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 : The aim of this placebo-controlled , r and omized , single-masked study was to establish the effects of a 10-week ambulatory exercise programme for osteoporotic patients on pain , use of analgesics , functional status , quality of life , balance and muscle strength .  Fifty-three ambulatory postmenopausal women with at least one spinal crush fracture and pains within the last 3 years were r and omized for physiotherapeutic training twice a week for 10 weeks or no training . The training included general training of balance and muscle strength , with stabilization of the lumbar spine . The participants were tested at baseline , week 5 and week 10 with a balance test , muscle strength test and question naires on pain , use of analgesics , functional status and quality of life . Twelve weeks after the supervised training had finished ( week 22 ) they answered the same question naires . The study groups were comparable at baseline . The training group had a significant reduction in use of analgesics ( p= 0.02 ) and pain level ( p= 0.01 ) during the training period . Distribution of functional score improved ; the improvement was reduced at week 22 . Quality of life score improved significantly throughout the study ( p= 0.0008 ) , even after week 22 . Balance improved non-significantly ( p= 0.08 ) . Quadriceps muscle strength improved significantly after 5 weeks ( p= 0.04 ) . Back extensor muscle strength improved almost significantly ( p= 0.09 ) . In conclusion , this training programme for osteoporotic patients  improved balance and level of daily function and decreased experience of pain and use of analgesics . Quality of life was improved even beyond the active training period Introduction : Specific pharmacological treatment reduces the incidence of fractures significantly in patients with osteoporosis . Unfortunately , compliance with such therapy is low in clinical practice and is inversely related to educational level . We hypothesized that patients '  knowledge of osteoporosis may be increased by a group-based multidisciplinary education programme . Methods : Three hundred patients , aged 45—81 years , recently diagnosed with osteoporosis and started on specific treatment  , were r and omized to either the " school ' ' or " control ' ' group . Teaching was performed by nurses , physiotherapists , dieticians , and doctors , and design ed to increase the patient 's empowerment . The patient 's knowledge of osteoporosis was tested at study entry and at 3 months using a vali date d question naire . Results : At study entry , no differences in age or score ( 22 ( 18—24 ) ( median ( 25—75 percentiles ) ) vs. 22 ( 18—24 ) ) were seen between the school and control groups . The change in knowledge during the study , however , differed significantly between the two groups ( p<0.001 ) . In the school group , the increase in knowledge score correlated inversely with the level of education ; that is , the lower the education level , the higher the gain in knowledge during the course ( Rho=-0.25 , p<0.01 ) . Conclusions : A group-based multidisciplinary education programme significantly increases patients ' knowledge of the disease OBJECTIVE To examine the effect of community-based nutrition education intervention on calcium intake and bone mass in Vietnamese postmenopausal women . DESIGN A controlled trial was conducted in two groups as intervention and control . The intervention group was given nutrition education during 18 months to improve calcium intake , while the control subjects had the usual diet .  Calcium intake and bone mass were evaluated every 6 months . Bone mass was assessed by speed of sound ( SOS ) at calcaneus , referred to as quantitative ultrasound measurement . Anthropometric indices and serum parathyroid hormone ( PTH ) were determined at baseline and at the end of intervention . SETTING Two rural communes of Hai Duong province located in the Red River Delta in Vietnam . SUBJECTS A total of 140 women aged 55 - 65 years , who were more than 5 years postmenopausal and with low calcium intake ( < 400 mg/d ) , were recruited . After 18 months of intervention , 108 women completed the study . RESULTS Calcium intake in the intervention group had increased significantly ( P < 0.01 ) while it had no significant changes in controls . SOS values were not changed significantly in the intervention