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: BACKGROUND There are relatively few studies in the literature that specifically evaluate accelerated rehabilitation protocol s for distal radial fractures treated with open reduction and internal fixation ( ORIF ) . The purpose of this study was to compare the early postoperative outcomes ( at zero to twelve weeks postoperatively ) of patients enrolled in an accelerated rehabilitation protocol  with those of patients enrolled in a st and ard rehabilitation protocol following ORIF for a distal radial fracture . We hypothesized that patients with accelerated rehabilitation after volar ORIF for a distal radial fracture would have an earlier return to function compared with patients who followed a st and ard protocol .  METHODS From November 2007 to November 2010 , eighty-one patients with an unstable distal radial fracture were prospect ively r and omized to follow either an accelerated or a st and ard rehabilitation protocol after undergoing ORIF with a volar plate for a distal radial fracture . Both groups began with gentle active range of motion at three to five days postoperatively . At two weeks , the accelerated group initiated wrist/forearm passive range of motion and strengthening exercises , whereas the st and ard group initiated passive range of motion and strengthening at six weeks postoperatively . Patients were assessed at three to five days , two weeks , three weeks , four weeks , six weeks , eight weeks , twelve weeks , and six months postoperatively . Outcomes included Disabilities of the Arm , Shoulder and H and ( DASH ) scores ( primary outcome ) and measurements of wrist flexion/extension , supination , pronation , grip strength , and palmar pinch . RESULTS The patients in the accelerated group had better mobility , strength , and DASH scores at the early postoperative time points ( zero to eight weeks postoperatively ) compared with the patients in the st and ard rehabilitation group . The difference between the groups was both clinical ly relevant and statistically significant . CONCLUSIONS Patients who follow an accelerated rehabilitation protocol that emphasizes motion immediately postoperatively and initiates strengthening at two weeks after volar ORIF of a distal radial fracture have an earlier return to function than patients who follow a more st and ard rehabilitation protocol . LEVEL OF EVIDENCE Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence Unilateral Colles ' fractures in 187 patients over the age of 55 years were studied in a r and omised prospect i ve trial : 97 fractures were minimally displaced and were treated either conventionally or in a crêpe b and age ; 90 displaced Colles ' fractures were reduced and of these 47 were treated conventionally while 43 were encouraged to mobilise the wrist in a cast which restricted extension . Early wrist movement hastened functional recovery and led to earlier resolution of wrist swelling . Discomfort was no greater than in patients who were treated conventionally . The bony deformity , which recurred irrespective of the method of treatment , was not adversely affected by early mobilisation PURPOSE To investigate whether there was a difference in Patient-Rated Wrist H and Evaluation ( PRWHE ) scores between patients with and without comorbidities who receive regular supervised therapy provided by a certified h and therapist ( CHT )  compared with patients who were provided with a home exercise program  and were regularly monitored . METHODS Fifty patients with a diagnosis of distal radius fractures and volar plate fixation were enrolled in a prospect i ve , r and omized clinical trial comparing those who received therapy under the supervision of a CHT with those enrolled in a home exercise program that was instructed and monitored by a CHT . The primary outcome measure ( PRWHE ) and secondary outcome measures , total arc of motion for wrist flexion and extension , supination and pronation , and grip strength , were assessed at 12 weeks . The primary outcome measure for both groups was also gathered at 6 months . RESULTS There were no statistically significant differences between the final scores of the PRWHE , wrist or forearm motion , pain , or grip strength between groups . Effect size calculations revealed that both groups experienced a large effect size for all outcomes . CONCLUSIONS Supervised clinic-based therapy is equally beneficial for patients without complications . Clinic-based therapy may be preferable for patients with noteworthy complications after a distal radius fracture with volar plate fixation . Patients with decreased finger motion and various comorbidities may benefit from therapy provided in a clinic under the supervision of a certified h and therapist . TYPE OF STUDY /LEVEL OF EVIDENCE Therapeutic II Background Distal radius fractures are among the most common fractures and account for approximately one-sixth of all fractures diagnosed . Therapy results after distal