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 : Interstitial lung disease ( ILD ) is characterised by exertional dyspnoea , exercise limitation and reduced quality of life . The role of exercise training in this diverse patient group is unclear . The aims of this study were to establish the safety of exercise training in ILD ; its effects on exercise capacity , dyspnoea and quality of life ; and whether patients with idiopathic pulmonary fibrosis ( IPF ) had similar responses to those with other types of ILD . Methods : 57 subjects with ILD ( 34 IPF ) were r and omised to receive 8 weeks of supervised exercise training or weekly telephone support . The 6 min walk distance ( 6MWD ) , incremental exercise test , modified Medical Research Council ( MRC ) dyspnoea score and Chronic Respiratory Disease Question naire ( CRDQ ) were performed at baseline , following intervention and at 6 months . Results : 80 % of subjects completed the exercise programme and no adverse events were recorded . The 6MWD increased following training ( mean difference to control 35 m , 95 % CI 6 to 64 m ) . A significant reduction in MRC score was observed ( 0.7 points , 95 % CI 0.1 to 1.3 ) along with improvements in dyspnoea ( p = 0.04 ) and fatigue ( p<0.01 ) on the CRDQ . There was no change in peak oxygen uptake ;  however , exercise training  reduced heart rate at maximum isoworkload ( p = 0.01 ) . There were no significant differences in response between those with and without IPF . After 6 months there were no differences between the training and control group for any outcome variable . Conclusions : Exercise training improves exercise capacity and symptoms in patients with ILD , but these benefits are not sustained 6 months following intervention . Trial registration number : summary We have developed a low-b and width , Internet-based telerehabilitation system to provide outpatient rehabilitation to patients who have undergone total knee arthroplasty . The preliminary efficacy of this treatment programme in terms of both physical and functional objective outcome measures was assessed on 21 patients . Subjects receiving a six-week rehabilitation programme were r and omized to the telerehabilitation system or the usual face-to-face method .  The physical and functional improvements in the telerehabilitation group were similar to those in the control group . There was a non-significant trend for greater improvements in the telerehabilitation group for most outcome measurements . The telerehabilitation programme was well received by patients . The results of this study provide evidence for the efficacy of low-b and width telerehabilitation consultations BACKGROUND Telemedical networks are a new approach to improve stroke care in community setting s. We aim ed to assess the effects of a stroke network with telemedical support in Germany on quality of care , according to acute processes and long-term outcome . METHODS Five community hospitals without pre-existing specialised stroke care were included in a network with telemedical support by two academic hospitals . In a non-r and omised , open intervention study , five community hospitals without specialised stroke care  served as the control group , matched individually to the network hospitals by predefined characteristics . Stroke patients admitted consecutively to one of the participating hospitals between July 7 , 2003 , and March 31 , 2005 , were included in the study . Patients in network and control hospitals were assessed in the same manner and were followed up for vital status , living situation , and disability at 3 months . Poor outcome was defined by death , institutional care , or disability ( Barthel index < 60 or modified Rankin scale > 3 ) . Predefined indicators for quality of acute stroke care were achieved . FINDINGS A total of 5696 patients with a sudden , non-convulsive loss of neurological function who were diagnosed with having suspected stroke were admitted to the ten hospitals participating in the study . After exclusion , 3122 were included in the final analysis , of whom 1971 ( 63 % ) were treated in the network hospitals . All indicators related to quality of acute stroke care were more commonly met in the network than in the control hospitals . After 3 months , 44 % of patients treated in network hospitals versus 54 % treated in control hospitals had a poor outcome ( p<0.0001 ) . In multivariate regression analysis , treatment in network hospitals independently reduced the probability of a poor outcome ( odds ratio 0.62 , 95 % CI 0.52 - 0.74 ; p<0.0001 ) . INTERPRETATION Telemedical networks with academic stroke centres offer new and innovative approaches to improve acute stroke care at