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 purpose of this study was to evaluate how weight training or nursing-based rehabilitative care programs in nursing homes impact on resident performance of Activities of Daily Living ( ADL ) and objectives tests of physical performance . METHODS This study involved a quasi-experimental control , longitudinal comparison of functional status over a 10-month period , where baseline status was adjusted through a weighting procedure based on functional status , cognitive status , and age . All residents from six residential care nursing home facilities were eligible except those with a terminal prognosis , a projected stay of less than 90 days , or with health complications that prohibited contact . Homes were placed into matched triplets based on patient characteristics : two members of each triplet were r and omly design ated to be experimental sites , the third became the control site . Baseline data were available for 468 subjects , follow-up for 392 .  ADL self-performance measures derived from the Minimum Data Set , including indicators of early loss ADL , locomotion , and late loss ADL ; a number of objective functional tests ( including measures of balance , power , and endurance ) ; and mood state as measured by the Geriatric Depression Scale . RESULTS Mean ADL values in the two experimental groups declined at a significantly lower rate than did rates for the controls . Functional decline was also lower in more specific measures : locomotion , early loss ADL , and late loss ADL . CONCLUSIONS With both interventions , facilities were able to implement a broad-based intervention that result ed in a significant reduction in ADL decline rates . A facility-wide nursing rehabilitation program can play a useful role in reversing functional decline , helping residents to maintain their involvement in a broad spectrum of ADL activities BACKGROUND Physical activity programs in nursing homes typically consist of seated , range of motion ( ROM ) exercises , regardless of resident abilities . The Functional Fitness for Long-Term Care ( FFLTC ) Program was design ed not only to maintain ROM , but also to improve strength , balance , flexibility , mobility , and function . In addition , it was tailored to meet the needs of both high and low mobility residents . METHODS The feasibility and efficacy of the FFLTC Program were evaluated with 68 residents ( mean age 80 ) from five institutions . Persons were classified as low or high mobility and r and omized into either the FFLTC program or a seated ROM program . Classes were conducted in groups of 4 to 10 residents by trained facility staff for 45 minutes , three times per week . Assessment s at baseline and 4 months consisted of mobility , balance , gait , flexibility , functional capacity , and several upper and lower extremity strength measures . RESULTS Attendance averaged 86 % for the FFLTC and 79 % for the ROM classes . Four months of exercise led to significant improvements in mobility ( 16 % ) , balance ( 9 % ) , flexibility ( 36 % ) , knee ( 55 % ) , and hip ( 12 % ) strength for the FFLTC group . Shoulder strength was the only improvement found for the ROM group . The ROM group significantly deteriorated in some areas , particularly hip strength , mobility , and functional ability . CONCLUSIONS Institutionalized seniors , even those who are physically frail , incontinent and /or have mild dementia , can respond positively to a challenging exercise program . The FFLTC program demonstrated clear benefits over typical , seated ROM exercises . Moreover , with minimal training , the program can be safely delivered at low cost by institutional staff and volunteers OBJECTIVE The purpose of this study was to determine if 1.0 Full-time Equivalent ( FTE ) physical therapy ( PT ) and 1.0 FTE occupational therapy ( OT ) per 50 beds result ed in differences in functional status for nursing home residents when compared to 1.0 FTE PT and 1.0 FTE OT per 200 beds . DESIGN R and omized control program evaluation , cost analysis . SETTING Nursing home in the province of Alberta , Canada . PATIENTS 115 residents assigned to 1 PT and 1 OT per 50 beds ( enhanced group ) versus 1 PT and 1 OT per 200 beds ( control group ) using stratified r and om allocation by severity of condition . INTERVENTIONS Both groups received ongoing treatment , follow-up , and restorative interventions , but enhanced group received more hours of service . OUTCOME MEASURES Functional Independence Measure ( FIM ) , Functional Assessment Measures ( FAM ) , and Clinical Outcome Variables Scale ( COVS ) recorded at 6-month intervals over a 2-year period . RESULTS Mean score differences favored the enhanced group for the tests over the 2 years . Significance was observed on FIM Total at 6 and 12 months , FIM Self Care at 6 months , FIM Communication at 24 months , and FIM Psychosocial at 6 , 12 , 18 , and 24 months ; FAM Total at 6 , 12 , 18 , and 24 months , FAM Self Care at 6 months , FAM Mobility at 12 months , FAM Communication at 6 and 24 months , FAM Psychosocial at 6 , 12 , 18 , and 24 months , and FAM Cognition at 6 and 12 months ; and COVS at 6 , 12 , 18 , and 24 months . A cost analysis demonstrated that PT/OT offered at the 1:50 ratio would result in a cost savings in terms of nursing staff dollars for 30 long-term-care beds of $ 16,973 over the 2 years of the study compared to the 1:200 ratio . This equates to an annual cost savings of $ 283 per bed . CONCLUSIONS Increasing the amount of PT/OT can have a positive effect on the functional status and cost of care of long-term care residents All persons aged 70 through 75 years ( N = 457 ) in a Swedish community were invited to participate in a 9 week balance training study . Out of 55 interested subjects , 15 were chosen at r and om for a study group ; 15 matched controls were also selected . Before and after the investigation period the balance function was assessed by clinical balance tests and dynamic posturography . In the clinical balance tests , the training group significantly improved their balance st and ing on one leg with eyes closed as well as st and ing on one leg while shaking the head ; they also walked 15 m back and forth faster . In the dynamic  posturography  the training group significantly improved their equilibrium scores in the 3 most difficult test conditions . The results of the control group were unchanged except for one test condition in the dynamic posturography . The differences in one-leg st and ing with head shaking , walking 2 x 15 m , and the equilibrium score using sway-referenced platform in dynamic posturography were proved to be attributable to the training . The first investigation in all 29 subjects formed normative dynamic posturography data for the age group 70 through 75 years . The normative posturographic data of this age group differed from previously obtained data in the age groups 20 through 59 and 60 through 69 years . It is concluded that elderly may improve their balance by regular balance training exercises for as short a period as 9 weeks . This might prove to be of great value in improving balance and thereby preventing accidental falls and subsequent fractures in elderly BACKGROUND Past studies suggest multidisciplinary interventions that include physical therapy ( PT ) can improve function of nursing home residents . This trial specifically evaluates effects of PT for frail long-stay nursing home residents . DESIGN R and omized , controlled trial . SETTING One academic nursing home and eight community nursing homes . PATIENTS A total of 194 elderly nursing home residents dependent in at least two activities of daily living residing in the nursing home for at least 3 months . INTERVENTIONS Patients were r and omized to individually tailored one-on-one PT sessions or friendly visits ( FVs ) three times a week for 4 months . Physical therapy included range-of-motion , strength , balance , transfer , and mobility exercises . MAIN OUTCOME MEASURES Performance-based physical function assessed by the Physical Disability Index ; self-perceived health status assessed with the Sickness Impact Profile ; observer-reported activities of daily living ; and falls . RESULTS Eighty-nine percent and 92 % of PT and FV sessions , respectively , were attended ; 5 % and 9 % of subjects dropped out in the PT group and FV group , respectively . Compared with the FV group , the PT group experienced no significant improvements in overall Physical Disability Index , Sickness Impact Profile , or activities of daily living scores . A 15.5 % improvement in the mobility subscale of the Physical Disability Index was seen ( 95 % confidence interval [ CI ] , 6.4 % to 24.7 % ) ; no benefits in range-of-motion , strength , or balance subscales were found . Compared with the FV group , the PT group used assistive devices for bed mobility tasks less often ( P = .06 ) and were less likely to use assistive devices and wheelchairs for locomotion ( P < .005 ) . There were 79 falls in the PT group vs 60 falls in the FV group ( P = .11 ) . Charge for the 4-month PT program was $ 1220 per subject ( 95 % CI , $ 412 to $ 1832 ) . CONCLUSION This st and ardized physical therapy program provided modest mobility benefits for very frail long-stay nursing home residents with physical disability due to multiple comorbid conditions BACKGROUND Identification of the physiologic factors most relevant to functional independence in the elderly population is critical for the design