***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 assess the effectiveness of an intervention planned and implemented by regional geriatric care teams in order to prevent disability in an elderly population . Design . R and omized , controlled trial with intention-to-treat and subgroup analyses . Subjects and setting . All home-dwelling persons aged 85 years or older in the City of Oulu ( n = 555 , 67 % ) , including 486 persons with a history of recurrent falls or at least one risk factor for disability in the activities of daily living ( ADL ) or mobility . Interventions . Programme consisting of home exercise , walking exercise , group exercise , and self-care exercise . Main outcome measures . Change in ADL and mobility during the intervention . Results . Change in ADL performance did not differ ( p = 0.462 ) but a positive change was found in mobility performance ( p = 0.013 ) in the intervention subjects ( n = 243 ) compared with the controls ( n = 243 ) . At the end of the intervention period , severe mobility restrictions existed similarly in intervention and control subjects : 48 ( 34 % ) and 46 ( 31 % ) ( p = 0.650 ) respectively . Frequency of admissions into long-term institutional care were similar in intervention and control groups : 15 ( 7 % ) and 13 ( 6 % ) ( p = 0.669 ) . Impaired balance existed in fewer intervention subjects ( 64 , 45 % ) than controls ( 89 , 59 % ) ( p = 0.015 ) . Frequency and times of home exercise activity reduced in control subjects ( p < 0.001 ) but did not change in subjects assigned to home exercise intervention ( p > 0.05 ) . Conclusion . A pragmatic intervention slowed down the reduction of movement performance but positive effects could not be found in subjects with severe movement and any ADL dysfunction . Positive effects were also found in balance performance OBJECTIVE To evaluate the effects of two exercise approaches , Tai Chi ( TC ) and computerized balance training ( BT ) , on specified primary outcomes ( biomedical , functional , and psychosocial indicators of frailty ) and secondary outcomes ( occurrence of falls ) . DESIGN The Atlanta FICSIT ( Frailty and Injuries : Cooperative Studies of Intervention Techniques ) , a prospect i ve , r and omized , controlled clinical trial with three arms ( TC , BT , and education [ ED ] . Intervention length was 15 weeks , with primary outcomes measured before and after intervention and at 4-month follow-up . Falls were monitored continuously throughout the study . SETTING Persons aged 70 and older living in the community . PARTICIPANTS A total of 200 participants , 162 women and 38 men ; mean age was 76.2 . MEASUREMENTS Biomedical ( strength , flexibility , cardiovascular endurance , body composition ) , functional ( IADL ) , and psychosocial well-being ( CES-D scale , fear of falling question naire , self-perception of present and future health , mastery index , perceived quality of sleep , and intrusiveness ) variables . RESULTS Grip strength declined in all groups , and lower extremity range of motion showed limited but statistically significant changes . Lowered blood pressure before and after a 12-minute walk was seen following TC participation . Fear of falling responses and intrusiveness responses were reduced after the TC intervention compared with the ED group ( P = .046 and P = .058 , respectively ) . After adjusting for fall risk factors , TC was found to reduce the risk of multiple falls by 47.5 % . CONCLUSIONS A moderate TC intervention can impact favorably on defined biomedical and psychosocial indices of frailty . This intervention can also have favorable effects upon the occurrence of falls .  Tai Chi warrants further study as an exercise treatment to improve the health of older people BACKGROUND Cognitive decline among seniors is a pressing health care issue . Specific exercise training may combat cognitive decline . We compared the effect of once-weekly and twice-weekly resistance training with that of twice-weekly balance and tone exercise training on the performance of executive cognitive functions in senior women . METHODS In this single-blinded r and omized trial , 155 community-dwelling women aged 65 to 75 years living in Vancouver were r and omly allocated to once-weekly ( n = 54 ) or twice-weekly ( n = 52 ) resistance training or twice-weekly balance and tone training ( control group ) ( n = 49 ) . The primary outcome measure was performance on the Stroop test , an executive cognitive test of selective attention and conflict resolution . Secondary outcomes of executive cognitive functions included set shifting as measured by the Trail Making Tests ( parts A and B ) and working memory as assessed by verbal digit span forward and backward tests . Gait speed , muscular function , and whole-brain volume were also secondary outcome measures . RESULTS Both resistance training groups significantly improved their performance on the Stroop test compared with those in the balance and tone group ( P < or = .03 ) . Task performance improved by 12.6 % and 10.9 % in the once-weekly and twice-weekly resistance training groups , respectively ; it deteriorated by 0.5 % in the balance and tone group . Enhanced selective attention and conflict resolution was significantly associated with increased gait speed . Both resistance training groups demonstrated reductions in whole-brain volume compared with the balance and tone group at the end of the study ( P < or = .03 ) . CONCLUSION Twelve months of once-weekly or twice-weekly resistance training benefited the executive cognitive function of selective attention and conflict resolution among senior women . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00426881 Frequent or recurrent fallers are more likely to have chronic medical conditions and physiological impairments , exhibit functional decline and have poor outcomes , than single fallers [ 1 ] . Fractures are also more common in recurrent fallers than single fallers [ 2 ] . Modern surgery for hip fracture can no longer improve on its outcomes [ 3 ] and therefore , effective prevention of falls [ 4 , 5 ] is the key to preventing disability and death . There is still no published evidence that a single intervention ( tailored group exercise ) can prevent falls or injuries in a high risk group of frequent fallers . This r and omised controlled trial ( RCT ) aim ed to investigate the impact of a 36 week individualised and tailored group and home exercise intervention , compared with a control intervention , in reducing falls and injuries in communitydwelling , independent-living , frequent falling women aged 65 years and over . Preliminary results have been published in abstract form [ 6 ] . The primary outcome was falls and fallrelated injuries . The secondary outcome was the number of frequent fallers who had died , had moved into residential care or were in hospital compared with the group they were in BACKGROUND recent studies have found that moderate intensity exercise is an effective intervention strategy for preventing falls  in older people . However , research is required to determine whether supervised group exercise programmes , conducted in community setting s with at-risk older people referred by their health care practitioner are also effective in improving physical functioning and preventing falls in this group . OBJECTIVES to determine whether participation in a weekly group exercise programme with ancillary home exercises over one year improves balance , muscle strength , reaction time , physical functioning , health status and prevents falls in at-risk community-dwelling older people . METHODS the sample comprised 163 people aged over 65 years identified as at risk of falling using a st and ardised assessment screen by their general practitioner or hospital-based physiotherapist , residing in South Western Sydney , Australia . Subjects were r and omised into either an exercise intervention group or a control group .  Physical performance and general health measures were assessed at baseline and repeated 6-months into the trial . Falls were measured over a 12-month follow-up period using monthly postal surveys . RESULTS at baseline both groups were well matched in their physical performance , health and activity levels . The intervention subjects attended a median of 23 exercise classes over the year , and most undertook the home exercise sessions at least weekly . At retest , the exercise group performed significantly better than the controls in three of six balance measures ; postural sway on the floor with eyes open and eyes closed and coordinated stability . The groups did not differ at retest in measures of strength , reaction time and walking speed or on Short-Form 36 , Physical Activity Scale for the Elderly or fear of falling scales . Within the 12-month trial period , the rate of falls in the intervention group was 40 % lower than that of the control group ( IRR=0.60 , 95 % CI 0.36 - 0.99 ) . CONCLUSIONS these findings indicate that participation in a weekly group exercise programme with ancillary home exercises can improve balance and reduce the rate of falling in at-risk community dwelling older people BACKGROUND Physical exercise affects many risk factors and diseases and therefore can play a vital role