***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: PURPOSE The aims of this pilot study were the following : 1 ) to examine patterns of adherence to a brisk walking program in women receiving adjuvant chemotherapy or radiation therapy for newly diagnosed breast cancer using a prospect i ve , r and omized , controlled experimental design ; 2 ) to examine the influence of disease symptoms and treatment side effects on exercise levels ; and 3 ) to suggest methods that may improve future clinical trials of moderate-intensity exercise in similar population s. DESCRIPTION OF STUDY Fifty-two patients with newly diagnosed breast cancer were r and omly assigned to one of two treatment arms : usual care or usual care plus exercise . Those assigned to the exercise group received a st and ardized , self-administered , home-based brisk walking intervention in addition to usual care . Each day subjects completed self-report diary forms that elicited information about activity levels , and the occurrence of symptoms and side effects during cancer treatment . RESULTS Analyses of self-reported daily activity levels revealed a diffusion of treatment effect . Fifty percent of the usual-care group reported maintaining or increasing their physical activity to a moderate-intensity level , while 33 % of the exercise group did not exercise at the prescribed levels . Analyses of self-reported disease symptoms and treatment side effects did not reveal clinical ly meaningful differences between the two groups . CLINICAL IMPLICATION S The results of this study suggest that women who exercised regularly before receiving a breast cancer diagnosis attempted to maintain their exercise programs . Women who lead sedentary lifestyles may benefit from a structured exercise program that includes information and support related to exercise adherence strategies The primary aim of this study was to test the effect of a Protection Motivation Theory (PMT)-based patient education intervention on physiotherapy patients ' beliefs about their injury and physiotherapy , intentions to adhere , rehabilitation adherence , and ankle function . A secondary aim was to explore the relationships between the patients ' injury and physiotherapy beliefs , intentions , adherence behaviours , and ankle function . A r and omized controlled trial was undertaken in New Zeal and ; 71 people with ankle sprains were allocated to either PMT present video information or two control groups ( non-PMT information about ankle sprains and no formal information ) before commencing their course of physiotherapy . The two information groups watched a video about ankle sprains and physiotherapy before answering the Beliefs about Ankle Sprains and Physiotherapy Scale and behavioural intentions question naires that measured the PMT constructs . Adherence was assessed at each treatment and ankle function was measured before and after the physiotherapy program . After viewing the video , the PMT present information group 's beliefs about severity , vulnerability , and response efficacy were significantly higher than the other two groups . The groups did not differ significantly on their self-efficacy , intentions , rehabilitation adherence , and post-physiotherapy program ankle function . Significant correlations existed between the patients ' PMT-based beliefs and intentions , intentions and adherence , and adherence and post-physiotherapy ankle function . With the exception of self-efficacy , the findings indicate that persuasive information grounded in PMT does enhance physiotherapy patients ' beliefs about their injury and treatment The feasibility and efficacy of an additional progressive home-based strengthening exercise program ( PHSEP ) on subjects that already attended supervised institutional exercise therapy  was investigated . Thirty-six hip patients with hip osteoarthritis ( OA ) and /or total hip replacement in at least one hip joint were r and omly assigned to an intervention group ( IG ) or a control group ( CG ) . IG ( 18 patients , mean age 64.9 , st and ard deviation ( SD ) 7.5 ) followed an 8-week PHSEP in addition to their weekly institutional exercise therapy , while CG ( 18 patients , mean age 64.7 , SD 9 ) solely continued the weekly institutional exercise sessions . Before and after the intervention period , strength of hip muscles was quantified applying isokinetic concentric and isometric measurements , and health-related quality of life was monitored using the SF36 question naire . Adherence to the exercise program was evaluated using exercise logs . The PHSEP was feasible for all subjects in IG with an adherence of 99 % . Exercise logs reported that pain result ing from the PHSEP was low . Increased strength in isokinetic concentric hip adduction ( 13 % ) and isometric hip abduction ( 9 % ) , adduction ( 12 % ) , and flexion ( 7 % ) was found in IG in comparison to CG . The results of the SF36 did not change during the intervention period . Consequently , supervised institutional exercise therapy supplemented by a PHSEP could increase hip muscle strength in patients with hip OA and /or total hip replacement . However , further research should evaluate the optimal frequency and