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: [ Purpose ] The purpose of the study was to evaluate the effects of conventional neurological treatment and a virtual reality training program on eye-h and coordination in children with cerebral palsy . [ Subjects ] Sixteen children ( 9 males , 7 females ) with spastic diplegic cerebral palsy were recruited and r and omly assigned to the conventional neurological physical therapy group ( CG ) and virtual reality training group ( VRG ) . [ Methods ] Eight children in the control group performed 45 minutes of therapeutic exercise twice a week for eight weeks . In the experimental group , the other eight children performed 30 minutes of therapeutic exercise and 15 minutes of a training program using virtual reality twice a week during the experimental period . [ Results ] After eight weeks of the training program , there were significant differences in eye-h and coordination and visual motor speed in the comparison of the virtual reality training group with the conventional neurological physical therapy group . [ Conclusion ] We conclude that a well- design ed training program using virtual reality can improve eye-h and coordination in children with cerebral palsy Summary The 12-week home-based virtual cycling training ( hVCT ) improved lower limb muscle strength and areal bone mineral density ( aBMD ) than the control program in children with cerebral palsy ( CP ) . A muscle strengthening program , rather than general physical activity , is more specific in enhancing aBMD for these children . A novel hVCT is an effective and efficient strategy that enhances lower limb bone density in these children . Introduction This is the first study to assess the efficacy of a novel hVCT program on bone density for children with spastic CP using a well- design ed r and omized controlled trial . Methods Twenty-seven ambulatory children with spastic CP , aged 6–12 years , were r and omly assigned to the hVCT group ( n = 13 ) or control group ( n = 14 ) . Outcome measures —motor function [ Gross Motor Function Measure-66 ( GMFM-66 ) ] , muscle strength ( curl up scores and isokinetic torque of knee extensor and flexor muscle ) and aBMD of the lumbar and distal femur — were administered before and immediately after the 12-week intervention . Results Analysis of covariance results show that the hVCT group had greater distal femur aBMD and isokinetic torques of knee extensor and flexor muscles than the control group at posttreatment ( p < 0.05 ) . However , curl up scores , GMFM-66 , and lumbar aBMD at posttreatment did not differ between the two groups . Conclusions Analytical findings suggest that the muscle strengthening program is more specific in enhancing bone density for children with CP than general physical activity . Thus , the proposed 12-week hVCT protocol is an effective and efficient strategy for improving lower limb aBMD in these children ABSTRACT Objective : To assess the effect of interactive video gaming ( IVG ) with Nintendo Wii ( Wii ) supplemented to conventional therapy in rehabilitation of children with cerebral palsy ( CP ) . Design : R and omized , controlled , assessor-blinded study . Participants : Children with CP ; 10 children each in the control and intervention groups . Intervention : IVG using Wii , given as a supplement to conventional therapy , for 45 min per day , 6 days a week for 3 weeks . The children in the control group received conventional therapy alone . Outcome Measures : Posture control and balance , upper limb function , visual-perceptual skills , and functional mobility . Results : Significant improvement in upper limb functions was seen in the intervention group but not in the control group . Improvements in balance , visual perception , and functional mobility were not significantly different between control and intervention groups . Conclusions : Wii-based IVG may be offered as an effective supplement to conventional therapy in the rehabilitation of children with CP Independent walking is an important goal of clinical and community-based rehabilitation for children with cerebral palsy ( CP ) .  