in general disease prevention and treatment of elderly individuals and may reduce costs . We sought to determine whether a single exercise program affects fracture risk ( bone mineral density [ BMD ] and falls ) , coronary heart disease ( CHD ) risk factors , and health care costs in community-dwelling elderly women . METHODS We conducted a r and omized , single-blinded , controlled trial from May 1 , 2005 , through July 31 , 2008 , recruiting women 65 years or older who were living independently in the area of Erlangen-Nuremberg , Germany . In all , 246 women were r and omly assigned to an 18-month exercise program ( exercise group ) or a wellness program ( control group ) . The exercise group ( n = 123 ) performed a multi purpose exercise program with special emphasis on exercise intensity ; the controls ( n = 123 ) focused on well-being with a low-intensity , low-frequency program . The main outcome measures were BMD , the number of falls , the Framingham-based 10-year CHD risk , and direct health care costs . RESULTS For the 227 women who completed the 18-month study , significant exercise effects were observed for BMD of the lumbar spine ( mean [ 95 % confidence interval ( CI ) ] percentage of change in BMD [ baseline to follow-up ] for the exercise group : 1.77 % [ 1.26 % to 2.28 % ] vs controls : 0.33 % [ -0.24 % to 0.91 % ] ; P < .001 ) , femoral neck ( exercise group : 1.01 % [ 0.37 % to 1.65 % ] vs controls : -1.05 % [ -1.70 % to -0.40 % ] ; P < .001 ) , and fall rate per person during 18 months ( exercise group : 1.00 [ 0.76 to 1.24 ] vs controls : 1.66 [ 1.33 to 1.99 ] ; P = .002 ) . The 10-year CHD risk was significantly affected in both subgroups ( absolute change for the exercise group : -1.96 % [ 95 % CI , -2.69 % to -1.23 % ] vs controls : -1.15 % [ -1.69 % to -0.62 % ] ; P = .22 ) , with no significant difference between the groups . The direct health care costs per participant during the 18-month intervention showed nonsignificant differences between the groups ( exercise group : 2255 euros[95 % CI , 1791 euros-2718 euros ] vs controls : 2780 euros [ 2187 euros-3372 euros ] ; P = .20 ) . CONCLUSION Compared with a general wellness program , our 18-month exercise program significantly improved BMD and fall risk , but not predicted CHD risk , in elderly women . This benefit occurred at no increase in direct costs . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00267839 BACKGROUND The authors ' objective was to evaluate the efficacy of a 6-month Tai Chi intervention for decreasing the number of falls and the risk for falling in older persons . METHODS This r and omized controlled trial involved a sample of 256 physically inactive , community-dwelling adults aged 70 to 92 ( mean age , 77.48 years ; st and ard deviation , 4.95 years ) who were recruited through a patient data base in Portl and , Oregon . Participants were r and omized to participate in a three-times-per-week Tai Chi group or to a stretching control group for 6 months . The primary outcome measure was the number of falls ; the secondary outcome measures included functional balance ( Berg Balance Scale , Dynamic Gait Index , Functional Reach , and single-leg st and ing ) , physical performance ( 50-foot speed walk , Up&Go ) , and fear of falling , assessed at baseline , 3 months , 6 months ( intervention termination ) , and at a 6-month postintervention follow-up . RESULTS At the end of the 6-month intervention , significantly fewer falls ( n=38 vs 73 ; p=.007 ) , lower proportions of fallers ( 28 % vs 46 % ; p=.01 ) , and fewer injurious falls ( 7 % vs 18 % ; p=.03 ) were observed in the Tai Chi group compared with the stretching control group . After adjusting for baseline covariates , the risk for multiple falls in the Tai Chi group was 55 % lower than that of the stretching control group ( risk ratio,.45 ; 95 % confidence interval , 0.30 to 0.70 ) . Compared with the stretching control participants , the Tai Chi participants showed significant improvements ( p<.001 ) in all measures of functional balance , physical performance , and reduced fear of falling . Intervention gains in these measures were maintained at a 6-month postintervention follow-up in the Tai Chi group . CONCLUSIONS A three-times-per-week , 6-month Tai Chi program is effective in decreasing the number of falls , the risk for falling , and the fear of falling , and it improves 
    Output:
    
CONCLUSIONS Exercise programmes design ed to prevent falls in older adults also seem to prevent injuries caused by falls , including the most severe ones .
Such programmes also reduce the rate of falls leading to medical care