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 Stroke is an important causal factor of deficiency and functional dependence worldwide . OBJECTIVE To determine the immediate effects of visual and auditory biofeedback , combined with partial body weight supported ( PBWS ) treadmill training on the gait of individuals with chronic hemiparesis . DESIGN R and omized controlled trial . SETTING Outpatient rehabilitation hospital . POPULATION S Thirty subjects with chronic hemiparesis and ability to walk with some help . METHODS Participants were r and omized to a control group that underwent only PBWS treadmill training ; or experimental I group with visual biofeedback from the display monitor , in the form of symbolic feet as the subject took a step ; or experimental group II with auditory biofeedback associated display , using a metronome at 115 % of the individual 's preferred cadence . They trained for 20 minutes and were evaluated before and after training . Spatio-temporal and angular gait variables were obtained by kinematics from the Qualisys Motion Analysis system . RESULTS Increases in speed and stride length were observed for all groups over time ( speed : F=25.63 ; P<0.001 ; stride length : F=27.18 ; P<0.001 ) , as well as changes in hip and ankle range of motion - ROM ( hip ROM : F=14.43 ; P=0.001 ; ankle ROM : F=4.76 ; P=0.038 ) , with no time*groups interaction . Other spatio-temporal and angular parameters remain unchanged . CONCLUSIONS Visual biofeedback and auditory biofeedback had no influence on PBWS treadmill training of individuals with chronic hemiparesis , in short term . Additional studies are needed to determine whether , in long term , the biofeedback will promote additional benefit to the PBWS treadmill training . CLINICAL REHABILITATION IMPACT The findings of this study indicate that visual and auditory biofeedback does not bring immediate benefits on PBWS treadmill training of individuals with chronic hemiparesis . This suggest that , for additional benefits are achieved with biofeedback , effects should be investigated after long-term training , which may determine if some kind of biofeedback is superior to another to improve the hemiparetic gait Evidence -based practice involves the use of evidence from systematic review s and r and omised controlled trials , but the extent of this evidence in physiotherapy has not previously been surveyed . The aim of this survey is to describe the quantity and quality of r and omised controlled trials and the quantity of systematic review s relevant to physiotherapy . The Physiotherapy Evidence Data base ( PEDro ) was search ed . The quality of trials was assessed with the PEDro scale . The search identified a total of 2,376 r and omised controlled trials and 332 systematic review s. The first trial was published in 1955 and the first review was published in 1982 . Since that time , the number of trials and review s has grown exponentially . The mean PEDro quality score has increased from 2.8 in trials published between 1955 and 1959 to 5.0 for trials published between 1995 and 1999 . There is a substantial body of evidence about the effects of physiotherapy . However , there remains scope for improvements in the quality of the conduct and reporting of clinical trials [ Purpose ] This study aim ed to eluci date the effects of a novel walking training program with postural correction and visual feedback on walking function in patients with post-stroke hemiparesis . [ Subjects ] Sixteen subjects were r and omly allocated to either the experimental group ( EG ) or the control group ( CG ) , with eight subjects in each . [ Methods ] EG and CG subjects performed a 30-min treadmill walking training exercise twice daily for 2 weeks . EG subjects also underwent postural correction using elastic b and s and received visual feedback during walking . The 10-m walk test was performed , and gait parameters were measured using a gait analysis system . [ Results ] All parameters showed significant main effects for the group factor and time-by-group interactions . Significant main effects for the time factor were found in the stride length and stance phase ratios . [ Conclusion ] The novel walking training program with postural correction and visual feedback may improve walking function in patients with post-stroke hemiparesis Visual and auditory feedback cues have been shown to improve gait and balance in patients with movement disorders , such as Parkinson 's disease and multiple sclerosis . Subsequently , closed-loop virtual reality was used to enhance the gait improvement effect of such cues . Objectives : To study the effects of gait training with visual and auditory feedback cues on the walking abilities of patients with gait disorders due to cerebral palsy . Methods : Visual and auditory feedback cues were generated by a wearable accelerometry-driven device . Ten r and omly selected patients with gait disorders due