Virtual reality-based rehabilitation therapy is effective in motivating children with CP . This study investigated the effects of treadmill training with virtual reality on gait , balance , muscular strength , and gross motor function in children with CP . Eighteen children with spastic CP were r and omly divided into the virtual reality treadmill training ( VRTT ) group ( 9 subjects , mean age , 10.2 years ) and treadmill training ( TT ) group ( 9 subjects , mean age , 9.4 years ) . The groups performed their respective programs as well as conventional physical therapy 3 times/week for 8 weeks . Muscle strength was assessed using a digitalized manual muscle tester . Gross motor function was assessed using the Gross Motor Functional Measure ( GMFM ) . Balance was assessed using the Pediatric Balance Scale ( PBS ) . Gait speed was assessed using the 10-meter walk test ( 10MWT ) , and gait endurance was assessed using the 2-minute walk test ( 2MWT ) . After training , gait and balance was improved in the VRTT compared to the TT group ( P < 0.05 ) . Muscular strength was significantly greater in the VRTT group than the TT group , except for right hamstring strength . The improvements in GMFM ( st and ing ) and PBS scores were greater in the VRTT group than the TT group ( P < 0.05 ) . Furthermore , the VRTT group showed the higher values of 10MWT and 2MWT compared to the TT group ( P < 0.05 ) . In conclusion , VRTT programs are effective for improving gait , balance , muscular strength , and gross motor function in children with CP BACKGROUND This study compared the effects of Nintendo Wii-Fit ® balance-based video games and conventional balance training in children with mild cerebral palsy ( CP ) . METHODS This r and omized controlled trial involved 30 ambulatory pediatric patients ( aged 5 - 18 years ) with CP . Participants were r and omized to either conventional balance training ( control group ) or to  Wii-Fit balance-based video games training ( Wii group ) . Both group received neuro-developmental treatment ( NDT ) during 24 sessions . In addition , while the control group received conventional balance training in each session , the Wii group played Nintendo Wii Fit games such as ski slalom , tightrope walk and soccer heading on balance board . Primary outcomes were Functional Reach Test ( forward and sideways ) , Sit-to-St and Test and Timed Get up and Go Test . Nintendo Wii Fit balance , age and game scores , 10 m walk test , 10-step climbing test and Wee-Functional Independence Measure ( Wee FIM ) were secondary outcomes . RESULTS After the treatment , changes in balance scores and independence level in activities of daily living were significant ( P < 0.05 ) in both groups . Statistically significant improvements were found in the Wii-based game group compared with the control group in all balance tests and total Wee FIM score ( P < 0.05 ) . CONCLUSION Wii-fit balance-based video games are better at improving both static and performance-related balance parameters when combined with NDT treatment in children with mild CP The aim of the present study was to determine the user satisfaction of the EyeToy for the training of the upper limb in children with cerebral palsy ( CP ) .  User satisfaction was measured in 12 children with CP , using a postexperience question naire , primarily based on a presence question naire . In general , children with CP were satisfied with and motivated by the EyeToy training . In addition , a first evaluation study was performed to determine the effect of this training method on the upper limb function . Ten children with CP were r and omly assigned to the intervention ( mean age 11 years , 9 months ; SD 2,3 ) and the control group ( mean age 12 years , 3 months ; SD 3,2 ) . After a treatment period of 6 weeks , the intervention group completed a  user satisfaction question naire . Functional outcome was measured using the Melbourne Assessment scores . Percentage scores of the Melbourne Assessment of 7 of the 10 children were the same or changed only 1 % to 2 % from baseline to followup . However , in the experimental group , two children improved more , 9 % and 13 % respectively . In conclusion , it can be said that the EyeToy is a motivational training tool for the training of children with CP and has the potential to improve upper extremity function OBJECTIVE This study aim ed at assessing how the addition of Nintendo Wii ™ ( NW ) system to the traditional therapy influences occupational performance , balance , and daily living activities in children with spastic hemiplegic Cerebral Palsy ( CP ) . MATERIAL S AND METHODS The present study is a single-blind and r and omized trial involving 24 children aged 6 - 14 years , classified as level I or II on the Gross Motor Function Classification System . The children were allocated into two groups : an intervention and a control group , and their families participated in the study . The activity performance analysis of the children was undertaken by using the Canadian Occupational Performance Measure ( COPM ) , functional balance was measured with the Pediatric Balance Scale ( PBS ) , and activities of daily living were assessed with Pediatric Evaluation of Disability Inventory ( PEDI ) . Twenty-four