community level for stroke patients living in non-urban areas OBJECTIVES To examine the effect on mobility self-efficacy of a multifactorial , individualized , occupational/physical therapy ( OT/PT ) intervention delivered via teletechnology or in-home visits . DESIGN R and omized , clinical trial . SETTING One Department of Veterans Affairs and one private rehabilitation hospital . PARTICIPANTS Sixty-five community-dwelling adults with new mobility devices . Thirty-three were r and omized to the control or usual care group ( UCG ) , 32 to the intervention group ( IG ) . INTERVENTION Four , once-weekly , 1-hour OT/PT sessions targeting three mobility and three transfer tasks . A therapist delivered the intervention in the traditional home setting ( trad group n = 16 ) or remotely via teletechnology ( tele group n = 16 ) . MEASUREMENTS Ten-item Likert-scale measure of mobility self-efficacy . RESULTS The IG had a statistically significantly greater increase in overall self-efficacy over the study period than the UCG ( mean change : IG 8.8 , 95 % confidence interval ( CI ) = 3.8 - 13.7 ; UCG 1.2 , 95 % CI = -5.8 - 8.2 ) . Descriptively , the IG exhibited positive changes in self-efficacy for all tasks and greater positive change than the UCG on all items with the exception of getting in and out of a chair . Comparisons of the two treatment delivery methods showed a medium st and ardized effect size ( SES ) in both the tele and trad groups , although it did not reach statistical significance for the tele group ( SES : tele = 0.35 , 95 % CI = -2.5 - 0.95 ; trad = 0.54 , 95 % CI = 0.06 - 1.14 ) . CONCLUSION A multifactorial , individualized , home-based OT/PT intervention can improve self-efficacy in mobility-impaired adults . The trend toward increased self-efficacy irrespective of the mode of rehabilitation delivery suggests that telerehabilitation can be a viable alternative to or can augment traditional in-home therapy Background Breast cancer survivors suffer physical impairment after oncology treatment . This impairment reduces quality of life ( QoL ) and increase the prevalence of h and icaps associated to unhealthy lifestyle ( for example , decreased aerobic capacity and strength , weight gain , and fatigue ) . Recent work has shown that exercise adapted to individual characteristics of patients is related to improved overall and disease-free survival . Nowadays , technological support using telerehabilitation systems is a promising strategy with great advantage of a quick and efficient contact with the health professional . It is not known the role of telerehabilitation through therapeutic exercise as a support tool to implement an active lifestyle which has been shown as an effective re source to improve fitness and reduce musculoskeletal disorders of these women . Methods / Design This study will use a two-arm , assessor blinded , parallel r and omized controlled trial design . People will be eligible if : their diagnosis is of stages I , II , or IIIA breast cancer ; they are without chronic disease or orthopedic issues that would interfere with ability to participate in a physical activity program ; they had access to the Internet and basic knowledge of computer use or living with a relative who has this knowledge ; they had completed adjuvant therapy except for hormone therapy and not have a history of cancer recurrence ; and they have an interest in improving lifestyle . Participants will be r and omized into e-CUI DATE or usual care groups . E-CUI DATE give participants access to a range of contents : planning exercise arranged in series with breathing exercises , mobility , strength , and stretching . All of these exercises will be assigned to women in the telerehabilitation group according to perceived needs . The control group will be asked to maintain their usual routine . Study endpoints will be assessed after 8 weeks ( immediate effects ) and after 6 months . The primary outcome will be QoL measured by The European Organization for Research and Treatment of Cancer Quality of Life Question naire Core 30 version 3.0 and breast module called The European Organization for Research and Treatment of Cancer Breast Cancer-Specific Quality of Life question naire . The secondary outcomes : pain ( algometry , Visual Analogue Scale , Brief Pain Inventory short form ) ; body composition ; physical measurement ( abdominal test , h and grip strength , back muscle strength , and multiple sit-to-st and test ) ; cardiorespiratory fitness ( International Fitness Scale , 6-minute walk test , International Physical Activity Question naire-Short Form ) ; fatigue ( Piper Fatigue Scale and Borg Fatigue Scale ) ; anxiety and depression ( Hospital Anxiety and Depression