***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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    Input: AIM To evaluate the effects of ' ' Playstation EyeToy Games ' ' on upper extremity motor recovery and upper extremity-related motor functioning of patients with subacute stroke . METHODS The authors design ed a r and omized , controlled , assessor-blinded , 4-week trial , with follow-up at 3 months . A total of 20 hemiparetic in patients ( mean age 61.1 years ) , all within 12 months post-stroke , received 30 minutes of treatment with ' ' Playstation EyeToy Games ' ' per day , consisting of flexion and extension of the paretic shoulder , elbow and wrist as well as abduction of the paretic shoulder or placebo therapy ( watching the games for the same duration without physical involvement into the games ) in addition to conventional program , 5 days a week , 2 - 5 hours/day for 4 weeks . Brunnstrom 's staging and self-care sub-items of the functional independence measure ( FIM ) were performed at 0 month ( baseline ) , 4 weeks ( post-treatment ) , and 3 months ( follow-up ) after the treatment . RESULTS The mean change score ( 95 % confidence interval ) of the FIM self-care score ( 5.5 [ 2.9 - 8.0 ] vs 1.8 [ 0.1 - 3.7 ] , P=0.018 ) showed significantly more improvement in the EyeToy group compared to the control group . No significant differences were found between the groups for the Brunnstrom stages for h and and upper extremity . CONCLUSION ' ' Playstation EyeToy Games ' ' combined with a conventional stroke rehabilitation program have a potential to enhance upper extremity-related motor functioning in subacute stroke patients OBJECTIVE The aim of this study was to assess , using a Web-based format , third-year medical students ' pediatric knowledge and perceptions of game playing with faculty facilitation compared with self- study computerized flash cards . METHODS This study used a repeated- measures experimental design with r and om assignment to a game group or self- study group . Pediatric knowledge was tested using multiple choice exams at baseline , week 6 of the clerkship following a 4-week intervention , and 6 weeks later . Perceptions about game playing and self- study  were evaluated using a question naire at week 6 . RESULTS The groups did not differ on content mastery , perceptions about content , or time involved in game playing or self- study . Perceptions about  game playing versus self- study as a pedagogical method appeared to favor game playing in underst and ing content ( P<.001 ) , perceived help with learning ( P<.05 ) , and enjoyment of learning ( P<.008 ) . An important difference was increased game group willingness to continue participating in the intervention . CONCLUSIONS Games can be an enjoyable and motivating method for learning pediatric content , enhanced by group interactions , competition , and fun . Computerized , Web-based tools can facilitate access to educational re sources and are feasible to apply as an adjunct to teaching clinical medicine Background Flashbacks are the hallmark symptom of Posttraumatic Stress Disorder ( PTSD ) . Although we have successful treatments for full-blown PTSD , early interventions are lacking . We propose the utility of developing a ‘ cognitive vaccine ’ to prevent PTSD flashback development following exposure to trauma . Our theory is based on two key findings : 1 ) Cognitive science suggests that the brain has selective re sources with limited capacity ; 2 ) The neurobiology of memory suggests a 6-hr window to disrupt memory consolidation . The rationale for a ‘ cognitive vaccine ’ approach is as follows : Trauma flashbacks are sensory-perceptual , visuospatial mental images . Visuospatial cognitive tasks selectively compete for re sources required to generate mental images . Thus , a visuospatial computer game ( e.g. “ Tetris ” ) will interfere with flashbacks . Visuospatial tasks post-trauma , performed within the time window for memory consolidation , will reduce subsequent flashbacks . We predicted that playing “ Tetris ” half an hour after viewing trauma would reduce flashback frequency over 1-week . Methodology /Principal Findings The  Trauma Film paradigm was used as a well-established experimental analog for Post-traumatic Stress . All participants viewed a traumatic film consisting  of  scenes of real injury and death  followed by a 30-min structured break . Participants were then r and omly allocated to either a no-task or visuospatial ( “ Tetris ” ) condition which they undertook for 10-min . Flashbacks were monitored for 1-week . Results indicated that compared to the no-task condition , the “ Tetris ” condition produced a significant reduction in flashback frequency over 1-week . Convergent results were found on a