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: The effects of 12 wk of exercise training using weighted vests on bone turnover and isokinetic strength were evaluated in postmenopausal women r and omly assigned as exercisers ( EX ; n = 9 ) or controls ( CON ; n = 7 ) .  Training included 3 multimodal exercise sessions per wk wearing weighted vests . The vest load was progressively increased each wk to a maximum of 15 % of body weight . Bone turnover was determined from resting levels of serum osteocalcin and NTx . Knee and ankle strength were measured at 60 degrees/s and 180 degrees/s using an isokinetic dynamometer . After 12 wk , NTx decreased by 14.5 % ( P < or= .05 ) in EX , with no significant changes in osteocalcin . EX also showed a 40 % ( P < or= .05 ) improvement in ankle plantar-flexion strength at 60 degrees/s . Relative body fat significantly decreased and fat-free mass increased in EX . Exercise compliance was 80 % . These findings support the use of progressive exercise training using weighted vests in postmenopausal women BACKGROUND Falls warrant investigation as a risk factor for nursing home admission because falls are common and are associated with functional disability and because they may be preventable . METHODS We conducted a prospect i ve study of a probability sample of 1103 people over 71 years of age who were living in the community . Data on demographic and medical characteristics , use of health care , and cognitive , functional , psychological , and social functioning were obtained at base line and one year later during assessment s in the participants ' homes . The primary outcome studied was the number of days from the initial assessment to a first long-term admission to a skilled-nursing facility during three years of follow-up . Patients were assigned to four categories during follow-up : those who had no falls , those who had one fall without serious injury , those who had two or more falls without serious injury , and those who had at least one fall causing serious injury . RESULTS A total of 133 participants ( 12.1 percent ) had long-term admissions to nursing homes . In an unadjusted model , the risk of admission increased progressively , as compared with that for the patients with no falls , for those with a single noninjurious fall ( relative risk , 4.9 ; 95 percent confidence interval , 3.2 to 7.5 ) , those with multiple noninjurious falls ( relative risk , 8.5 ; 95 percent confidence interval , 3.4 to 21.2 ) , and those with at least one fall causing serious injury ( relative risk , 19.9 ; 95 percent confidence interval , 12.2 to 32.6 ) . Adjustment for other risk factors lowered these ratios to 3.1 ( 95 percent confidence interval , 1.9 to 4.9 ) for one noninjurious fall , 5.5 ( 95 percent confidence interval , 2.1 to 14.2 ) for two or more noninjurious falls , and 10.2 ( 95 percent confidence interval , 5.8 to 17.9 ) for at least one fall causing serious injury , but the association between falls and admission to a nursing home remained strong and significant . The population attributable risk of long-term admission to a nursing home for these three groups ( the proportion of admissions directly attributable to the three categories of falls ) was 13 percent , 3 percent , and 10 percent , respectively . CONCLUSIONS Among older people living in the community falls are a strong predictor of placement in a skilled-nursing facility ; interventions that prevent falls and their sequelae may therefore delay or reduce the frequency of nursing home admissions BACKGROUND It is important to determine if permanent lifestyle changes may result from physical activity interventions and whether health may be affected by these changes . OBJECTIVE To conduct a 10-year follow-up of physical activity and self-reported health status in participants of a r and omized clinical trial of walking intervention .  METHODS Of the original 229 volunteer postmenopausal women who participated in the original clinical trial , 196 ( N = 96 intervention and 100 controls ) completed the 10-year follow-up telephone interview . The interview protocol included questions on  self-reported walking for exercise  and purpose s other than exercise , the Paffenbarger sport and exercise index , functional status , and various chronic diseases and conditions . RESULTS The median values for both usual walking for exercise and total walking  were significantly higher for walkers compared with controls ( for both , P = .01 ) , with median differences of 706 and 420 kcal/wk , respectively . After excluding women who reported heart disease during the original trial , 2 women in the walking group ( 2 % ) and 11 women in the control group ( 12 % ) reported physician-diagnosed heart disease over the last 10 years ( P = .07 ) . There were also fewer hospitalizations , surgeries , and