***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 
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    ***EXAMPLES*** 
    Input: OBJECTIVES To determine the immediate effects of applied forearm Kinesio taping on maximal grip strength and force sense of healthy collegiate athletes . DESIGN Single group , repeated measures study . SETTING Clinical sports medicine laboratory at a university hospital . PARTICIPANTS Twenty-one healthy collegiate athletes voluntarily participated in this study . All subjects were male ( average height : 181.24 ± 7.60 cm ; average body weight : 72.86 ± 7.03 kg ; average age : 20.86 ± 2.59 years ) . MAIN OUTCOME MEASURES First , maximal grip strength of the dominant h and was assessed by h and -held dynamometer . Then , 50 % of maximal grip strength was established as the reference value of force sense . Absolute and related force sense errors and maximal grip strength were measured under three conditions : ( 1 ) without taping ; ( 2 ) with placebo taping ; and ( 3 ) with Kinesio taping . RESULTS Results revealed no significant differences in maximal grip strength between the three conditions ( p = 0.936 ) . Both related and absolute force sense errors in grip strength measurements significantly increased the accuracy of the results under the three conditions ( related force sense errors : p < 0.05 ; absolute force sense errors : p < 0.05 ) . CONCLUSION Forearm Kinesio taping may enhance either related or absolute force sense in healthy collegiate athletes .  However , Kinesio taping did not result in changes in maximal grip strength in healthy subjects STUDY DESIGN Prospect i ve , r and omized , double-blinded , clinical trial using a repeated- measures design . OBJECTIVES To determine the short-term clinical efficacy of Kinesio Tape ( KT ) when applied to college students with shoulder pain , as compared to a sham tape application . BACKGROUND Tape is commonly used as an adjunct for treatment and prevention of musculoskeletal injuries . A majority of tape applications that are reported in the literature involve nonstretch tape . The KT method has gained significant popularity in recent years , but there is a paucity of evidence on its use . METHODS AND MEASURES Forty-two subjects clinical ly diagnosed with rotator cuff tendonitis/impingement were r and omly assigned to 1 of 2 groups : therapeutic KT group or sham KT group . Subjects wore the tape for 2 consecutive 3-day intervals . Self-reported pain and disability and pain-free active ranges of motion ( ROM ) were measured at multiple intervals to assess for differences between groups . RESULTS The therapeutic KT group showed immediate improvement in pain-free shoulder abduction ( mean + /- SD increase , 16.9 degrees + /- 23.2 degrees ; P = .005 ) after tape application . No other differences between groups regarding ROM , pain , or disability scores at any time interval were found . CONCLUSION KT may be of some assistance to clinicians in improving pain-free active ROM immediately after tape application for patients with shoulder pain . Utilization of KT for decreasing pain intensity or disability for young patients with suspected shoulder tendonitis/impingement is not supported . LEVEL OF EVIDENCE Therapy , level 1b- Although elevation of the upper limb is considered valuable for the prevention and of the reduction of swelling following major surgery or severe injuries to the h and , it is not clear how much elevation , if any , is required following minor surgery such as carpal tunnel decompression . We investigated this by r and omizing patients undergoing carpal tunnel decompression into two groups – one having high elevation at home and one being treated with a simple sling .  Volumetric analysis of the swelling of the h and 5 days postoperatively showed no significant difference between the two groups . In the trial group , the mean increase in volume of the operated h and was 11 ml ( 95 % CI + 4 to + 17 ) or 2.7 % . In the control group , the mean swelling was 13 ml ( 95 % CI + 4 to + 21 ) or 3.6 % . The findings of this study do not support the use of routine high arm elevation following day-case surgery of the h and Abstract Objective : The purpose of the study was to evaluate the efficacy of Kinesio Tape ( Kinesio USA , Albequerque , NM ) for reducing h and edema in individuals with hemiplegia post stroke . Methods : Seventeen individuals who experienced acute stroke were screened for visual signs of edema and were r and omly assigned to experimental and control groups . The experimental group received Kinesio Tape that was applied to h and and forearm for 6 days in combination with st and ard therapy ; the control group received st and ard therapy . Blinded raters assessed edema reduction via circumferential measurements . Results : Application of Kinesio Tape did not result in statistically significant reduction in edema . Large