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 : Some individuals with moderate/severe persistent asthma develop irreversible airway obstruction . These individuals present with dyspnoea , exercise intolerance and impaired quality of life ( QOL ) , all of which could potentially be alleviated with exercise training . Objective : To investigate whether exercise training improves functional exercise capacity and QOL in middle-aged and older adults with fixed airway obstruction asthma ( FAOA ) . Methods : 35 subjects aged 67.8 ± 10.6 years , with FEV1 59 ± 16 % of predicted , were r and omised to a 6-week  ‘ intervention ’ period of supervised exercise training ( n = 20 ) or usual care ( n = 15 ) . This period was preceded by a 3-week run-in period during which asthma control was assessed weekly . Functional exercise capacity ( 6-min walk distance , 6MWD ) and QOL ( Asthma QOL Question naire , AQLQ ) were measured before , immediately following and 3 months after the intervention period . Results : 34 subjects ( exercise group , n = 19 , and control group , n = 15 ) completed the intervention period . Relative to the control group , the exercise group had greater improvements immediately following and 3 months after the intervention in the AQLQ symptom domain ( 0.61 , p = 0.001 , and 0.57 points per item , p = 0.005 ) and AQLQ activity limitation domain ( 0.43 , p = 0.04 , and 0.55 points per item , p = 0.04 ) . 6MWD increased ( 36 ± 37 m , p < 0.01 ) in the exercise group immediately following training and remained elevated ( 34 ± 45 m , p < 0.01 ) at the 3-month follow-up . The magnitude of change in 6MWD between groups was not significant , despite no change in the control group . Conclusions : Supervised exercise training improves symptoms and QOL in adults with FAOA BACKGROUND Aerobic training has a number of well known beneficial effects in both normal and asthmatic children . However , the impact of training on the clinical management of the underlying bronchial asthma remains controversial , particularly in the most severe patients . METHODS Clinical evaluation , spirometric tests , symptom limited maximum exercise testing , and exercise challenge tests were performed in a group of children with stable moderate to severe asthma . Forty two patients ( 24 boys ) aged 8–16 were evaluated twice : before and after supervised aerobic training ( group 1 , n = 26 ) and two months apart ( untrained group 2 , n = 16 ) . RESULTS Spirometric and maximal exercise variables in the initial evaluation were significantly reduced in group 1 ( p<0.05 ) but medication and clinical scores and the occurrence of exercise induced bronchospasm ( EIB ) did not differ between the two groups . Aerobic improvement with training ( maximal oxygen uptake and /or anaerobic threshold increment > 10 % and 100 ml ) was inversely related to the baseline level of fitness and was independent of disease severity . Although the clinical score and the occurrence of EIB did not change after training , aerobic improvement was associated with a significant reduction in the medication score and the daily use of both inhaled and oral steroids ( p<0.05 ) . CONCLUSIONS Aerobic improvement with training in less fit asthmatic children is related to a short term decrease in the daily use of inhaled and oral steroids , independent of the severity of the disease Background . Supervised exercise leads to significant improvements in asthma control and quality -of-life in adults with partly controlled asthma ; however , the role of unsupervised exercise is unknown . Methods . The purpose of this study was to determine the impact of self-directed exercise on subjective and objective indices of asthma-related health .  Participants ( n = 24 ) were assigned to an exercise group or a control group for a 12-week period . Those in the exercise group were provided with exercise programs by a qualified exercise professional . These programs were up date d through electronic mail every 3 weeks to ensure progression . Controls maintained their current lifestyle habits for the intervention period . Assessment s of aerobic fitness , lung function , and subjective and objective asthma measures were conducted at baseline and after completion of the 12-week intervention period for both groups . Analysis of covariance was used to detect differences between groups from baseline to week 12 . Qualitative analyses were used to assess responses to open-ended questions . Results . Adherence to the program was poor . Perceived asthma control and self-reported frequency and severity of asthma improved significantly in the exercise group at week 12 compared with that in the control group . Objective measures of asthma such as asthma control , quality -of-life , and lung function , as well as peak and submaximal aerobic fitness did not change relative to controls . Responses to open-ended questions revealed improvements in three areas : asthma management , perceived fitness , and well-being . Conclusion . Adults with partly controlled asthma are able to improve perceived control and subjective measures of asthma-related health with 12 weeks of self-directed exercise ; however , supervision may be required to make significant improvements to measured asthma control , quality of life , and aerobic fitness . Future research should focus on the means