***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: Abstract Cognitive performance includes the processes of attention , memory , processing speed , and executive functioning , which typically declines with aging . Previous research has demonstrated that aerobic and resistance exercise improves cognitive performance immediately following exercise . However , there is limited research examining the effect that a cognitively complex exercise such as martial art training has on these cognitive processes . Our study compared the acute effects of 2 types of martial art training to aerobic exercise on cognitive performance in middle-aged adults . We utilized a repeated measures design with the order of the 3 exercise conditions r and omly assigned and counterbalanced . Ten recreational middle-aged martial artists ( mean age = 53.5 ± 8.6 years ) participated in 3 treatment conditions : a typical martial art class , an atypical martial art class , and a one-hour walk at a self-selected speed  . Cognitive performance was assessed by the Stroop Color and Word test . While all 3 exercise conditions improved attention and processing speed , only the 2 martial art conditions improved the highest order of cognitive performance , executive function . The effect of the 2 martial art conditions on executive function was not different . The improvement in executive function may be due to the increased cortical dem and required by the more complex , coordinated motor tasks of martial art exercise compared to the more repetitive actions of walking Injuries can be an adverse outcome of participation in sport and recreational activities . The aim of this study was to determine the public health impact of injury during sports and active recreation injury in a select population in Australia . A r and om household telephone survey was conducted quarterly over a 12-month period in a well-defined geographic region , the Latrobe Valley , Australia . Information was collected on participation in sport and active recreation and associated injuries over the previous 2 weeks for all household members aged over 4 years . Injury rates were calculated per 10,000 population and per 1000 sports participants . Data were collected on 1084 persons from 417 households . Overall , 648 people reported participating in at least one sport or active recreation and 34 ( 5.2 % , 95 % CI : 4.8 , 5.6 % ) of these sustained an injury during this activity . Overall , 51.4 % of injured cases had a significant impact : 26.5 % sought treatment , 34.4 % had their activities of daily living adversely affected and 36.0 % had their performance/participation limited . Cricket ( 51 injuries/10,000 population ) , horse riding ( 29/10,000 population ) and basketball ( 25/10,000 population ) had the highest injury rates . After adjusting for participation , cricket ( 242 injuries/1000 participants ) , horse riding ( 122/1000 participants ) and soccer ( 107/1000 participants ) had the highest injury rates . Cricket and soccer were the sports most associated with ' significant ' injuries . Injury prevention efforts should be aim ed at team ball sports ( especially cricket , soccer and netball ) because of their comparatively high rate of both overall and ' significant ' injury [ Purpose ] The aim of this study was to investigate the effects of Ving Tsun ( VT ) Chinese martial art training on radial bone strength , upper- and lower-limb muscular strength , shoulder joint mobility , balance performance , and self-efficacy in elderly participants . [ Subjects and Methods ] Twelve seniors voluntarily joined the VT training group , and twenty-seven seniors voluntarily joined the control group .  The VT group received VT training for three months , while the control group received no training . The bone strength of the distal radius was assessed using an ultrasound bone sonometer .  Muscular strength in the limbs was evaluated using a  Jamar h and grip dynamometer and the five times sit-to-st and test . Shoulder joint mobility was examined using a goniometer . Balance performance and self-efficacy were evaluated using the Berg Balance Scale and the Chinese version of the Activities-specific Balance Confidence Scale , respectively . [ Results ] The results revealed a nonsignificant group-by-time interaction effect , group effect , and time effect for all outcome variables . However , general trends of maintenance or improvement in all outcome parameters were observed to a greater extent in the VT group than in the control group . [ Conclusion ] VT training might be a potential fall-prevention exercise that can be used to maintain general physique , balance , and confidence in the elderly population . A further r and omized controlled trial is needed to confirm this postulation AIM the purpose of this study was to