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: INTRODUCTION Exercise training is beneficial for hemodialysis patients , but it should be tailored to individual abilities and willingness to participate . This study evaluated the effects of different 6-month programs of physical activity in 18 patients of a single hemodialysis unit . METHODS Before and after a 12-month control period ( T0 ) , and following 3 ( T3 ) and 6 ( T6 ) months of training , the patients underwent the 6-minute walk test ( 6MWT ) and constant treadmill test at 3 km/hour speed and 10 % grade ; spontaneous physical activity was assessed by pedometers . All patients trained for coordination , flexibility and muscular strengthening for 30 minutes within the first 2 hours of hemodialysis sessions : 9 patients underwent home exercise walking training ( advised walking group [ AWG ] ) ; the other 9 patients underwent the advised home training program plus an additional supervised gym training session , twice weekly ( supervised walking group [ SWG ] ) . RESULTS In both AWG and SWG , no changes occurred during the control period ( 232 ± 204 m and 248 ± 187 m at T0 ) . In contrast , endurance performance at treadmill increased at T3 and T6 in the AWG ( 377 ± 272 m and 615 ± 413 m ; p<0.01 ) and in the SWG ( 424 ± 272 m and 890 ± 364 m ; p<0.001 ) . No unwanted side effects occurred . CONCLUSION This study shows that physical exercise programs can safely increase physical performance in hemodialysis patients . The training program should be continued for at least 6 months to increase muscle strength and endurance .  Intradialytic exercise and home-based , pedometer-based regimens may be a useful and easy approach , whereas supervised programs can give additional benefits in motivated , selected patients BACKGROUND Patients on maintenance hemodialysis suffer from diminished physical health . Directly supervised exercise programs have been shown to be effective at improving physical function and optimizing well-being . However , nurses seldom include an exercise intervention in the care plan for hemodialysis patients . OBJECTIVES The purpose of this study was to examine the effects of a 12-week nurse-led case management program on home exercise training for hemodialysis patients . DESIGN The study was a r and omized , two-parallel group trial . SETTING S Hemodialysis units in two tertiary hospitals in Nanjing , mainl and China . PARTICIPANTS One hundred and thirteen adult patients who have been in stable condition while on dialysis treatment for more than 3 months were recruited and r and omly assigned to either the study group ( n=57 ) or the control group ( n=56 ) . METHODS Both groups underwent a brief weekly in-center exercise training session before their dialysis sessions for the first 6 weeks . The study group received additional nurse case management weekly for the first 6 weeks and biweekly for the following 6 weeks . The intervention was to facilitate patients in performing regular exercise at home . Outcome measures , including gait speed , 10-repetition sit-to-st and performance , and quality of life were collected at baseline , and at 6 and 12 weeks into the program . RESULTS The results revealed that patients in the study group demonstrated greater increases in normal gait speed [ F(1,111)=4.42 , p=0.038 ] than the control group . For the study group , a mean increase of 12.02 (±3.03)centimeters/second from baseline to week 12 was found . With regard to the fast gait speed , there was a marginally significant between-group effect [ F(1,111)=3.93 , p=0.050 ] . The study group showed a mean improvement of 11.08 (±3.32)cm/s , from baseline to week 12 . Patients from both groups showed improvements in their 10-repetition sit-to-st and performance . The between-group differences approached significance [ F(1,111)=3.92 , p=0.050 ] , with the study group showed greater improvement than the control group . The time taken by the patients in the study group to complete the 10-STS test increased by 5.75 (±3.88)s from baseline to week 12 . Significant improvements in quality of life across three time points were found only in the study group . CONCLUSIONS Home exercise using a nurse-led case management approach is practical and effective in improving the physical function and self-perceived health of stable hemodialysis patients Objective : To compare the effectiveness of unsupervised home and supervised