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 The majority of older adults do not reach the physical activity guidelines . One possible explanation for this may be that older adults overestimate their physical activity levels , because they are unable to identify exercise intensity . Methods Forty-four older adults were recruited and r and omly assigned into two walking groups lasting 6 weeks . The intervention group was asked to walk a minimum of 150 min per week at moderate intensity using walking cadence indicated with a pedometer . The control group did not get any feedback on walking intensity . Results The ability to identify moderate intensity while walking did not significantly improve in neither groups ( p = 0.530 ) . However , participants in the intervention group increased significantly the time spent at moderate intensity , in 10 min bouts ( p < 0.01 ) . Discussion A pedometer providing walking cadence to reach moderate intensity is a good tool for increasing time walked at the recommended intensity , but not because participants know more what is considered moderate intensity Rationale : Increasing physical activity is a key therapeutic aim in chronic obstructive pulmonary disease ( COPD ) .  Pulmonary rehabilitation ( PR ) improves exercise capacity , but there is conflicting evidence regarding its ability to improve physical activity levels . Objectives : To determine whether using pedometers as an adjunct to PR can enhance time spent in at least moderate‐intensity physical activity ( time expending ≥3 metabolic equivalents [ METs ] ) by people with COPD . Methods : In this single‐blind r and omized controlled trial , participants were assigned 1:1 to receive a control intervention ( PR comprising 8 wk , two supervised sessions per week ) or the trial intervention ( PR plus pedometer‐directed step targets , review ed weekly for 8 wk ) . In the r and omization process , we used minimization to balance groups for age , sex , FEV1 percent predicted , and baseline exercise capacity and physical activity levels . Outcome assessors and PR therapists were blinded to group allocation . The primary analysis was based on the intention‐to‐treat principle . Measurements and Main Results : The primary outcome was change from baseline to 8 weeks in accelerometer‐measured daily time expending at least 3 METs . A total of 152 participants ( 72 % male ; mean [ SD ] FEV1 percent predicted , 50.5 % [ 21.2 ] ; median [ first quartile , third quartile ] time expending ≥3 METs , 46 [ 21 , 92 ] min ) were enrolled and assigned to the intervention ( n = 76 ) or control ( n = 76 ) arm . There was no significant difference in change in time expending at least 3 METs between the intervention and control groups at 8 weeks ( median [ first quartile , third quartile ] difference , 0.5 [ −1.0 , 31.0 ] min ; P = 0.87 ) or at the 6‐month follow‐up ( 7.0 [ −9 , 27 ] min ; P = 0.16 ) . Conclusions : Pedometer‐directed step‐count targets during an outpatient PR program did not enhance moderate‐intensity physical activity levels in people with COPD . Clinical trial registered with www . clinical trials.gov ( NCT01719822 ) Background A physically active lifestyle has the potential to prevent cognitive decline and dementia , yet the optimal type of physical activity/exercise remains unclear . Dance is of special interest as it complex sensorimotor rhythmic activity with additional cognitive , social , and affective dimensions . Objectives To determine whether dance benefits executive function more than walking , an activity that is simple and functional . Methods Two-arm r and omized controlled trial among community-dwelling older adults . The intervention group received 1 h of ballroom dancing twice weekly over 8 months ( ~69 sessions ) in local community dance studios . The control group received a combination of a home walking program with a pedometer and optional biweekly group-based walking in local community park to facilitate socialization . Main outcomes Executive function tests : processing speed and task shift by the Trail Making Tests , response inhibition by the Stroop Color-Word Test , working memory by the Digit Span Backwards test , immediate and delayed verbal recall by the Rey Auditory Verbal Learning Test , and visuospatial recall by the Brief Visuospatial Memory Test ( BVST ) . Results One hundred and fifteen adults ( mean 69.5 years , SD 6.4 ) completed baseline and delayed baseline ( 3 weeks apart ) before being r and omized to either dance ( n = 60 ) or walking ( n = 55 ) . Of those r and omized , 79 ( 68 % ) completed the follow-up measurements ( 32 weeks from baseline ) . In the dance group only , “ non-completers ” had significantly lower baseline scores on all executive function tests than