subjects while it decreased significantly by 0.5 % in the controls ( P < 0.01 ) . The intervention led to a decrease in serum PTH by 12 % ( P < 0.01 ) . In the controls , there was an increase in serum PTH by 32 % ( P < 0.001 ) . CONCLUSION Nutrition education intervention was effective in improving calcium intake and retarding bone loss in the studied subjects OBJECTIVE : To define the effects of therapeutic exercise on bone density and back complaints . METHODS : A r and omised controlled trial with parallel groups was conducted in an outpatient clinic , Medical School , University of Vienna . Ninety two sedentary post-menopausal women with back problems were r and omly allocated to either exercise ( groups 1 and 2 ) or control ( group 3 , no exercise , n = 31 ) ; the exercise group was retrospectively subdivided into compliant ( group 1 , n = 27 ) and not fully compliant patients ( group 2 , n = 34 ) . Regular , initially supervised therapeutic exercise aim ed at restoring biomechanical function was performed for four years . Bone density in the forearm was measured by single photon absorptiometry at entry and after four years ; subjective back complaints were documented . RESULTS : A significant decrease in bone density was observed in groups 2 and 3 ; no change was noted in group 1 ; back complaints decreased in group 1 only . CONCLUSIONS : Sedentary postmenopausal women may benefit from regular long term therapeutic exercise in terms of subjective back complaints and slowed loss of bone mass Alp A , Kanat E , Yurtkuran M : Efficacy of a self-management program for osteoporotic subjects . Am J Phys Med Rehabil 2007;86:633–640 . Objective : This study is based on whether the self-management program choices For Better Bone Health is effective to promote behavioral strategies for improving bone health , life quality , pain perception , physical function , and balance in osteoporotic subjects . Design : In this single-blind , r and omized controlled study , a total of 50 sedentary women with postmenopausal and idiopathic osteoporosis were selected from the out patients of Atatürk Balneotherapy and Rehabilitation Center according to their physical activity level and T scores of dual-energy x-ray absorptiometry as the inclusion criteria . Fifty sedentary women with BMD T scores of −2.5 or lower were r and omized into two groups ( self-management group : group 1 ; and control group : group 2 ) and enrolled in a 6-mo study . Participants attended self-management class once a week for 5 wks . Evaluations were done at baseline , at the end of the fifth week , and at the sixth month . Pain-intensity evaluation by Visual Analogue Scale ( VAS ) , life- quality assessment s by SF-36 , balance testing by Sensitized Romberg Test ( SRT ) , and functional assessment by Timed Sit to St and test ( TSS ) and a simple question naire were the outcome measures . Results : When the groups were compared by change scores and percentages of change , improvements observed in pain intensity by VAS ( P < 0.001 ) , SF-36 Physical Function ( P < 0.001 ) , SF-36 Physical Role Limitations ( P < 0.001 ) , SF-36 Social Function ( P < 0.001 ) , SF-36 Mental Health ( P < 0.001 ) , SF-36 Vitality ( P < 0.01 ) , SF-36 Pain ( P < 0.001 ) , SF-36 General Health Perceptions ( P < 0.05 ) , SF-36 Emotional Role Limitations ( P < 0.01 ) , SRT eyes open ( P < 0.001 ) , SRT eyes closed ( P < 0.001 ) , and TSS ( P < 0.001 ) were determined to be superior in group 1 at the end of the sixth month . Seventy-four percent of patients in group 1 engaged in regular physical activities , and 92 % of them declared that they understood the purpose and benefits of medications and  dietary calcium intake . Fifty-seven percent of them formed personal plans for preventing traumas , whereas 8 % of the subjects in group 2 experienced new falls but no fractures . Conclusion : It is determined that the self-management class led to improvements in functional , balance , and life- quality outcomes and to reductions in pain perception OBJECTIVE To evaluate the effects of a 3-month home-based physical therapy ( PT ) program for patients with hip fracture after surgery . DESIGN R and omized controlled trial . SETTING Home . PARTICIPANTS Twenty-five patients recently discharged from an acute orthopedic department . INTERVENTIONS Patients were r and omized to the home-based PT group ( n=13 ) , where they received home-based