group exercise on parameters related to risk of falling among older adults . Design : Prospect i ve , single-blind , r and omized and controlled trial . Setting : Nursing home . Subjects : The subjects were selected from 535 independent individuals who resided in a nursing home . Forty-two older adults , aged > 65 years , with risk of falling were recruited , and 32 of them completed the study . Intervention : The 42 subjects were divided into two groups ( unsupervised home exercise and supervised exercise group ) r and omly . Exercise sessions were performed three times a week for a period of eight weeks . Main measures : Measurements were taken at baseline and after the completion of the exercise programme . The fear of falling was evaluated using a visual analogue scale , quadriceps muscle strength was measured with a dynamometer , flexibility was assessed with the sit and reach test , functional mobility was determined using the Timed Up and Go Test , balance was evaluated using one-leg and t and em st and ing , and Berg Balance Scale and proprioception was assessed with knee position sense . Results : Thirty-two subjects ( unsupervised home exercise n = 15 , supervised group exercise n = 17 ) completed the exercise programme and all of the measurements . The unsupervised home exercise group showed significant improvement in balance , functional mobility and flexibility ( P > 0.05 ) . In addition to balance , functional mobility and flexibility , the supervised exercise group also showed significant improvements in both strength and proprioception ( P > 0.05 ) . Conclusions : Supervised group exercise is more effective at reducing the risk factors related to falling among older adults living in a nursing home than is unsupervised home exercise Dehydration , a common practice among competitive athletes in sports including weight classes , has uncertain effects on strength . This study examined the effects of passive dehydration ( D , ∼2 hours in a sauna ) followed by rehydration ( R , ∼2 hours of rest with water ad libitum ) on bench press one-repetition maximum ( 1RM ) . Ten weight-trained males ( x ± SE ; age = 25 ± 1 years ; mass = 85.5 ± 5.2 kg ; height = 173.5 ± 1.7 cm ; body fat = 17.8 ± 2.2 % ; 1RM = 118 ± 8 kg ) completed 2 testing sessions ( E1/E2 and D/R ) consisting of , respectively , 2 euhydration 1RM measurements separated by 2 hours of rest ; and D 1RM followed by R 1RM . Testing sessions were administered in counterbalanced order and separated by 1 week . D result ed in increases ( p < 0.005 ) in body temperature , urine specific gravity , hematocrit , and hemoglobin ( calculated 8 % decrease in plasma volume ) as well as decreased body mass ( p < 0.005 ) . 1RM was decreased following D ( 111.4 ± 7.2 kg ) compared to both E1 ( 118 ± 7.6 kg , p = 0.0015 ) and R ( 117.3 ± 7.8 kg , p = 0.0023 ) , with no significant difference between E1 and R. A significant association ( r = −0.67 , p < 0.05 ) was observed between percent lean body mass ( % LBM ) and the change in 1RM following D. In conclusion , passive dehydration result ing in—1.5 % loss of body mass adversely affects bench press 1RM performance . The adverse affects of dehydration seem to be overcome by a 2-hour rest period and water consumption AIM To assess the association of measured gait speed with hemodialysis ( HD ) patients ' hospitalization , in conjunction with , and apart from , recent fall history . METHODS  Gait speed was measured by a st and ard protocol and  falls during the past 12 mo were ascertained for a prevalent multi-center HD cohort ( n = 668 ) aged 20 - 92 . Hospitalization during the past 12 mo was identified in the patient 's clinic records , and the first hospitalization after gait speed assessment ( or the competing event of death ) was identified in the 2013 United States Renal Data System St and ard Analysis Files . RESULTS Slow gait speed , defined as < 0.8 m/s , characterized 34.7 % of the patients , and 27.1 % had experienced a recent fall . Patients with slow gait speed but without a history of recent falls were 1.79 times more likely to have been hospitalized during the past 12 mo ( OR = 1.79 , 95%CI : 1.11 - 2.88 , P = 0.02 ) , and patients with slow gait speed and a history of recent falls were over two times more likely to have been hospitalized ( OR = 2.10 , 95%CI : 1.19 - 3.73 , P = 0.01 ) , compared with patients having faster gait speed and no recent fall history . Prospect i ve examination of gait speed/fall history status in relation to first hospitalization ( or death ) incurred by the end of follow-up December 31 , 2011 also showed that slow gait speed was associated with these events in conjunction with a history of falls ( HR = 1.54 , 95%CI : 1.04 - 2.30 , P = 0.03 ) . CONCLUSION The International Task Force on Nutrition and Aging reported that gait speed is a powerful predictor for older adults of adverse outcomes such as hospitalization . In our data , gait speed -- apart from , as well as in conjunction with , recent fall history -- was associated with HD patients ' hospitalization for multiple causes . Gait speed may be a sensitive health indicator among HD patients across the age spectrum Background : The  ‘ timed up and go ’ test ( TUG ) is a simple , quick and widely used clinical performance-based measure of lower extremity function , mobility and fall risk . We speculated that its properties may be different from other performance-based tests and assessed whether cognitive function may contribute to the differences among these tests in a cohort of healthy older adults . Objective : To evaluate psychometric properties of the TUG in healthy older adults in comparison to the Berg balance test ( BBT ) and the Dynamic Gait Index ( DGI ) . Methods : The  TUG , DGI and BBT  were assessed in 265 healthy older adults ( 76.4 ± 4.3 years ; 58.3 % women ) who participated in a 3-year prospect i ve study . The  Mini-Mental State Examination , digit span and verbal fluency measured cognitive function . The one- sample Kolmogorov-Smirnov test evaluated deviations from a normal distribution and Pearson ’s correlation coefficients quantified associations . Results : The mean scores of the BBT , DGI and TUG were : 54.0 ± 2.4 , 22.8 ± 1.5 , 9.5 ± 1.7 s , respectively . The BBT and the DGI were not normally distributed ( p < 0.001 ) , but the TUG was ( p = 0.713 ) . The TUG times were mildly associated ( p < 0.01 ) with digit span and verbal fluency and were related to future falls , while the BBT and the DGI were not . Conclusions : The TUG appears to be an appropriate tool for clinical assessment of functional mobility even in healthy older adults . It does not suffer from ceiling effect limitations , is normally distributed and is apparently related to executive function . The BBT and the DGI do not share these beneficial properties . Perhaps the transferring and turning components of the TUG help to convert this relatively simple motor task into a more complex measure that also depends on cognitive re sources BACKGROUND Hemodialysis patients show reduced physical function and greater risk of increased arterial stiffness because of hypertension , metabolic disturbances , and vascular calcification . Exercise interventions potentially could improve their vascular risk profile . STUDY DESIGN R and omized controlled pilot clinical study comparing the effects of 6 months of supervised intradialytic exercise training versus home-based exercise training or usual care on physical function and arterial stiffness in hemodialysis patients . SETTING & PARTICIPANTS 70 hemodialysis patients from 3 renal units . INTERVENTION Intradialytic-exercise patients trained 3 times/wk for 6 months on a cycle ergometer and home-based-exercise patients followed a walking program to achieve the same weekly physical activity . Usual-care patients received no specific intervention . OUTCOMES & MEASUREMENTS Primary outcome measures were distance traveled during a 6-minute walk test and aortic pulse wave velocity . Secondary outcome measures included augmentation index ( augmentation pressure as a percentage of central pulse pressure ) , peripheral ( brachial ) and central blood pressures ( measured noninvasively using radial tonometry ) , physical activity , and self-reported physical functioning . Measurements were made at baseline and 6 months . RESULTS At 6 months , there were no significant differences between changes in 6-minute walk test distance ( intradialytic exercise , + 14 % ; home-based exercise , + 11 % ; usual care , + 5 % ) , pulse wave velocity ( intradialytic exercise , -4 % ; home-based exercise , -2 % ; usual care , + 5 
    Output:
    
agent
Conclusions : Compared to age-matched population s , people with ESKD/HD had significantly slower GS and reduced walk distances ; with intervention , the change in the distance walked was significant .