clinical measure of PTSD symptomatology at 1-week . Recognition memory between groups did not differ significantly . Conclusions / Significance Playing “ Tetris ” after viewing traumatic material reduces unwanted , involuntary memory flashbacks to that traumatic film , leaving deliberate memory recall of the event intact . Pathological aspects of human memory in the aftermath of trauma may be malleable using non-invasive , cognitive interventions . This has implication s for a novel avenue of preventative treatment development , much-needed as a crisis intervention for the aftermath of traumatic events An interactive multimedia computer game to enhance self-management skills and thereby improve asthma outcomes in inner city children with asthma was evaluated . Subjects aged 6 - 17 were recruited from four pediatric practice s and r and omly assigned to the computer intervention condition or to the usual-care comparison .  The main character in the game could match the subject on gender and ethnicity . Characteristics of the protagonist 's asthma were tailored to be like those of the subject . Subjects played the computer game as part of regular asthma visits . Time between pre- and post-test varied from 4 to 15.6 months ( mean , 7.6 months ) . Analysis of covariance , with pre-test scores , age , and asthma severity as covariates , found that the intervention was associated with fewer hospitalizations , better symptom scores , increased functional status , greater knowledge of asthma management , and better child self-management behavior for those in the intervention condition . Interactions with covariates were found and discussed in terms of variable efficacy of the intervention The objective of this study was to test the efficacy and suitability of virtual reality ( VR ) as a pain distraction for pediatric intravenous ( i.v . ) placement . Twenty children ( 12 boys , 8 girls ) requiring i.v . placement for a magnetic resonance imaging/computed tomography ( MRI/CT ) scan were r and omly assigned to two conditions : ( 1 ) VR distraction using Street Luge ( 5DT ) , presented via a head-mounted display , or ( 2 ) st and ard of care ( topical anesthetic ) with no distraction .  Children , their parents , and nurses completed self-report question naires that assessed numerous health-related outcomes . Responses from the Faces Pain Scale-Revised indicated a fourfold increase in affective pain within the control condition ; by contrast , no significant differences were detected within the VR condition . Significant associations between multiple measures of anticipatory anxiety , affective pain , i.v . pain intensity , and measures of past procedural pain provided support for the complex interplay of a multimodal assessment of pain perception . There was also a sufficient amount of evidence supporting the efficacy of Street Luge as a pediatric pain distraction tool during i.v . placement : an adequate level of presence , no simulator sickness , and significantly more child- , parent- , and nurse-reported satisfaction with pain management . VR pain distraction was positively endorsed by all reporters and is a promising tool for decreasing pain , and anxiety in children undergoing acute medical interventions . However , further research with larger sample sizes and other routine medical procedures is warranted Blood glucose ( BG ) monitoring ( BGM ) is an important component of diabetes management . New wireless technologies may facilitate BGM and help to optimize glycemic control . We evaluated an integrated wireless approach with and without a motivational game in youth with diabetes . Forty youth , 8 - 18 years old , each received a h and held device fitted with a wireless modem and diabetes data management software , plus a wireless-enabled BG monitor . Half were r and omized to receive the new technologies along with an integrated motivational game in which the participants would guess a BG level following collection of three earlier readings ( Game Group ) . BG data , insulin doses , and carbohydrate intake were displayed graphically prior to the glucose estimation . The other group received the new technologies alone ( Control Group ) . Both groups were instructed to perform BGM four times daily and transmit their data to a central server via the wireless modem . Feasibility of implementation and outcomes were ascertained after 4 weeks . Ninety-three percent of participants successfully transmitted their data wirelessly to the server . The Game Group transmitted significantly more glucose values than the Control Group ( P < 0.001 ) . The Game Group also had significantly less hyperglycemia ( glucose > /=13.9 mmol/L or > /=250 mg/dL ) than the Control Group ( P < 0.001 ) . Youth in the Game Group displayed a significant increase in diabetes knowledge over the 4-week trial ( P < 0.005 ) . Finally , there was a trend for more youth in the Game Group to maintain hemoglobin A1C values < /=8 % ( P = 0.06 ) . Thus a pediatric population with diabetes can successfully implement new technologies to facilitate BGM . Use of a motivational game appears to increase the frequency of monitoring , reduce the frequency of hyperglycemia , and improve diabetes knowledge , and may help to optimize glycemic control The aim of the present study was to determine the user satisfaction of the EyeToy for the training of the upper limb in children with cerebral palsy ( CP ) .  