of effective interventions . It has been suggested that muscle power may be more directly related to impaired physical performance than muscle strength in elderly persons . We tested the hypothesis that peak muscle power is closely associated with self-reported functional status in sedentary elderly community-dwelling women . METHODS We used baseline data that were collected as part of a 1-year r and omized controlled clinical trial of a combined program of strength , power , and endurance training in 80 elderly women ( mean age 74.8 + /- 5.0 years ) with 3.2 + /- 1.9 chronic diseases , selected for baseline functional impairment and /or falls . RESULTS Functional status at baseline was related in univariate analyses to physiologic capacity , habitual physical activity level , neuropsychological status , and medical diagnoses . Leg power had the strongest univariate correlation to self-reported functional status ( r = -.47 , p < .0001 ) of any of the physiologic factors we tested . In a forward stepwise regression model , leg press power and habitual physical activity level were the only two factors that contributed independently to functional status ( r = .64 , p < .0001 ) , accounting for 40 % of the variance in functional status . CONCLUSIONS Leg power is a strong predictor of self-reported functional status in elderly women Regular exercise is widely advocated for the young and middle-aged , but less is heard about its relevance to elderly people . This study reports the findings of a controlled trial of seated exercise in residents of local authority homes for the elderly . Forty-nine residents aged 64 - 91 years volunteered for the 7-month project , and participated in either twice-weekly exercise or reminiscence sessions . Primary outcome measures were postural sway , flexibility of the spine and knees , h and -grip strength and functional capacity . The average ( range of ) attendance at the exercise sessions was 91 % ( 64 - 100 % ) , and at the reminiscence sessions was 86 % ( 46 - 100 % ) . By the end of the project , the change observed in the exercise group was significantly different from that of the reminiscence group in terms of grip strength ( p < 0.02 ) , spinal flexion ( p < 0.001 ) , chair-to-st and time ( p < 0.001 ) , activities of daily living ( p < 0.05 ) , and self-rating of depression ( p < 0.01 ) . Even very elderly residents of old peoples homes can benefit from participation in regular seated exercise and improve their functional capacity The purpose of this study was to determine whether a moderate to high intensity strengthening and aerobic exercise program can improve the strength , exercise capacity , gait and balance of deconditioned male nursing home residents . Ambulatory subjects who scored 30 or less on the modified Tinetti gait and balance assessment scale , who demonstrated less than 80 % of age-matched lower extremity strength on isokinetic muscle testing and who gave informed consent were enrolled . Subjects were r and omized to either an  exercise ( n = 8) or a  control ( n = 6 ) group . All participants underwent an exercise test to determine maximal oxygen uptake ( Vo2max ) and received quantitative gait and balance measurements . The subjects assigned to the exercise group then completed a 12-wk program of weight training for the lower extremities and stationary cycling . Both the exercise and control groups were then retested . Ten outcome variables were assessed : Tinetti mobility scores , Vo2max , isokinetic-tested lower extremity strength and endurance , stride length , gait velocity , stance time , gait duration , cadence and balance . The exercise group , after completion of the program , demonstrated significant improvements in Tinetti mobility scores ( P < 0.05 ) , combined right and left quadricep muscle strength ( P < 0.01 ) , right and left lower extremity muscular endurance ( P < 0.01 ) , left stride length and gait velocity ( P < 0.05 ) , although other outcome variables changed insignificantly . The control group revealed no changes of significance with the exception of improvement of the combined right and left hamstring muscle strength ( P < 0.05 ) . Nevertheless , for those outcome variables that had improved significantly in the exercise group , the changes amounted to only a 5 to 10 % increase over the baseline measurements . These findings 
    Output:
    
agent
There was a large heterogeneity in the studies concerning sample size , types of interventions and types of assessment s. There is strong evidence for a positive effect of  physical training  on muscle strength and mobility ; moderate evidence for an effect on range of motion ; and contradictory evidence regarding gait , activities of daily living , balance and endurance .
