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: Objective : To examine the psychometric properties of the sensory scale of the Fugl-Meyer Assessment ( FMA-S ) in stroke patients with a broad range of neurological and functional impairment at times from 14 to 180 days after stroke . Subjects : A total of 176 first stroke patients consecutively admitted to a university based medical centre . Design : This prospect i ve , longitudinal investigation was based on data collected at 14 , 30 , 90 and 180 days after stroke . Main outcome measures : Reliability ( inter-rater reliability and internal consistency ) , validity ( convergent and predictive validity ) and responsiveness of the FMA-S  were examined . Results : The inter-rater agreement of the total score of the FMA-S was excellent , with an intraclass correlation coefficient of 0.93 . The Cronbach 's alphas of the FMA-S at four time points after stroke ranged from 0.94 to 0.98 , indicating excellent internal consistency . However , the FMA-S showed a significant ceiling effect ( more than 44.4 % of the subjects achieving the highest score ) , poor to moderate inter-rater reliability for light touch items ( weighted kappa ranging from 0.30 to 0.55 ) , low to moderate validity ( Spearman 's rho ranging from 0.29 to 0.53 ) , and low to moderate responsiveness ( st and ardized response mean ranging from 0.27 to 0.67 ) at different post-stroke stages of recovery . Conclusions : The psychometric properties of the FMA-S in measuring sensory function do not support its clinical use in stroke patients . Further studies on methods to improve the psychometric properties of the FMA-S are needed Developing an evidence base for making public health decisions will require using data from evaluation studies with r and omized and nonr and omized design s. Assessing individual studies and using studies in quantitative research syntheses require transparent reporting of the study , with sufficient detail and clarity to readily see differences and similarities among studies in the same area . The Consoli date d St and ards of Reporting Trials ( CONSORT ) statement provides guidelines for transparent reporting of r and omized clinical trials . We present the initial version of the Transparent Reporting of Evaluations with Nonr and omized Design s ( TREND ) statement . These guidelines emphasize the reporting of theories used and descriptions of intervention and comparison conditions , research design , and methods of adjusting for possible biases in evaluation studies that use nonr and omized design OBJECTIVE . We investigated changes in functional arm use after retraining for stroke-related somatosensory loss and identified whether such changes are associated with somatosensory discrimination skills . METHOD . Data were pooled ( N = 80 ) from two r and omized controlled trials of somatosensory retraining . We used the Motor Activity Log to measure perceived amount of arm use in daily activities and the Action Research Arm Test to measure performance capacity . Somatosensory discrimination skills were measured using st and ardized modality-specific measures . RESULTS . Participants ’ arm use improved after somatosensory retraining ( z = −6.80 , p < .01 ) . Change in arm use was weakly associated with somatosensation ( tactile , & bgr ; = 0.31 , p < .01 ; proprioception , & bgr ; = −0.17 , p > .05 ; object recognition , & bgr ; = 0.13 , p < .05 ) . CONCLUSION . Change in daily arm use was related to a small amount of variance in somatosensory outcomes . Stroke survivors  ’ functional arm use can increase after somatosensory retraining , with change varying among survivors Objective : To investigate the feasibility and potential efficacy of ‘ activeTENS ’ ( that is transcutaneous electrical nerve stimulation ( TENS ) during everyday activities ) by assessing the immediate effects on strength , proprioception , balance/falls risk and mobility after stroke . Design : A paired- sample r and omized cross-over trial . Subjects : Twenty-nine mobile chronic stroke survivors with no pre-existing conditions limiting balance or mobility or contra-indications to TENS . Setting : University clinical research facility . Intervention : A single session of ‘ activeTENS ’ delivered via a ‘ sock electrode ’ ( 70–130 Hz , five second cycle ) plus a session of control treatment ( wearing the sock electrode with no stimulation ) , lasting approximately two hours in total . Main Outcomes : Dorsiflexor and plantarflexor strength and proprioception using an isokinetic dyanometer , balance and falls risk ( St and ing Forward Reach Test ) and gait speed ( 10-m walk test ) . Results : All participants tolerated ‘ active TENS ’  . Most parameters improved during stimulation with activeTENS ; balance ( p = 0.009 ) , gait speed ( p = 0.002 ) , plantarflexor strength ( p = 0.008 ) and proprioception of plantarflexion ( p = 0.029 ) , except dorsiflexor strength ( p = 0.194 ) and dorsiflexion proprioception ( p = 0.078 ) . Conclusions : The results provide initial evidence of the potential of ‘ active TENS ’ to benefit physical function after stroke which warrants further phase II trials to develop the intervention . Concerns that stimulation could have a detrimental impact on balance and increase risk of falls were not supported Background The study evaluates the effectiveness of Compelled Body Weight Shift ( CBWS ) approach in the rehabilitation of individuals with stroke .  