falls among women in the walking group , although these differences were not statistically significant ( P>.05 ) . CONCLUSIONS Although limited by self-report , this study may be the first to demonstrate long-term exercise compliance to a r and omized control trial in older women and to suggest that health benefits may have ensued as a result of these increased activity levels BACKGROUND AND PURPOSE Menopause may induce a phase of rapid decreases in bone mineral density , aerobic fitness , muscle strength , and balance , especially in sedentary women . The purpose of this study was to examine the effects and feasibility of an exercise program of 1 or 2 bouts of walking and resistance training on lower-extremity muscle strength ( the force-generating capacity of muscle ) , balance , and walking performance in women who recently went through menopause . SUBJECTS AND METHODS The subjects were 134 women who recently went through menopause . The study was a 15-week , r and omized , controlled trial with continuous and fractionated exercise groups . The outcomes assessed were lower-extremity muscle strength , balance , and walking time over 2 km . Feasibility was assessed by question naires , interviews , and training logs . RESULTS One hundred twenty-eight women completed the study .  Adherence to the study protocol was 92 % . Both continuous and fractionated exercise groups improved equally in lower-extremity muscle strength and walking time but not in balance . Almost 70 % of the subjects considered the program to be feasible . Two daily walking sessions caused fewer lower-extremity problems than did continuous walking . DISCUSSION AND CONCLUSION Brisk walking combined with moderate resistance training is feasible and effective . Fractionating the walking into 2 daily sessions is more feasible than continuous walking Physical activity ( PA ) helps to prevent osteoporosis , but older women are often sedentary . This study used a pre-post r and omized controlled design to evaluate a 12-week exercise education intervention program based on the stages of change ( SoC ) and processes of change from the transtheoretical change model ( TTM ) to improve adherence with strength and balance training recommendations at levels sufficient to prevent osteoporosis in Iranian women aged 40 - 65 years . The home-based exercise prescription consisted of strength and balance training that was progressive , individually tailored and included a walking program . Individuals in the training group ( n=61 ) had a positive , significant progression in psychological SoC ( P<0.001 ) , whereas no progression in stages occurred in the control group ( n=55 ) . After the intervention , the training group demonstrated significant improvements in PA , lower body muscle strength , static and dynamic balance , with no significant changes in the control group . These results support the applicability of the TTM for a PA intervention and indicate that this training program is very effective in improving balance and lower body strength in older women Objective To assess the effectiveness of a primary care based programme of exercise on prescription among relatively inactive women over a two year period . Design R and omised controlled trial . Setting 17 primary care practice s in Wellington , New Zeal and Participants 1089 women aged 40 - 74 not undertaking 30 minutes of moderate intensity physical activity on at least five days of the week  Intervention Brief physical activity intervention led by nurse with six month follow-up visit and monthly telephone support over nine months . Main outcome measure Physical activity assessed at baseline and 12 and 24 months . Secondary outcomes were quality of life ( SF-36 ) , weight , waist circumference , blood pressure , concentrations of fasting serum lipids , glycated haemoglobin ( HbA1c ) , glucose , insulin , and physical fitness . Results Mean age was 58.9 ( SD 7 ) years . Trial retention rates were 93 % and 89 % at 12 and 24 months , respectively . At baseline , 10 % of intervention participants and 11 % of control participants were achieving 150 minutes of at least moderate intensity physical activity a week . At 12 months rates increased to 43 % and 30 % and at 24 months to 39.3 % and 32.8 % ( P<0.001 ) , respectively . SF-36 physical functioning ( P=0.03 ) and mental health ( P<0.05 ) scores improved more in intervention compared with control participants , but role physical scores were significantly lower ( P<0.01 ) . There were no significant differences in clinical outcomes . More falls ( P<0.001 ) and injuries ( P=0.03 ) were recorded in the intervention group . Conclusions This programme of exercise on prescription increased physical activity and quality of life over two years , although falls and injuries also increased . This finding supports the use of exercise on prescription programmes as part of population strategies to reduce physical inactivity . Trial registration Australian New Zeal and Clinical Trials Registry ( ANZCTR ) ANZCTRN012605000490673 This study was aim ed at investigating the effects of a 21-week period of progressive strength or endurance training on peripheral blood mononuclear cells ( P BMC ) antioxidant enzyme gene expression and activity in healthy middle-aged untrained men .  