to cerebral palsy trained with visual feedback cues while ten such patients trained with auditory feedback cues . Baseline performance ( walking speed and stride length along a 10 m straight track ) was measured before device use . Following 20min training with the device , performance without the device was measured again and compared to the baseline performance . Results : For patients training with visual feedback , the average improvement in walking speed was 21.70%+/−36.06 % and in stride length 8.72%±9.47 % . For patients training with auditory feedback , average improvement in walking speed was 25.43%±28.65 % and in stride length 13.58%±13.10 % . Conclusion : Visual and auditory feedback cues can improve gait parameters in patients with gait disorders due to cerebral palsy Background Gait and balance impairments lead to frequent falls and injuries in individuals with Huntington 's disease ( HD ) .  Assistive devices ( ADs ) such as canes and walkers are often prescribed to prevent falls , but their efficacy is unknown . We systematic ally examined the effects of different types of ADs on quantitative gait measures during walking in a straight path and around obstacles . Methods Spatial and temporal gait parameters were measured in 21 subjects with HD as they walked across a GAITRite walkway under 7 conditions ( i.e. , using no AD and 6  commonly prescribed ADs : a cane , a weighted cane , a st and ard walker , and a 2 , 3 or 4 wheeled walker ) . Subjects also were timed and observed for number of stumbles and falls while walking around two obstacles in a figure-of-eight pattern . Results Gait measure variability ( i.e. , coefficient of variation ) , an indicator of fall risk , was consistently better when using the 4WW compared to other ADs . Subjects also walked the fastest and had the fewest number of stumbles and falls when using the 4WW in the figure-of-eight course . Subjects walked significantly slower using ADs compared to no AD both across the GAITRite and in the figure-of-eight . Measures reflecting gait stability and safety improved with the 4WW but were made worse by some other ADs BACKGROUND This study was a prospect i ve , r and omized , open , blinded-endpoint trial with the aim of examining whether gait training with a gait-assistance robot ( GAR ) improves gait disturbances in subacute non-ambulatory hemiplegic stroke patients more than overground conventional gait training . The GAR adopts a robot arm control system with full weight bearing and foot pressure visual biofeedback . METHODS Twenty-six hemiplegic patients were r and omly assigned to either the  GAR-assisted gait training ( GAGT ) group or the  overground conventional gait training ( OCGT ) group . Both groups underwent 60 min of st and ard physical therapy and 20 min of GAGT or OCGT 5 days a week for 4 weeks . The primary outcome measure was the Functional Ambulation Classification ( FAC ) . The secondary outcome measures were the peak torque of the extensor muscles in the lower extremities and a 10-m walking test . The lower extremity function was evaluated using the Fugl-Meyer Assessment , and activities of daily living were assessed using the Functional Independence Measure . RESULTS The GAGT group demonstrated significantly greater improvements in FAC and peak torque on the unaffected side ( p=0.02 ) than the OCGT group . Additionally , gait speed tended to be faster ( p=0.07 ) in the GAGT group . CONCLUSIONS GAGT combined with st and ard physical therapy in subacute non-ambulatory hemiplegic patients led to significant improvements in gait and peak torque on the unaffected side compared to OCGT Background and Purpose . Equinovarus foot is a common sign after stroke . The aim of this study is to investigate the effect of task specific exercises , gait training , and visual biofeedback on correcting equinovarus gait among individuals with stroke . Subjects and Methods . Sixteen subjects with ischemic stroke were r and omly assigned to two equal groups ( G1 and G2 ) . All the patients were at stage 4 of motor recovery of foot according to Chedoke-McMaster Stroke Assessment without any cognitive dysfunction . E-med pedography was used to measure contact time , as well as force underneath hind and forefoot during walking . Outcome measures were collected before r and omization , one week after the last session , and four weeks later . Participants in G1 received task specific exercises , gait training , and visual biofeedback and a traditional physical therapy program was applied for participants in G2 for 8 weeks . Results . Significant improvement was observed among G1 patients ( P ≤ 0.05 ) which lasts one month after therapy termination . On the other h and , there were no significant differences between measurements of the participants in G2 . Between groups comparison also revealed a significant improvement in G1 with long lasting effect . Conclusion . The results of this study