***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: OBJECTIVE To examine the physical function , gait , and quality of life of patients after total hip replacement ( THR ) r and omly assigned to either a targeted home- or center-based exercise program . DESIGN R and omized controlled trial . SETTING Rehabilitation research center in Australia . PARTICIPANTS Twenty-three patients with unilateral THR were r and omly assigned to a supervised center-based exercise group ( n=11 ) or an unsupervised home-based exercise group ( n=12 ) . INTERVENTION The center-based group completed an 8-week targeted exercise program while under the direct supervision of a physiotherapist . After initial instruction , the home-based group completed the 8-week targeted exercise program at home without further supervision . MAIN OUTCOME MEASURES Quality of life , physical function , and spatiotemporal measures of gait . RESULTS No significant interaction ( group by time ) or main effects of grouping were found . Within each group , quality of life , and stair climbing improved significantly ( P<.05 ) as did Timed Up & Go test and 6-minute walk test performances ( P<.05 ) . Walking speed increased by 16 cm/s ( P<.01 ) , cadence by 8 steps/min ( P<.05 ) , step length by 4.7 cm ( P<.05 ) , and double-support time reduced by a factor of 16 % . Step length symmetry showed significant improvement ( P<.05 ) over time . Step length differential between the affected and unaffected limbs reduced from 4.0 to 2.7 cm . CONCLUSIONS The targeted strengthening program was effective for both the home- and center-based groups . No group differences were found in the majority of the outcome measures . This finding is important because it shows that THR patients can achieve significant improvements through a targeted strengthening program delivered at a center or at home Background and Purpose : Resistance exercise via negative , eccentrically induced work ( RENEW ) has been shown to be associated with improvements in strength , mobility , and balance in multiple clinical population s. However , RENEW has not been reported for individuals with multiple sclerosis ( MS ) . Methods : Nineteen individuals with MS ( 8 men , 11 women ; age mean = 49 ± 11 years ; Exp and ed Disability Status Scale [ EDSS ] mean = 5.2 ± 0.9 ) were r and omized into either st and ard exercise ( ST AND ) or st and ard exercise and RENEW training ( RENEW ) for 3 × /week for 12 weeks . Outcome measures were lower extremity strength ( hip/knee flexion and extension , ankle plantar and dorsiflexion , and the sum of these individual values [ sum strength ] ) ; Timed Up and Go ( TUG ) , 10-m walk , self-selected pace ( TMWSS ) and maximal-pace ( TMWMP ) , stair ascent ( S-A ) and descent ( S-D ) and 6-Minute Walk Test ( 6MWT ) , Berg Balance Scale ( BBS ) , Fatigue Severity Scale ( FSS ) . Results : No significant time effects or interactions were observed for strength , TUG , TMWSS , TMWMP , or 6MWT . However , the mean difference in sum strength in the RENEW group was 38.60 ( representing a 15 % increase ) compared to the sum strength observed in the ST AND group with a mean difference of 5.58 ( a 2 % increase ) . A significant interaction was observed for S-A , S-D , and BBS as the ST AND group improved whereas the RENEW group did not improve in these measures . Discussion and Conclusions : Contrary to results in other population s , the addition of eccentric training to st and ard exercises did not result in significantly greater lower extremity strength gains in this group of individuals with MS . Further this training was not as effective as st and ard exercise alone in improving balance or the ability to ascend and descend stairs . Following data collection , re assessment of required sample size indicates we were likely underpowered to detect strength differences between groups This study was design ed to investigate the effects of vibration on muscle performance and mobility in a healthy , untrained , older population . Forty-three participants ( 23 men , 20 women , 66 - 85 y old ) performed tests of sit-to-st and ( STS ) , 5- and 10-m fast walk , timed up- and -go test , stair mobility , and strength . Participants were r and omly assigned to a vibration group , an exercise-withoutvibration group , or a control group . Training consisted of 3 sessions/wk for 2 mo . After training , the vibration and exercise groups showed improved STS ( 12.4 % , 10.2 % ) , 5-m fast walk ( 3.0 % , 3.7 % ) , and knee-extension strength ( 8.1 % , 7.2 % ) compared with the control ( p < 0.05 ) . Even though vibration training improved lower limb strength , it did not appear to have a facilitatory effect on functional-performance tasks compared with the exercise-without-vibration group . Comparable mobility and performance changes between the experimental groups suggest that improvements are linked with greater knee-extension strength and largely attributed to the unloaded squats performed by both exercise groups Background and Purpose — To evaluate the efficacy of supervised high-intensity progressive resistance training ( PRT ) on lower extremity strength , function , and disability in older , long-term stroke survivors . Methods — Forty-two volunteers aged 50 years and above , 6 months to 6 years after a single mild to moderate stroke , were r and omized into either a control group of upper extremity stretching or a PRT group that received a 12-week supervised high-intensity resistance training program consisting of bilateral leg press ( LP ) , unilateral paretic and nonparetic knee extension ( KE ) , ankle dorsiflexion ( DF ) , and plantarflexion ( PF ) exercises .  Functional performance was assessed using the 6-minute walk , stair-climb time , repeated chair-rise time , and habitual and maximal gait velocities . Self-reported changes in function and disability were evaluated using the Late Life Function and Disability Instrument ( LLFDI ) . Results — Single-repetition maximum strength significantly improved in the PRT group for LP ( 16.2 % ) , paretic KE ( 31.4 % ) , and nonparetic KE ( 38.2 % ) with no change in the control group . Paretic ankle DF ( 66.7 % versus −24.0 % ) , paretic ankle PF ( 35.5 % versus −20.3 % ) , and nonparetic ankle PF ( 14.7 % versus −13.8 % ) significantly improved in the PRT group compared with the control . The PRT group showed significant improvement in self-reported function and disability with no change in the control . There was no significant difference between groups for any performance-based measure of function . Conclusions — High-intensity PRT improves both paretic and nonparetic lower extremity strength after stroke , and results in reductions in functional limitations and disability PURPOSE To examine the effect of progressive resistance training on muscle function , functional performance , balance , body composition , and muscle thickness in men receiving and rogen deprivation for prostate cancer . METHODS Ten men aged 59 - 82 yr on and rogen deprivation for localized prostate cancer undertook progressive resistance training for 20 wk at 6- to 12-repetition maximum ( RM ) for 12 upper- and lower-body exercises in a university exercise rehabilitation clinic . Outcome measures included muscle strength and muscle endurance for the upper and lower body , functional performance ( repeated chair rise , usual and fast 6-m walk , 6-m backwards walk , stair climb , and 400-m walk time ) , and balance by sensory organization test . Body composition was measured by dual-energy x-ray absorptiometry and muscle thickness at four anatomical sites by B-mode ultrasound . Blood sample s were assessed for prostate specific antigen ( PSA ) , testosterone , growth hormone ( GH ) , cortisol , and hemoglobin . RESULTS Muscle strength ( chest press , 40.5 % ; seated row , 41.9 % ; leg press , 96.3 % ; P < 0.001 ) and muscle endurance ( chest press , 114.9 % ; leg press , 167.1 % ; P < 0.001 ) increased significantly after training . Significant improvement ( P < 0.05 ) occurred in the 6-m usual walk ( 14.1 % ) , 6-m backwards walk ( 22.3 % ) , chair rise ( 26.8 % ) , stair climbing ( 10.4 % ) , 400-m walk ( 7.4 % ) , and balance ( 7.8 % ) . Muscle thickness increased ( P < 0.05 ) by 15.7 % at the quadriceps site . Whole-body lean mass was preserved with no change in fat mass . There were no significant changes in PSA , testosterone , GH , cortisol , or hemoglobin . CONCLUSIONS Progressive resistance exercise has beneficial effects on muscle strength , functional performance and balance in older men receiving and rogen deprivation for prostate cancer and should be considered to preserve body composition and reduce treatment side effects The aim of this study was to evaluate the effects of electrical stimulation program on pain , disability , and quadriceps strength in the patients with knee osteoarthritis . Fifty women diagnosed as knee osteoarthritis were r and omized into two groups as electrical stimulation and biofeedback-assisted isometric exercises . Both