Scale ) ; cognitive function ( Trail Making Test and Auditory Consonant Trigram ) ; accelerometry ; lymphedema ; and anthropometric perimeters . Discussion This study investigates the feasibility and effectiveness of a telerehabilitation system during adjuvant treatment of patients with breast cancer . If this treatment option is effective , telehealth systems could offer a choice of supportive care to cancer patients during the survivorship phase . Trial registration Clinical Trials.gov Identifier : Background . Spinal cord injury ( SCI ) survivors with tetraplegia have great difficulty performing activities of daily living ( ADLs ) . Functional electrical stimulation ( FES ) combined with exercise therapy ( ET ) can improve h and function , but delivering the treatment is problematic . Objective . To compare 2 ET treatments delivered by in-home tele-therapy ( IHT ) . Methods . Each treatment involved ET , tele-supervised 1 h/d , 5 d/wk for 6 weeks . Treatment 1 : “ conventional ET ” comprised strength training , computer games played with a trackball , and therapeutic electrical stimulation ( TES ) . Treatment 2 : “ ReJoyce ET ” comprised FES-ET on a workstation , the Rehabilitation Joystick for Computerized Exercise ( ReJoyce ) with which participants played computer games associated with ADLs . Participants were block-r and omized into group 1 receiving conventional ET first , followed by 1-month washout , and then ReJoyce ET and group 2 in reverse order . In all , 13 participants took part , 5 completing the study with both h and s , such that both groups had a sample size of 9 . Primary outcome measure : Action Research Arm Test ( ARAT ) . Secondary outcome measures : grasp and pinch forces and the ReJoyce automated h and function test ( RAHFT ) . Results . ARAT scores improved more after ReJoyce ET ( 13.0 % ± 9.8 % ) than after conventional ET ( 4.0 % ± 9.6 % ; F = 10.6 , P < .01 ) . RAHFT scores also improved more after ReJoyce ET ( 16.9 % ± 8.6 % ) than conventional ET ( 3.3 % ± 10.2 % ; F = 20.4 , P < .01 ) . Conclusions . FES-ET on a workstation , supervised over the Internet , is feasible and may be effective for patients who can meet the residual motor function requirements of our study We conducted a pilot telerehabilitation study with post-stroke patients with arm motor impairment . We compared the degree of satisfaction of patients undergoing a virtual reality ( VR ) therapy programme at home ( Tele-VR group ) to satisfaction experienced by those undergoing the same VR therapy in a hospital setting ( VR-group ) . The rehabilitation equipment used a 3D motion tracking system to create a virtual environment in which the patient 's movement was represented . In tele-therapy , the patient equipment was installed in their homes , connected to the hospital by four ISDN lines at a total b and width of 512 kbit/s . Rehabilitation data were transmitted via one line and videoconferencing via the other three . Ten patients with mild to intermediate arm motor impairment due to an ischaemic stroke , were r and omized into VR or Tele-VR groups . A question naire was used at the end of treatment to measure each patient 's degree of satisfaction . Tele-VR treated patients showed median values equal to or higher than the VR group patients in all 12 items investigated , except one . In motor performance , the Tele-VR group improved significantly ( P ≤ 0.05 ) , while the VR group showed no significant change . Patients assigned to the Tele-VR group were able to engage in therapy at home and the videoconferencing system ensured a good relationship between the patient and the physical therapist whose physical proximity was not required We conducted a r and omized controlled trial to evaluate the perception , satisfaction and utilization of a home telehealth service  for frail elderly people living independently in their home communities .  Control group subjects continued with their usual care and intervention group subjects were able to supplement their usual care with the use of a web portal . The web portal allowed videoconferencing and electronic messaging between home care nurses and clients , ordering health-related and home care services , access to health-related information and general access to the Internet . A total of 99 eligible people ( 59 female , 40 male ) from one urban and one rural study site agreed to participate in the study . Eighty-four subjects were active participants for nine months . There were no significant differences in perception of technology between the two groups at baseline . At 60-day follow-up , the intervention group was significantly more positive towards technology compared to their own baseline ( 