those who completed the full program . Intention-to-treat analyses showed no group effect . In a r and om effects model including participants who completed all measurements , adjusted for baseline score and covariates ( age , education , estimated verbal intelligence , and community ) , a between-group effect in favor of dance was noted only for BVST total learning ( Cohen ’s D Effect size 0.29 , p = 0.07 ) and delayed recall ( Cohen ’s D Effect size = 0.34 , p = 0.06 ) . Conclusion The superior potential of dance over walking on executive functions of cognitively healthy and active older adults was not supported . Dance improved one of the cognitive domains ( spatial memory ) important for learning dance . Controlled trials targeting inactive older adults and of a higher dose may produce stronger effects , particularly for novice dancers . Trial registration Australian and New Zeal and Clinical Trials Register ( ACTRN12613000782730 ) Background Physical activity contributes to older adults ’ autonomy , mobility , and quality of life as they age , yet fewer than 1 in 5 engage in activities as recommended . Many older adults track their exercise using pencil and paper , or their memory . Commercially available physical activity monitors ( PAM ) have the potential to facilitate these tracking practice s and , in turn , physical activity . An assessment of older adults ’ long-term experiences with PAM is needed to underst and this potential . Objective To assess short and long-term experiences of adults > 70 years old using a PAM ( Fitbit One ) in terms of acceptance , ease-of-use , and usefulness : domains in the technology acceptance model . Methods This prospect i ve study included 95 community-dwelling older adults , all of whom received a PAM as part of r and omized controlled trial piloting a fall-reducing physical activity promotion intervention . Ten-item surveys were administered 10 weeks and 8 months after the study started . Survey ratings are described and analyzed over time , and compared by sex , education , and age . Results Participants were mostly women ( 71/95 , 75 % ) , 70 to 96 years old , and had some college education ( 68/95 , 72 % ) . Most participants ( 86/95 , 91 % ) agreed or strongly agreed that the  PAM  was easy to use , useful , and acceptable both 10 weeks and 8 months after enrolling in the study . Ratings dropped between these time points in all survey domains : ease-of-use ( median difference 0.66 points , P=.001 ) ; usefulness ( median difference 0.16 points , P=.193 ) ; and acceptance ( median difference 0.17 points , P=.032 ) . Differences in ratings by sex or educational attainment were not statistically significant at either time point . Most participants 80 + years of age ( 28/37 , 76 % ) agreed or strongly agreed with survey items at long-term follow-up , however their ratings were significantly lower than participants in younger age groups at both time points . Conclusions Study results indicate it is feasible for older adults ( 70 - 90 + years of age ) to use PAMs when self-tracking their physical activity , and provide a basis for developing recommendations to integrate PAMs into promotional efforts . Trial Registration Clinical trials.gov NCT02433249 ; https:// clinical trials.gov/ct2/show/NCT02433249 ( Archived by WebCite at http://www.webcitation.org/6gED6eh0I Background Brisk walking in older people can increase step-counts and moderate to vigorous intensity physical activity ( MVPA ) in ≥10-minute bouts , as advised in World Health Organization guidelines . Previous interventions have reported step-count increases , but not change in objective ly measured MVPA in older people . We assessed whether a primary care nurse-delivered complex intervention increased objective ly measured step-counts and MVPA . Methods and Findings A total of 988 60–75 year olds , able to increase walking and r and omly selected from three UK family practice s , were invited to participate in a parallel two-arm cluster r and omised trial ; r and omisation was by household . Two-hundred-ninety-eight people from 250 households were r and omised between 2011 and 2012 ; 150 individuals to the intervention group , 148 to the usual care control group .  