showed a positive long lasting effect of the task specific exercises , gait training , and visual biofeedback on equinovarus gait pattern among individuals with stroke [ Purpose ] The acquisition of motor skills are fundamental to human life . There is a lack of research on whether knowledge of performance or knowledge of result as augmented feedback is more effective . The objective of this study was to compare the effectiveness of knowledge of result and knowledge of performance in the learning of a skilled motor activity by healthy young adults . [ Subjects and Methods ] A total of thirty healthy young adult males and females without any neurological or musculoskeletal impairment , between the age of 18–30 years were the subjects of the study . They were r and omly allocated to 2 groups : group 1 was given knowledge of result as feedback , and knowledge of performance was given as feedback to group 2 . Both the groups practice d the task of throwing a soft spongy ball for 6 days per week for 4 weeks , with 40 trials each day . The outcome measure used was the distance of the throw . [ Results ] The results were analyzed using the t-test . The mean distances thrown by both the groups showed highly significant improvements and throwing distance of group 2 showed better improvement than that of group 1 . [ Conclusion ] Both types of augmented feedback were effective at improving skilled motor activity , but the knowledge of performance group showed better improvement than the knowledge of result group Background Increasing evidence suggests that use of augmented visual feedback could be a useful approach to stroke rehabilitation . In current clinical practice , visual feedback of movement performance is often limited to the use of mirrors or video . However , neither approach is optimal since cognitive and self-image issues can distract or distress patients and their movement can be obscured by clothing or limited viewpoints . Three-dimensional motion capture has the potential to provide accurate kinematic data required for objective assessment and feedback in the clinical environment . However , such data are currently presented in numerical or graphical format , which is often impractical in a clinical setting . Our hypothesis is that presenting this kinematic data using bespoke visualisation software , which is tailored for gait rehabilitation after stroke , will provide a means whereby feedback of movement performance can be communicated in a more meaningful way to patients . This will result in increased patient underst and ing of their rehabilitation and will enable progress to be tracked in a more accessible way . Methods The hypothesis will be assessed using an exploratory ( phase II ) r and omised controlled trial . Stroke survivors eligible for this trial will be in the subacute stage of stroke and have impaired walking ability ( Functional Ambulation Classification of 1 or more ) . Participants ( n = 45 ) will be r and omised into three groups to compare the use of the visualisation software during overground physical therapy gait training against an intensity-matched and attention-matched placebo group and a usual care control group . The primary outcome measure will be walking speed . Secondary measures will be Functional Ambulation Category , Timed Up and Go , Rivermead Visual Gait Assessment , Stroke Impact Scale-16 and spatiotemporal parameters associated with walking . Additional qualitative measures will be used to assess the participant ’s experience of the visual feedback provided in the study . Discussion Results from the trial will explore whether the early provision of visual feedback of biomechanical movement performance during gait rehabilitation demonstrates improved mobility outcomes after stroke and increased patient underst and ing of their rehabilitation . Trial registration Current Controlled Trials IS RCT Background and Purpose : Cardiovascular fitness is greatly reduced after stroke . Although individuals with mild to moderate impairments benefit from conventional cardiovascular exercise interventions , there is a lack of effective approaches for persons with severely impaired physical function . This r and omized controlled pilot trial investigated efficacy and feasibility of feedback-controlled robotics-assisted treadmill exercise ( FC-RATE ) for cardiovascular rehabilitation in persons with severe impairments early after stroke . Methods : Twenty individuals ( age 61 ± 11 years ; 52 ± 31 days poststroke ) with severe motor limitations ( Functional Ambulation Classification 0 - 2 ) were recruited for FC-RATE or conventional robotics-assisted treadmill exercise ( RATE ) ( 4 weeks , 3 × 30-minute sessions/wk ) . Outcome measures focused on peak cardiopulmonary performance parameters , training intensity , and feasibility , with examiners blinded to allocation . Results : All 14 allocated participants ( 70 % of recruited ) completed 