    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: Background : Interstitial lung disease ( ILD ) is characterised by exertional dyspnoea , exercise limitation and reduced quality of life . The role of exercise training in this diverse patient group is unclear . The aims of this study were to establish the safety of exercise training in ILD ; its effects on exercise capacity , dyspnoea and quality of life ; and whether patients with idiopathic pulmonary fibrosis ( IPF ) had similar responses to those with other types of ILD . Methods : 57 subjects with ILD ( 34 IPF ) were r and omised to receive 8 weeks of supervised exercise training or weekly telephone support . The 6 min walk distance ( 6MWD ) , incremental exercise test , modified Medical Research Council ( MRC ) dyspnoea score and Chronic Respiratory Disease Question naire ( CRDQ ) were performed at baseline , following intervention and at 6 months . Results : 80 % of subjects completed the exercise programme and no adverse events were recorded . The 6MWD increased following training ( mean difference to control 35 m , 95 % CI 6 to 64 m ) . A significant reduction in MRC score was observed ( 0.7 points , 95 % CI 0.1 to 1.3 ) along with improvements in dyspnoea ( p = 0.04 ) and fatigue ( p<0.01 ) on the CRDQ . There was no change in peak oxygen uptake ;  however , exercise training  reduced heart rate at maximum isoworkload ( p = 0.01 ) . There were no significant differences in response between those with and without IPF . After 6 months there were no differences between the training and control group for any outcome variable . Conclusions : Exercise training improves exercise capacity and symptoms in patients with ILD , but these benefits are not sustained 6 months following intervention . Trial registration number : summary We have developed a low-b and width , Internet-based telerehabilitation system to provide outpatient rehabilitation to patients who have undergone total knee arthroplasty . The preliminary efficacy of this treatment programme in terms of both physical and functional objective outcome measures was assessed on 21 patients . Subjects receiving a six-week rehabilitation programme were r and omized to the telerehabilitation system or the usual face-to-face method .  The physical and functional improvements in the telerehabilitation group were similar to those in the control group . There was a non-significant trend for greater improvements in the telerehabilitation group for most outcome measurements . The telerehabilitation programme was well received by patients . The results of this study provide evidence for the efficacy of low-b and width telerehabilitation consultations BACKGROUND Telemedical networks are a new approach to improve stroke care in community setting s. We aim ed to assess the effects of a stroke network with telemedical support in Germany on quality of care , according to acute processes and long-term outcome . METHODS Five community hospitals without pre-existing specialised stroke care were included in a network with telemedical support by two academic hospitals . In a non-r and omised , open intervention study , five community hospitals without specialised stroke care  served as the control group , matched individually to the network hospitals by predefined characteristics . Stroke patients admitted consecutively to one of the participating hospitals between July 7 , 2003 , and March 31 , 2005 , were included in the study . Patients in network and control hospitals were assessed in the same manner and were followed up for vital status , living situation , and disability at 3 months . Poor outcome was defined by death , institutional care , or disability ( Barthel index < 60 or modified Rankin scale > 3 ) . Predefined indicators for quality of acute stroke care were achieved . FINDINGS A total of 5696 patients with a sudden , non-convulsive loss of neurological function who were diagnosed with having suspected stroke were admitted to the ten hospitals participating in the study . After exclusion , 3122 were included in the final analysis , of whom 1971 ( 63 % ) were treated in the network hospitals . All indicators related to quality of acute stroke care were more commonly met in the network than in the control hospitals . After 3 months , 44 % of patients treated in network hospitals versus 54 % treated in control hospitals had a poor outcome ( p<0.0001 ) . In multivariate regression analysis , treatment in network hospitals independently reduced the probability of a poor outcome ( odds ratio 0.62 , 95 % CI 0.52 - 0.74 ; p<0.0001 ) . INTERPRETATION Telemedical networks with academic stroke centres offer new and innovative approaches to improve acute stroke care at