***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 purpose of this study was to evaluate how weight training or nursing-based rehabilitative care programs in nursing homes impact on resident performance of Activities of Daily Living ( ADL ) and objectives tests of physical performance . METHODS This study involved a quasi-experimental control , longitudinal comparison of functional status over a 10-month period , where baseline status was adjusted through a weighting procedure based on functional status , cognitive status , and age . All residents from six residential care nursing home facilities were eligible except those with a terminal prognosis , a projected stay of less than 90 days , or with health complications that prohibited contact . Homes were placed into matched triplets based on patient characteristics : two members of each triplet were r and omly design ated to be experimental sites , the third became the control site . Baseline data were available for 468 subjects , follow-up for 392 .  ADL self-performance measures derived from the Minimum Data Set , including indicators of early loss ADL , locomotion , and late loss ADL ; a number of objective functional tests ( including measures of balance , power , and endurance ) ; and mood state as measured by the Geriatric Depression Scale . RESULTS Mean ADL values in the two experimental groups declined at a significantly lower rate than did rates for the controls . Functional decline was also lower in more specific measures : locomotion , early loss ADL , and late loss ADL . CONCLUSIONS With both interventions , facilities were able to implement a broad-based intervention that result ed in a significant reduction in ADL decline rates . A facility-wide nursing rehabilitation program can play a useful role in reversing functional decline , helping residents to maintain their involvement in a broad spectrum of ADL activities BACKGROUND Physical activity programs in nursing homes typically consist of seated , range of motion ( ROM ) exercises , regardless of resident abilities . The Functional Fitness for Long-Term Care ( FFLTC ) Program was design ed not only to maintain ROM , but also to improve strength , balance , flexibility , mobility , and function . In addition , it was tailored to meet the needs of both high and low mobility residents . METHODS The feasibility and efficacy of the FFLTC Program were evaluated with 68 residents ( mean age 80 ) from five institutions . Persons were classified as low or high mobility and r and omized into either the FFLTC program or a seated ROM program . Classes were conducted in groups of 4 to 10 residents by trained facility staff for 45 minutes , three times per week . Assessment s at baseline and 4 months consisted of mobility , balance , gait , flexibility , functional capacity , and several upper and lower extremity strength measures . RESULTS Attendance averaged 86 % for the FFLTC and 79 % for the ROM classes . Four months of exercise led to significant improvements in mobility ( 16 % ) , balance ( 9 % ) , flexibility ( 36 % ) , knee ( 55 % ) , and hip ( 12 % ) strength for the FFLTC group . Shoulder strength was the only improvement found for the ROM group . The ROM group significantly deteriorated in some areas , particularly hip strength , mobility , and functional ability . CONCLUSIONS Institutionalized seniors , even those who are physically frail , incontinent and /or have mild dementia , can respond positively to a challenging exercise program . The FFLTC program demonstrated clear benefits over typical , seated ROM exercises . Moreover , with minimal training , the program can be safely delivered at low cost by institutional staff and volunteers OBJECTIVE The purpose of this study was to determine if 1.0 Full-time Equivalent ( FTE ) physical therapy ( PT ) and 1.0 FTE occupational therapy ( OT ) per 50 beds result ed in differences in functional status for nursing home residents when compared to 1.0 FTE PT and 1.0 FTE OT per 200 beds . DESIGN R and omized control program evaluation , cost analysis . SETTING Nursing home in the province of Alberta , Canada . PATIENTS 115 residents assigned to 1 PT and 1 OT per 50 beds ( enhanced group ) versus 1 PT and 1 OT per 200 beds ( control group ) using stratified r and om allocation by severity of condition . INTERVENTIONS Both groups received ongoing treatment , follow-up , and restorative interventions , but enhanced group received more hours of service . OUTCOME MEASURES Functional Independence Measure ( FIM ) , Functional Assessment Measures ( FAM ) , and Clinical Outcome Variables Scale ( COVS ) recorded at 