities and quality of life Balance and motor impairments are most evident among inactive individuals with ID that might be particularly susceptible to a loss of basic functioning and further limit the person 's autonomy in activities of daily living . The aim of the study was to assess the effect of a 12-week trampoline exercise intervention program on motor and balance ability of school aged children with intellectual disability ( ID ) . Eighteen healthy schools aged children ( mean age=10.3 ± 1.6 years ) with moderate ID were assigned either to an experimental group ( n=9 ) or a control group ( n=9 ) . The experiment group attended a 12 weeks trampoline training intervention program consisting of daily individualized 20-min sessions , while the control group followed the regular school  schedule . Balance was assessed using three tasks of increased difficulty ( double-leg stance with eyes opened or closed , and one-leg stance with eyes opened ) performed while st and ing on an electronic pressure platform ( EPS ) . Motor performance of all participants was tested using sit and reach test and long and vertical jump tests all derived from the Eurofit Test Battery of physical fitness . Trampoline intervention result ed in significant improvements of participants ' performance in all motor and balance tests . In conclusion , trampoline training can be an effective intervention for improving functional outcomes and can be recommended as an alternative mode of physical activity programming for improving balance and motor performance . Furthermore , it also supports the idea that individuals with ID require enjoyable and interesting intervention programs such as the trampoline program used in this study so as to remain active and consequently to facilitate their overall development and promote a more active and healthier way of life BACKGROUND Adolescents with intellectual disabilities often present with problems of balance and mobility .  Balance training is an important component of physical activity interventions , with growing evidence that it can be beneficial for people with intellectual disabilities . OBJECTIVE The aim of this study was to investigate the effect of balance training on postural balance , gait , and functional strength in adolescents with intellectual disabilities . METHODS Thirty-two adolescents with intellectual disabilities aged 14 - 19 years were r and omly assigned either to a balance training group ( n = 15 ) or a control group ( n = 16 ) . Subjects in the balance training group underwent balance training for 40 min per day , two times a week , for 8 weeks . All subjects were assessed with posture sway and the one-leg stance test for postural balance ; the timed up- and -go test and 10-m walk test for gait ; and sit to st and test for functional strength . RESULTS Postural balance and functional strength showed significant improvements in the balance training group ( p < 0.05 ) as compared to baseline ; however , postural balance and muscle strength showed no significant improvements in the control group . Further , postural balance and functional strength significantly improved in the balance training group compared with those in the control group . CONCLUSIONS Balance training for adolescents with intellectual disabilities might be beneficial for improving postural balance and functional strength Children with intellectual disability ( ID ) demonstrate lower balance ability which results in substantial delays in motor growth and limits their function level . Psychomotor education comprises a holistic movement approach , with the aim to improve all aspects of each child personality . The aim of this study was to assess the effect of a psychomotor education program on static balance of school-aged children with ID . Twenty children with ID who were 8 - 12 years old participated in the study . They were assigned to 2 groups , 1 experiment and 1 control . The experiment group attended 
    Output:
    
INTERPRETATION The review ed exercise interventions seem to represent an effective means for improving the static and dynamic balance of young people with intellectual disabilities .
WHAT THIS PAPER ADDS Exercise intervention results in large and significant improvements in static and dynamic balance in young people with intellectual disabilities .
Exercise intervention results in a large but non-significant improvement in static-dynamic balance .
Static balance improvement was significantly higher in quasi-experimental versus experimental studies .
Dynamic balance improvement was significantly higher in young people with mild versus mild-moderate intellectual disability .
No significant differences related to age group , balance measures , and components of exercise intervention were found