and medium effect sizes were seen for edema reduction at the metacarpophalangeal and wrist joints , respectively , with Kinesio Tape . Conclusion : Further research is warranted to investigate the utility of Kinesio Tape in edema reduction The CONSORT ( Consoli date d St and ards of Reporting Trials ) statement is used worldwide to improve the reporting of r and omized , controlled trials . Schulz and colleagues describe the latest version , CONSORT 2010 , which up date s the reporting guideline based on new method ological evidence and accumulating experience . Objective : To describe the components used in the practice of occupational therapy and physiotherapy for people with stroke and to examine variability between services . Design : A time-sampling strategy in which therapists recorded their face-to-face interventions with stroke patients during 12 weeks over a total of 17 months . Setting s and subjects : Six occupational therapists and seven physiotherapists from four services ( three day hospitals and one domiciliary stroke rehabilitation service ) recorded interventions with 89 stroke patients recruited to a larger r and omized controlled trial . Main outcome measures : Frequencies of use of interventions , together with other details about delivery of therapy , were recorded using a data collection booklet and coding system design ed by the participating therapists . Results : The median treatment time for a session was 45 minutes . The most frequently recorded components of physiotherapy intervention were ‘ walking ’ , ‘ st and ing balance ’ and ‘ upper limb movement pattern ’ , and of occupational therapy ‘ physical function ’ , ‘ social and leisure activities ' and ‘ other ’ . There was variability between the services in terms of median treatment time , use of intervention codes , frequency of treatment sessions , amount of time spent working with assistance and amount of group work . Conclusions : The findings support the view that occupational therapy and physiotherapy with people with stroke are not homogeneous activities , and vary between therapists and services . Recommendations include further development of the tool , and use of other method ologies to explore the process and nature of stroke rehabilitation Background The grading of recommendation , assessment , development and evaluation ( GRADE ) approach is widely implemented in health technology assessment and guideline development organisations throughout the world . GRADE provides a transparent approach to reaching judgements about the quality of evidence on the effects of a health care intervention , but is complex and therefore challenging to apply in a consistent manner . Methods We developed a checklist to guide the research er to extract the data required to make a GRADE assessment . We applied the checklist to 29 meta-analyses of r and omised controlled trials on the effectiveness of health care interventions . Two review ers used the checklist for each paper and used these data to rate the quality of evidence for a particular outcome . Results For most ( 70 % ) checklist items , there was good agreement between review ers . The main problems were for items relating to indirectness where considerable judgement is required . Conclusions There was consistent agreement between review ers on most items in the checklist . The use of this checklist may be an aid to improving the consistency and reproducibility of GRADE assessment s , particularly for inexperienced users or in rapid review s without the re sources to conduct assessment s by two research ers independently The purpose of this study was to evaluate the efficacy of the use of neuromuscular stimulation (NMS)-induced contraction of the paralyzed muscles to produce an active muscle pump for removing excess fluid and compare its effect with elevation of the upper extremity . The effects of 30 minutes of NMS of the finger and wrist flexors and extensors were compared with the effects of 30 minutes of limb elevation alone . Each of eight cerebrovascular accident ( CVA ) patients with visible h and edema received both treatments , one on each of 2 consecutive days . Measures of h and and arm volume and upper and lower arm girth were taken before and after each treatment . Analyses comparing mean percentage change scores for both treatments showed large and significant treatment effects for all dependent measures . The finding suggests that NMS was more effective for reduction of h and edema than limb elevation alone for this sample of eight CVA patients OBJECTIVE To evaluate the efficacy of intermittent pneumatic compression in treating oedema in the hemiplegic h and of stroke patients . DESIGN Single-blind r and omized control trial . SETTING acute and rehabilitation elderly care wards in a teaching district . SUBJECTS 37 Subjects with a first ever hemisphere stroke were r and omized to treatment