to improve adherence of self-directed exercise programs  in this population The present multicentre study evaluates the differences in efficacy between a 3 month rehabilitation programme including drug treatment , and a 3 month control period of drug treatment only , for asthmatic patients and patients with chronic obstructive pulmonary disease ( COPD ) . The programme was run by physiotherapists in eight local practice s , and included exercise training , patient education , breathing retraining , evacuation of mucus , relaxation techniques , and recreational activities . In a r and omized controlled trial with a cross-over design , the effects of rehabilitation were evaluated 3 and 6 months after baseline measurements in terms of exercise tolerance and quality of life ( QOL ) . Exercise tolerance was assessed using submaximal cycle ergometer tests and 6 min walking tests .  QOL was evaluated by means of the Chronic Respiratory Disease Question naire ( CRDQ ) . After 3 months , the patients who started with rehabilitation showed significant improvements in endurance time ( 421 s ) and cardiac frequency ( 6 beats.min-1 ) during cycling , walking distance ( 39 m ) , and total CRDQ score ( 17 points ) compared to the control group . These improvements were still significant after 6 months . Additional analysis indicated that the asthmatic patients and the patients with COPD responded to rehabilitation in a similar way , with the exception that there was a greater improvement in walking distance for asthmatics . Improvements in exercise tolerance were not significantly correlated with improvements in QOL .  Rehabilitation of patients with asthma or chronic obstructive pulmonary disease in local physiotherapy practice s improves exercise tolerance and quality of life OBJECTIVE To investigate the medium-term benefits of a swimming program in schoolchildren and adolescents with moderate persistent atopic asthma ( MPAA ) . METHODS A r and omized , prospect i ve study of children and adolescents ( age 7 - 18 years ) with MPAA was carried out at the Hospital de Clínicas of Universidade Estadual de Campinas ( UNICAMP ) , Campinas , Brazil . After a 1-month run-in period , 61 patients ( 34 female ) were r and omized into two groups , a swimming group ( n = 30 ) and a control group ( n = 31 ) , and followed for 3 months . Both patient groups received inhaled fluticasone ( dry powder , 250 mcg twice a day ) and salbutamol as needed . The swim training program consisted of two weekly classes over a 3-month period for a total of 24 sessions . Both groups underwent  spirometric assessment  and methacholine challenge test -- provocative concentration of methacholine causing a 20 % fall in FEV1 (PC₂₀)--before and after the study period . Maximal inspiratory pressure ( MIP ) and maximal expiratory pressure ( MEP ) were measured only in the swimming group . RESULTS Significant increases in PC₂₀ ( pre-training , 0.31±0.25 ; post-training , 0.63±0.78 ; p = 0.008 ) , MIP ( pre-training , 67.08±17.13 cm H₂O ; post-training 79.46±18.66 ; p < 0.001 ) , and MEP ( pre-training , 71.69±20.01 cm H₂O ; post-training , 78.92±21.45 cm H₂O ; p < 0.001 ) were found in the swimming group . CONCLUSION Children and adolescents with MPAA subjected to a swim training program experienced a significant decrease in bronchial hyperresponsiveness , as determined by increased PC₂₀ values , when compared with asthmatic controls who did not undergo swim training . Participants in the swimming group also showed improvement in elastic recoil of the chest wall In a programme to examine the effect of 5 months of swimming training on school-children with asthma , 46 children swam a total distance of 3608 km ( 2242 miles ) during 2806 training sessions . On post-training re-examination , nonspecific effects of physical conditioning were detected including improved posture and fitness , reduced fat folds , and enhanced swimming ability . Continuous monitoring of asthma and medication showed significant decreases in both parameters during the final phases of the study between children who continued to swim regularly and those who did not . The frequency and severity of exercise-induced asthma ( after running ) was unchanged by swimming training . Post-training question naires indicated a high degree of enthusiasm and acceptance of the programme by children and parents . No significant adverse effects were observed or reported during the study The aim of this study was to evaluate the long-term outcome of an outpatient pulmonary rehabilitation programme ( PRP ) in patients with chronic airway obstruction ( CAO ) . In 61 CAO patients ( 35 asthmatics and 26 chronic obstructive pulmonary disease ( COPD ) ) lung and respiratory muscle function , exercise tolerance ( by symptom limited cycloergometer and walking tests ) , dyspnoea ( Borg scale , visual analogue scale ( VAS ) , baseline and transitional dyspnoea index ( BDI and TDI , respectively ) ) and quality of life ( St George 's Respiratory Question naire ( SGRQ ) ) were assessed at baseline ( to ) , at discharge ( t1 ) and 12 months postdischarge ( t2 ) . Preprogramme and post-programme hospital admissions and exacerbations of disease were also recorded . In comparison with baseline , no significant change was observed in lung function tests in either diagnostic group , either at t1 or