    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 Stroke is an important causal factor of deficiency and functional dependence worldwide . OBJECTIVE To determine the immediate effects of visual and auditory biofeedback , combined with partial body weight supported ( PBWS ) treadmill training on the gait of individuals with chronic hemiparesis . DESIGN R and omized controlled trial . SETTING Outpatient rehabilitation hospital . POPULATION S Thirty subjects with chronic hemiparesis and ability to walk with some help . METHODS Participants were r and omized to a control group that underwent only PBWS treadmill training ; or experimental I group with visual biofeedback from the display monitor , in the form of symbolic feet as the subject took a step ; or experimental group II with auditory biofeedback associated display , using a metronome at 115 % of the individual 's preferred cadence . They trained for 20 minutes and were evaluated before and after training . Spatio-temporal and angular gait variables were obtained by kinematics from the Qualisys Motion Analysis system . RESULTS Increases in speed and stride length were observed for all groups over time ( speed : F=25.63 ; P<0.001 ; stride length : F=27.18 ; P<0.001 ) , as well as changes in hip and ankle range of motion - ROM ( hip ROM : F=14.43 ; P=0.001 ; ankle ROM : F=4.76 ; P=0.038 ) , with no time*groups interaction . Other spatio-temporal and angular parameters remain unchanged . CONCLUSIONS Visual biofeedback and auditory biofeedback had no influence on PBWS treadmill training of individuals with chronic hemiparesis , in short term . Additional studies are needed to determine whether , in long term , the biofeedback will promote additional benefit to the PBWS treadmill training . CLINICAL REHABILITATION IMPACT The findings of this study indicate that visual and auditory biofeedback does not bring immediate benefits on PBWS treadmill training of individuals with chronic hemiparesis . This suggest that , for additional benefits are achieved with biofeedback , effects should be investigated after long-term training , which may determine if some kind of biofeedback is superior to another to improve the hemiparetic gait Evidence -based practice involves the use of evidence from systematic review s and r and omised controlled trials , but the extent of this evidence in physiotherapy has not previously been surveyed . The aim of this survey is to describe the quantity and quality of r and omised controlled trials and the quantity of systematic review s relevant to physiotherapy . The Physiotherapy Evidence Data base ( PEDro ) was search ed . The quality of trials was assessed with the PEDro scale . The search identified a total of 2,376 r and omised controlled trials and 332 systematic review s. The first trial was published in 1955 and the first review was published in 1982 . Since that time , the number of trials and review s has grown exponentially . The mean PEDro quality score has increased from 2.8 in trials published between 1955 and 1959 to 5.0 for trials published between 1995 and 1999 . There is a substantial body of evidence about the effects of physiotherapy . However , there remains scope for improvements in the quality of the conduct and reporting of clinical trials [ Purpose ] This study aim ed to eluci date the effects of a novel walking training program with postural correction and visual feedback on walking function in patients with post-stroke hemiparesis . [ Subjects ] Sixteen subjects were r and omly allocated to either the experimental group ( EG ) or the control group ( CG ) , with eight subjects in each . [ Methods ] EG and CG subjects performed a 30-min treadmill walking training exercise twice daily for 2 weeks . EG subjects also underwent postural correction using elastic b and s and received visual feedback during walking . The 10-m walk test was performed , and gait parameters were measured using a gait analysis system . [ Results ] All parameters showed significant main effects for the group factor and time-by-group interactions . Significant main effects for the time factor were found in the stride length and stance phase ratios . [ Conclusion ] The novel walking training program with postural correction and visual feedback may improve walking function in patients with post-stroke hemiparesis Visual and auditory feedback cues have been shown to improve gait and balance in patients with movement disorders , such as Parkinson 's disease and multiple sclerosis . Subsequently , closed-loop virtual reality was used to enhance the gait improvement effect of such cues . Objectives : To study the effects of gait training with visual and auditory feedback cues on the walking abilities of patients with gait disorders due to cerebral palsy . Methods : Visual and auditory feedback cues were generated by a wearable accelerometry-driven device . Ten r and omly selected patients with gait disorders due to