CBWS involves a forced shift of body weight towards a person ’s affected side by means of a shoe insert that establishes a lift of the nonaffected lower extremity . Methods Eleven patients with acute stroke were r and omly assigned to experimental and control groups . The experimental group received a two-week conventional physical therapy combined with CBWS and the control group received only a two-week conventional therapy .  Weight bearing , Gait velocity , Berg ’s Balance , and Fugl-Meyer ’s Scores were recorded before and after the intervention . Results Weight bearing on the affected side increased in the experimental group and decreased in the control group . The increase in gait velocity with treatment was significant in both the groups ( P < 0.05 ) . However , experimental group ( P = 0.01 ) demonstrated larger improvements in gait velocity compared to the control group ( P = 0.002 ) . Berg Balance and Fugl-Meyer scores increased for both the groups . Conclusion The implementation of a two-week intervention with CBWS result ed in the improvement in weight bearing and gait velocity of individuals with acute stroke . The present preliminary study suggests that CBWS technique could be implemented as an adjunct to conventional rehabilitation program for individuals with acute stroke Objective : To investigate whether cutaneous electrical stimulation has a role in the enhancement of sensorimotor function in chronic stroke . Subjects and setting : Fifty-nine patients with chronic stroke received cutaneous stimulation during their three-week-long inpatient rehabilitation . Thirty-two received active treatment in the paretic h and and eight received no-current placebo treatment in the paretic h and . Nineteen patients received active stimulation of the paretic foot . None received stimulation in both upper and lower limbs . Intervention : Cutaneous stimulation was delivered twice daily via a special glove/sock electrode . Main outcome measures : Modified Motor Assessment Scale , 10-metre walking test , paretic limb function , limb skin sensation and somatosensory evoked potentials ( SEP ) were performed before and after the treatment . Results : Modified Motor Assessment Scale ( p < 0.001 ) , 10-metre walking test ( p < 0.05 ) , paretic h and function ( p < 0.01 ) , upper limb skin sensation ( p < 0.01 ) and SEP normality classification of paretic upper limb ( p < 0.01 ) and paretic lower limb ( p < 0.5 ) improved significantly in the treatment group ( n = 51 ) after three weeks of stimulation . When active h and treatment and placebo h and treatment were compared , a significant improvement in the sensory and motor function was observed only in the actively treated group . Conclusions : Cutaneous stimulation had positive effects in the motor performance , limb sensation and the configuration of SEP of the paretic limb in chronic stroke patients [ Purpose ] The purpose of the present study was to examine and compare the effects of proprioceptive training accompanied by motor imagery training and general proprioceptive training on the balance of stroke patients . [ Subjects and Methods ] Thirty-six stroke patients were r and omly assigned to either an experimental group of 18 patients or a control group of 18 patients . The experimental group was given motor imagery training for 5 minutes and proprioceptive training for 25 minutes , while the control group was given proprioceptive training for 30 minutes . Each session and training program was implemented 5 times a week for 8 weeks . The Korean version of the Berg Balance Scale ( K-BBS ) , Timed Up and Go test ( TUG ) , weight bearing ratio ( AFA-50 , Alfoots , Republic of Korea ) , and joint position sense error ( Dualer IQ Inclinometer , JTECH Medical , USA ) were measured . [ Results ] Both groups showed improvements in K-BBS , TUG , weight bearing ratio , and joint position sense error . The measures of the experimental group showed greater improvement than the control group . [ Conclusion ] Motor imagery training , which is not subject to time restrictions , is not very risky and can be used as an effective treatment method for improving the balance ability of stroke patients This study assessed whether sense of movement is impaired at the ankle in persons post-stroke who are able to walk independently . Eleven chronic post-stroke subjects ( > 4 months post stroke ) who were ambulatory with or without walking aids and living within the community , and 10 healthy age-matched control subjects volunteered to participate .  