human
***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 Objective : To assess the efficacy of an educational intervention explaining symptoms to encourage grade d exercise in patients with chronic fatigue syndrome . Design : R and omised controlled trial . Setting : Chronic fatigue clinic and infectious diseases outpatient clinic . Subjects : 148 consecutively referred patients fulfilling Oxford criteria for chronic fatigue syndrome . Interventions : Patients r and omised to the control group received st and ardised medical care .  Patients r and omised to intervention received two individual treatment sessions and two telephone follow up calls , supported by a comprehensive educational pack , describing the role of disrupted physiological regulation in fatigue symptoms and encouraging home based grade d exercise . The minimum intervention group had no further treatment , but the telephone intervention group received an additional seven follow up calls and the maximum intervention group an additional seven face to face sessions over four months . Main outcome measure : A score of 25 or an increase of 10 on the SF-36 physical functioning subscale ( range 10 to 30 ) 12 months after r and omisation . Results : 21 patients dropped out , mainly from the intervention groups . Intention to treat analysis showed 79 ( 69 % ) of patients in the intervention groups achieved a satisfactory outcome in physical functioning compared with two ( 6 % ) of controls , who received st and ardised medical care ( P<0.0001 ) . Similar improvements were observed in fatigue , sleep , disability , and mood . No significant differences were found between the three intervention groups . Conclusions : Treatment incorporating evidence based physiological explanations for symptoms  was effective in encouraging self managed grade d exercise . This result ed in substantial improvement compared with st and ardised medical care OBJECTIVE To determine the prevalence and characteristics of fibromyalgia in the general population . METHODS A r and om sample of 3,006 persons in Wichita , KS , were characterized according to the presence of no pain , non-widespread pain , and widespread pain . A sub sample of 391 persons , including 193 with widespread pain , were examined and interviewed in detail . RESULTS The prevalence of fibromyalgia was 2.0 % ( 95 % confidence interval [ 95 % CI ] 1.4 , 2.7 ) for both sexes , 3.4 % ( 95 % CI 2.3 , 4.6 ) for women , and 0.5 % ( 95 % CI 0.0 , 1.0 ) for men . The prevalence of the syndrome increased with age , with highest values attained between 60 and 79 years ( > 7.0 % in women ) . Demographic , psychological , dolorimetry , and symptom factors were associated with fibromyalgia . CONCLUSION Fibromyalgia is common in the population , and occurs often in older persons . Characteristic features of fibromyalgia -- pain threshold and symptoms -- are similar in community and clinic population s , but overall severity , pain , and functional disability are more severe in the clinic population OBJECTIVE To compare 2 exercise modalities , aerobic fitness training and stretching exercises , in patients with fibromyalgia ( FM ) in relation to function , pain , quality of life , depression , and anxiety , and to correlate the cardiorespiratory fitness gain with symptom improvement . METHODS Seventy-six women with FM between 18 and 60 years old were r and omized to either an aerobic program or stretching program , for 20 weeks . They were evaluated at the beginning of the program and after 10 and 20 weeks in relation to the improvement of aerobic fitness , flexibility , function , Fibromyalgia Impact Question naire ( FIQ ) , Short-form Health Survey ( SF-36 ) , and depression and anxiety levels . Ventilatory anaerobic threshold ( VT ) and maximum oxygen uptake ( VO2max ) were determined by expired gas analyses . RESULTS Aerobic exercise was superior to stretching in relation to VO2 max , VT , function , depression , pain , and the emotional aspects and mental health domains of SF-36 . Patients in the stretching group showed no improvement in depression , " role emotional , " and " mental health . " No association was noted between improvement in aerobic fitness as measured by VT and the improvement of pain , function , or scores in FIQ and SF-36 . CONCLUSION Our results confirm that aerobic exercise is beneficial to patients with FM , but the cardiorespiratory fitness gain is not related to improvement of FM symptoms OBJECTIVE Fibromyalgia syndrome ( FMS ) is characterized by widespread musculoskeletal pain and lowered pain threshold . Other prominent symptoms include disordered sleep and fatigue . FMS affects an estimated 2 % of