6-month intervals over a 2-year period . RESULTS Mean score differences favored the enhanced group for the tests over the 2 years . Significance was observed on FIM Total at 6 and 12 months , FIM Self Care at 6 months , FIM Communication at 24 months , and FIM Psychosocial at 6 , 12 , 18 , and 24 months ; FAM Total at 6 , 12 , 18 , and 24 months , FAM Self Care at 6 months , FAM Mobility at 12 months , FAM Communication at 6 and 24 months , FAM Psychosocial at 6 , 12 , 18 , and 24 months , and FAM Cognition at 6 and 12 months ; and COVS at 6 , 12 , 18 , and 24 months . A cost analysis demonstrated that PT/OT offered at the 1:50 ratio would result in a cost savings in terms of nursing staff dollars for 30 long-term-care beds of $ 16,973 over the 2 years of the study compared to the 1:200 ratio . This equates to an annual cost savings of $ 283 per bed . CONCLUSIONS Increasing the amount of PT/OT can have a positive effect on the functional status and cost of care of long-term care residents All persons aged 70 through 75 years ( N = 457 ) in a Swedish community were invited to participate in a 9 week balance training study . Out of 55 interested subjects , 15 were chosen at r and om for a study group ; 15 matched controls were also selected . Before and after the investigation period the balance function was assessed by clinical balance tests and dynamic posturography . In the clinical balance tests , the training group significantly improved their balance st and ing on one leg with eyes closed as well as st and ing on one leg while shaking the head ; they also walked 15 m back and forth faster . In the dynamic  posturography  the training group significantly improved their equilibrium scores in the 3 most difficult test conditions . The results of the control group were unchanged except for one test condition in the dynamic posturography . The differences in one-leg st and ing with head shaking , walking 2 x 15 m , and the equilibrium score using sway-referenced platform in dynamic posturography were proved to be attributable to the training . The first investigation in all 29 subjects formed normative dynamic posturography data for the age group 70 through 75 years . The normative posturographic data of this age group differed from previously obtained data in the age groups 20 through 59 and 60 through 69 years . It is concluded that elderly may improve their balance by regular balance training exercises for as short a period as 9 weeks . This might prove to be of great value in improving balance and thereby preventing accidental falls and subsequent fractures in elderly BACKGROUND Past studies suggest multidisciplinary interventions that include physical therapy ( PT ) can improve function of nursing home residents . This trial specifically evaluates effects of PT for frail long-stay nursing home residents . DESIGN R and omized , controlled trial . SETTING One academic nursing home and eight community nursing homes . PATIENTS A total of 194 elderly nursing home residents dependent in at least two activities of daily living residing in the nursing home for at least 3 months . INTERVENTIONS Patients were r and omized to individually tailored one-on-one PT sessions or friendly visits ( FVs ) three times a week for 4 months . Physical therapy included range-of-motion , strength , balance , transfer , and mobility exercises . MAIN OUTCOME MEASURES Performance-based physical function assessed by the Physical Disability Index ; self-perceived health status assessed with the Sickness Impact Profile ; observer-reported activities of daily living ; and falls . RESULTS Eighty-nine percent and 92 % of PT and FV sessions , respectively , were attended ; 5 % and 9 % of subjects dropped out in the PT group and FV group , respectively . Compared with the FV group , the PT group experienced no significant improvements in overall Physical Disability Index , Sickness Impact Profile , or activities of daily living scores . A 15.5 % improvement in the mobility subscale of the Physical Disability Index was seen ( 95 % confidence interval [ CI ] , 6.4 % to 24.7 % ) ; no benefits in range-of-motion , strength , or balance subscales were found . Compared with the FV group , the PT group used assistive devices for bed mobility tasks less often ( P = .06 ) and were less likely to use assistive devices and wheelchairs for locomotion ( P < .005 ) . There were 79 falls in the PT group vs 60 falls in the FV group ( P = .11 ) . Charge for the 4-month PT program was $ 1220 per subject ( 95 % CI , $ 412 to $ 1832 ) . CONCLUSION This st and ardized physical therapy program provided modest mobility benefits