Proprioceptive acuity at the ankle , measured by sense of movement  , was tested at three velocities , 0.1 , 0.5 , and 2.5 deg/sec , in r and om order . In addition ,  ankle range of motion and the distance that subjects walked in 6 minutes were assessed . Stroke subjects were significantly poorer ( p < 0.001 ) at detecting movement at the affected ankle compared with either the unaffected ankle or with the control group at each of the velocities tested . Six out of 11 stroke subjects demonstrated significant impairment in movement detection compared to controls . The usual primary impairments following stroke are loss of strength and loss of co-ordination . However , reduced proprioceptive acuity at the affected ankle may also contribute to a person 's ability to position and load the foot during walking . This could explain the moderate relationship found between proprioceptive acuity and walking endurance in persons following stroke ( Spearman 's rho = 0.63 to 0.77 ) Objective : To investigate the frequency of somatosensory impairment in stroke patients within different somatosensory modalities and different body areas , and their recovery . Design : Prospect i ve observational study . Setting : Two stroke rehabilitation units . Subjects : Seventy patients with a first stroke ( 36 men , 34 women ; average age , 71 , SD 10.00 years ; average time since stroke onset , 15 days ) were assessed on admission and two , four and six months after stroke . Interventions : Not applicable . Main measure : Nottingham Sensory Assessment . Results : Somatosensory impairment was common after stroke ; 7—53 % had impaired tactile sensations , 31—89 % impaired stereognosis , and 34—64 % impaired proprioception . When comparing somatosensory modalities within body areas the kappa values were low ( kappa values < 0.54 ) . Recovery occurred over time , though not significantly in lower limb tactile sensations . Stroke severity was the main factor influencing initial somatosensory impairment , but accounted for a small amount of the variance ( 21—41 % ) . Initial somatosensory impairment was significantly related to somatosensory ability at six months , accounting for 46—71 % of the variance . Conclusions : Proprioception and stereognosis were more frequently impaired than tactile sensations . The different somatosensory modalities showed only slight agreement between impairment within the same body areas , suggesting that the modalities are independent of each other and all should be assessed . High agreements were found between different body areas for each somatosensory modality . Somatosensory impairment was associated with stroke severity , however low variance indicated other factors were involved Objective : To characterize the nature of sensory impairments after stroke , identify associated factors , and assess the relationships between sensory impairment , disability , and recovery . Methods : Prospect i ve cross-sectional survey of 102 people with hemiparesis following their first stroke .  Tactile and proprioceptive sensation  in the affected arm and leg were measured using the Rivermead Assessment of Somatosensory Perception 2 - 4 weeks post-stroke . Demographics , stroke pathology , weakness , neglect , disability , and recovery were documented . Results : Tactile impairment was more common than proprioceptive ( P < .000 ) , impairment of discrimination was more common than detection ( P < .000 ) , and tactile sensation was more severely impaired in the leg than the arm ( P < .000 ) . No difference in proprioception between the arm and leg ( P = .703 ) or between proximal and distal joints ( P = .589 , P = .705 ) was found . The degree of weakness and the degree of stroke severity were significantly associated with sensory impairment ; demographics , stroke side and type , and neglect were not associated . All the sensory modalities were significantly related to independence , mobility , and recovery ( r = 0.287 [ P < .011 ] to r = 0.533 [ P < .000 ] ) . Conclusion : Sensory impairments of all modalities are common after stroke , although tactile impairment is more frequent than proprioceptive loss , especially in the leg . They are associated with the degree of weakness and the degree of stroke severity but not demographics 