cerebral palsy trained with visual feedback cues while ten such patients trained with auditory feedback cues . Baseline performance ( walking speed and stride length along a 10 m straight track ) was measured before device use . Following 20min training with the device , performance without the device was measured again and compared to the baseline performance . Results : For patients training with visual feedback , the average improvement in walking speed was 21.70%+/−36.06 % and in stride length 8.72%±9.47 % . For patients training with auditory feedback , average improvement in walking speed was 25.43%±28.65 % and in stride length 13.58%±13.10 % . Conclusion : Visual and auditory feedback cues can improve gait parameters in patients with gait disorders due to cerebral palsy Background Gait and balance impairments lead to frequent falls and injuries in individuals with Huntington 's disease ( HD ) .  Assistive devices ( ADs ) such as canes and walkers are often prescribed to prevent falls , but their efficacy is unknown . We systematic ally examined the effects of different types of ADs on quantitative gait measures during walking in a straight path and around obstacles . Methods Spatial and temporal gait parameters were measured in 21 subjects with HD as they walked across a GAITRite walkway under 7 conditions ( i.e. , using no AD and 6  commonly prescribed ADs : a cane , a weighted cane , a st and ard walker , and a 2 , 3 or 4 wheeled walker ) . Subjects also were timed and observed for number of stumbles and falls while walking around two obstacles in a figure-of-eight pattern . Results Gait measure variability ( i.e. , coefficient of variation ) , an indicator of fall risk , was consistently better when using the 4WW compared to other ADs . Subjects also walked the fastest and had the fewest number of stumbles and falls when using the 4WW in the figure-of-eight course . Subjects walked significantly slower using ADs compared to no AD both across the GAITRite and in the figure-of-eight . Measures reflecting gait stability and safety improved with the 4WW but were made worse by some other ADs BACKGROUND This study was a prospect i ve , r and omized , open , blinded-endpoint trial with the aim of examining whether gait training with a gait-assistance robot ( GAR ) improves gait disturbances in subacute non-ambulatory hemiplegic stroke patients more than overground conventional gait training . The GAR adopts a robot arm control system with full weight bearing and foot pressure visual biofeedback . METHODS Twenty-six hemiplegic patients were r and omly assigned to either the  GAR-assisted gait training ( GAGT ) group or the  overground conventional gait training ( OCGT ) group . Both groups underwent 60 min of st and ard physical therapy and 20 min of GAGT or OCGT 5 days a week for 4 weeks . The primary outcome measure was the Functional Ambulation Classification ( FAC ) . The secondary outcome measures were the peak torque of the extensor muscles in the lower extremities and a 10-m walking test . The lower extremity function was evaluated using the Fugl-Meyer Assessment , and activities of daily living were assessed using the Functional Independence Measure . RESULTS The GAGT group demonstrated significantly greater improvements in FAC and peak torque on the unaffected side ( p=0.02 ) than the OCGT group . Additionally , gait speed tended to be faster ( p=0.07 ) in the GAGT group . CONCLUSIONS GAGT combined with st and ard physical therapy in subacute non-ambulatory hemiplegic patients led to significant improvements in gait and peak torque on the unaffected side compared to OCGT Background and Purpose . Equinovarus foot is a common sign after stroke . The aim of this study is to investigate the effect of task specific exercises , gait training , and visual biofeedback on correcting equinovarus gait among individuals with stroke . Subjects and Methods . Sixteen subjects with ischemic stroke were r and omly assigned to two equal groups ( G1 and G2 ) . All the patients were at stage 4 of motor recovery of foot according to Chedoke-McMaster Stroke Assessment without any cognitive dysfunction . E-med pedography was used to measure contact time , as well as force underneath hind and forefoot during walking . Outcome measures were collected before r and omization , one week after the last session , and four weeks later . Participants in G1 received task specific exercises , gait training , and visual biofeedback and a traditional physical therapy program was applied for participants in G2 for 8 weeks . Results . Significant improvement was observed among G1 patients ( P ≤ 0.05 ) which lasts one month after therapy termination . On the other h and , there were no significant differences between measurements of the participants in G2 . Between groups comparison also revealed a significant improvement in G1 with long lasting effect . Conclusion . The results of this study showed a