the population , predominantly women . This trial was design ed to evaluate the efficacy and safety of pregabalin , a novel alpha(2)-delta lig and , for treatment of symptoms associated with FMS . METHODS This multicenter , double-blind , 8-week , r and omized clinical trial compared the effects of placebo with those of 150 , 300 , and 450 mg/day pregabalin on pain , sleep , fatigue , and health-related quality of life in 529 patients with FMS . The primary outcome variable was the comparison of end point mean pain scores , derived from daily diary ratings of pain intensity , between each of the pregabalin treatment groups and the placebo group . RESULTS Pregabalin at 450 mg/day significantly reduced the average severity of pain in the primary analysis compared with placebo ( -0.93 on a 0 - 10 scale ) ( P < /= 0.001 ) , and significantly more patients in this group had > /=50 % improvement in pain at the end point ( 29 % , versus 13 % in the placebo group ; P = 0.003 ) . Pregabalin at 300 and 450 mg/day was associated with significant improvements in sleep quality , fatigue , and global measures of change .  Pregabalin at 450 mg/day improved several domains of health-related quality of life . Dizziness and somnolence were the most frequent adverse events . Rates of discontinuation due to adverse events were similar across all 4 treatment groups . CONCLUSION Pregabalin at 450 mg/day was efficacious for the treatment of FMS , reducing symptoms of pain , disturbed sleep , and fatigue compared with placebo . Pregabalin was well tolerated and improved global measures and health-related quality of life OBJECTIVE To compare responses to trigger point ( TrP ) injection between patients having both myofascial pain syndrome ( MPS ) caused by active TrPs and fibromyalgia syndrome ( FMS ) and patients with MPS due to TrPs but without FMS . DESIGN Prospect i ve design blinded measurement , before- after trial . SETTING A pain control medical clinic . PATIENTS Group 1 : MPS + FMS ; Group 2 : MPS only . All patients ( 9 in each group ) had active TrPs in the upper trapezius muscle . INTERVENTION Myofascial TrP injection with 0.5 % xylocaine . MAIN OUTCOME MEASURES Subjective pain intensity ( PI ) , pain threshold ( PT ) , and range of motion ( ROM ) were assessed before , immediately after , and 2 weeks after TrP injection . RESULTS In a comparison of preinjection measures to immediate postinjection measures , only ROM was significantly improved ( p < .05 ) in Group 1 patients ; all three parameters were significantly improved ( p < .05 ) in the Group 2 patients who had only MPS . Two weeks after injection , both groups showed significant improvement ( p < .05 ) in all three measured parameters as compared to preinjection measurements . In a comparison of the two groups , the immediate effectiveness of  TrP injection  was significantly less ( p < .05 ) in Group 1 than in Group 2 for all three parameters . Two weeks after injection , the degree of improvement in PT or ROM ( but not PI ) was not significantly different between two groups . Postinjection soreness ( different from myofascial pain ) was more severe , developed sooner , and lasted longer in Group 1 than in Group 2 . CONCLUSION Trigger point injection is a valuable procedure for pain relief for patients in both group . Patients with FMS are likely to experience significant but delayed and attenuated pain relief following injection of their active TrPs compared to myofascial pain patients with similar TrPs but without FMS . Also , FMS patients are likely to experience significantly more postinjection soreness for a longer period of time OBJECTIVE To assess the utility of an exercise program , which included aerobic , flexibility and strengthening elements , in the treatment of fibromyalgia ( FM ) . FM is a chronic musculoskeletal condition characterized by diffuse musculoskeletal pain and aching . It has been suggested that aerobic exercise is helpful in its treatment . METHODS We studied 60 patients who met American College of Rheumatology criteria for FM and had no significant comorbidities . Measurements performed on each patient at the pre and post study assessment included the number of tender points ( TP ) , total myalgic scores ( TM ) , aerobic fitness ( AF ) , flexibility and isokinetic strength . After initial evaluation patients were r and omly assigned to either an exercise or a relaxation group . Each group met 3 times per week for 6 weeks for 1 h of supervised exercise or relaxation . All patients data were stored in a computerized data base and statistical analysis was performed on all pre and post study assessment s. RESULTS Thirty-eight patients ( 18 exercise and 