    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: Objective : To examine the psychometric properties of the sensory scale of the Fugl-Meyer Assessment ( FMA-S ) in stroke patients with a broad range of neurological and functional impairment at times from 14 to 180 days after stroke . Subjects : A total of 176 first stroke patients consecutively admitted to a university based medical centre . Design : This prospect i ve , longitudinal investigation was based on data collected at 14 , 30 , 90 and 180 days after stroke . Main outcome measures : Reliability ( inter-rater reliability and internal consistency ) , validity ( convergent and predictive validity ) and responsiveness of the FMA-S  were examined . Results : The inter-rater agreement of the total score of the FMA-S was excellent , with an intraclass correlation coefficient of 0.93 . The Cronbach 's alphas of the FMA-S at four time points after stroke ranged from 0.94 to 0.98 , indicating excellent internal consistency . However , the FMA-S showed a significant ceiling effect ( more than 44.4 % of the subjects achieving the highest score ) , poor to moderate inter-rater reliability for light touch items ( weighted kappa ranging from 0.30 to 0.55 ) , low to moderate validity ( Spearman 's rho ranging from 0.29 to 0.53 ) , and low to moderate responsiveness ( st and ardized response mean ranging from 0.27 to 0.67 ) at different post-stroke stages of recovery . Conclusions : The psychometric properties of the FMA-S in measuring sensory function do not support its clinical use in stroke patients . Further studies on methods to improve the psychometric properties of the FMA-S are needed Developing an evidence base for making public health decisions will require using data from evaluation studies with r and omized and nonr and omized design s. Assessing individual studies and using studies in quantitative research syntheses require transparent reporting of the study , with sufficient detail and clarity to readily see differences and similarities among studies in the same area . The Consoli date d St and ards of Reporting Trials ( CONSORT ) statement provides guidelines for transparent reporting of r and omized clinical trials . We present the initial version of the Transparent Reporting of Evaluations with Nonr and omized Design s ( TREND ) statement . These guidelines emphasize the reporting of theories used and descriptions of intervention and comparison conditions , research design , and methods of adjusting for possible biases in evaluation studies that use nonr and omized design OBJECTIVE . We investigated changes in functional arm use after retraining for stroke-related somatosensory loss and identified whether such changes are associated with somatosensory discrimination skills . METHOD . Data were pooled ( N = 80 ) from two r and omized controlled trials of somatosensory retraining . We used the Motor Activity Log to measure perceived amount of arm use in daily activities and the Action Research Arm Test to measure performance capacity . Somatosensory discrimination skills were measured using st and ardized modality-specific measures . RESULTS . Participants ’ arm use improved after somatosensory retraining ( z = −6.80 , p < .01 ) . Change in arm use was weakly associated with somatosensation ( tactile , & bgr ; = 0.31 , p < .01 ; proprioception , & bgr ; = −0.17 , p > .05 ; object recognition , & bgr ; = 0.13 , p < .05 ) . CONCLUSION . Change in daily arm use was related to a small amount of variance in somatosensory outcomes . Stroke survivors  ’ functional arm use can increase after somatosensory retraining , with change varying among survivors Objective : To investigate the feasibility and potential efficacy of ‘ activeTENS ’ ( that is transcutaneous electrical nerve stimulation ( TENS ) during everyday activities ) by assessing the immediate effects on strength , proprioception , balance/falls risk and mobility after stroke . Design : A paired- sample r and omized cross-over trial . Subjects : Twenty-nine mobile chronic stroke survivors with no pre-existing conditions limiting balance or mobility or contra-indications to TENS . Setting : University clinical research facility . Intervention : A single session of ‘ activeTENS ’ delivered via a ‘ sock electrode ’ ( 70–130 Hz , five second cycle ) plus a session of control treatment ( wearing the sock electrode with no stimulation ) , lasting approximately two hours in total . Main Outcomes : Dorsiflexor and plantarflexor strength and proprioception using an isokinetic dyanometer , balance and falls risk ( St and ing Forward Reach Test ) and gait speed ( 10-m walk test ) . Results : All participants tolerated ‘ active TENS ’  . Most parameters improved during stimulation with activeTENS ; balance ( p = 0.009 ) , gait speed ( p = 0.002 ) , plantarflexor strength ( p = 0.008 ) and proprioception of plantarflexion ( p = 0.029 ) , except dorsiflexor strength ( p = 0.194 ) and dorsiflexion proprioception ( p = 0.078 ) . Conclusions : The results provide initial evidence of the potential of ‘ active TENS ’ to benefit physical function after stroke which warrants further phase II trials to develop the intervention . Concerns that stimulation could have a detrimental impact on balance and increase risk of falls were not supported Background The study evaluates the effectiveness of Compelled Body Weight Shift ( CBWS ) approach in the rehabilitation of individuals with stroke .  