radius fracture , especially of elderly patients , are often suboptimal . The inevitable immobilization for several weeks leads to reduction in range of motion , deterioration of muscle strength , malfunction of fine motor skills as well as changes of motor and sensory representations in the brain . Currently , there are no strategies to counteract these immobilization problems . The overall aim of the study is to investigate the therapeutic potential of motor-cognitive approaches ( mental practice or mirror therapy ) on h and function after wrist fracture . Methods / Design This study is a controlled , r and omized , longitudinal intervention study with three intervention groups . One experimental group imagines movements of the fractured upper extremity without executing them ( mental practice ) . The second experimental group receives a mirror therapy program consisting of the performance of functional movement synergies using the unaffected forearm , wrist , and h and . The control group completes a relaxation training regime . Additionally , all patients receive usual care by the general practitioner . We include women aged 60 years and older having a distal radius fracture and sufficient cognitive function . All groups are visited at home for therapy sessions 5 times per week for the first 3 weeks and 3 times per week for weeks 4 to 6 . Measurements are taken at therapy onset , and after 3 , 6 and 12 weeks . The primary outcome measure will assess upper extremity functioning ( Patient-Rated Wrist Evaluation [ PRWE ] ) , while secondary outcome measures cover subjective wrist function ( Disabilities of the Arm and Shoulder ; [ DASH ] , objective impairment ( range of motion , grip force ) and quality of life ( EuroQol-5D , [ EQ5D ] ) . Discussion Results from this trial will contribute to the evidence on motor-cognitive approaches in the early therapy of distal radius fractures . Trial registration The trial is registered at Clinical Trials.gov with registration number NCT01394809 and was granted permission by the Medical Ethical Review Committee of the University of Tübingen in June 2011 The results of a prospect i ve controlled trial of early mobilisation of Colles ' fractures in the elderly are presented . Early mobilisation produced less pain and a stronger grip . It did not lead to any greater loss of reduction of the fracture . However , there was no significant improvement in the final range of movement of the wrist .  Immobilisation of the wrist for six weeks in plaster is extremely inconvenient for the elderly living alone and the patients greatly appreciated the reduction of this period of time to a minimum Abstract Colles ’ fracture patients who received physiotherapy  immediately following cast removal were compared with patients who received no active therapy following cast removal in a prospect i ve r and omised study . Patients who attended physiotherapy achieved significantly greater increases in wrist extension and grip strength after 6 weeks compared to patients who received no active therapy 42 patients with undisplaced , proximal humeral fractures were r and omly assigned into two groups in order to compare the results of instruction to the patient for independent exercises and conventional physiotherapy . No differences appeared between the groups subjectively or as regards functional parameters at 1 as well as at 3 months after the fracture and at a follow up more than 1 year later . As no disadvantage could be found instructions to the patients should in these cases be regarded as a satisfactory after-treatment Introduction This study was conducted according to GCP criteria as a prospect i ve r and omized cross-over study . The primary goal of the study was to determine clinical findings and patient satisfaction with postoperative treatment . 29 patients with a distal radius fracture that was surgically stabilized from volar and who met the inclusion criteria were enrolled over a 12-month period . Each patient r and omly received either a dorsal plaster splint or a vacuum-fit flexible but blocked orthosis applied postoperatively in the operating theatre to achieve postoperative immobilization . After one week all patients were crossed over to the complementary device maintaining the immobilization until end of week 2 . After week 2 both groups were allowed to exercise wrist mobility with a physiotherapist , in the orthosis group the device was deblocked , thus allowing limited wrist mobility . After week 4 the devices were removed in both groups . Follow-up exams were performed after postoperative weeks 1 , 2 , 4 and 12 . Results and Discussion Results were determined after week 1 and 2 using SF 36 and a personally compiled question naire ; after weeks 4 and 12 with a clinical check-up , calculation of ROM and the DASH Score . Comparison of the two groups showed a significant difference in ROM for volar flexion after 4 weeks , but no significant differences in DASH Score , duration of disability or