Strength ( n=11 ) and endurance ( n=12 ) training were performed twice a week , including resistance exercises to activate all the main muscle groups or cycle-ergometer pedaling , respectively . mRNA levels of catalase , glutathione peroxidase ( GPx ) , mitochondrial superoxide dismutase ( MnSOD ) and cytosolic superoxide dismutase ( CuZnSOD ) were increased after 21 weeks of strength training , while endurance training induced significant changes only in MnSOD and GPx mRNA levels . CuZnSOD protein content was significantly increased only in strength-trained subjects . The program of strength or endurance exercise training had no significant effects on the activity of any of the antioxidant enzymes . In conclusion , in a middle-aged population , 21 weeks of strength or endurance training was a sufficient stimulus to up-regulate mRNA levels of P BMC antioxidant enzymes , the strength training being a more optimal stimulus . However , the discrepancies between enzyme protein and mRNA levels suggest that the present systematic strength or endurance training period had no beneficial effects on enzymatic antioxidant defense mechanisms in previously untrained middle-aged men With advancing age , the postural balance function deteriorates as a consequence of decreased functional capacity . Deteriorating balance is a risk factor for bone fractures due to increased risks of falls . It has been suggested that the loss of estrogen , which occurs in relation to the menopause , may be associated with loss of balance . Regular physical exercise without balance training has , in some studies , been shown to have positive effects on the postural balance . The aim of the present study was to examine balance function during the perimenopausal period , and evaluate the effect of estrogen plus progesterone therapy ( EPT ) or  aerobic training  on balance .  Sixty perimenopausal women were recruited to the study . The subjects were then r and omised to either physical training ( n = 20 ) , EPT ( n = 20 ) , or to a control group ( n = 20 ) . The study period was 18 months . Postural stability was measured every third month using a custom‐made force platform . The women using EPT achieved better results in 3 of 6 parameters , after 18 months Properly conducted r and omised trials can aid clinical decision-making by providing unbiased estimates of the average size of treatment effects . This paper , the first of two , discusses how readers of clinical trials can extract simple estimates of treatment effect size from trial reports when trial outcomes are measured on a continuous scale . When making decisions about therapy for individual patients , these estimates can be modified on the basis of patient characteristics . Modified estimates of treatment effect size can be used to determine if the effect of treatment is likely to be large enough to be " clinical ly worthwhile " . This approach optimises clinical decision-making by combining unbiased estimates of the size of treatment effect from clinical trials with clinical intuition and patient preferences OBJECTIVES To examine the association between physical activity and the risk of incident disability , including impairment in activities of daily living ( ADLs ) and instrumental activities of daily living ( IADLs ) , in community-based older persons free of dementia . DESIGN Prospect i ve , observational cohort study . SETTING Approximately 40 retirement communities across the Chicago metropolitan area . PARTICIPANTS More than 1,000 older persons from the Rush Memory and Aging Project , an ongoing longitudinal clinical -pathological study of common chronic conditions of old age . MEASUREMENTS All participants underwent detailed annual clinical evaluations that included assessment s of  physical activity , ADLs , IADLs , and gait performance . The associations between  physical activity , mortality , and incident disability were examined using a series of Cox proportional hazards models controlled for age , sex , education , and baseline gait . RESULTS At baseline , participants spent a mean+/-st and ard deviation of 3.0+/-3.5 hours per week engaging in physical activity ( range 0 - 35 ) . In a proportional hazards model , the risk of death decreased 11 % 
    Output:
    
agent
This review found that muscle strength , balance , and endurance can be improved by physical activity in people aged 40 - 65 years .