children with CP were r and omly divided into two groups : intervention ( n = 12 ) and control group ( n = 12 ) . All children in both groups continued their traditional physiotherapy program twice a week , 45 minutes per session , whereas the participants in the intervention group , additionally , were trained with NW , two other days of the week for 12 weeks , with each session lasting for 30 minutes . RESULTS Self-care , mobility , PEDI total , PBS , and performance of COPM scores increased in the NW group after intervention . Self-care , mobility , and total PEDI increased in the control group as well . However , there was no statistically significant difference found between the groups , except for PBS ( P < 0.05 ) . CONCLUSIONS NW contributed to the implementation of occupational performance , daily living activities , and functional balance . We recommend that NW could be used in the rehabilitation program to engage play-based activities with fun AIM The study aim ed to investigate the effectiveness of a web-based therapy programme , ' Move it to improve it ' ( Mitii ( ™ ) ) , in children with unilateral cerebral palsy ( UCP ) on occupational performance , upper limb function , and visual perception . METHOD Participants ( n=102 ) were matched in pairs and r and omized to intervention ( Mitii for 20wks ; 26 males , mean age 11y 8mo [ 2y 4mo ] , Manual Ability Classification System level I=11 , II=39 , III=1 ) or control ( st and ard care ; 25 males , mean age 11y 10mo [ 2y 5mo ] , Manual Ability Classification System level I=13 , II=37 ) . Outcomes were the Assessment of Motor and Process Skills ( AMPS ) , Assisting H and Assessment , Jebsen-Taylor Test of H and Function ( JTTHF ) , Melbourne Assessment of Unilateral Upper Limb Function ( MUUL ) , Canadian Occupational Performance Measure ( COPM ) , and Test of Visual Perceptual Skills ( TVPS-3 ) . RESULTS Participants completed on average 32.4 hours of Mitii ( range 3.7 - 74.7h ) . The Mitii group demonstrated significantly greater post-intervention scores than the comparison group on the AMPS , JTTHF dominant upper limb , COPM , and TVPS-3 . The differences between groups were not clinical ly significant . There were no differences between groups on measures of impaired upper limb function . INTERPRETATION Mitii delivers individualized , web-based therapy at home and has potential to increase therapy dose . Mitii can be considered as an option to enhance occupational performance and visual perception for children with UCP The current priority of investigations involving transcranial direct current stimulation ( tDCS ) and neurorehabilitation is to identify biomarkers associated with the positive results of the interventions such that respondent and non-respondent patients can be identified in the early phases of treatment . The aims were to determine whether : ( 1 ) present motor evoked potential ( MEP ) ; and ( 2 ) injuries involving the primary motor cortex , are associated with tDCS-enhancement in functional outcome following gait training in children with cerebral palsy ( CP ) . We review ed the data from our parallel , r and omized , sham-controlled , double-blind studies . Fifty-six children with spastic CP received gait training ( either treadmill training or virtual reality training ) and tDCS ( active or sham ) . Univariate and multivariate logistic regression analyses were employed to identify clinical , neurophysiologic and neuroanatomic predictors associated with the responsiveness to treatment with tDCS .  MEP presence during the initial evaluation and the subcortical injury were associated with positive effects in the functional results . The logistic regression revealed that present MEP was a significant predictor for the six-minute walk test ( 6MWT ; p = 0.003 ) and gait speed ( p = 0.028 ) , whereas the subcortical injury was a significant predictor of gait kinematics ( p = 0.013 ) and gross motor function ( p = 0.021 ) . In this preliminary study involving children with CP , two important prediction factors of good responses to anodal tDCS combined with gait training were identified . Apparently , MEP ( integrity of the corticospinal tract ) and subcortical location of the brain injury exerted different influences on aspects related to gait , such as velocity and kinematics AIMS To determine whether the multi-modal web-based rehabilitation ' Move it to improve it ' ( Mitii ) is more effective than wait list control ( usual care ) to improve occupational performance , upper limb function , and visual perception in children with acquired brain injury ( ABI ) . METHOD Fifty-eight r and omly allocated children ( 53 % males ; mean age 11y  
    Output:
    
agent