***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: INTRODUCTION Exercise training is beneficial for hemodialysis patients , but it should be tailored to individual abilities and willingness to participate . This study evaluated the effects of different 6-month programs of physical activity in 18 patients of a single hemodialysis unit . METHODS Before and after a 12-month control period ( T0 ) , and following 3 ( T3 ) and 6 ( T6 ) months of training , the patients underwent the 6-minute walk test ( 6MWT ) and constant treadmill test at 3 km/hour speed and 10 % grade ; spontaneous physical activity was assessed by pedometers . All patients trained for coordination , flexibility and muscular strengthening for 30 minutes within the first 2 hours of hemodialysis sessions : 9 patients underwent home exercise walking training ( advised walking group [ AWG ] ) ; the other 9 patients underwent the advised home training program plus an additional supervised gym training session , twice weekly ( supervised walking group [ SWG ] ) . RESULTS In both AWG and SWG , no changes occurred during the control period ( 232 ± 204 m and 248 ± 187 m at T0 ) . In contrast , endurance performance at treadmill increased at T3 and T6 in the AWG ( 377 ± 272 m and 615 ± 413 m ; p<0.01 ) and in the SWG ( 424 ± 272 m and 890 ± 364 m ; p<0.001 ) . No unwanted side effects occurred . CONCLUSION This study shows that physical exercise programs can safely increase physical performance in hemodialysis patients . The training program should be continued for at least 6 months to increase muscle strength and endurance .  Intradialytic exercise and home-based , pedometer-based regimens may be a useful and easy approach , whereas supervised programs can give additional benefits in motivated , selected patients BACKGROUND Patients on maintenance hemodialysis suffer from diminished physical health . Directly supervised exercise programs have been shown to be effective at improving physical function and optimizing well-being . However , nurses seldom include an exercise intervention in the care plan for hemodialysis patients . OBJECTIVES The purpose of this study was to examine the effects of a 12-week nurse-led case management program on home exercise training for hemodialysis patients . DESIGN The study was a r and omized , two-parallel group trial . SETTING S Hemodialysis units in two tertiary hospitals in Nanjing , mainl and China . PARTICIPANTS One hundred and thirteen adult patients who have been in stable condition while on dialysis treatment for more than 3 months were recruited and r and omly assigned to either the study group ( n=57 ) or the control group ( n=56 ) . METHODS Both groups underwent a brief weekly in-center exercise training session before their dialysis sessions for the first 6 weeks . The study group received additional nurse case management weekly for the first 6 weeks and biweekly for the following 6 weeks . The intervention was to facilitate patients in performing regular exercise at home . Outcome measures , including gait speed , 10-repetition sit-to-st and performance , and quality of life were collected at baseline , and at 6 and 12 weeks into the program . RESULTS The results revealed that patients in the study group demonstrated greater increases in normal gait speed [ F(1,111)=4.42 , p=0.038 ] than the control group . For the study group , a mean increase of 12.02 (±3.03)centimeters/second from baseline to week 12 was found . With regard to the fast gait speed , there was a marginally significant between-group effect [ F(1,111)=3.93 , p=0.050 ] . The study group showed a mean improvement of 11.08 (±3.32)cm/s , from baseline to week 12 . Patients from both groups showed improvements in their 10-repetition sit-to-st and performance . The between-group differences approached significance [ F(1,111)=3.92 , p=0.050 ] , with the study group showed greater improvement than the control group . The time taken by the patients in the study group to complete the 10-STS test increased by 5.75 (±3.88)s from baseline to week 12 . Significant improvements in quality of life across three time points were found only in the study group . CONCLUSIONS Home exercise using a nurse-led case management approach is practical and effective in improving the physical function and self-perceived health of stable hemodialysis patients