There were bigger effects on muscle strength from programs that used resistance exercises , indicating the need to include a resistance training component if strength enhancement is the goal
***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: The effects of 12 wk of exercise training using weighted vests on bone turnover and isokinetic strength were evaluated in postmenopausal women r and omly assigned as exercisers ( EX ; n = 9 ) or controls ( CON ; n = 7 ) .  Training included 3 multimodal exercise sessions per wk wearing weighted vests . The vest load was progressively increased each wk to a maximum of 15 % of body weight . Bone turnover was determined from resting levels of serum osteocalcin and NTx . Knee and ankle strength were measured at 60 degrees/s and 180 degrees/s using an isokinetic dynamometer . After 12 wk , NTx decreased by 14.5 % ( P < or= .05 ) in EX , with no significant changes in osteocalcin . EX also showed a 40 % ( P < or= .05 ) improvement in ankle plantar-flexion strength at 60 degrees/s . Relative body fat significantly decreased and fat-free mass increased in EX . Exercise compliance was 80 % . These findings support the use of progressive exercise training using weighted vests in postmenopausal women BACKGROUND Falls warrant investigation as a risk factor for nursing home admission because falls are common and are associated with functional disability and because they may be preventable . METHODS We conducted a prospect i ve study of a probability sample of 1103 people over 71 years of age who were living in the community . Data on demographic and medical characteristics , use of health care , and cognitive , functional , psychological , and social functioning were obtained at base line and one year later during assessment s in the participants ' homes . The primary outcome studied was the number of days from the initial assessment to a first long-term admission to a skilled-nursing facility during three years of follow-up . Patients were assigned to four categories during follow-up : those who had no falls , those who had one fall without serious injury , those who had two or more falls without serious injury , and those who had at least one fall causing serious injury . RESULTS A total of 133 participants ( 12.1 percent ) had long-term admissions to nursing homes . In an unadjusted model , the risk of admission increased progressively , as compared with that for the patients with no falls , for those with a single noninjurious fall ( relative risk , 4.9 ; 95 percent confidence interval , 3.2 to 7.5 ) , those with multiple noninjurious falls ( relative risk , 8.5 ; 95 percent confidence interval , 3.4 to 21.2 ) , and those with at least one fall causing serious injury ( relative risk , 19.9 ; 95 percent confidence interval , 12.2 to 32.6 ) . Adjustment for other risk factors lowered these ratios to 3.1 ( 95 percent confidence interval , 1.9 to 4.9 ) for one noninjurious fall , 5.5 ( 95 percent confidence interval , 2.1 to 14.2 ) for two or more noninjurious falls , and 10.2 ( 95 percent confidence interval , 5.8 to 17.9 ) for at least one fall causing serious injury , but the association between falls and admission to a nursing home remained strong and significant . The population attributable risk of long-term admission to a nursing home for these three groups ( the proportion of admissions directly attributable to the three categories of falls ) was 13 percent , 3 percent , and 10 percent , respectively . CONCLUSIONS Among older people living in the community falls are a strong predictor of placement in a skilled-nursing facility ; interventions that prevent falls and their sequelae may therefore delay or reduce the frequency of nursing home admissions BACKGROUND It is important to determine if permanent lifestyle changes may result from physical activity interventions and whether health may be affected by these changes . OBJECTIVE To conduct a 10-year follow-up of physical activity and self-reported health status in participants of a r and omized clinical trial of walking intervention .  METHODS Of the original 229 volunteer postmenopausal women who participated in the original clinical trial , 196 ( N = 96 intervention and 100 controls ) completed the 10-year follow-up telephone interview . The interview protocol included questions on  self-reported walking for exercise  and purpose s other than exercise , the Paffenbarger sport and exercise index , functional status , and various chronic diseases and conditions . RESULTS The median values for both usual walking for exercise and total walking  were significantly higher for walkers compared with controls ( for both , P = .01 ) , with median differences of 706 and 420 kcal/wk , respectively . After excluding women who reported heart disease during the original trial , 2 women in the walking group ( 2 % ) and 