***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 evaluate the effect of 8-week moderate intensity aerobic ( heart-rate reserve 40–60 % ) exercise on neuropathy quality of life in type 2 diabetes . Methods A single blind , parallel-group , r and omized controlled trial was carried out in a tertiary setting . People with type 2 diabetes were eligible for the study if they had clinical neuropathy which was defined by a minimum score of seven on the Michigan diabetic neuropathy score . Following which , the patients were r and omly assigned to an 8-week program by a computer-generated r and om number tables to intervention or control group . Repeated measure analysis of variance was used for data analysis ( p < 0.05 was considered significant ) . Results There were 47 participants in the control group and 40 participants in the study group after r and omization but 37 from the control group and 29 from the intervention group completed the final analysis . The two groups had a significant difference , pre – post intervention in scores of pain ( F = 7 , p = 0.01 ) , sensory symptoms ( F = 4.60 , p = 0.04 ) , restricted activities of daily living ( F = 4.97 , p = 0.03 ) , disruptions in social relationships ( F = 5.43 , p = 0.02 ) , specific impact on quality of life ( F = 9.28 , p < 0.001 ) overall quality of life ( F = 28.72 , p < 0.001 ) , and total score ( F = 31.10 , p < 0.001 ) . Degrees of freedom for all the components were 1 , 62 . Conclusion Moderate intensity aerobic exercise is cornerstone in improving the quality of life of individuals with peripheral neuropathy in type 2 diabetes Abstract Complex regional pain syndrome type I ( CRPS-I ) highly affects patients ' ability to perform daily life activities . Pain-related fear might be a key target to reduce disability in chronic pain . Current treatments aim ing at reducing pain show little improvements on pain and disability , whereas novel exposure-based treatments targeting pain-related fears have shown to be promising . We conducted a r and omized controlled trial ( N = 46 ) comparing exposure in vivo ( EXP ) with pain-contingent treatment as usual ( TAU ) , for CRPS-I patients with at least moderate levels of pain-related fear . Primary outcome is self-reported disability , for upper and lower extremity , respectively . Secondary outcomes are self-reported pain-intensity , pain-catastrophizing , perceived harmfulness of physical activity , and health-related quality of life . Pretreatment to posttreatment and pretreatment to 6-month follow-up change scores were tested using r and omization-based inference . EXP was superior to TAU in reducing upper extremity disability from pretreatment to posttreatment ( between-group difference , 1.082 ; 95 % confidence interval [ CI ] , 0.563 - 1.601 ; P < 0.001 ) and from pretreatment to 6-month follow-up ( 1.303 ; 95 % CI , 0.917 - 1.690 ; P < 0.001 ) . EXP was superior in reducing lower extremity disability from pretreatment to 6-month follow-up ( 3.624 ; 95 % CI , 0.467 - 6.781 ; P = 0.02 ) , but not from pretreatment to posttreatment ( 3.055 ; 95 % CI , −0.018 to 6.128 ; P = 0.054 ) . All secondary outcomes significantly favored EXP pretreatment to posttreatment , as well as pretreatment to 6-month follow-up . Exposure to daily activities shows to be more effective than a protective pain-contingent TAU in reducing self-reported disability in daily life of CRPS-I patients with at least moderate levels of pain-related fear PURPOSE The aim of this study was to determine the effects of Tai Chi exercise on glucose control , neuropathy scores , balance , and quality of life in patients with type 2 diabetes and neuropathy . METHODS A pretest-posttest design with a nonequivalent control group was utilized to recruit 59 diabetic patients with neuropathy from an outpatient clinic of a university hospital . A st and ardized Tai Chi for diabetes program was provided , which comprised 1 hour of Tai Chi per session , twice a week for 12 weeks . Outcome variables were fasting blood glucose and glycosylated hemoglobin for glucose control , the Semmes-Weinstein 10-g monofilament examination scores and total symptom scores for neuropathy , single leg stance for balance , and the Korean version of the SF-36v2 for quality of life . Thirty-nine patients completed the posttest measures after the 12-week Tai Chi intervention , giving a 34 % dropout rate . RESULTS The mean age of the participants was 64 years , and they had been diagnosed with type 2 diabetes for more than 12 years . The status was significantly better for the participants in the Tai Chi group ( n=20 ) than for their control ( i.e. , nonintervention ) counterparts ( n=19 ) in terms of total symptom scores , glucose control , balance , and quality of life . CONCLUSION Tai Chi improved