20 relaxation ) completed the study . Analysis of our data showed no significant difference between the groups in their pre study assessment . Post study assessment s , however , showed a significant improvement between the exercise and relaxation groups in TP ( p < 0.05 ) , TM ( p < 0.05 ) , and AF ( p < 0.05 ) . Similar improvements were also found when the pre and post study assessment of the exercise group were compared . CONCLUSION Exercise is helpful in the management of FM in the short term . It also shows that FM patients can undertake an exercise program which includes aerobic , flexibility , and strength training exercises without adverse effects . The long term utility of this type of exercise requires further evaluation OBJECTIVE To determine the efficacy of a 12-week individualized home-based exercise programme on physical functioning , pain severity and psychological distress for women with fibromyalgia ( FM ) . METHODS Seventy-nine women with a primary diagnosis of FM were r and omized to a 12-week individualized home-based moderate-intensity exercise programme or to a usual care control group . Outcomes were functional capacity ( Fibromyalgia Impact Question naire ) , pain severity and psychological distress . Outcomes were measured at study entry , at the end of the 12-week intervention , and at 3 and 9 months following completion of the intervention . RESULTS On the basis of intention-to-treat analyses , a significant improvement in functional capacity at 3 and 9 months following treatment for participants in the exercise group who were more functionally disabled at study entry was observed . At both 3 and 9 months post-treatment , the mean estimated benefit of the intervention was more than 10 points [ -12.3 ( 95 % CI , -21.9 to -2.8 ) ; -10.8 ( 95 % CI , -21.5 to -0.2 ) ] . Compared with the control group , statistically significant improvements in upper body pain were evident in the exercise group at post-treatment . These between-group differences in upper body pain were maintained at 3 and 9 months post-treatment . No statistically significant group differences on lower body pain and psychological distress were found . CONCLUSIONS Home-based exercise , a relatively low-cost treatment modality , has the potential to improve important health outcomes in FM OBJECTIVE To measure mood and physical function of individuals with fibromyalgia , 6 and 12 months following 23 weeks of supervised aerobic exercise . METHODS This is a followup report of individuals who were previously enrolled in 23 weeks of l and -based and water-based aerobic exercise classes .  Outcomes included the 6-minute walk test , Beck Depression Inventory ( BDI ) , State-Trait Anxiety Inventory , Arthritis Self-Efficacy Scale ( ASES ) , Fibromyalgia Impact Question naire ( FIQ ) , tender point count , patient global assessment score , and exercise compliance . Outcomes were measured at the start and end of the exercise classes and 6 and 12 months later . RESULTS Analyses were conducted on 29 ( intent-to-treat ) or 18 ( efficacy ) subjects .  Six-minute walk distances and BDI total scores were improved at followup ( all analyses ) . BDI cognitive/affective scores were improved at the end of 23 weeks of exercise ( both analyses ) and at the 12-month followup ( efficacy analysis only ) . BDI somatic scores were improved at 6-month ( both analyses ) and 12-month followup ( intent-to-treat only ) . FIQ and ASES function were improved at all followup points . ASES pain was improved in efficacy analyses only ( all followup points ) . Tender points were unchanged after 23 weeks of exercise and at followup . Exercise duration at followup ( total minutes of aerobic plus anaerobic exercise in the preceding week ) was related to gains in physical function ( 6- and 12-month followup ) and mood ( 6-month followup ) . CONCLUSION Exercise can improve physical function , mood , symptom severity , and aspects of self efficacy for at least 12 months . Exercising at followup was related to improvements in physical function and perhaps mood OBJECTIVE To estimate the point prevalence of fibromyalgia syndrome ( FM )  among noninstitutionalized Canadian adults ; and to assess the effect of demographic variables on the odds of having FM . METHODS A screening question naire was administered via telephone to a r and om community sample of 3395 noninstitutionalized adults residing in London , Ontario . Individuals screening positive were invited to be examined by a rheum 
    Output:
    
agent
Although some systematic review s have not established an unequivocal benefit of physical training , most authors report a benefit for patients with chronic pain or fatigue .