11 women in the control group ( 12 % ) reported physician-diagnosed heart disease over the last 10 years ( P = .07 ) . There were also fewer hospitalizations , surgeries , and falls among women in the walking group , although these differences were not statistically significant ( P>.05 ) . CONCLUSIONS Although limited by self-report , this study may be the first to demonstrate long-term exercise compliance to a r and omized control trial in older women and to suggest that health benefits may have ensued as a result of these increased activity levels BACKGROUND AND PURPOSE Menopause may induce a phase of rapid decreases in bone mineral density , aerobic fitness , muscle strength , and balance , especially in sedentary women . The purpose of this study was to examine the effects and feasibility of an exercise program of 1 or 2 bouts of walking and resistance training on lower-extremity muscle strength ( the force-generating capacity of muscle ) , balance , and walking performance in women who recently went through menopause . SUBJECTS AND METHODS The subjects were 134 women who recently went through menopause . The study was a 15-week , r and omized , controlled trial with continuous and fractionated exercise groups . The outcomes assessed were lower-extremity muscle strength , balance , and walking time over 2 km . Feasibility was assessed by question naires , interviews , and training logs . RESULTS One hundred twenty-eight women completed the study .  Adherence to the study protocol was 92 % . Both continuous and fractionated exercise groups improved equally in lower-extremity muscle strength and walking time but not in balance . Almost 70 % of the subjects considered the program to be feasible . Two daily walking sessions caused fewer lower-extremity problems than did continuous walking . DISCUSSION AND CONCLUSION Brisk walking combined with moderate resistance training is feasible and effective . Fractionating the walking into 2 daily sessions is more feasible than continuous walking Physical activity ( PA ) helps to prevent osteoporosis , but older women are often sedentary . This study used a pre-post r and omized controlled design to evaluate a 12-week exercise education intervention program based on the stages of change ( SoC ) and processes of change from the transtheoretical change model ( TTM ) to improve adherence with strength and balance training recommendations at levels sufficient to prevent osteoporosis in Iranian women aged 40 - 65 years . The home-based exercise prescription consisted of strength and balance training that was progressive , individually tailored and included a walking program . Individuals in the training group ( n=61 ) had a positive , significant progression in psychological SoC ( P<0.001 ) , whereas no progression in stages occurred in the control group ( n=55 ) . After the intervention , the training group demonstrated significant improvements in PA , lower body muscle strength , static and dynamic balance , with no significant changes in the control group . These results support the applicability of the TTM for a PA intervention and indicate that this training program is very effective in improving balance and lower body strength in older women Objective To assess the effectiveness of a primary care based programme of exercise on prescription among relatively inactive women over a two year period . Design R and omised controlled trial . Setting 17 primary care practice s in Wellington , New Zeal and Participants 1089 women aged 40 - 74 not undertaking 30 minutes of moderate intensity physical activity on at least five days of the week  Intervention Brief physical activity intervention led by nurse with six month follow-up visit and monthly telephone support over nine months . Main outcome measure Physical activity assessed at baseline and 12 and 24 months . Secondary outcomes were quality of life ( SF-36 ) , weight , waist circumference , blood pressure , concentrations of fasting serum lipids , glycated haemoglobin ( HbA1c ) , glucose , insulin , and physical fitness . Results Mean age was 58.9 ( SD 7 ) years . Trial retention rates were 93 % and 89 % at 12 and 24 months , respectively . At baseline , 10 % of intervention participants and 11 % of control participants were achieving 150 minutes of at least moderate intensity physical activity a week . At 12 months rates increased to 43 % and 30 % and at 24 months to 39.3 % and 32.8 % ( P<0.001 ) , respectively . SF-36 physical functioning ( P=0.03 ) and mental health ( P<0.05 ) scores improved more in intervention compared with control participants , but role physical scores were significantly lower ( P<0.01 ) . There were no significant differences in clinical outcomes . More falls ( P<0.001 ) and injuries ( P=0.03 ) were recorded in the intervention group . Conclusions This programme of exercise on prescription increased physical activity and quality of life over two years , although falls and injuries also increased . This finding supports the use of exercise on prescription programmes as part of population strategies to reduce physical inactivity . Trial registration Australian New Zeal and Clinical Trials Registry ( ANZCTR ) ANZCTRN012605000490673 This study was aim ed at investigating the effects of a 21-week period of progressive strength or endurance training on peripheral blood mononuclear cells ( P BMC ) antioxidant enzyme gene expression and activity in healthy middle-aged untrained men .  