***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: [ Purpose ] The purpose of the study was to evaluate the effects of conventional neurological treatment and a virtual reality training program on eye-h and coordination in children with cerebral palsy . [ Subjects ] Sixteen children ( 9 males , 7 females ) with spastic diplegic cerebral palsy were recruited and r and omly assigned to the conventional neurological physical therapy group ( CG ) and virtual reality training group ( VRG ) . [ Methods ] Eight children in the control group performed 45 minutes of therapeutic exercise twice a week for eight weeks . In the experimental group , the other eight children performed 30 minutes of therapeutic exercise and 15 minutes of a training program using virtual reality twice a week during the experimental period . [ Results ] After eight weeks of the training program , there were significant differences in eye-h and coordination and visual motor speed in the comparison of the virtual reality training group with the conventional neurological physical therapy group . [ Conclusion ] We conclude that a well- design ed training program using virtual reality can improve eye-h and coordination in children with cerebral palsy Summary The 12-week home-based virtual cycling training ( hVCT ) improved lower limb muscle strength and areal bone mineral density ( aBMD ) than the control program in children with cerebral palsy ( CP ) . A muscle strengthening program , rather than general physical activity , is more specific in enhancing aBMD for these children . A novel hVCT is an effective and efficient strategy that enhances lower limb bone density in these children . Introduction This is the first study to assess the efficacy of a novel hVCT program on bone density for children with spastic CP using a well- design ed r and omized controlled trial . Methods Twenty-seven ambulatory children with spastic CP , aged 6–12 years , were r and omly assigned to the hVCT group ( n = 13 ) or control group ( n = 14 ) . Outcome measures —motor function [ Gross Motor Function Measure-66 ( GMFM-66 ) ] , muscle strength ( curl up scores and isokinetic torque of knee extensor and flexor muscle ) and aBMD of the lumbar and distal femur — were administered before and immediately after the 12-week intervention . Results Analysis of covariance results show that the hVCT group had greater distal femur aBMD and isokinetic torques of knee extensor and flexor muscles than the control group at posttreatment ( p < 0.05 ) . However , curl up scores , GMFM-66 , and lumbar aBMD at posttreatment did not differ between the two groups . Conclusions Analytical findings suggest that the muscle strengthening program is more specific in enhancing bone density for children with CP than general physical activity . Thus , the proposed 12-week hVCT protocol is an effective and efficient strategy for improving lower limb aBMD in these children ABSTRACT Objective : To assess the effect of interactive video gaming ( IVG ) with Nintendo Wii ( Wii ) supplemented to conventional therapy in rehabilitation of children with cerebral palsy ( CP ) . Design : R and omized , controlled , assessor-blinded study . Participants : Children with CP ; 10 children each in the control and intervention groups . Intervention : IVG using Wii , given as a supplement to conventional therapy , for 45 min per day , 6 days a week for 3 weeks . The children in the control group received conventional therapy alone . Outcome Measures : Posture control and balance , upper limb function , visual-perceptual skills , and functional mobility . Results : Significant improvement in upper limb functions was seen in the intervention group but not in the control group . Improvements in balance , visual perception , and functional mobility were not significantly different between control and intervention groups . Conclusions : Wii-based IVG may be offered as an effective supplement to conventional therapy in the rehabilitation of children with CP Independent walking is an important goal of clinical and community-based rehabilitation for children with cerebral palsy ( CP ) .  