CBWS involves a forced shift of body weight towards a person ’s affected side by means of a shoe insert that establishes a lift of the nonaffected lower extremity . Methods Eleven patients with acute stroke were r and omly assigned to experimental and control groups . The experimental group received a two-week conventional physical therapy combined with CBWS and the control group received only a two-week conventional therapy .  Weight bearing , Gait velocity , Berg ’s Balance , and Fugl-Meyer ’s Scores were recorded before and after the intervention . Results Weight bearing on the affected side increased in the experimental group and decreased in the control group . The increase in gait velocity with treatment was significant in both the groups ( P < 0.05 ) . However , experimental group ( P = 0.01 ) demonstrated larger improvements in gait velocity compared to the control group ( P = 0.002 ) . Berg Balance and Fugl-Meyer scores increased for both the groups . Conclusion The implementation of a two-week intervention with CBWS result ed in the improvement in weight bearing and gait velocity of individuals with acute stroke . The present preliminary study suggests that CBWS technique could be implemented as an adjunct to conventional rehabilitation program for individuals with acute stroke Objective : To investigate whether cutaneous electrical stimulation has a role in the enhancement of sensorimotor function in chronic stroke . Subjects and setting : Fifty-nine patients with chronic stroke received cutaneous stimulation during their three-week-long inpatient rehabilitation . Thirty-two received active treatment in the paretic h and and eight received no-current placebo treatment in the paretic h and . Nineteen patients received active stimulation of the paretic foot . None received stimulation in both upper and lower limbs . Intervention : Cutaneous stimulation was delivered twice daily via a special glove/sock electrode . Main outcome measures : Modified Motor Assessment Scale , 10-metre walking test , paretic limb function , limb skin sensation and somatosensory evoked potentials ( SEP ) were performed before and after the treatment . Results : Modified Motor Assessment Scale ( p < 0.001 ) , 10-metre walking test ( p < 0.05 ) , paretic h and function ( p < 0.01 ) , upper limb skin sensation ( p < 0.01 ) and SEP normality classification of paretic upper limb ( p < 0.01 ) and paretic lower limb ( p < 0.5 ) improved significantly in the treatment group ( n = 51 ) after three weeks of stimulation . When active h and treatment and placebo h and treatment were compared , a significant improvement in the sensory and motor function was observed only in the actively treated group . Conclusions : Cutaneous stimulation had positive effects in the motor performance , limb sensation and the configuration of SEP of the paretic limb in chronic stroke patients [ Purpose ] The purpose of the present study was to examine and compare the effects of proprioceptive training accompanied by motor imagery training and general proprioceptive training on the balance of stroke patients . [ Subjects and Methods ] Thirty-six stroke patients were r and omly assigned to either an experimental group of 18 patients or a control group of 18 patients . The experimental group was given motor imagery training for 5 minutes and proprioceptive training for 25 minutes , while the control group was given proprioceptive training for 30 minutes . Each session and training program was implemented 5 times a week for 8 weeks . The Korean version of the Berg Balance Scale ( K-BBS ) , Timed Up and Go test ( TUG ) , weight bearing ratio ( AFA-50 , Alfoots , Republic of Korea ) , and joint position sense error ( Dualer IQ Inclinometer , JTECH Medical , USA ) were measured . [ Results ] Both groups showed improvements in K-BBS , TUG , weight bearing ratio , and joint position sense error . The measures of the experimental group showed greater improvement than the control group . [ Conclusion ] Motor imagery training , which is not subject to time restrictions , is not very risky and can be used as an effective treatment method for improving the balance ability of stroke patients This study assessed whether sense of movement is impaired at the ankle in persons post-stroke who are able to walk independently . Eleven chronic post-stroke subjects ( > 4 months post stroke ) who were ambulatory with or without walking aids and living within the community , and 10 healthy age-matched control subjects volunteered to participate .  