PT 8 times from discharge to month 3 postdischarge , or to the control group ( n=12 ) . The home-based PT program included exercises for muscle strengthening , range of motion ( ROM ) , balance , and functional training . Patients in the control group were instructed to practice the exercise program given at bedside before discharge . MAIN OUTCOME MEASURES Patients were evaluated for hip ROM , strength , walking velocity , Harris hip score , and health-related quality of life ( HRQOL ) at the week of discharge and at 1 , 3 , and 6 months after discharge . RESULTS The baseline characteristics showed no difference between the 2 groups . Harris score of the home-based PT group progressed from 58.6+/-8.5 to 90.1+/-5.4 at month 3 , whereas Harris score of the control group progressed from 54.6+/-14.5 to 77.4+/-10.0 ( P<.01 ) . Scores of the psychologic domain of HRQOL for the home-based PT group were significantly better at month 1 ( P<.05 ) and month 3 ( P<.01 ) after discharge . Moreover , the physical domain score of the home-based PT group was also significantly better ( P<.05 ) at 3 months after discharge . CONCLUSIONS Home-based PT programs could help patients regain function and HRQOL earlier BACKGROUND Exercise programs improve balance , strength and agility in elderly people and thus may prevent falls . However , specific exercise programs that might be widely used in the community and that might be " prescribed " by physicians , especially for patients with osteoporosis , have not been evaluated . We conducted a r and omized controlled trial of such a program design ed specifically for women with osteoporosis . METHODS We identified women 65 to 75 years of age in whom osteoporosis had been diagnosed by dual-energy X-ray absorptiometry in our hospital between 1996 and 2000 and who were not engaged in regular weekly programs of moderate or hard exercise .  Women who agreed to participate were r and omly assigned to participate in a twice-weekly exercise class or to not participate in the class . We measured baseline data and , 20 weeks later , changes in static balance ( by dynamic posturography ) , dynamic balance ( by a timed figure-eight run ) and knee extension strength ( by dynamometry ) . RESULTS Of 93 women who began the trial , 80 completed it . Before adjustment for covariates , the intervention group tended to have greater , although nonsignificant , improvements in static balance ( mean difference 4.8 % , 95 % confidence interval [ CI ] -1.3 % to 11.0 % ) , dynamic balance ( mean difference 3.3 % , 95 % CI -1.7 % to 8.4 % ) and knee extension strength ( mean difference 7.8 % , 95 % CI -5.4 % to 21.0 % ) . Mean crude changes in the static balance score were -0.85 ( 95 % CI -2.91 to 1.21 ) for the control group and 1.40 ( 95 % CI -0.66 to 3.46 ) for the intervention group . Mean crude changes in figure-eight velocity ( dynamic balance ) were 0.08 ( 95 % CI 0.02 to 0.14 ) m/s for the control group and 0.14 ( 95 % CI 0.08 to 0.20 ) m/s for the intervention group . For knee extension strength , mean changes were -0.58 ( 95 % CI -3.02 to 1.81 ) kg/m for the control group and 1.03 ( 95 % CI -1.31 to 3.34 ) kg/m for the intervention group . After adjustment for age , physical activity and years of estrogen use , the improvement in dynamic balance was 4.9 % greater for the intervention group than for the control group ( p = 0.044 ) . After adjustment for physical activity , cognitive status and number of fractures ever , the improvement in knee extension strength was 12.8 % greater for the intervention group than for the control group ( p = 0.047 ) . The intervention group also had a 6.3 % greater improvement in static balance after adjustment for rheumatoid arthritis and osteoarthritis , but this difference was not significant ( p = 0.06 ) . INTERPRETATION Relative to controls , participants in the exercise program experienced improvements in dynamic balance and strength , both important determinants of risk for falls , particularly in older women with osteoporosis CONTEXT Hip fractures are common in the elderly , and despite st and ar 
    Output:
    
agent
Collectively , these studies provided some evidence to show that interventions by healthcare professionals improved the QOL medication compliance and calcium intake of patients but its effects on BMD , medication persistence , knowledge , and other lifestyle modifications were less conclusive .