Objective : To compare the effectiveness of unsupervised home and supervised group exercise on parameters related to risk of falling among older adults . Design : Prospect i ve , single-blind , r and omized and controlled trial . Setting : Nursing home . Subjects : The subjects were selected from 535 independent individuals who resided in a nursing home . Forty-two older adults , aged > 65 years , with risk of falling were recruited , and 32 of them completed the study . Intervention : The 42 subjects were divided into two groups ( unsupervised home exercise and supervised exercise group ) r and omly . Exercise sessions were performed three times a week for a period of eight weeks . Main measures : Measurements were taken at baseline and after the completion of the exercise programme . The fear of falling was evaluated using a visual analogue scale , quadriceps muscle strength was measured with a dynamometer , flexibility was assessed with the sit and reach test , functional mobility was determined using the Timed Up and Go Test , balance was evaluated using one-leg and t and em st and ing , and Berg Balance Scale and proprioception was assessed with knee position sense . Results : Thirty-two subjects ( unsupervised home exercise n = 15 , supervised group exercise n = 17 ) completed the exercise programme and all of the measurements . The unsupervised home exercise group showed significant improvement in balance , functional mobility and flexibility ( P > 0.05 ) . In addition to balance , functional mobility and flexibility , the supervised exercise group also showed significant improvements in both strength and proprioception ( P > 0.05 ) . Conclusions : Supervised group exercise is more effective at reducing the risk factors related to falling among older adults living in a nursing home than is unsupervised home exercise Dehydration , a common practice among competitive athletes in sports including weight classes , has uncertain effects on strength . This study examined the effects of passive dehydration ( D , ∼2 hours in a sauna ) followed by rehydration ( R , ∼2 hours of rest with water ad libitum ) on bench press one-repetition maximum ( 1RM ) . Ten weight-trained males ( x ± SE ; age = 25 ± 1 years ; mass = 85.5 ± 5.2 kg ; height = 173.5 ± 1.7 cm ; body fat = 17.8 ± 2.2 % ; 1RM = 118 ± 8 kg ) completed 2 testing sessions ( E1/E2 and D/R ) consisting of , respectively , 2 euhydration 1RM measurements separated by 2 hours of rest ; and D 1RM followed by R 1RM . Testing sessions were administered in counterbalanced order and separated by 1 week . D result ed in increases ( p < 0.005 ) in body temperature , urine specific gravity , hematocrit , and hemoglobin ( calculated 8 % decrease in plasma volume ) as well as decreased body mass ( p < 0.005 ) . 1RM was decreased following D ( 111.4 ± 7.2 kg ) compared to both E1 ( 118 ± 7.6 kg , p = 0.0015 ) and R ( 117.3 ± 7.8 kg , p = 0.0023 ) , with no significant difference between E1 and R. A significant association ( r = −0.67 , p < 0.05 ) was observed between percent lean body mass ( % LBM ) and the change in 1RM following D. In conclusion , passive dehydration result ing in—1.5 % loss of body mass adversely affects bench press 1RM performance . The adverse affects of dehydration seem to be overcome by a 2-hour rest period and water consumption AIM To assess the association of measured gait speed with hemodialysis ( HD ) patients ' hospitalization , in conjunction with , and apart from , recent fall history . METHODS  Gait speed was measured by a st and ard protocol and  falls during the past 12 mo were ascertained for a prevalent multi-center HD cohort ( n = 668 ) aged 20 - 92 . Hospitalization during the past 12 mo was identified in the patient 's clinic records , and the first hospitalization after gait speed assessment ( or the competing event of death ) was identified in the 2013 United States Renal Data System St and ard Analysis Files . RESULTS Slow gait speed , defined as < 0.8 m/s , characterized 34.7 % of the patients , and 27.1 % had experienced a recent fall . Patients with slow gait speed but without a history of recent falls were 1.79 times more likely to have been hospitalized during the past 12 mo ( OR = 1.79 , 95%CI : 1.11 - 2.88 , P = 0.02 ) , and patients with slow gait speed and a history of recent falls were over two times more likely to have