community level for stroke patients living in non-urban areas OBJECTIVES To examine the effect on mobility self-efficacy of a multifactorial , individualized , occupational/physical therapy ( OT/PT ) intervention delivered via teletechnology or in-home visits . DESIGN R and omized , clinical trial . SETTING One Department of Veterans Affairs and one private rehabilitation hospital . PARTICIPANTS Sixty-five community-dwelling adults with new mobility devices . Thirty-three were r and omized to the control or usual care group ( UCG ) , 32 to the intervention group ( IG ) . INTERVENTION Four , once-weekly , 1-hour OT/PT sessions targeting three mobility and three transfer tasks . A therapist delivered the intervention in the traditional home setting ( trad group n = 16 ) or remotely via teletechnology ( tele group n = 16 ) . MEASUREMENTS Ten-item Likert-scale measure of mobility self-efficacy . RESULTS The IG had a statistically significantly greater increase in overall self-efficacy over the study period than the UCG ( mean change : IG 8.8 , 95 % confidence interval ( CI ) = 3.8 - 13.7 ; UCG 1.2 , 95 % CI = -5.8 - 8.2 ) . Descriptively , the IG exhibited positive changes in self-efficacy for all tasks and greater positive change than the UCG on all items with the exception of getting in and out of a chair . Comparisons of the two treatment delivery methods showed a medium st and ardized effect size ( SES ) in both the tele and trad groups , although it did not reach statistical significance for the tele group ( SES : tele = 0.35 , 95 % CI = -2.5 - 0.95 ; trad = 0.54 , 95 % CI = 0.06 - 1.14 ) . CONCLUSION A multifactorial , individualized , home-based OT/PT intervention can improve self-efficacy in mobility-impaired adults . The trend toward increased self-efficacy irrespective of the mode of rehabilitation delivery suggests that telerehabilitation can be a viable alternative to or can augment traditional in-home therapy Background Breast cancer survivors suffer physical impairment after oncology treatment . This impairment reduces quality of life ( QoL ) and increase the prevalence of h and icaps associated to unhealthy lifestyle ( for example , decreased aerobic capacity and strength , weight gain , and fatigue ) . Recent work has shown that exercise adapted to individual characteristics of patients is related to improved overall and disease-free survival . Nowadays , technological support using telerehabilitation systems is a promising strategy with great advantage of a quick and efficient contact with the health professional . It is not known the role of telerehabilitation through therapeutic exercise as a support tool to implement an active lifestyle which has been shown as an effective re source to improve fitness and reduce musculoskeletal disorders of these women . Methods / Design This study will use a two-arm , assessor blinded , parallel r and omized controlled trial design . People will be eligible if : their diagnosis is of stages I , II , or IIIA breast cancer ; they are without chronic disease or orthopedic issues that would interfere with ability to participate in a physical activity program ; they had access to the Internet and basic knowledge of computer use or living with a relative who has this knowledge ; they had completed adjuvant therapy except for hormone therapy and not have a history of cancer recurrence ; and they have an interest in improving lifestyle . Participants will be r and omized into e-CUI DATE or usual care groups . E-CUI DATE give participants access to a range of contents : planning exercise arranged in series with breathing exercises , mobility , strength , and stretching . All of these exercises will be assigned to women in the telerehabilitation group according to perceived needs . The control group will be asked to maintain their usual routine . Study endpoints will be assessed after 8 weeks ( immediate effects ) and after 6 months . The primary outcome will be QoL measured by The European Organization for Research and Treatment of Cancer Quality of Life Question naire Core 30 version 3.0 and breast module called The European Organization for Research and Treatment of Cancer Breast Cancer-Specific Quality of Life question naire . The secondary outcomes : pain ( algometry , Visual Analogue Scale , Brief Pain Inventory short form ) ; body composition ; physical measurement ( abdominal test , h and grip strength , back muscle strength , and multiple sit-to-st and test ) ; cardiorespiratory fitness ( International Fitness Scale , 6-minute walk test , International Physical Activity Question naire-Short Form ) ; fatigue ( Piper Fatigue Scale and Borg Fatigue Scale ) ; anxiety and depression ( Hospital Anxiety and Depression