x-ray findings . With regard to satisfaction with comfort and hygiene , patients were significantly more satisfied with the dynamic orthosis , and 23 of the 29 patients would prefer the flexible vacuum orthosis in future . Trial Registration German Clinical Trials Register ( DRKS ) OBJECTIVE To determine the effect of 2 different postoperative therapy approaches after operative stabilization of the wrist fractures :  treatment by a physical therapist with 12 sessions and an unassisted home exercise program . DESIGN R and omized controlled cohort study . SETTING Hospital-based care , primary center of orthopedic surgery . PARTICIPANTS Volunteers ( N=48 ) with fractures of the distal radius after internal fixation with locking plates . There were 46 patients available for follow-up after exclusion of 2 participants due to physiotherapy sessions in excess of the study protocol . INTERVENTIONS Not applicable . MAIN OUTCOME MEASURES Evaluation of grip strength using a Jamar dynamometer , range of motion ( ROM ) , and Patient Related Wrist Evaluation ( PRWE ) . RESULTS After a 6-week period of postoperative treatment , the patients ( n=23 ) performing an independent home exercise program using a training diary showed a significantly greater improvement of the functionality of the wrist . Grip strength reached 54 % ( P=.003 ) , and ROM in extension and flexion 79 % ( P<.001 ) of the uninjured side . Ulnar and radial abduction was also higher in this group . In contrast , patients who were treated by a physical therapist achieved grip strength equal to 32 % , and ROM in extension and flexion of 52 % of the uninjured side . Patients who were performing the home training after operation recorded an improved wrist function with a nearly 50 % lower value ( P<.001 ) in the PRWE score . CONCLUSIONS In the postoperative rehabilitation of wrist fractures , instructions in a home exercise program are an effective alternative to prescribed physical therapy treatment QUESTION Are 6 weeks of synergistic wrist and finger exercises with the metacarpophalangeal joint constrained in an orthosis ( constrained exercises ) more effective than traditional finger exercises with the metacarpophalangeal joint unconstrained ( unconstrained exercises ) after open reduction and internal fixation of a proximal phalangeal fracture in terms of impairment , activity limitation and participation restriction at 6 and 12 weeks ? DESIGN R and omised , parallel-group trial with concealed allocation , intention-to-treat analysis and blinded outcome assessors . PARTICIPANTS Sixty-six participants within 1 week of open reduction and internal fixation of proximal phalangeal fractures . INTERVENTION The experimental group carried out 6 weeks of synergistic wrist and finger exercises with the metacarpophalangeal joint constrained , whilst the control group carried out finger exercises with the metacarpophalangeal joint unconstrained , as part of a comprehensive rehabilitation program . OUTCOME MEASURES The primary outcomes were : active proximal interphalangeal joint extension of the injured finger , total active range of motion , and strength . Secondary outcomes were : pain , difficulty with specific h and activity and difficulty with usual h and activity . A blinded assessor measured outcomes at Weeks 1 , 6 and 12 . RESULTS By Week 6 , there were no significant between-group differences in improvement for : active proximal interphalangeal joint extension ( MD 2 deg , 95 % CI -3 to 7 ) ; total active finger range of motion ( MD 0 deg , 95 % CI -21 to 22 ) ; strength ( MD -2 kg , 95 % CI -8 to 4 ) ; pain ( MD 1/50 , 95 % CI -3 to 5 ) ; difficulty with specific h and activity ( MD 2/60 , 95 % CI -3 to 8) ; or difficulty with usual h and activity ( MD 0/40 , 95 % CI -4 to 3 ) . By Week 12 , there were also no significant between-group differences in any outcome . CONCLUSIONS Constrained and unconstrained exercises has similar effects after open reduction and internal fixation of proximal phalangeal fracture . REGISTRATION Australian New Zeal and Clinical Trials Registry ( ACTRN12610000294055 ) Two methods of physiotherapy after fracture of the proximal end of the humerus were compared . The study was design ed as a r and omized , controlled and single-blind trial . Twenty patients were assigned to two groups 10 - 12 days after the injury . One group was treated conventionally , the other received instructions in self-training with follow-up control of results .  Objective examination and subjective assessment were made at five intervals , up to one year after the injury . The greatest improvement in function was shown in both groups between 3 and 8 weeks . The patients deemed their daily life functions to be normal 8 weeks after 
    Output:
    
agent
There was preliminary evidence from one trial that exercise to the non-injured arm during immobilisation might lead to short-term benefits on increasing grip strength and range of movement following distal radius fracture .