been hospitalized ( OR = 2.10 , 95%CI : 1.19 - 3.73 , P = 0.01 ) , compared with patients having faster gait speed and no recent fall history . Prospect i ve examination of gait speed/fall history status in relation to first hospitalization ( or death ) incurred by the end of follow-up December 31 , 2011 also showed that slow gait speed was associated with these events in conjunction with a history of falls ( HR = 1.54 , 95%CI : 1.04 - 2.30 , P = 0.03 ) . CONCLUSION The International Task Force on Nutrition and Aging reported that gait speed is a powerful predictor for older adults of adverse outcomes such as hospitalization . In our data , gait speed -- apart from , as well as in conjunction with , recent fall history -- was associated with HD patients ' hospitalization for multiple causes . Gait speed may be a sensitive health indicator among HD patients across the age spectrum Background : The  ‘ timed up and go ’ test ( TUG ) is a simple , quick and widely used clinical performance-based measure of lower extremity function , mobility and fall risk . We speculated that its properties may be different from other performance-based tests and assessed whether cognitive function may contribute to the differences among these tests in a cohort of healthy older adults . Objective : To evaluate psychometric properties of the TUG in healthy older adults in comparison to the Berg balance test ( BBT ) and the Dynamic Gait Index ( DGI ) . Methods : The  TUG , DGI and BBT  were assessed in 265 healthy older adults ( 76.4 ± 4.3 years ; 58.3 % women ) who participated in a 3-year prospect i ve study . The  Mini-Mental State Examination , digit span and verbal fluency measured cognitive function . The one- sample Kolmogorov-Smirnov test evaluated deviations from a normal distribution and Pearson ’s correlation coefficients quantified associations . Results : The mean scores of the BBT , DGI and TUG were : 54.0 ± 2.4 , 22.8 ± 1.5 , 9.5 ± 1.7 s , respectively . The BBT and the DGI were not normally distributed ( p < 0.001 ) , but the TUG was ( p = 0.713 ) . The TUG times were mildly associated ( p < 0.01 ) with digit span and verbal fluency and were related to future falls , while the BBT and the DGI were not . Conclusions : The TUG appears to be an appropriate tool for clinical assessment of functional mobility even in healthy older adults . It does not suffer from ceiling effect limitations , is normally distributed and is apparently related to executive function . The BBT and the DGI do not share these beneficial properties . Perhaps the transferring and turning components of the TUG help to convert this relatively simple motor task into a more complex measure that also depends on cognitive re sources BACKGROUND Hemodialysis patients show reduced physical function and greater risk of increased arterial stiffness because of hypertension , metabolic disturbances , and vascular calcification . Exercise interventions potentially could improve their vascular risk profile . STUDY DESIGN R and omized controlled pilot clinical study comparing the effects of 6 months of supervised intradialytic exercise training versus home-based exercise training or usual care on physical function and arterial stiffness in hemodialysis patients . SETTING & PARTICIPANTS 70 hemodialysis patients from 3 renal units . INTERVENTION Intradialytic-exercise patients trained 3 times/wk for 6 months on a cycle ergometer and home-based-exercise patients followed a walking program to achieve the same weekly physical activity . Usual-care patients received no specific intervention . OUTCOMES & MEASUREMENTS Primary outcome measures were distance traveled during a 6-minute walk test and aortic pulse wave velocity . Secondary outcome measures included augmentation index ( augmentation pressure as a percentage of central pulse pressure ) , peripheral ( brachial ) and central blood pressures ( measured noninvasively using radial tonometry ) , physical activity , and self-reported physical functioning . Measurements were made at baseline and 6 months . RESULTS At 6 months , there were no significant differences between changes in 6-minute walk test distance ( intradialytic exercise , + 14 % ; home-based exercise , + 11 % ; usual care , + 5 % ) , pulse wave velocity ( intradialytic exercise , -4 % ; home-based exercise , -2 % ; usual care , + 5 
    Output:
    