***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 Objective : To assess the efficacy of an educational intervention explaining symptoms to encourage grade d exercise in patients with chronic fatigue syndrome . Design : R and omised controlled trial . Setting : Chronic fatigue clinic and infectious diseases outpatient clinic . Subjects : 148 consecutively referred patients fulfilling Oxford criteria for chronic fatigue syndrome . Interventions : Patients r and omised to the control group received st and ardised medical care .  Patients r and omised to intervention received two individual treatment sessions and two telephone follow up calls , supported by a comprehensive educational pack , describing the role of disrupted physiological regulation in fatigue symptoms and encouraging home based grade d exercise . The minimum intervention group had no further treatment , but the telephone intervention group received an additional seven follow up calls and the maximum intervention group an additional seven face to face sessions over four months . Main outcome measure : A score of 25 or an increase of 10 on the SF-36 physical functioning subscale ( range 10 to 30 ) 12 months after r and omisation . Results : 21 patients dropped out , mainly from the intervention groups . Intention to treat analysis showed 79 ( 69 % ) of patients in the intervention groups achieved a satisfactory outcome in physical functioning compared with two ( 6 % ) of controls , who received st and ardised medical care ( P<0.0001 ) . Similar improvements were observed in fatigue , sleep , disability , and mood . No significant differences were found between the three intervention groups . Conclusions : Treatment incorporating evidence based physiological explanations for symptoms  was effective in encouraging self managed grade d exercise . This result ed in substantial improvement compared with st and ardised medical care OBJECTIVE To determine the prevalence and characteristics of fibromyalgia in the general population . METHODS A r and om sample of 3,006 persons in Wichita , KS , were characterized according to the presence of no pain , non-widespread pain , and widespread pain . A sub sample of 391 persons , including 193 with widespread pain , were examined and interviewed in detail . RESULTS The prevalence of fibromyalgia was 2.0 % ( 95 % confidence interval [ 95 % CI ] 1.4 , 2.7 ) for both sexes , 3.4 % ( 95 % CI 2.3 , 4.6 ) for women , and 0.5 % ( 95 % CI 0.0 , 1.0 ) for men . The prevalence of the syndrome increased with age , with highest values attained between 60 and 79 years ( > 7.0 % in women ) . Demographic , psychological , dolorimetry , and symptom factors were associated with fibromyalgia . CONCLUSION Fibromyalgia is common in the population , and occurs often in older persons . Characteristic features of fibromyalgia -- pain threshold and symptoms -- are similar in community and clinic population s , but overall severity , pain , and functional disability are more severe in the clinic population OBJECTIVE To compare 2 exercise modalities , aerobic fitness training and stretching exercises , in patients with fibromyalgia ( FM ) in relation to function , pain , quality of life , depression , and anxiety , and to correlate the cardiorespiratory fitness gain with symptom improvement . METHODS Seventy-six women with FM between 18 and 60 years old were r and omized to either an aerobic program or stretching program , for 20 weeks . They were evaluated at the beginning of the program and after 10 and 20 weeks in relation to the improvement of aerobic fitness , flexibility , function , Fibromyalgia Impact Question naire ( FIQ ) , Short-form Health Survey ( SF-36 ) , and depression and anxiety levels . Ventilatory anaerobic threshold ( VT ) and maximum oxygen uptake ( VO2max ) were determined by expired gas analyses . RESULTS Aerobic exercise was superior to stretching in relation to VO2 max , VT , function , depression , pain , and the emotional aspects and mental health domains of SF-36 . Patients in the stretching group showed no improvement in depression , " role emotional , " and " mental health . " No association was noted between improvement in aerobic fitness as measured by VT and the improvement of pain , function , or scores in FIQ and SF-36 . CONCLUSION Our results confirm that aerobic exercise is beneficial to patients with FM , but the cardiorespiratory fitness gain is not related to improvement of FM symptoms OBJECTIVE Fibromyalgia syndrome ( FMS ) is characterized by widespread musculoskeletal pain and lowered pain threshold . Other prominent symptoms include disordered