of the programs were performed 5 days a week , for a duration of 4 weeks . Outcome measures for pain were visual analogue scale pain score and Western Ontario McMaster osteoarthritis index ( WOMAC ) pain score . Disability and stiffness were assessed with WOMAC physical function and stiffness score . One repetition maximum ( RM ) and 10 RM were used for measuring quadriceps strength . In addition , 50 m walking time and 10 steps stairs climbing up-down time were evaluated . Both groups showed significant improvements in pain , physical function , and stiffness scores after the therapy . There were statistically significant improvements in 50 m walking time and 10 steps stairs climbing up-down time and 1 RM and 10 RM values indicating the improvement in muscle strength . In addition , there were no significant differences between the groups after the therapy . We conclude that electrical stimulation treatment was as effective as exercise in knee osteoarthritis and electrical stimulation treatment can be suggested especially for the patients who have difficulty in or contraindications to perform an exercise program BACKGROUND Strength training has been shown to be beneficial in older adults . However , very little data exist on the effects of strength training in older diabetics . METHODS 31 community-dwelling older adults with diabetes ( mean age = 66.1 years ) were r and omly assigned to either an exercise ( EX ) or control ( CO ) group . The EX group trained the plantar flexors , knee extensors , knee flexors , hip extensors , and hip flexors muscle groups at 50 % , 60 % , and 70 % of 1-repetition maximum , 2.6 days a week , for 24 months . Mobility tests included the timed up and go , 50-foot walk , and walking up and down 8 stairs . Strength and mobility for both groups were evaluated at 6-month intervals . RESULTS There was a group and time effect as the EX group increased 31.4 % ( p < .001 ) in strength for all muscle groups after the first 6 months of training , and the strength gains were retained for the duration of the training intervention . There was also a group and time effect for mobility as performance increased 8.6 % and 9.8 % ( p = .032 and p = 0.031 ) for the first 6 and 12 months , respectively , but decreased to 4.6 % above baseline at the end of the intervention . There were essentially no changes from baseline strength or mobility values for the CO group . CONCLUSION In conclusion , these data suggest that a moderate-intensity resistive-training program can improve mobility and strength for the duration of a 24-month intervention in older adults with diabetes , thus potentially reducing the rate of mobility loss during aging OBJECTIVE To examine the effect of a topical cream consisting of cetylated fatty acids on functional performance in patients diagnosed with osteoarthritis ( OA ) of one or both knees . METHODS Forty patients diagnosed with knee OA were r and omly assigned to one of 2 topical treatment groups : ( 1 ) cetylated fatty acid ( CFA )  ( n = 20 ; age 62.7 + /- 11.7 yrs ) ; or ( 2 ) placebo group ( n = 20 ; age 64.6 + /- 10.5 yrs ) . Patients were tested on 3 occasions : ( 1 ) baseline ( T1 ) , ( 2 ) 30 min after initial treatment ( T2 ) , and ( 3 ) after 30-day treatment of cream application twice per day ( T3 ) . Assessment s included knee range of motion ( ROM ) , timed " up- and -go " from a chair and stair climbing , medial step-down test , and the unilateral anterior reach . RESULTS For stair climbing ability and the up- and -go test , significant decreases in time were observed at T2 and T3 compared to T1 in the CFA group only . These differences were significant between groups . Supine ROM of the knees increased at T2 and T3 in CFA group , whereas no difference was observed in the placebo group . For the medial step-down test , significant improvement was observed at T2 and T3 compared to T1 in CFA group . For the unilateral anterior reach , significant improvement was observed for both legs in CFA group and in only the left leg in the placebo group . However , the improvements observed in CFA group 
    Output:
    
Method ologies varied considerably with  stair ascent , stair descent , or a combination of the two being used across a wide range of ages and medical conditions .
Times increased with age for ascent , descent , and combined and for a variety of medical problems .
Timed stair tests  appear to be sensitive to medical conditions but further data are required to obtain normative values for this test .