***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 : The aim of this placebo-controlled , r and omized , single-masked study was to establish the effects of a 10-week ambulatory exercise programme for osteoporotic patients on pain , use of analgesics , functional status , quality of life , balance and muscle strength .  Fifty-three ambulatory postmenopausal women with at least one spinal crush fracture and pains within the last 3 years were r and omized for physiotherapeutic training twice a week for 10 weeks or no training . The training included general training of balance and muscle strength , with stabilization of the lumbar spine . The participants were tested at baseline , week 5 and week 10 with a balance test , muscle strength test and question naires on pain , use of analgesics , functional status and quality of life . Twelve weeks after the supervised training had finished ( week 22 ) they answered the same question naires . The study groups were comparable at baseline . The training group had a significant reduction in use of analgesics ( p= 0.02 ) and pain level ( p= 0.01 ) during the training period . Distribution of functional score improved ; the improvement was reduced at week 22 . Quality of life score improved significantly throughout the study ( p= 0.0008 ) , even after week 22 . Balance improved non-significantly ( p= 0.08 ) . Quadriceps muscle strength improved significantly after 5 weeks ( p= 0.04 ) . Back extensor muscle strength improved almost significantly ( p= 0.09 ) . In conclusion , this training programme for osteoporotic patients  improved balance and level of daily function and decreased experience of pain and use of analgesics . Quality of life was improved even beyond the active training period Introduction : Specific pharmacological treatment reduces the incidence of fractures significantly in patients with osteoporosis . Unfortunately , compliance with such therapy is low in clinical practice and is inversely related to educational level . We hypothesized that patients '  knowledge of osteoporosis may be increased by a group-based multidisciplinary education programme . Methods : Three hundred patients , aged 45—81 years , recently diagnosed with osteoporosis and started on specific treatment  , were r and omized to either the " school ' ' or " control ' ' group . Teaching was performed by nurses , physiotherapists , dieticians , and doctors , and design ed to increase the patient 's empowerment . The patient 's knowledge of osteoporosis was tested at study entry and at 3 months using a vali date d question naire . Results : At study entry , no differences in age or score ( 22 ( 18—24 ) ( median ( 25—75 percentiles ) ) vs. 22 ( 18—24 ) ) were seen between the school and control groups . The change in knowledge during the study , however , differed significantly between the two groups ( p<0.001 ) . In the school group , the increase in knowledge score correlated inversely with the level of education ; that is , the lower the education level , the higher the gain in knowledge during the course ( Rho=-0.25 , p<0.01 ) . Conclusions : A group-based multidisciplinary education programme significantly increases patients ' knowledge of the disease OBJECTIVE To examine the effect of community-based nutrition education intervention on calcium intake and bone mass in Vietnamese postmenopausal women . DESIGN A controlled trial was conducted in two groups as intervention and control . The intervention group was given nutrition education during 18 months to improve calcium intake , while the control subjects had the usual diet .  Calcium intake and bone mass were evaluated every 6 months . Bone mass was assessed by speed of sound ( SOS ) at calcaneus , referred to as quantitative ultrasound measurement . Anthropometric indices and serum parathyroid hormone ( PTH ) were determined at baseline and at the end of intervention . SETTING Two rural communes of Hai Duong province located in the Red River Delta in Vietnam . SUBJECTS A total of 140 women aged 55 - 65 years , who were more than 5 years postmenopausal and with low calcium intake ( < 400 mg/d ) , were recruited . After 18 months of intervention , 108 women completed the study . RESULTS Calcium intake in the intervention group had increased significantly ( P < 0.01 ) while it