sleep and fatigue . FMS affects an estimated 2 % of the population , predominantly women . This trial was design ed to evaluate the efficacy and safety of pregabalin , a novel alpha(2)-delta lig and , for treatment of symptoms associated with FMS . METHODS This multicenter , double-blind , 8-week , r and omized clinical trial compared the effects of placebo with those of 150 , 300 , and 450 mg/day pregabalin on pain , sleep , fatigue , and health-related quality of life in 529 patients with FMS . The primary outcome variable was the comparison of end point mean pain scores , derived from daily diary ratings of pain intensity , between each of the pregabalin treatment groups and the placebo group . RESULTS Pregabalin at 450 mg/day significantly reduced the average severity of pain in the primary analysis compared with placebo ( -0.93 on a 0 - 10 scale ) ( P < /= 0.001 ) , and significantly more patients in this group had > /=50 % improvement in pain at the end point ( 29 % , versus 13 % in the placebo group ; P = 0.003 ) . Pregabalin at 300 and 450 mg/day was associated with significant improvements in sleep quality , fatigue , and global measures of change .  Pregabalin at 450 mg/day improved several domains of health-related quality of life . Dizziness and somnolence were the most frequent adverse events . Rates of discontinuation due to adverse events were similar across all 4 treatment groups . CONCLUSION Pregabalin at 450 mg/day was efficacious for the treatment of FMS , reducing symptoms of pain , disturbed sleep , and fatigue compared with placebo . Pregabalin was well tolerated and improved global measures and health-related quality of life OBJECTIVE To compare responses to trigger point ( TrP ) injection between patients having both myofascial pain syndrome ( MPS ) caused by active TrPs and fibromyalgia syndrome ( FMS ) and patients with MPS due to TrPs but without FMS . DESIGN Prospect i ve design blinded measurement , before- after trial . SETTING A pain control medical clinic . PATIENTS Group 1 : MPS + FMS ; Group 2 : MPS only . All patients ( 9 in each group ) had active TrPs in the upper trapezius muscle . INTERVENTION Myofascial TrP injection with 0.5 % xylocaine . MAIN OUTCOME MEASURES Subjective pain intensity ( PI ) , pain threshold ( PT ) , and range of motion ( ROM ) were assessed before , immediately after , and 2 weeks after TrP injection . RESULTS In a comparison of preinjection measures to immediate postinjection measures , only ROM was significantly improved ( p < .05 ) in Group 1 patients ; all three parameters were significantly improved ( p < .05 ) in the Group 2 patients who had only MPS . Two weeks after injection , both groups showed significant improvement ( p < .05 ) in all three measured parameters as compared to preinjection measurements . In a comparison of the two groups , the immediate effectiveness of  TrP injection  was significantly less ( p < .05 ) in Group 1 than in Group 2 for all three parameters . Two weeks after injection , the degree of improvement in PT or ROM ( but not PI ) was not significantly different between two groups . Postinjection soreness ( different from myofascial pain ) was more severe , developed sooner , and lasted longer in Group 1 than in Group 2 . CONCLUSION Trigger point injection is a valuable procedure for pain relief for patients in both group . Patients with FMS are likely to experience significant but delayed and attenuated pain relief following injection of their active TrPs compared to myofascial pain patients with similar TrPs but without FMS . Also , FMS patients are likely to experience significantly more postinjection soreness for a longer period of time OBJECTIVE To assess the utility of an exercise program , which included aerobic , flexibility and strengthening elements , in the treatment of fibromyalgia ( FM ) . FM is a chronic musculoskeletal condition characterized by diffuse musculoskeletal pain and aching . It has been suggested that aerobic exercise is helpful in its treatment . METHODS We studied 60 patients who met American College of Rheumatology criteria for FM and had no significant comorbidities . Measurements performed on each patient at the pre and post study assessment included the number of tender points ( TP ) , total myalgic scores ( TM ) , aerobic fitness ( AF ) , flexibility and isokinetic strength . After initial evaluation patients were r and omly assigned to either an exercise or a relaxation group . Each group met 3 times per week for 6 weeks for 1 h of supervised exercise or relaxation . All patients data were stored in a computerized data base and