Virtual reality-based rehabilitation therapy is effective in motivating children with CP . This study investigated the effects of treadmill training with virtual reality on gait , balance , muscular strength , and gross motor function in children with CP . Eighteen children with spastic CP were r and omly divided into the virtual reality treadmill training ( VRTT ) group ( 9 subjects , mean age , 10.2 years ) and treadmill training ( TT ) group ( 9 subjects , mean age , 9.4 years ) . The groups performed their respective programs as well as conventional physical therapy 3 times/week for 8 weeks . Muscle strength was assessed using a digitalized manual muscle tester . Gross motor function was assessed using the Gross Motor Functional Measure ( GMFM ) . Balance was assessed using the Pediatric Balance Scale ( PBS ) . Gait speed was assessed using the 10-meter walk test ( 10MWT ) , and gait endurance was assessed using the 2-minute walk test ( 2MWT ) . After training , gait and balance was improved in the VRTT compared to the TT group ( P < 0.05 ) . Muscular strength was significantly greater in the VRTT group than the TT group , except for right hamstring strength . The improvements in GMFM ( st and ing ) and PBS scores were greater in the VRTT group than the TT group ( P < 0.05 ) . Furthermore , the VRTT group showed the higher values of 10MWT and 2MWT compared to the TT group ( P < 0.05 ) . In conclusion , VRTT programs are effective for improving gait , balance , muscular strength , and gross motor function in children with CP BACKGROUND This study compared the effects of Nintendo Wii-Fit ® balance-based video games and conventional balance training in children with mild cerebral palsy ( CP ) . METHODS This r and omized controlled trial involved 30 ambulatory pediatric patients ( aged 5 - 18 years ) with CP . Participants were r and omized to either conventional balance training ( control group ) or to  Wii-Fit balance-based video games training ( Wii group ) . Both group received neuro-developmental treatment ( NDT ) during 24 sessions . In addition , while the control group received conventional balance training in each session , the Wii group played Nintendo Wii Fit games such as ski slalom , tightrope walk and soccer heading on balance board . Primary outcomes were Functional Reach Test ( forward and sideways ) , Sit-to-St and Test and Timed Get up and Go Test . Nintendo Wii Fit balance , age and game scores , 10 m walk test , 10-step climbing test and Wee-Functional Independence Measure ( Wee FIM ) were secondary outcomes . RESULTS After the treatment , changes in balance scores and independence level in activities of daily living were significant ( P < 0.05 ) in both groups . Statistically significant improvements were found in the Wii-based game group compared with the control group in all balance tests and total Wee FIM score ( P < 0.05 ) . CONCLUSION Wii-fit balance-based video games are better at improving both static and performance-related balance parameters when combined with NDT treatment in children with mild CP The aim of the present study was to determine the user satisfaction of the EyeToy for the training of the upper limb in children with cerebral palsy ( CP ) .  User satisfaction was measured in 12 children with CP , using a postexperience question naire , primarily based on a presence question naire . In general , children with CP were satisfied with and motivated by the EyeToy training . In addition , a first evaluation study was performed to determine the effect of this training method on the upper limb function . Ten children with CP were r and omly assigned to the intervention ( mean age 11 years , 9 months ; SD 2,3 ) and the control group ( mean age 12 years , 3 months ; SD 3,2 ) . After a treatment period of 6 weeks , the intervention group completed a  user satisfaction question naire . Functional outcome was measured using the Melbourne Assessment scores . Percentage scores of the Melbourne Assessment of 7 of the 10 children were the same or changed only 1 % to 2 % from baseline to followup . However , in the experimental group , two children improved more , 9 % and 13 % respectively . In conclusion , it can be said that the EyeToy is a motivational training tool for the training of children with CP and has the potential to improve upper extremity function OBJECTIVE This study aim ed at assessing how the addition of Nintendo Wii ™ ( NW ) system to the traditional therapy influences occupational performance , balance , and daily living activities in children with spastic hemiplegic Cerebral Palsy ( CP ) . MATERIAL S AND METHODS The present study is a single-blind and r and omized trial involving 24 children aged 6 - 14 years , classified as level I or II on the Gross Motor Function Classification System . The children were allocated into two groups : an intervention and a control group , and their families participated in the study . The activity performance analysis of the children was undertaken by using the Canadian Occupational Performance Measure ( COPM ) , functional balance was measured with the Pediatric Balance Scale ( PBS ) , and activities of daily living were assessed with Pediatric Evaluation of Disability Inventory ( PEDI ) . Twenty-four