duration of such supplementary sessions and their potential to increase physical function and reduce pain Background Despite emerging evidence that foot problems and inappropriate footwear increase the risk of falls , there is little evidence as to whether foot-related intervention strategies can be successfully implemented . The aim of this study was to evaluate adherence rates , barriers to adherence , and the predictors of adherence to a multifaceted podiatry intervention for the prevention of falls in older people . Methods The intervention group ( n = 153 , mean age 74.2 years ) of a r and omised trial that investigated the effectiveness of a multifaceted podiatry intervention to prevent falls was assessed for adherence to the three components of the intervention : ( i ) foot orthoses , ( ii ) footwear advice and footwear cost subsidy , and ( iii ) a home-based foot and ankle exercise program . Adherence to each component and the barriers to adherence were documented , and separate discriminant function analyses were undertaken to identify factors that were significantly and independently associated with adherence to the three intervention components . Results Adherence to the three components of the intervention was as follows : foot orthoses ( 69 % ) , footwear ( 54 % ) and home-based exercise ( 72 % ) . Discriminant function analyses identified that being younger was the best predictor of orthoses use , higher physical health status and lower fear of falling were independent predictors of footwear adherence , and higher physical health status was the best predictor of exercise adherence . The predictive accuracy of these models was only modest , with 62 to 71 % of participants correctly classified . Conclusions Adherence to a multifaceted podiatry intervention in this trial ranged from 54 to 72 % . People with better physical health , less fear of falling and a younger age exhibited greater adherence , suggesting that strategies need to be developed to enhance adherence in frailer older people who are most at risk of falling . Trial registration Australian New Zeal and Clinical Trials Registry ACTRN12608000065392 STUDY DESIGN A prospect i ve unblinded r and omized clinical trial . OBJECTIVES To compare the effectiveness of 2 types of home program instruction , videotape versus personal instruction by a physical therapist , on subjective outcomes and exercise compliance following arthroscopic repair of a full-thickness rotator cuff tear . BACKGROUND Advances in orthopedic surgery and rehabilitation have placed increased emphasis on home exercise programs . Therefore , assessing the effectiveness of different methods of home program instruction is important . METHODS AND MEASURES Patients who consented to undergo surgical repair were r and omly assigned to either a videotape or personal instruction group . A self-reported compliance log categorized subjects as fully compliant , partially compliant , or noncompliant . The Shoulder Pain and Disability Index and the University of Pennsylvania Shoulder Scale scores were obtained from subjects preoperatively and at 12 , 24 , and 52 weeks postoperatively . The null hypotheses that neither group would have better outcomes as measured by 2 shoulder outcome scales at any level of compliance over 4 levels of time , were assessed by 2 separate 2x3x4 multiple analyses of variances ( MANOVAs ) , 1 for each outcome measure ( alpha = 0.025 ) . RESULTS Neither MANOVA was significant and the null hypotheses were not rejected . The main effect of time ( number of weeks postsurgery ) was significant across all time intervals for both outcome measures ( P < 0.0005 ) . CONCLUSIONS With a therapist available for questions , patients who utilized the videotape method for their home program instruction had self-reported outcomes equal to patients instructed in their home program personally by a physical therapist . Self-reported compliance with the rehabilitation program had little effect on the outcomes OBJECTIVES The purpose s of this study were 1 ) to determine compliance with a pedometer and mobile phone- based physical activity diary , and 2 ) to assess concordance between self-reported daily steps recorded and transmitted by a mobile phone and pedometer-measured daily steps in sedentary women . METHODS In this 3-week pilot clinical study , 41 sedentary women who met all inclusion criteria were recruited from local communities . We asked the participants to wear a pedometer every day and to report their daily  steps  using a mobile phone diary each night before retiring . In the first week , women were asked to monitor their daily steps ( baseline steps ) . In the second and third weeks , they were asked to increase their steps by 20 % from the previous week . Although the pedometer can automatically store the most recent 41 days ' performance , the participants were not informed of this function of the pedometer . RESULTS Overall compliance was 93.8 % with pedometer use and 88.3 % with the mobile phone physical activity diary . Bl and Altman plots showed that the agreement between self-reported daily steps by mobile phone diary and pedometer-recorded daily steps from week 1 to week 3 was high . CONCLUSION