with st and ard physiotherapy either alone or combined with intermittent pneumatic compression . MAIN OUTCOME MEASURES The effect of treatment on oedema was assessed using measures of the h and volume of the hemiplegic h and . The impact on function was assessed using the motricity index . RESULTS The treated group showed no change in the mean stroke h and volume . In the control group the mean stroke h and volume decreased by 3.2 ml . There was no statistically significant difference between the groups . The median scores for the motricity index increased for both groups but there was no significant difference between the groups and any improvement in motor function was independent of any treatment effects . CONCLUSION Intermittent pneumatic compression at the prescribed pressure and duration of this study is not an effective treatment for the oedematous stroke h and Purpose Cryotherapy and compression as integral part of the RICE regimen are thought to improve treatment outcome after sport injuries . Using st and ardized cryotherapy and compression perioperatively has been reported with conflicting clinical results . The impact of combined cryotherapy and compression is compared to st and ard care among patients undergoing wrist arthroscopy . Methods Fifty-six patients undergoing wrist arthroscopy were assessed , 54 patients were r and omized to either Cryo/Cuff ™ ( 3 × 10 min twice daily ) or st and ard care over 3 weeks . Follow-up clinical visits were at postoperative days 1 , 8 , and 21 . One patient in each group was lost during follow-up . Fifty-two patients were analyzed . Statistics were performed as Intention-to-treat analysis . Outcome parameters were pain , three-dimensional volume of the wrist , range of motion , and DASH score . Results The Cryo/Cuff ™ group had a 49 % reduction in pain level ( VAS 3.5 ± 0.4 vs. VAS 1.8 ± 0.2 on the 21st postoperative day ) when compared to a reduction of 41 % in the control group ( VAS 5.1 ± 0.6 preoperatively vs. VAS 3.0 ± 0.5 on the 21st postoperative day ) . Swelling and range of motion were not as significantly different between the two groups as were DASH scores ( DASH-score Cryo/Cuff group preoperatively 37.3 ± 3.5 and postoperatively 36.9 ± 3.5 ; DASH-score control group preoperatively 42.8 ± 4.3 and postoperatively 41.9 ± 4.9 ) . The CONSORT score reached 17 out of 22 . Conclusion There was no significant effect of additional home-based combined cryotherapy and compression using the Cryo/Cuff ™ wrist b and age , following wrist arthroscopy regarding pain , swelling , range of motion , and subjective impairment assessed using the DASH score over 3 weeks in comparison with the control group The purpose of this study was to compare the efficacy of intermittent pneumatic compression ( IPC ) and high voltage pulsed current ( HVPC ) in reducing  chronic posttraumatic h and edema . Thirty patients with posttraumatic h and edema were r and omly assigned to IPC , HVPC , or placebo-HVPC groups ( 10 patients in each group ) . Patients received a single application of the respective treatment for 30 minutes . Measurements were made before and after a 10-minute rest period and after the 30-minute treatment . A volumetric method was used to quantify edema reduction . Reduction in h and edema was significant between the IPC and placebo-HVPC groups ( p = .01 ) . Differences in edema reduction between the HVPC and placebo-HVPC groups did not reach statistical significance ( p = .04 ) , but were considered clinical ly significant . There was no significant difference between the IPC and HVPC groups . A single 30-minute administration of IPC produced a significant reduction in h and edema . Additional clinical studies are needed to delineate maximally effective treatment protocol s for reduction of chronic posttraumatic h and edema . [ Griffin JW , Newsome LS , Stralka SW , et al : Reduction of chronic posttraumatic h and edema : A comparison of high voltage pulsed current , intermittent pneumatic compression , and placebo treatments The aim of this study was to evaluate the efficacy of manual lymph drainage , as described by Vodder , in reducing oedema in the h and after a traumatic injury . During a period of 10 months in 1996 - 7 , a total of 26 consecutive patients with a fracture of the distal radius that was treated by external fixation were included in the study . Patients were r and omised into an  experimental ( n = 12 ) and a  control group ( n = 14 ) . Treatment started 11 days after application of the external fixator . All patients had the same conventional treatment with exercises , movement , oedema control , and education . The experimental 
    Output:
    
There is low to moderate quality evidence with limited confidence in the effect estimate to support the use of manual edema mobilization methods in conjunction with st and ard therapy to reduce problematic h and edema .