Intervention participants received four primary care nurse physical activity ( PA ) consultations over 3 months , incorporating behaviour change techniques , pedometer step-count and accelerometer PA intensity feedback , and an individual PA diary and plan . Assessors were not blinded to group status , but statistical analyses were conducted blind . The primary outcome was change in accelerometry assessed average daily step-counts between baseline and 3 months , with change at 12 months a secondary outcome . Other secondary outcomes were change from baseline in time in MVPA weekly in ≥10-minute bouts , accelerometer counts , and counts/minute at 3 months and 12 months . Other outcomes were adverse events , anthropometric measures , mood , and pain . Qualitative evaluations of intervention participants and practice nurses assessed the intervention ’s acceptability . At 3 months , eight participants had withdrawn or were lost to follow-up , 280 ( 94 % ) individuals provided primary outcome data . At 3 months changes in both average daily step-counts and weekly MVPA in ≥10-minute bouts were significantly higher in the intervention than control group : by 1,037 ( 95 % CI 513–1,560 ) steps/day and 63 ( 95 % CI 40–87 ) minutes/week , respectively . At 12 months corresponding differences were 609 ( 95 % CI 104–1,115 ) steps/day and 40 ( 95 % CI 17–63 ) minutes/week . Counts and counts/minute showed similar effects to steps and MVPA . Adverse events , anthropometry , mood , and pain were similar in the two groups . Participants and practice nurses found the intervention acceptable and enjoyable . Conclusions The PACE-Lift trial increased both step-counts and objective ly measured  MVPA  in ≥10-minute bouts in 60–75 year olds at 3 and 12 months , with no effect on adverse events . To our knowledge , this is the first trial in this age group to demonstrate objective MVPA increases and highlights the value of individualised support incorporating objective PA assessment in a primary care setting . Trial Registration Controlled-Trials.com IS RCT Background People over the age of 70 carry the greatest burden of chronic disease , disability and health care use . Participation in physical activity is crucial for health , and walking accounts for much of the physical activity undertaken by sedentary individuals . Pedometers are a useful motivational tool to encourage increased walking and they are cheap and easy to use . The aim of this pilot study was to evaluate the feasibility of the use of pedometers plus a theory-based intervention to assist sedentary older women to accumulate increasing amounts of physical activity , mainly through walking . Methods Female participants over the age of 70 were recruited from primary care and r and omised to receive either pedometer plus a theory-based intervention or a theory-based intervention alone . The theory-based intervention consisted of motivational techniques , goal - setting , barrier identification and self-monitoring with pedometers and daily diaries . The pedometer group were further r and omised to one of three target groups : a 10 % , 15 % or 20 % monthly increase in step count to assess the achievability and acceptability of a range of targets . The primary outcome was change in daily activity levels measured by accelerometry . Secondary outcome measures were lower limb function , health related quality of life , anxiety and depression . Results 54 participants were recruited into the study , with an average age of 76 . There were 9 drop outs , 45 completing the study . All participants in the pedometer group found the pedometers easy to use and there was good compliance with diary keeping ( 96 % in the pedometer group and 83 % in the theory-based intervention alone group ) . There was a strong correlation ( 0.78 ) between accelerometry and pedometer step counts i.e. indicating that walking was the main physical activity amongst participants . There was a greater increase in activity ( accelerometry ) amongst those in the 20 % target pedometer group compared to the other groups , although not reaching statistical significance ( p = 0.192 ) . Conclusion We have demonstrated that it is feasible to use pedometers and provide theory-based advice to community dwelling sedentary older women to increase physical activity levels and a larger study is planned to investigate this further BACKGROUND Although many Japanese older adults spend more than an hour each day walking for exercise , the intensity is often lower than the minimum level associated with various health benefits . The purpose of this study was to evaluate the efficacy of a lifestyle physical activity intervention on improving quantity and quality of daily physical activity ( DPA ) as well as cardiorespiratory endurance in community-dwelling older women . METHODS 68 women ( 60 - 78 yr of age ) were r and omly assigned to either a lifestyle physical activity intervention group ( LIFE ) or control group . During the 12-wk intervention , feedback based on accelerometer DPA data ( number of daily steps ( STEPS ) and time spent performing daily moderate intensity physical activity ( MPA ) was provided to each participant in LIFE every 
    Output:
    
agent
No impact of patient and intervention characteristics on the effect estimates were found .