glucose control , balance , neuropathic symptoms , and some dimensions of quality of life in diabetic patients with neuropathy . Further studies with larger sample s and long-term follow-up are needed to confirm the effects of Tai Chi on the management of diabetic neuropathy , which may have an impact on fall prevention in this population Aims /hypothesisStructured exercise is considered a cornerstone in type 2 diabetes treatment . However , adherence to combined resistance and endurance type exercise or medical fitness intervention programmes is generally poor . Group-based brisk walking may represent an attractive alternative , but its long-term efficacy as compared with an individualised approach such as medical fitness intervention programmes is unknown . We compared the clinical benefits of a 12-month exercise intervention programme consisting of either brisk walking or a medical fitness programme in type 2 diabetes patients . Methods We r and omised 92 type 2 diabetes patients ( 60 ± 9 years old ) to either three times a week of 60 min brisk walking ( n = 49 ) or medical fitness programme ( n = 43 ) . Primary outcome was the difference in changes in HbA1c values at 12 months . Secondary outcomes were differences in changes in blood pressure , plasma lipid concentrations , insulin sensitivity , body composition , physical fitness , programme adherence rate and health-related quality of life . Results After 12 months , 18 brisk walking and 19 medical fitness participants were still actively participating . In both programmes , 50 and 25 % of the dropout was attributed to overuse injuries and lack of motivation , respectively . Intention-to-treat analyses showed no important differences between brisk walking and medical fitness programme in primary or secondary outcome variables . Conclusions /interpretationThe prescription of group-based brisk walking represents an equally effective intervention to modulate glycaemic control and cardiovascular risk profile in type 2 diabetes patients when compared with more individualised medical fitness programmes . Future exercise intervention programmes should anticipate the high attrition rate due to overuse injuries and motivation problems & NA ; Fear of (re)injury/movement has been identified as a potential predictor of chronic disability in complex regional pain syndrome type I ( CRPS‐I ) . In order to reduce pain‐related fears and pain disability , grade d exposure in vivo ( GEXP ) is likely to be an appropriate treatment . Indeed , there is evidence that in chronic pain patients reporting substantial fear of (re)injury/movement , GEXP is successful in reducing pain disability . However , the efficacy of exposure‐based protocol s in the treatment of CRPS‐I patients for reducing pain disability has not been tested . The main research question of this study was whether the reduction of pain‐related fear through GEXP also result ed in a decrease of disability in a subgroup of patients with CRPS‐I who report substantial pain‐related fear . A single‐case experimental ABCD‐ design was used with r and om determination of the start of the intervention . Eight patients with CRPS‐I were included in the study . To assess daily changes in pain intensity , pain‐related fear , pain catastrophizing , and activity goal achievement , a diary was used . St and ardized question naires of pain‐related fear , pain disability , and self‐reported signs and symptoms of CRPS‐I were administered before and after each intervention , and at 6‐month follow‐up . The current study supports a GEXP approach to chronic CRPS‐I. The GEXP was successful in decreasing levels of self‐reported pain‐related fear , pain intensity , disability , and physiological signs and symptoms . These results support the hypothesis that the meaning people attach to a noxious stimulus influences its experienced painfulness , and that GEXP activates cortical networks and reconciles motor output and sensory feedback & NA ; Since pain‐related fear may contribute to the development and maintenance of chronic low back pain ( CLBP ) , an exposure in vivo treatment ( EXP ) was developed for CLBP patients . We examined the effectiveness as well as specific mediating mechanisms of EXP versus operant grade d activity ( GA ) directly and 6 months post‐treatment in a multi‐centre r and omized controlled trial . In total , 85 patients suffering from disabling non‐specific CLBP reporting at least moderate pain‐related fear were r and omly allocated to EXP or GA . It was demonstrated that EXP , despite excelling in diminishing pain catastrophizing and perceived harmfulness of activities , was equally effective as GA in improving functional disability and main complaints , although the group difference almost reached statistical significance favouring EXP . Both