positive long lasting effect of the task specific exercises , gait training , and visual biofeedback on equinovarus gait pattern among individuals with stroke [ Purpose ] The acquisition of motor skills are fundamental to human life . There is a lack of research on whether knowledge of performance or knowledge of result as augmented feedback is more effective . The objective of this study was to compare the effectiveness of knowledge of result and knowledge of performance in the learning of a skilled motor activity by healthy young adults . [ Subjects and Methods ] A total of thirty healthy young adult males and females without any neurological or musculoskeletal impairment , between the age of 18–30 years were the subjects of the study . They were r and omly allocated to 2 groups : group 1 was given knowledge of result as feedback , and knowledge of performance was given as feedback to group 2 . Both the groups practice d the task of throwing a soft spongy ball for 6 days per week for 4 weeks , with 40 trials each day . The outcome measure used was the distance of the throw . [ Results ] The results were analyzed using the t-test . The mean distances thrown by both the groups showed highly significant improvements and throwing distance of group 2 showed better improvement than that of group 1 . [ Conclusion ] Both types of augmented feedback were effective at improving skilled motor activity , but the knowledge of performance group showed better improvement than the knowledge of result group Background Increasing evidence suggests that use of augmented visual feedback could be a useful approach to stroke rehabilitation . In current clinical practice , visual feedback of movement performance is often limited to the use of mirrors or video . However , neither approach is optimal since cognitive and self-image issues can distract or distress patients and their movement can be obscured by clothing or limited viewpoints . Three-dimensional motion capture has the potential to provide accurate kinematic data required for objective assessment and feedback in the clinical environment . However , such data are currently presented in numerical or graphical format , which is often impractical in a clinical setting . Our hypothesis is that presenting this kinematic data using bespoke visualisation software , which is tailored for gait rehabilitation after stroke , will provide a means whereby feedback of movement performance can be communicated in a more meaningful way to patients . This will result in increased patient underst and ing of their rehabilitation and will enable progress to be tracked in a more accessible way . Methods The hypothesis will be assessed using an exploratory ( phase II ) r and omised controlled trial . Stroke survivors eligible for this trial will be in the subacute stage of stroke and have impaired walking ability ( Functional Ambulation Classification of 1 or more ) . Participants ( n = 45 ) will be r and omised into three groups to compare the use of the visualisation software during overground physical therapy gait training against an intensity-matched and attention-matched placebo group and a usual care control group . The primary outcome measure will be walking speed . Secondary measures will be Functional Ambulation Category , Timed Up and Go , Rivermead Visual Gait Assessment , Stroke Impact Scale-16 and spatiotemporal parameters associated with walking . Additional qualitative measures will be used to assess the participant ’s experience of the visual feedback provided in the study . Discussion Results from the trial will explore whether the early provision of visual feedback of biomechanical movement performance during gait rehabilitation demonstrates improved mobility outcomes after stroke and increased patient underst and ing of their rehabilitation . Trial registration Current Controlled Trials IS RCT Background and Purpose : Cardiovascular fitness is greatly reduced after stroke . Although individuals with mild to moderate impairments benefit from conventional cardiovascular exercise interventions , there is a lack of effective approaches for persons with severely impaired physical function . This r and omized controlled pilot trial investigated efficacy and feasibility of feedback-controlled robotics-assisted treadmill exercise ( FC-RATE ) for cardiovascular rehabilitation in persons with severe impairments early after stroke . Methods : Twenty individuals ( age 61 ± 11 years ; 52 ± 31 days poststroke ) with severe motor limitations ( Functional Ambulation Classification 0 - 2 ) were recruited for FC-RATE or conventional robotics-assisted treadmill exercise ( RATE ) ( 4 weeks , 3 × 30-minute sessions/wk ) . Outcome measures focused on peak cardiopulmonary performance parameters , training intensity , and feasibility , with examiners blinded to allocation . Results : All 14 allocated participants ( 70 % of recruited ) completed 
    Output:
    