Short conclusion Low quality of evidence was found for a moderate effect of physical activity monitor-based interventions on physical activity compared with control interventions .
***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 The majority of older adults do not reach the physical activity guidelines . One possible explanation for this may be that older adults overestimate their physical activity levels , because they are unable to identify exercise intensity . Methods Forty-four older adults were recruited and r and omly assigned into two walking groups lasting 6 weeks . The intervention group was asked to walk a minimum of 150 min per week at moderate intensity using walking cadence indicated with a pedometer . The control group did not get any feedback on walking intensity . Results The ability to identify moderate intensity while walking did not significantly improve in neither groups ( p = 0.530 ) . However , participants in the intervention group increased significantly the time spent at moderate intensity , in 10 min bouts ( p < 0.01 ) . Discussion A pedometer providing walking cadence to reach moderate intensity is a good tool for increasing time walked at the recommended intensity , but not because participants know more what is considered moderate intensity Rationale : Increasing physical activity is a key therapeutic aim in chronic obstructive pulmonary disease ( COPD ) .  Pulmonary rehabilitation ( PR ) improves exercise capacity , but there is conflicting evidence regarding its ability to improve physical activity levels . Objectives : To determine whether using pedometers as an adjunct to PR can enhance time spent in at least moderate‐intensity physical activity ( time expending ≥3 metabolic equivalents [ METs ] ) by people with COPD . Methods : In this single‐blind r and omized controlled trial , participants were assigned 1:1 to receive a control intervention ( PR comprising 8 wk , two supervised sessions per week ) or the trial intervention ( PR plus pedometer‐directed step targets , review ed weekly for 8 wk ) . In the r and omization process , we used minimization to balance groups for age , sex , FEV1 percent predicted , and baseline exercise capacity and physical activity levels . Outcome assessors and PR therapists were blinded to group allocation . The primary analysis was based on the intention‐to‐treat principle . Measurements and Main Results : The primary outcome was change from baseline to 8 weeks in accelerometer‐measured daily time expending at least 3 METs . A total of 152 participants ( 72 % male ; mean [ SD ] FEV1 percent predicted , 50.5 % [ 21.2 ] ; median [ first quartile , third quartile ] time expending ≥3 METs , 46 [ 21 , 92 ] min ) were enrolled and assigned to the intervention ( n = 76 ) or control ( n = 76 ) arm . There was no significant difference in change in time expending at least 3 METs between the intervention and control groups at 8 weeks ( median [ first quartile , third quartile ] difference , 0.5 [ −1.0 , 31.0 ] min ; P = 0.87 ) or at the 6‐month follow‐up ( 7.0 [ −9 , 27 ] min ; P = 0.16 ) . Conclusions : Pedometer‐directed step‐count targets during an outpatient PR program did not enhance moderate‐intensity physical activity levels in people with COPD . Clinical trial registered with www . clinical trials.gov ( NCT01719822 ) Background A physically active lifestyle has the potential to prevent cognitive decline and dementia , yet the optimal type of physical activity/exercise remains unclear . Dance is of special interest as it complex sensorimotor rhythmic activity with additional cognitive , social , and affective dimensions . Objectives To determine whether dance benefits executive function more than walking , an activity that is simple and functional . Methods Two-arm r and omized controlled trial among community-dwelling older adults . The intervention group received 1 h of ballroom dancing twice weekly over 8 months ( ~69 sessions ) in local community dance studios . The control group received a combination of a home walking program with a pedometer and optional biweekly group-based walking in local community park to facilitate socialization . Main outcomes Executive function tests : processing speed and task shift by the Trail Making Tests , response inhibition by the Stroop Color-Word Test , working memory by the Digit Span Backwards test , immediate and delayed verbal recall by the Rey Auditory Verbal Learning Test , and visuospatial recall by the Brief Visuospatial Memory Test ( BVST ) . Results One hundred and fifteen adults ( mean 69.5 years , SD 6.4 ) completed baseline and delayed baseline ( 3 weeks apart ) before being r and omized to either dance ( n = 60 ) or walking ( n = 55 ) . Of those r and omized , 79 ( 68 % ) completed the follow-up measurements ( 32 weeks from baseline ) . In the dance group only , “ non-completers ” had significantly lower baseline scores on all executive function tests than those who completed the full program . Intention-to-treat analyses showed no group effect . In a r and om effects model including participants who completed all measurements , adjusted for baseline score and covariates ( age , education , estimated verbal intelligence , and community ) , a between-group effect in favor of dance was noted only for BVST total learning ( Cohen ’s D Effect size 0.29 , p = 0.07 ) and delayed recall ( Cohen ’s D Effect size = 0.34 , p = 0.06 ) . Conclusion The superior potential of dance over walking on executive functions of cognitively healthy and active older adults was not supported . Dance improved one of the cognitive domains ( spatial memory ) important for learning dance . Controlled trials targeting inactive older adults and of a higher dose may produce stronger effects , particularly for novice dancers . Trial registration Australian and New Zeal and Clinical Trials Register ( ACTRN12613000782730 ) Background Physical activity contributes to older adults ’ autonomy , mobility , and quality of life as they age , yet fewer than 1 in 5 engage in activities as recommended . Many older adults track their exercise using pencil and paper , or their memory . Commercially available physical activity monitors ( PAM ) have the potential to facilitate these tracking practice s and , in turn , physical activity . An assessment of older adults ’ long-term experiences with PAM is needed to underst and this potential . Objective To assess short and long-term experiences of adults > 70 years old using a PAM ( Fitbit One ) in terms of acceptance , ease-of-use , and usefulness : domains in the technology acceptance model . Methods This prospect i ve study included 95 community-dwelling older adults , all of whom received a PAM as part of r and omized controlled trial piloting a fall-reducing physical activity promotion intervention . Ten-item surveys were administered 10 weeks and 8 months after the study started . Survey ratings are described and analyzed over time , and compared by sex , education , and age . Results Participants were mostly women ( 71/95 , 75 % ) , 70 to 96 years old , and had some college education ( 68/95 , 72 % ) . Most participants ( 86/95 , 91 % ) agreed or strongly agreed that the  PAM  was easy to use , useful , and acceptable both 10 weeks and 8 months after enrolling in the study . Ratings dropped between these time points in all survey domains : ease-of-use ( median difference 0.66 points , P=.001 ) ; usefulness ( median difference 0.16 points , P=.193 ) ; and acceptance ( median difference 0.17 points , P=.032 ) . Differences in ratings by sex or educational attainment were not statistically significant at either time point . Most participants 80 + years of age ( 28/37 , 76 % ) agreed or strongly agreed with survey items at long-term follow-up , however their ratings were significantly lower than participants in younger age groups at both time points . Conclusions Study results indicate it is feasible for older adults ( 70 - 90 + years of age ) to use PAMs when self-tracking their physical activity , and provide a basis for developing recommendations to integrate PAMs into promotional efforts . Trial Registration Clinical trials.gov NCT02433249 ; https:// clinical trials.gov/ct2/show/NCT02433249 ( Archived by WebCite at http://www.webcitation.org/6gED6eh0I Background Brisk walking in older people can increase step-counts and moderate to vigorous intensity physical activity ( MVPA ) in ≥10-minute bouts , as advised in World Health Organization guidelines . Previous interventions have reported step-count increases , but not change in objective ly measured MVPA in older people . We assessed whether a primary care nurse-delivered complex intervention increased objective ly measured step-counts and MVPA . Methods and Findings A total of 988 60–75 year olds , able to increase walking and r and omly selected from three UK family practice s , were invited to participate in a parallel two-arm cluster r and omised trial ; r and omisation was by household . Two-hundred-ninety-eight people from 250 households were r and omised between 2011 and 2012 ; 150 individuals to the intervention group , 148 to the usual care control group .  