treatment conditions did not differ in pain intensity and daily activity levels either . Nor was EXP superior to GA in the subgroup of highly fearful patients . Irrespective of treatment , approximately half the patients reported clinical ly relevant improvements in main complaints and functional disability , although for the latter outcome the group difference was almost significant favouring EXP . Furthermore , the effect of EXP relative to GA on functional disability and main complaints was mediated by decreases in catastrophizing and perceived harmfulness of activities . In sum , this study demonstrates that up to 6 months after treatment EXP is an effective treatment , but not more effective than GA , in moderately to highly fearful CLBP patients , although its superiority in altering pain catastrophizing and perceived harmfulness of activities is clearly established . Possible explanations for these findings are discussed OBJECTIVE To evaluate the effect of moderate intensity aerobic exercise ( 40%-60 % of Heart Rate Reserve ( HRR ) ) on diabetic peripheral neuropathy . METHODS A parallel-group , r and omized controlled trial was carried out in a tertiary health care setting , India . The study comprised of experimental ( moderate intensity aerobic exercise and st and ard care ) and control groups ( st and ard care ) .  Population with type 2 diabetes with clinical neuropathy , defined as a minimum score of seven on the Michigan Diabetic Neuropathy Score ( MDNS )  , was r and omly assigned to experimental and control groups by computer generated r and om number tables . RANOVA was used for data analysis ( p<0.05 was significant ) . RESULTS A total of 87 patients with DPN were evaluated in the study . After r and omization there were 47 patients in the control group and 40 patients in the experimental group . A comparison of two groups using RANOVA for anthropometric measures showed an insignificant change at eight weeks . For distal peroneal nerve 's conduction velocity there was a significant difference in two groups at eight weeks ( p<0.05 ) , Degrees of freedom (Df)=1 , 62 , F=5.14 , and p=0.03 . Sural sensory nerve at eight weeks showed a significant difference in two groups for conduction velocity , Df = 1 , 60 , F=10.16 , and p=0.00 . Significant differences in mean scores of MDNS were also observed in the two groups at eight weeks ( p value significant<0.05 ) . CONCLUSION Moderate intensity aerobic exercises can play a valuable role to disrupt the normal progression of DPN in type 2 diabetes Background and objectiveS everal cognitive – behavioral factors contribute to the persistence of pain disability in patients with chronic back pain . Fear-avoidance beliefs and fear of movement/(re)injury in particular have been shown to be strong predictors of physical performance and pain disability . Patients reporting substantial pain-related fear might benefit from exposure in vivo to a set of individually tailored , fear-eliciting , and hierarchically ordered physical movements rather than more general grade d activity . Patients and interventions Six consecutive patients with chronic low back pain who reported substantial fear of movement/(re)injury were included in the study . After a no-treatment baseline measurement period , the patients were r and omly assigned to one of two interventions . In the first intervention , patients received exposure in vivo first , followed by grade d activity . In the second intervention , the sequence of treatment modules was reversed . Before each treatment module , treatment credibility was assessed . Daily measures of pain-related fear , pain catastrophizing , and pain intensity were completed using visual analog scales . In addition , st and ardized measures of pain disability , pain-related fear , and pain vigilance were taken before and after each treatment module and at the 1-year follow-up . To obtain more objective data on actual activity levels , an ambulatory activity monitor was carried by the patients during 1 week before and after each treatment module . Results Time series analysis of the daily measures showed that improvements in pain-related fear and pain catastrophizing occurred only during the exposure in vivo and not during the grade d activity , irrespective of the treatment order . Analysis of the pretreatment to post-treatment differences also revealed that decreases in pain-related fear also concurred with decreases in pain disability and pain vigil 
    Output:
    
Conclusions Based on increasing knowledge in the domain of chronic pain , it could be assumed that integrated rehabilitation treatments for patients with PDN are beneficial .
There is no literature to support this and more research should be done on integrated biopsychosocial interventions in patients with PDN .