for very frail long-stay nursing home residents with physical disability due to multiple comorbid conditions BACKGROUND Identification of the physiologic factors most relevant to functional independence in the elderly population is critical for the design of effective interventions . It has been suggested that muscle power may be more directly related to impaired physical performance than muscle strength in elderly persons . We tested the hypothesis that peak muscle power is closely associated with self-reported functional status in sedentary elderly community-dwelling women . METHODS We used baseline data that were collected as part of a 1-year r and omized controlled clinical trial of a combined program of strength , power , and endurance training in 80 elderly women ( mean age 74.8 + /- 5.0 years ) with 3.2 + /- 1.9 chronic diseases , selected for baseline functional impairment and /or falls . RESULTS Functional status at baseline was related in univariate analyses to physiologic capacity , habitual physical activity level , neuropsychological status , and medical diagnoses . Leg power had the strongest univariate correlation to self-reported functional status ( r = -.47 , p < .0001 ) of any of the physiologic factors we tested . In a forward stepwise regression model , leg press power and habitual physical activity level were the only two factors that contributed independently to functional status ( r = .64 , p < .0001 ) , accounting for 40 % of the variance in functional status . CONCLUSIONS Leg power is a strong predictor of self-reported functional status in elderly women Regular exercise is widely advocated for the young and middle-aged , but less is heard about its relevance to elderly people . This study reports the findings of a controlled trial of seated exercise in residents of local authority homes for the elderly . Forty-nine residents aged 64 - 91 years volunteered for the 7-month project , and participated in either twice-weekly exercise or reminiscence sessions . Primary outcome measures were postural sway , flexibility of the spine and knees , h and -grip strength and functional capacity . The average ( range of ) attendance at the exercise sessions was 91 % ( 64 - 100 % ) , and at the reminiscence sessions was 86 % ( 46 - 100 % ) . By the end of the project , the change observed in the exercise group was significantly different from that of the reminiscence group in terms of grip strength ( p < 0.02 ) , spinal flexion ( p < 0.001 ) , chair-to-st and time ( p < 0.001 ) , activities of daily living ( p < 0.05 ) , and self-rating of depression ( p < 0.01 ) . Even very elderly residents of old peoples homes can benefit from participation in regular seated exercise and improve their functional capacity The purpose of this study was to determine whether a moderate to high intensity strengthening and aerobic exercise program can improve the strength , exercise capacity , gait and balance of deconditioned male nursing home residents . Ambulatory subjects who scored 30 or less on the modified Tinetti gait and balance assessment scale , who demonstrated less than 80 % of age-matched lower extremity strength on isokinetic muscle testing and who gave informed consent were enrolled . Subjects were r and omized to either an  exercise ( n = 8) or a  control ( n = 6 ) group . All participants underwent an exercise test to determine maximal oxygen uptake ( Vo2max ) and received quantitative gait and balance measurements . The subjects assigned to the exercise group then completed a 12-wk program of weight training for the lower extremities and stationary cycling . Both the exercise and control groups were then retested . Ten outcome variables were assessed : Tinetti mobility scores , Vo2max , isokinetic-tested lower extremity strength and endurance , stride length , gait velocity , stance time , gait duration , cadence and balance . The exercise group , after completion of the program , demonstrated significant improvements in Tinetti mobility scores ( P < 0.05 ) , combined right and left quadricep muscle strength ( P < 0.01 ) , right and left lower extremity muscular endurance ( P < 0.01 ) , left stride length and gait velocity ( P < 0.05 ) , although other outcome variables changed insignificantly . The control group revealed no changes of significance with the exception of improvement of the combined right and left hamstring muscle strength ( P < 0.05 ) . Nevertheless , for those outcome variables that had improved significantly in the exercise group , the changes amounted to only a 5 to 10 % increase over the baseline measurements . These findings 
    Output:
    