Intervention participants received four primary care nurse physical activity ( PA ) consultations over 3 months , incorporating behaviour change techniques , pedometer step-count and accelerometer PA intensity feedback , and an individual PA diary and plan . Assessors were not blinded to group status , but statistical analyses were conducted blind . The primary outcome was change in accelerometry assessed average daily step-counts between baseline and 3 months , with change at 12 months a secondary outcome . Other secondary outcomes were change from baseline in time in MVPA weekly in ≥10-minute bouts , accelerometer counts , and counts/minute at 3 months and 12 months . Other outcomes were adverse events , anthropometric measures , mood , and pain . Qualitative evaluations of intervention participants and practice nurses assessed the intervention ’s acceptability . At 3 months , eight participants had withdrawn or were lost to follow-up , 280 ( 94 % ) individuals provided primary outcome data . At 3 months changes in both average daily step-counts and weekly MVPA in ≥10-minute bouts were significantly higher in the intervention than control group : by 1,037 ( 95 % CI 513–1,560 ) steps/day and 63 ( 95 % CI 40–87 ) minutes/week , respectively . At 12 months corresponding differences were 609 ( 95 % CI 104–1,115 ) steps/day and 40 ( 95 % CI 17–63 ) minutes/week . Counts and counts/minute showed similar effects to steps and MVPA . Adverse events , anthropometry , mood , and pain were similar in the two groups . Participants and practice nurses found the intervention acceptable and enjoyable . Conclusions The PACE-Lift trial increased both step-counts and objective ly measured  MVPA  in ≥10-minute bouts in 60–75 year olds at 3 and 12 months , with no effect on adverse events . To our knowledge , this is the first trial in this age group to demonstrate objective MVPA increases and highlights the value of individualised support incorporating objective PA assessment in a primary care setting . Trial Registration Controlled-Trials.com IS RCT Background People over the age of 70 carry the greatest burden of chronic disease , disability and health care use . Participation in physical activity is crucial for health , and walking accounts for much of the physical activity undertaken by sedentary individuals . Pedometers are a useful motivational tool to encourage increased walking and they are cheap and easy to use . The aim of this pilot study was to evaluate the feasibility of the use of pedometers plus a theory-based intervention to assist sedentary older women to accumulate increasing amounts of physical activity , mainly through walking . Methods Female participants over the age of 70 were recruited from primary care and r and omised to receive either pedometer plus a theory-based intervention or a theory-based intervention alone . The theory-based intervention consisted of motivational techniques , goal - setting , barrier identification and self-monitoring with pedometers and daily diaries . The pedometer group were further r and omised to one of three target groups : a 10 % , 15 % or 20 % monthly increase in step count to assess the achievability and acceptability of a range of targets . The primary outcome was change in daily activity levels measured by accelerometry . Secondary outcome measures were lower limb function , health related quality of life , anxiety and depression . Results 54 participants were recruited into the study , with an average age of 76 . There were 9 drop outs , 45 completing the study . All participants in the pedometer group found the pedometers easy to use and there was good compliance with diary keeping ( 96 % in the pedometer group and 83 % in the theory-based intervention alone group ) . There was a strong correlation ( 0.78 ) between accelerometry and pedometer step counts i.e. indicating that walking was the main physical activity amongst participants . There was a greater increase in activity ( accelerometry ) amongst those in the 20 % target pedometer group compared to the other groups , although not reaching statistical significance ( p = 0.192 ) . Conclusion We have demonstrated that it is feasible to use pedometers and provide theory-based advice to community dwelling sedentary older women to increase physical activity levels and a larger study is planned to investigate this further BACKGROUND Although many Japanese older adults spend more than an hour each day walking for exercise , the intensity is often lower than the minimum level associated with various health benefits . The purpose of this study was to evaluate the efficacy of a lifestyle physical activity intervention on improving quantity and quality of daily physical activity ( DPA ) as well as cardiorespiratory endurance in community-dwelling older women . METHODS 68 women ( 60 - 78 yr of age ) were r and omly assigned to either a lifestyle physical activity intervention group ( LIFE ) or control group . During the 12-wk intervention , feedback based on accelerometer DPA data ( number of daily steps ( STEPS ) and time spent performing daily moderate intensity physical activity ( MPA ) was provided to each participant in LIFE every 
    Output:
    