children with CP were r and omly divided into two groups : intervention ( n = 12 ) and control group ( n = 12 ) . All children in both groups continued their traditional physiotherapy program twice a week , 45 minutes per session , whereas the participants in the intervention group , additionally , were trained with NW , two other days of the week for 12 weeks , with each session lasting for 30 minutes . RESULTS Self-care , mobility , PEDI total , PBS , and performance of COPM scores increased in the NW group after intervention . Self-care , mobility , and total PEDI increased in the control group as well . However , there was no statistically significant difference found between the groups , except for PBS ( P < 0.05 ) . CONCLUSIONS NW contributed to the implementation of occupational performance , daily living activities , and functional balance . We recommend that NW could be used in the rehabilitation program to engage play-based activities with fun AIM The study aim ed to investigate the effectiveness of a web-based therapy programme , ' Move it to improve it ' ( Mitii ( ™ ) ) , in children with unilateral cerebral palsy ( UCP ) on occupational performance , upper limb function , and visual perception . METHOD Participants ( n=102 ) were matched in pairs and r and omized to intervention ( Mitii for 20wks ; 26 males , mean age 11y 8mo [ 2y 4mo ] , Manual Ability Classification System level I=11 , II=39 , III=1 ) or control ( st and ard care ; 25 males , mean age 11y 10mo [ 2y 5mo ] , Manual Ability Classification System level I=13 , II=37 ) . Outcomes were the Assessment of Motor and Process Skills ( AMPS ) , Assisting H and Assessment , Jebsen-Taylor Test of H and Function ( JTTHF ) , Melbourne Assessment of Unilateral Upper Limb Function ( MUUL ) , Canadian Occupational Performance Measure ( COPM ) , and Test of Visual Perceptual Skills ( TVPS-3 ) . RESULTS Participants completed on average 32.4 hours of Mitii ( range 3.7 - 74.7h ) . The Mitii group demonstrated significantly greater post-intervention scores than the comparison group on the AMPS , JTTHF dominant upper limb , COPM , and TVPS-3 . The differences between groups were not clinical ly significant . There were no differences between groups on measures of impaired upper limb function . INTERPRETATION Mitii delivers individualized , web-based therapy at home and has potential to increase therapy dose . Mitii can be considered as an option to enhance occupational performance and visual perception for children with UCP The current priority of investigations involving transcranial direct current stimulation ( tDCS ) and neurorehabilitation is to identify biomarkers associated with the positive results of the interventions such that respondent and non-respondent patients can be identified in the early phases of treatment . The aims were to determine whether : ( 1 ) present motor evoked potential ( MEP ) ; and ( 2 ) injuries involving the primary motor cortex , are associated with tDCS-enhancement in functional outcome following gait training in children with cerebral palsy ( CP ) . We review ed the data from our parallel , r and omized , sham-controlled , double-blind studies . Fifty-six children with spastic CP received gait training ( either treadmill training or virtual reality training ) and tDCS ( active or sham ) . Univariate and multivariate logistic regression analyses were employed to identify clinical , neurophysiologic and neuroanatomic predictors associated with the responsiveness to treatment with tDCS .  MEP presence during the initial evaluation and the subcortical injury were associated with positive effects in the functional results . The logistic regression revealed that present MEP was a significant predictor for the six-minute walk test ( 6MWT ; p = 0.003 ) and gait speed ( p = 0.028 ) , whereas the subcortical injury was a significant predictor of gait kinematics ( p = 0.013 ) and gross motor function ( p = 0.021 ) . In this preliminary study involving children with CP , two important prediction factors of good responses to anodal tDCS combined with gait training were identified . Apparently , MEP ( integrity of the corticospinal tract ) and subcortical location of the brain injury exerted different influences on aspects related to gait , such as velocity and kinematics AIMS To determine whether the multi-modal web-based rehabilitation ' Move it to improve it ' ( Mitii ) is more effective than wait list control ( usual care ) to improve occupational performance , upper limb function , and visual perception in children with acquired brain injury ( ABI ) . METHOD Fifty-eight r and omly allocated children ( 53 % males ; mean age 11y  
    Output:
    