statistical analysis was performed on all pre and post study assessment s. RESULTS Thirty-eight patients ( 18 exercise and 20 relaxation ) completed the study . Analysis of our data showed no significant difference between the groups in their pre study assessment . Post study assessment s , however , showed a significant improvement between the exercise and relaxation groups in TP ( p < 0.05 ) , TM ( p < 0.05 ) , and AF ( p < 0.05 ) . Similar improvements were also found when the pre and post study assessment of the exercise group were compared . CONCLUSION Exercise is helpful in the management of FM in the short term . It also shows that FM patients can undertake an exercise program which includes aerobic , flexibility , and strength training exercises without adverse effects . The long term utility of this type of exercise requires further evaluation OBJECTIVE To determine the efficacy of a 12-week individualized home-based exercise programme on physical functioning , pain severity and psychological distress for women with fibromyalgia ( FM ) . METHODS Seventy-nine women with a primary diagnosis of FM were r and omized to a 12-week individualized home-based moderate-intensity exercise programme or to a usual care control group . Outcomes were functional capacity ( Fibromyalgia Impact Question naire ) , pain severity and psychological distress . Outcomes were measured at study entry , at the end of the 12-week intervention , and at 3 and 9 months following completion of the intervention . RESULTS On the basis of intention-to-treat analyses , a significant improvement in functional capacity at 3 and 9 months following treatment for participants in the exercise group who were more functionally disabled at study entry was observed . At both 3 and 9 months post-treatment , the mean estimated benefit of the intervention was more than 10 points [ -12.3 ( 95 % CI , -21.9 to -2.8 ) ; -10.8 ( 95 % CI , -21.5 to -0.2 ) ] . Compared with the control group , statistically significant improvements in upper body pain were evident in the exercise group at post-treatment . These between-group differences in upper body pain were maintained at 3 and 9 months post-treatment . No statistically significant group differences on lower body pain and psychological distress were found . CONCLUSIONS Home-based exercise , a relatively low-cost treatment modality , has the potential to improve important health outcomes in FM OBJECTIVE To measure mood and physical function of individuals with fibromyalgia , 6 and 12 months following 23 weeks of supervised aerobic exercise . METHODS This is a followup report of individuals who were previously enrolled in 23 weeks of l and -based and water-based aerobic exercise classes .  Outcomes included the 6-minute walk test , Beck Depression Inventory ( BDI ) , State-Trait Anxiety Inventory , Arthritis Self-Efficacy Scale ( ASES ) , Fibromyalgia Impact Question naire ( FIQ ) , tender point count , patient global assessment score , and exercise compliance . Outcomes were measured at the start and end of the exercise classes and 6 and 12 months later . RESULTS Analyses were conducted on 29 ( intent-to-treat ) or 18 ( efficacy ) subjects .  Six-minute walk distances and BDI total scores were improved at followup ( all analyses ) . BDI cognitive/affective scores were improved at the end of 23 weeks of exercise ( both analyses ) and at the 12-month followup ( efficacy analysis only ) . BDI somatic scores were improved at 6-month ( both analyses ) and 12-month followup ( intent-to-treat only ) . FIQ and ASES function were improved at all followup points . ASES pain was improved in efficacy analyses only ( all followup points ) . Tender points were unchanged after 23 weeks of exercise and at followup . Exercise duration at followup ( total minutes of aerobic plus anaerobic exercise in the preceding week ) was related to gains in physical function ( 6- and 12-month followup ) and mood ( 6-month followup ) . CONCLUSION Exercise can improve physical function , mood , symptom severity , and aspects of self efficacy for at least 12 months . Exercising at followup was related to improvements in physical function and perhaps mood OBJECTIVE To estimate the point prevalence of fibromyalgia syndrome ( FM )  among noninstitutionalized Canadian adults ; and to assess the effect of demographic variables on the odds of having FM . METHODS A screening question naire was administered via telephone to a r and om community sample of 3395 noninstitutionalized adults residing in London , Ontario . Individuals screening positive were invited to be examined by a rheum 
    Output:
    