There is emerging evidence that current prescribed exercise regimens may not be effective in reducing impairments and improving activity following an upper limb fracture .
Starting exercise early combined with a shorter immobilisation period is more effective than starting exercise after a longer immobilisation period .
***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: BACKGROUND There are relatively few studies in the literature that specifically evaluate accelerated rehabilitation protocol s for distal radial fractures treated with open reduction and internal fixation ( ORIF ) . The purpose of this study was to compare the early postoperative outcomes ( at zero to twelve weeks postoperatively ) of patients enrolled in an accelerated rehabilitation protocol  with those of patients enrolled in a st and ard rehabilitation protocol following ORIF for a distal radial fracture . We hypothesized that patients with accelerated rehabilitation after volar ORIF for a distal radial fracture would have an earlier return to function compared with patients who followed a st and ard protocol .  METHODS From November 2007 to November 2010 , eighty-one patients with an unstable distal radial fracture were prospect ively r and omized to follow either an accelerated or a st and ard rehabilitation protocol after undergoing ORIF with a volar plate for a distal radial fracture . Both groups began with gentle active range of motion at three to five days postoperatively . At two weeks , the accelerated group initiated wrist/forearm passive range of motion and strengthening exercises , whereas the st and ard group initiated passive range of motion and strengthening at six weeks postoperatively . Patients were assessed at three to five days , two weeks , three weeks , four weeks , six weeks , eight weeks , twelve weeks , and six months postoperatively . Outcomes included Disabilities of the Arm , Shoulder and H and ( DASH ) scores ( primary outcome ) and measurements of wrist flexion/extension , supination , pronation , grip strength , and palmar pinch . RESULTS The patients in the accelerated group had better mobility , strength , and DASH scores at the early postoperative time points ( zero to eight weeks postoperatively ) compared with the patients in the st and ard rehabilitation group . The difference between the groups was both clinical ly relevant and statistically significant . CONCLUSIONS Patients who follow an accelerated rehabilitation protocol that emphasizes motion immediately postoperatively and initiates strengthening at two weeks after volar ORIF of a distal radial fracture have an earlier return to function than patients who follow a more st and ard rehabilitation protocol . LEVEL OF EVIDENCE Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence Unilateral Colles ' fractures in 187 patients over the age of 55 years were studied in a r and omised prospect i ve trial : 97 fractures were minimally displaced and were treated either conventionally or in a crêpe b and age ; 90 displaced Colles ' fractures were reduced and of these 47 were treated conventionally while 43 were encouraged to mobilise the wrist in a cast which restricted extension . Early wrist movement hastened functional recovery and led to earlier resolution of wrist swelling . Discomfort was no greater than in patients who were treated conventionally . The bony deformity , which recurred irrespective of the method of treatment , was not adversely affected by early mobilisation PURPOSE To investigate whether there was a difference in Patient-Rated Wrist H and Evaluation ( PRWHE ) scores between patients with and without comorbidities who receive regular supervised therapy provided by a certified h and therapist ( CHT )  compared with patients who were provided with a home exercise program  and were regularly monitored . METHODS Fifty patients with a diagnosis of distal radius fractures and volar plate fixation were enrolled in a prospect i ve , r and omized clinical trial comparing those who received therapy under the supervision of a CHT with those enrolled in a home exercise program that was instructed and monitored by a CHT . The primary outcome measure ( PRWHE ) and secondary outcome measures , total arc of motion for wrist flexion and extension , supination and pronation , and grip strength , were assessed at 12 weeks . The primary outcome measure for both groups was also gathered at 6 months . RESULTS There were no statistically significant differences between the final scores of the PRWHE , wrist or forearm motion , pain , or grip strength between groups . Effect size calculations revealed that both groups experienced a large effect size for all outcomes . CONCLUSIONS Supervised clinic-based therapy is equally beneficial for patients without complications . Clinic-based therapy may be preferable for patients with noteworthy complications after a distal radius fracture with volar plate fixation . Patients with decreased finger motion and various comorbidities may benefit from therapy