User satisfaction was measured in 12 children with CP , using a postexperience question naire , primarily based on a presence question naire . In general , children with CP were satisfied with and motivated by the EyeToy training . In addition , a first evaluation study was performed to determine the effect of this training method on the upper limb function . Ten children with CP were r and omly assigned to the intervention ( mean age 11 years , 9 months ; SD 2,3 ) and the control group ( mean age 12 years , 3 months ; SD 3,2 ) . After a treatment period of 6 weeks , the intervention group completed a  user satisfaction question naire . Functional outcome was measured using the Melbourne Assessment scores . Percentage scores of the Melbourne Assessment of 7 of the 10 children were the same or changed only 1 % to 2 % from baseline to followup . However , in the experimental group , two children improved more , 9 % and 13 % respectively . In conclusion , it can be said that the EyeToy is a motivational training tool for the training of children with CP and has the potential to improve upper extremity function BACKGROUND Asthma guidelines urge teaching patients the knowledge and skills required for self-management , based on the assumption that education will lead to improved skills and better asthma control . METHODS In a prospect i ve , r and omized controlled trial of 65 adults with mild-to-moderate asthma , we examined whether an educational self-management intervention would improve adherence to inhaled corticosteroid therapy , decrease markers of airway inflammation , and improve clinical control . Peak flow , symptoms , and adherence were monitored for 7 weeks . After a 1-week run-in , subjects were assigned r and omly to either the educational intervention or control group . The 30-minute intervention was delivered and reinforced at biweekly intervals . RESULTS Compared with the control group , the intervention group had improvements in adherence to inhaled corticosteroid therapy ( by 30 % vs. -5 % , P = 0.01 ) , self-reported control of asthma ( by 14 % vs. 5 % , P = 0.04 ) , and perhaps quality of life ( by 37 % vs. 21 % , P = 0.06 ) . The direction of change for all other clinical outcomes was more favorable in the intervention group , but not significantly so . Markers of inflammation in sputum decreased more in the intervention group , with sputum eosinophils declining significantly ( P = 0.02 ) . CONCLUSION In asthmatic patients treated with inhaled corticosteroids , education and training in self-management improves adherence with inhaled therapy , perceived control of asthma , and sputum eosinophilia OBJECTIVE . Suboptimal adherence to self-administered medications is a common problem . The purpose of this study was to determine the effectiveness of a video-game intervention for improving adherence and other behavioral outcomes for adolescents and young adults with malignancies including acute leukemia , lymphoma , and soft-tissue sarcoma . METHODS . A r and omized trial with baseline and 1- and 3-month assessment s was conducted from 2004 to 2005 at 34 medical centers in the United States , Canada , and Australia . A total of 375 male and female patients who were 13 to 29 years old , had an initial or relapse diagnosis of a malignancy , and currently undergoing treatment and expected to continue treatment for at least 4 months from baseline assessment were r and omly assigned to the intervention or control group . The intervention was a video game that addressed issues of cancer treatment and care for teenagers and young adults . Outcome measures included adherence , self-efficacy , knowledge , control , stress , and quality of life . For patients who were prescribed prophylactic antibiotics  , adherence to trimethoprim-sulfamethoxazole was tracked by electronic pill-monitoring devices ( n = 200 ) . Adherence to 6-mercaptopurine was assessed through serum metabolite assays ( n = 54 ) . RESULTS . Adherence to trimethoprim 
    Output:
    
There is potential promise for video games to improve health outcomes , particularly in the areas of psychological therapy and physical therapy .