examine the effect of kickboxing training on physical fitness . METHODS 30 subjects were r and omized into a kickboxing-group  ( n=15 ) and  control group ( n=15 ) . Each group trained approximately 1-hour per day , three-times per a week during five weeks . Muscle-power ( upper-body : bench-press-test , medicine-ball-test ; lower-body : squat-jump and counter-movement-jump-test ) , flexibility , speed and agility , aerobic ( progressive maximal exercise test ) , anaerobic fitness ( Wingate test ) and body composition were assessed before and after the training period . RESULTS the kickboxing group showed significant improvement ( p < 0.05 ) in upper-body muscle power , aerobic power , anaerobic fitness , flexibility , speed and agility after training whereas body composition , squat jump and counter movement jump ( height , power and velocity components ) did not change for both groups . CONCLUSION kickboxing- practice was effective to change many physical variables . Thus , this activity can be useful for enhancing physical fitness , but complementary activities and /or nutritional interventions should be necessary Objective : To investigate the epidemiology of sports and recreation-related injury ( SRI ) among emergency department ( ED ) attendees . Design : Descriptive epidemiology study . Setting : An Irish university hospital ED . Participants : All patients aged over 4 years attending a large regional ED , during a 6-month period , for the treatment of SRI were prospect ively surveyed . Assessment of Risk Factors : In all cases identified as SRI the attending physician completed a specifically design ed question naire . It was postulated that recreation-related injury is a significant proportion of reported SRI . Results : Fracture rate was highest in the 4–9-year age group ( 44 % ) . On multivariate logistic regression the adjusted odds ratio ( OR ; 95 % CI ) of fracture was higher for children ( vs adults ) at 1.21 ( 1.0 to 1.45 ) . The adjusted OR was higher for upper-limb 5.8 ( 4.5 to 7.6 ) and lower-limb injuries 1.87 ( 1.4 to 2.5 ) versus axial site of injury and for falls 2.2 ( 1.6 to 2.9 ) and external force 1.59 ( 1.2 to 2.1 ) versus an overextension mechanism of injury . In the same model , “ play ” was independently associated with fracture risk , adjusted OR 1.98 ( 1.2 to 3.0 ; p = 0.001 ) versus low-risk ball sports 1.0 ( reference ) ; an effect size similar to that seen for combat sports 1.96 ( 1.2 to 3.3 ; p = 0.01 ) and greater than that seen for presumed high-risk field sports 1.4 ( 0.9 to 2.0 ) Conclusion : Fall and subsequent upper-limb injury was the commonest mechanism underlying SRI fracture . Domestic “ play ” in all age groups at the time of injury accorded a higher fracture risk than field sports . Patient education regarding the dangers of unsupervised play and recreation represents a means of reducing the burden of SRI IMPORTANCE Few studies have examined how different proportions of moderate and vigorous physical activity affect health outcomes . OBJECTIVE To examine whether the proportion of total moderate to vigorous activity ( MVPA ) that is achieved through vigorous activity is associated with all-cause mortality independently of the total amount of MVPA . DESIGN , SETTING , AND PARTICIPANTS We performed a prospect i ve cohort study with activity data linked to all-cause mortality data from February 1 , 2006 , through June 15 , 2014 , in 204,542 adults aged 45 through 75 years from the 45 and Up population -based cohort study from New South Wales , Australia ( mean [ SD ] follow-up , 6.52 [ 1.23 ] years ) . Associations between different contributions of vigorous activity to total MVPA and mortality were examined using Cox proportional hazards models , adjusted for total MVPA and sociodemographic and health covariates . EXPOSURES Different proportions of total MVPA as vigorous activity . Physical activity was measured with the Active Australia Survey . MAIN OUTCOMES AND MEASURES All-cause mortality during the follow-up period . RESULTS During 1,444,927 person-years of follow-up , 7435 deaths were registered . Compared with those who reported no MVPA ( crude death rate , 8.34 % ) , the adjusted hazard ratios for all-cause mortality were 0.66 ( 95 % CI , 0.61 - 0.71 ; crude death rate , 4.81 % ) , 0.53 ( 95 % CI , 0.48 - 0.57 ; crude death rate , 3.17 % ) , and 0.46 ( 95 % CI , 0.43 - 0.49 ; crude death rate , 2.64 % ) for reporting 10 through 149 , 150 through 299 , and 300 min/wk or more of activity , respectively . Among those who reported any MVPA , the proportion of vigorous activity revealed an inverse dose-response relationship with all-cause mortality : compared with those reporting no vigorous activity ( crude death rate , 3.84 % ) the fully adjusted hazard ratio was 0.91 ( 95 % CI , 0.84 - 0.98 ; crude