provided in a clinic under the supervision of a certified h and therapist . TYPE OF STUDY /LEVEL OF EVIDENCE Therapeutic II Background Distal radius fractures are among the most common fractures and account for approximately one-sixth of all fractures diagnosed . Therapy results after distal radius fracture , especially of elderly patients , are often suboptimal . The inevitable immobilization for several weeks leads to reduction in range of motion , deterioration of muscle strength , malfunction of fine motor skills as well as changes of motor and sensory representations in the brain . Currently , there are no strategies to counteract these immobilization problems . The overall aim of the study is to investigate the therapeutic potential of motor-cognitive approaches ( mental practice or mirror therapy ) on h and function after wrist fracture . Methods / Design This study is a controlled , r and omized , longitudinal intervention study with three intervention groups . One experimental group imagines movements of the fractured upper extremity without executing them ( mental practice ) . The second experimental group receives a mirror therapy program consisting of the performance of functional movement synergies using the unaffected forearm , wrist , and h and . The control group completes a relaxation training regime . Additionally , all patients receive usual care by the general practitioner . We include women aged 60 years and older having a distal radius fracture and sufficient cognitive function . All groups are visited at home for therapy sessions 5 times per week for the first 3 weeks and 3 times per week for weeks 4 to 6 . Measurements are taken at therapy onset , and after 3 , 6 and 12 weeks . The primary outcome measure will assess upper extremity functioning ( Patient-Rated Wrist Evaluation [ PRWE ] ) , while secondary outcome measures cover subjective wrist function ( Disabilities of the Arm and Shoulder ; [ DASH ] , objective impairment ( range of motion , grip force ) and quality of life ( EuroQol-5D , [ EQ5D ] ) . Discussion Results from this trial will contribute to the evidence on motor-cognitive approaches in the early therapy of distal radius fractures . Trial registration The trial is registered at Clinical Trials.gov with registration number NCT01394809 and was granted permission by the Medical Ethical Review Committee of the University of Tübingen in June 2011 The results of a prospect i ve controlled trial of early mobilisation of Colles ' fractures in the elderly are presented . Early mobilisation produced less pain and a stronger grip . It did not lead to any greater loss of reduction of the fracture . However , there was no significant improvement in the final range of movement of the wrist .  Immobilisation of the wrist for six weeks in plaster is extremely inconvenient for the elderly living alone and the patients greatly appreciated the reduction of this period of time to a minimum Abstract Colles ’ fracture patients who received physiotherapy  immediately following cast removal were compared with patients who received no active therapy following cast removal in a prospect i ve r and omised study . Patients who attended physiotherapy achieved significantly greater increases in wrist extension and grip strength after 6 weeks compared to patients who received no active therapy 42 patients with undisplaced , proximal humeral fractures were r and omly assigned into two groups in order to compare the results of instruction to the patient for independent exercises and conventional physiotherapy . No differences appeared between the groups subjectively or as regards functional parameters at 1 as well as at 3 months after the fracture and at a follow up more than 1 year later . As no disadvantage could be found instructions to the patients should in these cases be regarded as a satisfactory after-treatment Introduction This study was conducted according to GCP criteria as a prospect i ve r and omized cross-over study . The primary goal of the study was to determine clinical findings and patient satisfaction with postoperative treatment . 29 patients with a distal radius fracture that was surgically stabilized from volar and who met the inclusion criteria were enrolled over a 12-month period . Each patient r and omly received either a dorsal plaster splint or a vacuum-fit flexible but blocked orthosis applied postoperatively in the operating theatre to achieve postoperative immobilization . After one week all patients were crossed over to the complementary device maintaining the immobilization until end of week 2 . After week 2 both groups were allowed to exercise wrist mobility with a physiotherapist , in the orthosis group the device was deblocked , thus allowing limited wrist mobility . After week 4 the devices were removed in both groups . Follow-up exams were performed after postoperative weeks 1 , 2 , 4 and 12 . Results and Discussion Results were determined after week 1 and 2 using SF 36 and a personally compiled question naire ; after weeks 4 and 12 with a clinical check-up , calculation of ROM and the DASH Score . Comparison of the two groups showed a significant difference in ROM for volar flexion after 4 weeks , but no significant differences in DASH Score , duration of disability or x-ray findings . With regard to satisfaction with comfort and hygiene , patients were significantly more satisfied with the dynamic orthosis , and 23 of the 29 patients would prefer the flexible vacuum orthosis in future . Trial Registration German Clinical Trials Register ( DRKS ) OBJECTIVE To determine the effect of 2 different postoperative therapy approaches after operative stabilization of the wrist fractures :  treatment by a physical therapist with 12 sessions and an unassisted home exercise program . DESIGN R and omized controlled cohort study . SETTING Hospital-based care , primary center of orthopedic surgery . PARTICIPANTS Volunteers ( N=48 ) with fractures of the distal radius after internal fixation with locking plates . There were 46 patients available for follow-up after exclusion of 2 participants due to physiotherapy sessions in excess of the study protocol . INTERVENTIONS Not applicable . MAIN OUTCOME MEASURES Evaluation of grip strength using a Jamar dynamometer , range of motion ( ROM ) , and Patient Related Wrist Evaluation ( PRWE ) . RESULTS After a 6-week period of postoperative treatment , the patients ( n=23 ) performing an independent home exercise program using a training diary showed a significantly greater improvement of the functionality of the wrist . Grip strength reached 54 % ( P=.003 ) , and ROM in extension and flexion 79 % ( P<.001 ) of the uninjured side . Ulnar and radial abduction was also higher in this group . In contrast , patients who were treated by a physical therapist achieved grip strength equal to 32 % , and ROM in extension and flexion of 52 % of the uninjured side . Patients who were performing the home training after operation recorded an improved wrist function with a nearly 50 % lower value ( P<.001 ) in the PRWE score . CONCLUSIONS In the postoperative rehabilitation of wrist fractures , instructions in a home exercise program are an effective alternative to prescribed physical therapy treatment QUESTION Are 6 weeks of synergistic wrist and finger exercises with the metacarpophalangeal joint constrained in an orthosis ( constrained exercises ) more effective than traditional finger exercises with the metacarpophalangeal joint unconstrained ( unconstrained exercises ) after open reduction and internal fixation of a proximal phalangeal fracture in terms of impairment , activity limitation and participation restriction at 6 and 12 weeks ? DESIGN R and omised , parallel-group trial with concealed allocation , intention-to-treat analysis and blinded outcome assessors . PARTICIPANTS Sixty-six participants within 1 week of open reduction and internal fixation of proximal phalangeal fractures . INTERVENTION The experimental group carried out 6 weeks of synergistic wrist and finger exercises with the metacarpophalangeal joint constrained , whilst the control group carried out finger exercises with the metacarpophalangeal joint unconstrained , as part of a comprehensive rehabilitation program . OUTCOME MEASURES The primary outcomes were : active proximal interphalangeal joint extension of the injured finger , total active range of motion , and strength . Secondary outcomes were : pain , difficulty with specific h and activity and difficulty with usual h and activity . A blinded assessor measured outcomes at Weeks 1 , 6 and 12 . RESULTS By Week 6 , there were no significant between-group differences in improvement for : active proximal interphalangeal joint extension ( MD 2 deg , 95 % CI -3 to 7 ) ; total active finger range of motion ( MD 0 deg , 95 % CI -21 to 22 ) ; strength ( MD -2 kg , 95 % CI -8 to 4 ) ; pain ( MD 1/50 , 95 % CI -3 to 5 ) ; difficulty with specific h and activity ( MD 2/60 , 95 % CI -3 to 8) ; or difficulty with usual h and activity ( MD 0/40 , 95 % CI -4 to 3 ) . By Week 12 , there were also no significant between-group differences in any outcome . CONCLUSIONS Constrained and unconstrained exercises has similar effects after open reduction and internal fixation of proximal phalangeal fracture . REGISTRATION Australian New Zeal and Clinical Trials Registry ( ACTRN12610000294055 ) Two methods of physiotherapy after fracture of the proximal end of the humerus were compared . The study was design ed as a r and omized , controlled and single-blind trial . Twenty patients were assigned to two groups 10 - 12 days after the injury . One group was treated conventionally , the other received instructions in self-training with follow-up control of results .  Objective examination and subjective assessment were made at five intervals , up to one year after the injury . The greatest improvement in function was shown in both groups between 3 and 8 weeks . The patients deemed their daily life functions to be normal 8 weeks after 
    Output:
    