had no significant changes in controls . SOS values were not changed significantly in the intervention subjects while it decreased significantly by 0.5 % in the controls ( P < 0.01 ) . The intervention led to a decrease in serum PTH by 12 % ( P < 0.01 ) . In the controls , there was an increase in serum PTH by 32 % ( P < 0.001 ) . CONCLUSION Nutrition education intervention was effective in improving calcium intake and retarding bone loss in the studied subjects OBJECTIVE : To define the effects of therapeutic exercise on bone density and back complaints . METHODS : A r and omised controlled trial with parallel groups was conducted in an outpatient clinic , Medical School , University of Vienna . Ninety two sedentary post-menopausal women with back problems were r and omly allocated to either exercise ( groups 1 and 2 ) or control ( group 3 , no exercise , n = 31 ) ; the exercise group was retrospectively subdivided into compliant ( group 1 , n = 27 ) and not fully compliant patients ( group 2 , n = 34 ) . Regular , initially supervised therapeutic exercise aim ed at restoring biomechanical function was performed for four years . Bone density in the forearm was measured by single photon absorptiometry at entry and after four years ; subjective back complaints were documented . RESULTS : A significant decrease in bone density was observed in groups 2 and 3 ; no change was noted in group 1 ; back complaints decreased in group 1 only . CONCLUSIONS : Sedentary postmenopausal women may benefit from regular long term therapeutic exercise in terms of subjective back complaints and slowed loss of bone mass Alp A , Kanat E , Yurtkuran M : Efficacy of a self-management program for osteoporotic subjects . Am J Phys Med Rehabil 2007;86:633–640 . Objective : This study is based on whether the self-management program choices For Better Bone Health is effective to promote behavioral strategies for improving bone health , life quality , pain perception , physical function , and balance in osteoporotic subjects . Design : In this single-blind , r and omized controlled study , a total of 50 sedentary women with postmenopausal and idiopathic osteoporosis were selected from the out patients of Atatürk Balneotherapy and Rehabilitation Center according to their physical activity level and T scores of dual-energy x-ray absorptiometry as the inclusion criteria . Fifty sedentary women with BMD T scores of −2.5 or lower were r and omized into two groups ( self-management group : group 1 ; and control group : group 2 ) and enrolled in a 6-mo study . Participants attended self-management class once a week for 5 wks . Evaluations were done at baseline , at the end of the fifth week , and at the sixth month . Pain-intensity evaluation by Visual Analogue Scale ( VAS ) , life- quality assessment s by SF-36 , balance testing by Sensitized Romberg Test ( SRT ) , and functional assessment by Timed Sit to St and test ( TSS ) and a simple question naire were the outcome measures . Results : When the groups were compared by change scores and percentages of change , improvements observed in pain intensity by VAS ( P < 0.001 ) , SF-36 Physical Function ( P < 0.001 ) , SF-36 Physical Role Limitations ( P < 0.001 ) , SF-36 Social Function ( P < 0.001 ) , SF-36 Mental Health ( P < 0.001 ) , SF-36 Vitality ( P < 0.01 ) , SF-36 Pain ( P < 0.001 ) , SF-36 General Health Perceptions ( P < 0.05 ) , SF-36 Emotional Role Limitations ( P < 0.01 ) , SRT eyes open ( P < 0.001 ) , SRT eyes closed ( P < 0.001 ) , and TSS ( P < 0.001 ) were determined to be superior in group 1 at the end of the sixth month . Seventy-four percent of patients in group 1 engaged in regular physical activities , and 92 % of them declared that they understood the purpose and benefits of medications and  dietary calcium intake . Fifty-seven percent of them formed personal plans for preventing traumas , whereas 8 % of the subjects in group 2 experienced new falls but no fractures . Conclusion : It is determined that the self-management class led to improvements in functional , balance , and life- quality outcomes and to reductions in pain perception OBJECTIVE To evaluate the effects of a 3-month home-based physical therapy ( PT ) program for patients with hip fracture after surgery . DESIGN R and omized controlled trial . SETTING Home . PARTICIPANTS Twenty-five patients recently discharged from an acute orthopedic department . INTERVENTIONS Patients were r and omized to the home-based PT group ( n=13 ) , where they received home-based PT 8 times from discharge to month 3 postdischarge , or to the control group ( n=12 ) . The home-based PT program included exercises for muscle strengthening , range of motion ( ROM ) , balance , and functional training . Patients in the control group were instructed to practice the exercise program given at bedside before discharge . MAIN OUTCOME MEASURES Patients were evaluated for hip ROM , strength , walking velocity , Harris hip score , and health-related quality of life ( HRQOL ) at the week of discharge and at 1 , 3 , and 6 months after discharge . RESULTS The baseline characteristics showed no difference between the 2 groups . Harris score of the home-based PT group progressed from 58.6+/-8.5 to 90.1+/-5.4 at month 3 , whereas Harris score of the control group progressed from 54.6+/-14.5 to 77.4+/-10.0 ( P<.01 ) . Scores of the psychologic domain of HRQOL for the home-based PT group were significantly better at month 1 ( P<.05 ) and month 3 ( P<.01 ) after discharge . Moreover , the physical domain score of the home-based PT group was also significantly better ( P<.05 ) at 3 months after discharge . CONCLUSIONS Home-based PT programs could help patients regain function and HRQOL earlier BACKGROUND Exercise programs improve balance , strength and agility in elderly people and thus may prevent falls . However , specific exercise programs that might be widely used in the community and that might be " prescribed " by physicians , especially for patients with osteoporosis , have not been evaluated . We conducted a r and omized controlled trial of such a program design ed specifically for women with osteoporosis . METHODS We identified women 65 to 75 years of age in whom osteoporosis had been diagnosed by dual-energy X-ray absorptiometry in our hospital between 1996 and 2000 and who were not engaged in regular weekly programs of moderate or hard exercise .  Women who agreed to participate were r and omly assigned to participate in a twice-weekly exercise class or to not participate in the class . We measured baseline data and , 20 weeks later , changes in static balance ( by dynamic posturography ) , dynamic balance ( by a timed figure-eight run ) and knee extension strength ( by dynamometry ) . RESULTS Of 93 women who began the trial , 80 completed it . Before adjustment for covariates , the intervention group tended to have greater , although nonsignificant , improvements in static balance ( mean difference 4.8 % , 95 % confidence interval [ CI ] -1.3 % to 11.0 % ) , dynamic balance ( mean difference 3.3 % , 95 % CI -1.7 % to 8.4 % ) and knee extension strength ( mean difference 7.8 % , 95 % CI -5.4 % to 21.0 % ) . Mean crude changes in the static balance score were -0.85 ( 95 % CI -2.91 to 1.21 ) for the control group and 1.40 ( 95 % CI -0.66 to 3.46 ) for the intervention group . Mean crude changes in figure-eight velocity ( dynamic balance ) were 0.08 ( 95 % CI 0.02 to 0.14 ) m/s for the control group and 0.14 ( 95 % CI 0.08 to 0.20 ) m/s for the intervention group . For knee extension strength , mean changes were -0.58 ( 95 % CI -3.02 to 1.81 ) kg/m for the control group and 1.03 ( 95 % CI -1.31 to 3.34 ) kg/m for the intervention group . After adjustment for age , physical activity and years of estrogen use , the improvement in dynamic balance was 4.9 % greater for the intervention group than for the control group ( p = 0.044 ) . After adjustment for physical activity , cognitive status and number of fractures ever , the improvement in knee extension strength was 12.8 % greater for the intervention group than for the control group ( p = 0.047 ) . The intervention group also had a 6.3 % greater improvement in static balance after adjustment for rheumatoid arthritis and osteoarthritis , but this difference was not significant ( p = 0.06 ) . INTERPRETATION Relative to controls , participants in the exercise program experienced improvements in dynamic balance and strength , both important determinants of risk for falls , particularly in older women with osteoporosis CONTEXT Hip fractures are common in the elderly , and despite st and ar 
    Output:
    