death rate , 2.35 % ) in those who reported some vigorous activity ( but < 30 % of total activity ) and 0.87 ( 95 % CI , 0.81 - 0.93 ; crude death rate , 2.08 % ) among those who reported 30 % or more of activity as vigorous . These associations were consistent in men and women , across categories of body mass index and volume of MVPA , and in those with and without existing cardiovascular disease or diabetes mellitus . CONCLUSIONS AND RELEVANCE Among people reporting any activity , there was an inverse dose-response relationship between proportion of vigorous activity and mortality . Our findings suggest that vigorous activities should be endorsed in clinical and public health activity guidelines to maximize the population benefits of physical activity BACKGROUND Given the evidence that regular physical activity produces substantial health benefits , participation in sports , exercise , and recreation is widely encouraged . The objective of this study was to describe participation in sports , exercise , and recreational physical activities among US adults . METHODS Data from 2 national surveys of respondents age 18 years and older were analyzed . Respondents to the American Time Use Survey ( ATUS ) from 2003 through 2005 ( N=45,246 ) reported all activities on 1 r and omly selected survey day . Respondents to the National Health and Nutrition Examination Survey ( NHANES ) from 1999 through 2004 ( N=17,061 ) reported leisure-time physical activities in the 30 days before the interview . RESULTS One-quarter of adults participated in any  sport , exercise , or recreational activity  on a r and om day , and 60.9 % of adults participated in any leisure-time activity in the previous 30 days . The most common types of activities were walking , gardening and yard work , and other forms of exercise . The sports and recreational activities had typical duration s of 1/2 to 3 hours per session , and the exercise activities typically lasted 1 hour or less . CONCLUSIONS The prevalence of sports , exercise , and recreational physical activities is generally low among US adults ; exercise is the most commonly reported type of activity BACKGROUND The Cochrane Collaboration is strongly encouraging the use of a newly developed tool , the Cochrane Collaboration Risk of Bias Tool ( CCRBT ) , for all review groups . However , the psychometric properties of this tool to date have yet to be described . Thus , the objective of this study was to add information about psychometric properties of the CCRBT including inter-rater reliability and concurrent validity , in comparison with the Effective Public Health Practice Project Quality Assessment Tool ( EPHPP ) . METHODS Both tools were used to assess the method ological quality of 20 r and omized controlled trials included in our systematic review of the effectiveness of knowledge translation interventions  to improve the management of cancer pain . Each study assessment was completed independently by two review ers using each tool . We analysed the inter-rater reliability of each tool 's individual domains , as well as final grade assigned to each study . RESULTS The EPHPP had fair inter-rater agreement for individual domains and excellent agreement for the final grade . In contrast , the CCRBT had slight inter-rater agreement for individual domains and fair inter-rater agreement for final grade . Of interest , no agreement between the two tools was evident in their final grade assigned to each study . Although both tools were developed to assess ' quality of the evidence ' , they appear to measure different constructs . CONCLUSIONS Both tools performed quite differently when evaluating the risk of bias or method ological quality of studies in knowledge translation interventions for cancer pain . The newly introduced CCRBT assigned these studies a higher risk of bias . Its psychometric properties need to be more thoroughly vali date d , in a range of research fields , to underst and fully how to interpret results from its application Self-reported rates of participation in sport vary by country . In the UK , about 40 % of men and women aged 16 years or older participate in at least one sport every week . Although few data exist to assess trends for participation in sport , there is little evidence of change in the past de 
    Output:
    
The majority of studies reported positive effects result ing from hard martial arts practice , showing some improvement and maintenance of balance , cognitive function and psychological health .
Benefits may be obtained regardless of the age of practice commencement .
“ Hard ” martial arts seem to have potential to improve balance and cognitive functions that decline with age , which can lead to poorer health outcomes among the elderly ( e.g. cognitive decline , falls and fractures ) .