Proprioceptive acuity at the ankle , measured by sense of movement  , was tested at three velocities , 0.1 , 0.5 , and 2.5 deg/sec , in r and om order . In addition ,  ankle range of motion and the distance that subjects walked in 6 minutes were assessed . Stroke subjects were significantly poorer ( p < 0.001 ) at detecting movement at the affected ankle compared with either the unaffected ankle or with the control group at each of the velocities tested . Six out of 11 stroke subjects demonstrated significant impairment in movement detection compared to controls . The usual primary impairments following stroke are loss of strength and loss of co-ordination . However , reduced proprioceptive acuity at the affected ankle may also contribute to a person 's ability to position and load the foot during walking . This could explain the moderate relationship found between proprioceptive acuity and walking endurance in persons following stroke ( Spearman 's rho = 0.63 to 0.77 ) Objective : To investigate the frequency of somatosensory impairment in stroke patients within different somatosensory modalities and different body areas , and their recovery . Design : Prospect i ve observational study . Setting : Two stroke rehabilitation units . Subjects : Seventy patients with a first stroke ( 36 men , 34 women ; average age , 71 , SD 10.00 years ; average time since stroke onset , 15 days ) were assessed on admission and two , four and six months after stroke . Interventions : Not applicable . Main measure : Nottingham Sensory Assessment . Results : Somatosensory impairment was common after stroke ; 7—53 % had impaired tactile sensations , 31—89 % impaired stereognosis , and 34—64 % impaired proprioception . When comparing somatosensory modalities within body areas the kappa values were low ( kappa values < 0.54 ) . Recovery occurred over time , though not significantly in lower limb tactile sensations . Stroke severity was the main factor influencing initial somatosensory impairment , but accounted for a small amount of the variance ( 21—41 % ) . Initial somatosensory impairment was significantly related to somatosensory ability at six months , accounting for 46—71 % of the variance . Conclusions : Proprioception and stereognosis were more frequently impaired than tactile sensations . The different somatosensory modalities showed only slight agreement between impairment within the same body areas , suggesting that the modalities are independent of each other and all should be assessed . High agreements were found between different body areas for each somatosensory modality . Somatosensory impairment was associated with stroke severity , however low variance indicated other factors were involved Objective : To characterize the nature of sensory impairments after stroke , identify associated factors , and assess the relationships between sensory impairment , disability , and recovery . Methods : Prospect i ve cross-sectional survey of 102 people with hemiparesis following their first stroke .  Tactile and proprioceptive sensation  in the affected arm and leg were measured using the Rivermead Assessment of Somatosensory Perception 2 - 4 weeks post-stroke . Demographics , stroke pathology , weakness , neglect , disability , and recovery were documented . Results : Tactile impairment was more common than proprioceptive ( P < .000 ) , impairment of discrimination was more common than detection ( P < .000 ) , and tactile sensation was more severely impaired in the leg than the arm ( P < .000 ) . No difference in proprioception between the arm and leg ( P = .703 ) or between proximal and distal joints ( P = .589 , P = .705 ) was found . The degree of weakness and the degree of stroke severity were significantly associated with sensory impairment ; demographics , stroke side and type , and neglect were not associated . All the sensory modalities were significantly related to independence , mobility , and recovery ( r = 0.287 [ P < .011 ] to r = 0.533 [ P < .000 ] ) . Conclusion : Sensory impairments of all modalities are common after stroke , although tactile impairment is more frequent than proprioceptive loss , especially in the leg . They are associated with the degree of weakness and the degree of stroke severity but not demographics 
    Output:
    