The combination of a pedometer and a mobile phone diary may enhance the quality of self-reported data in clinical studies Despite the numerous benefits of physical activity for patients with diabetes , most healthcare providers in busy clinical setting s rarely find time to counsel their patients about it . A Web-based program for healthcare providers can be used as an effective counseling tool , when strategies are outlined for specific stages of readiness for physical activity . Seventy-three adults with type 2 diabetes were r and omly assigned to Web-based intervention , printed- material intervention , or usual care . After 12 weeks , the effects of the interventions on physical activity , fasting blood sugar , and glycosylated hemoglobin were evaluated . Both Web-based and printed material intervention , compared with usual care , were effective in increasing physical activity ( P < .001 ) and decreasing fasting blood sugar ( P<.01 ) and glycosylated hemoglobin ( P < .01 ) . Post hoc analysis for change scores indicated significant differences between Web-based intervention and usual care and between printed material intervention and usual care , but not between web-based and printed material intervention . The findings of this study support the value of Web-based and printed material interventions in healthcare counseling . With increasing Web access , the effectiveness of Web-based programs offered directly to patients needs to be tested OBJECTIVES /HYPOTHESES There are many documented barriers to successful adherence to voice therapy . However , methods for facilitating adherence are not well understood . The purpose of this study was to determine if patient adherence and motivation for practice could be improved by providing patients with practice support between sessions using mobile treatment videos . METHODS Thirteen voice therapy participants were provided with portable media players containing videos of voice exercises exemplified by their therapists and themselves . A r and omized crossover design of two conditions was used : ( 1 ) st and ard of care voice therapy where participants were provided with written homework descriptions ; and ( 2 ) video-enhanced voice therapy where participants received a portable digital media player with clinician and self-videos . The duration of each condition was 1 week . Self-report measures of practice frequency and aspects of motivation were obtained at the end of each session . RESULTS Practice of voice exercises was significantly greater in the video-enhanced voice therapy condition than in the st and ard of care " written " condition ( P<0.05 ) . Three aspects of participant motivation for practice -overall commitment to practice , importance of practice , and confidence in the ability to practice were also significantly greater after video-enhanced condition than after st and ard of care condition . CONCLUSION These results support the use of video examples and portable digital media players in voice therapy for individuals who are comfortable using such technology OBJECTIVE Great efforts have been made to find effective treatments for back pain . Nevertheless , the effectiveness of a particular treatment can depend on patient compliance . The objective of this study was to prospect ively investigate whether patients ' demographic factors , clinical factors , external barriers in following the treatment , and perceptions of disability , quality of life , depression , and control over health were predictive of compliance with a physical therapy program carried out with patients with low back pain . METHODS This was an exploratory prospect i ve cohort study that was carried out in New York City during 1999 . All study participants answered a question naire at the initial clinical evaluation by a physical therapist and were followed during the treatment . The study assessed compliance with the three treatment regimens that were prescribed for every patient : attending scheduled physical therapy sessions , following a program of home exercises , and watching back-education videotapes . Depending on the individual patient , the planned treatment program could last from 2 to 6 weeks . The study employed a battery of instruments to measure patient characteristics that included perceived functional limitations , perceived quality of life , depression , and their beliefs about their health . Student 's t tests and chi-square tests were used to determine if non- and low-compliant patients differed significantly from high-compliant patients . Logistic regression was used to estimate adjusted odds ratios expressing the association of selected variables with compliance . RESULTS We found that 51 % of the patients were either noncompliant or low-compliant overall with the low back pain treatment program . There were differences in compliance behavior among the three treatment regimens , with compliance being highest for watching the back-education videotapes and lowest for doing the home exercises . Po 
    Output:
    
The results expose a gap in the literature for well-developed measures that capture self-reported adherence to prescribed but unsupervised home-based rehabilitation exercises