Strength ( n=11 ) and endurance ( n=12 ) training were performed twice a week , including resistance exercises to activate all the main muscle groups or cycle-ergometer pedaling , respectively . mRNA levels of catalase , glutathione peroxidase ( GPx ) , mitochondrial superoxide dismutase ( MnSOD ) and cytosolic superoxide dismutase ( CuZnSOD ) were increased after 21 weeks of strength training , while endurance training induced significant changes only in MnSOD and GPx mRNA levels . CuZnSOD protein content was significantly increased only in strength-trained subjects . The program of strength or endurance exercise training had no significant effects on the activity of any of the antioxidant enzymes . In conclusion , in a middle-aged population , 21 weeks of strength or endurance training was a sufficient stimulus to up-regulate mRNA levels of P BMC antioxidant enzymes , the strength training being a more optimal stimulus . However , the discrepancies between enzyme protein and mRNA levels suggest that the present systematic strength or endurance training period had no beneficial effects on enzymatic antioxidant defense mechanisms in previously untrained middle-aged men With advancing age , the postural balance function deteriorates as a consequence of decreased functional capacity . Deteriorating balance is a risk factor for bone fractures due to increased risks of falls . It has been suggested that the loss of estrogen , which occurs in relation to the menopause , may be associated with loss of balance . Regular physical exercise without balance training has , in some studies , been shown to have positive effects on the postural balance . The aim of the present study was to examine balance function during the perimenopausal period , and evaluate the effect of estrogen plus progesterone therapy ( EPT ) or  aerobic training  on balance .  Sixty perimenopausal women were recruited to the study . The subjects were then r and omised to either physical training ( n = 20 ) , EPT ( n = 20 ) , or to a control group ( n = 20 ) . The study period was 18 months . Postural stability was measured every third month using a custom‐made force platform . The women using EPT achieved better results in 3 of 6 parameters , after 18 months Properly conducted r and omised trials can aid clinical decision-making by providing unbiased estimates of the average size of treatment effects . This paper , the first of two , discusses how readers of clinical trials can extract simple estimates of treatment effect size from trial reports when trial outcomes are measured on a continuous scale . When making decisions about therapy for individual patients , these estimates can be modified on the basis of patient characteristics . Modified estimates of treatment effect size can be used to determine if the effect of treatment is likely to be large enough to be " clinical ly worthwhile " . This approach optimises clinical decision-making by combining unbiased estimates of the size of treatment effect from clinical trials with clinical intuition and patient preferences OBJECTIVES To examine the association between physical activity and the risk of incident disability , including impairment in activities of daily living ( ADLs ) and instrumental activities of daily living ( IADLs ) , in community-based older persons free of dementia . DESIGN Prospect i ve , observational cohort study . SETTING Approximately 40 retirement communities across the Chicago metropolitan area . PARTICIPANTS More than 1,000 older persons from the Rush Memory and Aging Project , an ongoing longitudinal clinical -pathological study of common chronic conditions of old age . MEASUREMENTS All participants underwent detailed annual clinical evaluations that included assessment s of  physical activity , ADLs , IADLs , and gait performance . The associations between  physical activity , mortality , and incident disability were examined using a series of Cox proportional hazards models controlled for age , sex , education , and baseline gait . RESULTS At baseline , participants spent a mean+/-st and ard deviation of 3.0+/-3.5 hours per week engaging in physical activity ( range 0 - 35 ) . In a proportional hazards model , the risk of death decreased 11 % 
    Output:
    