Scale ) ; cognitive function ( Trail Making Test and Auditory Consonant Trigram ) ; accelerometry ; lymphedema ; and anthropometric perimeters . Discussion This study investigates the feasibility and effectiveness of a telerehabilitation system during adjuvant treatment of patients with breast cancer . If this treatment option is effective , telehealth systems could offer a choice of supportive care to cancer patients during the survivorship phase . Trial registration Clinical Trials.gov Identifier : Background . Spinal cord injury ( SCI ) survivors with tetraplegia have great difficulty performing activities of daily living ( ADLs ) . Functional electrical stimulation ( FES ) combined with exercise therapy ( ET ) can improve h and function , but delivering the treatment is problematic . Objective . To compare 2 ET treatments delivered by in-home tele-therapy ( IHT ) . Methods . Each treatment involved ET , tele-supervised 1 h/d , 5 d/wk for 6 weeks . Treatment 1 : “ conventional ET ” comprised strength training , computer games played with a trackball , and therapeutic electrical stimulation ( TES ) . Treatment 2 : “ ReJoyce ET ” comprised FES-ET on a workstation , the Rehabilitation Joystick for Computerized Exercise ( ReJoyce ) with which participants played computer games associated with ADLs . Participants were block-r and omized into group 1 receiving conventional ET first , followed by 1-month washout , and then ReJoyce ET and group 2 in reverse order . In all , 13 participants took part , 5 completing the study with both h and s , such that both groups had a sample size of 9 . Primary outcome measure : Action Research Arm Test ( ARAT ) . Secondary outcome measures : grasp and pinch forces and the ReJoyce automated h and function test ( RAHFT ) . Results . ARAT scores improved more after ReJoyce ET ( 13.0 % ± 9.8 % ) than after conventional ET ( 4.0 % ± 9.6 % ; F = 10.6 , P < .01 ) . RAHFT scores also improved more after ReJoyce ET ( 16.9 % ± 8.6 % ) than conventional ET ( 3.3 % ± 10.2 % ; F = 20.4 , P < .01 ) . Conclusions . FES-ET on a workstation , supervised over the Internet , is feasible and may be effective for patients who can meet the residual motor function requirements of our study We conducted a pilot telerehabilitation study with post-stroke patients with arm motor impairment . We compared the degree of satisfaction of patients undergoing a virtual reality ( VR ) therapy programme at home ( Tele-VR group ) to satisfaction experienced by those undergoing the same VR therapy in a hospital setting ( VR-group ) . The rehabilitation equipment used a 3D motion tracking system to create a virtual environment in which the patient 's movement was represented . In tele-therapy , the patient equipment was installed in their homes , connected to the hospital by four ISDN lines at a total b and width of 512 kbit/s . Rehabilitation data were transmitted via one line and videoconferencing via the other three . Ten patients with mild to intermediate arm motor impairment due to an ischaemic stroke , were r and omized into VR or Tele-VR groups . A question naire was used at the end of treatment to measure each patient 's degree of satisfaction . Tele-VR treated patients showed median values equal to or higher than the VR group patients in all 12 items investigated , except one . In motor performance , the Tele-VR group improved significantly ( P ≤ 0.05 ) , while the VR group showed no significant change . Patients assigned to the Tele-VR group were able to engage in therapy at home and the videoconferencing system ensured a good relationship between the patient and the physical therapist whose physical proximity was not required We conducted a r and omized controlled trial to evaluate the perception , satisfaction and utilization of a home telehealth service  for frail elderly people living independently in their home communities .  Control group subjects continued with their usual care and intervention group subjects were able to supplement their usual care with the use of a web portal . The web portal allowed videoconferencing and electronic messaging between home care nurses and clients , ordering health-related and home care services , access to health-related information and general access to the Internet . A total of 99 eligible people ( 59 female , 40 male ) from one urban and one rural study site agreed to participate in the study . Eighty-four subjects were active participants for nine months . There were no significant differences in perception of technology between the two groups at baseline . At 60-day follow-up , the intervention group was significantly more positive towards technology compared to their own baseline ( 
    Output:
    