at t2 . In both groups improvements in respiratory muscle strength , exercise tolerance , Borg scale and VAS reported at t1 were partially reduced at t2 . Analysis of variance showed that these changes over time were similar in the two groups . Mean values of SGRQ and BDI/TDI improved at t1 , and , unlike exercise tolerance , did not worsen at t2 . However , a clinical ly relevant difference in SGRQ between t2 and to was reported only in 56 % of asthmatics and 52 % of COPD patients . Compared with the preceding 2 yrs , in the year following PRP , hospital admissions and disease exacerbations decreased significantly in both diagnostic groups . Regardless of diagnosis , patients with chronic airway obstruction who underwent an outpatient pulmonary rehabilitation programme maintained an improved quality of life 12 months postdischarge despite a partial loss of the improvement in exercise tolerance The aim of the present study was to examine the effects of a course of aerobic exercise on pulmonary function and tolerance of activity in asthmatic patients . Among the asthmatic patients , 36 patients ( M= 16 , F= 20 ) were chosen after clinical examinations , pulmonary function test , skin prick test ( SPT ) for aeroallergen and a six minute walk test ( 6MWT ) on their own free will . A patient was said to have Exercise Induced Asthma ( EIA ) when he/she fulfilled the following criteria ; ( 1 ) FEV1 less than 80 % , ( 2 ) 12 % increase or more in FEV1 or PEF after short-acting ss2 agonist prescription and ( 3 ) 15 % decrease in FEV1 or PEF after 6MWT with 70 % or 80 % of maximum heart rate . The patients were r and omly put into two groups of case ( M=8 , F=10 , Mean age=27 ) and control ( M=8 , F=10 , Mean age=29 ) . Case group participated in eight-week aerobic exercise plan , while control group had no plan of exercise .  Pulmonary function tests were done before and after the course of exercise . There were significant changes in FEV1 , FVC , PEF , FEF25 - 75 % , MVV , RF and 6MWT between asthmatic patients of the two groups ( P less than or equal to 0.05 ) , but FEV1/FVC showed no significant change . Mean of changes in FEV1 , FVC , PEF , FEF25 - 75 % , MVV , RF and 6MWT were -25.56 , -17.19 , 32.09 , -27.93 , -22.18 , 5.63 and -307.5 in case group respectively while they were 6.2 , 4.67 , 1.96 , 6.65 , 15.56,-2.87 and 18.78 in the control group . This study shows that aerobic exercises in asthmatic patients lead to an improvement in pulmonary functions .  Aerobic exercise rehabilitation can be a complement to medical treatment of asthma The effects of a  
    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 : Some individuals with moderate/severe persistent asthma develop irreversible airway obstruction . These individuals present with dyspnoea , exercise intolerance and impaired quality of life ( QOL ) , all of which could potentially be alleviated with exercise training . Objective : To investigate whether exercise training improves functional exercise capacity and QOL in middle-aged and older adults with fixed airway obstruction asthma ( FAOA ) . Methods : 35 subjects aged 67.8 ± 10.6 years , with FEV1 59 ± 16 % of predicted , were r and omised to a 6-week  ‘ intervention ’ period of supervised exercise training ( n = 20 ) or usual care ( n = 15 ) . This period was preceded by a 3-week run-in period during which asthma control was assessed weekly . Functional exercise capacity ( 6-min walk distance , 6MWD ) and QOL ( Asthma QOL Question naire , AQLQ ) were measured before , immediately following and 3 months after the intervention period . Results : 34 subjects ( exercise group , n = 19 , and control group , n = 15 ) completed the intervention period . Relative to the control group , the exercise group had greater improvements immediately following and 3 months after the intervention in the AQLQ symptom domain ( 0.61 , p = 0.001 , and 0.57 points per item , p = 0.005 ) and AQLQ activity limitation domain ( 0.43 , p = 0.04 , and 0.55 points per item , p = 0.04 ) . 6MWD increased ( 36 ± 37 m , p < 0.01 ) in the exercise group immediately following training and remained elevated ( 34 ± 45 m , p < 0.01 ) at the 3-month follow-up . The magnitude of change in 6MWD between groups was not significant , despite no change in the control group . Conclusions : Supervised exercise training improves symptoms and QOL in adults with FAOA BACKGROUND Aerobic training has a number of well known beneficial effects in both normal and asthmatic children . However , the impact of training on the clinical management of the underlying bronchial asthma remains controversial , particularly in the most severe patients . METHODS Clinical evaluation , spirometric tests , symptom limited maximum exercise testing , and exercise challenge tests were performed in a group of children with stable moderate to severe asthma . Forty two patients ( 24 boys ) aged 8–16 were evaluated twice : before and after supervised aerobic training ( group 1 , n = 26 ) and two months apart ( untrained group 2 , n = 16 ) . RESULTS Spirometric and maximal exercise variables in the initial evaluation were significantly reduced in group 1 ( p<0.05 ) but medication and clinical scores and the occurrence of exercise induced bronchospasm ( EIB ) did not differ between the two groups . Aerobic improvement with training ( maximal oxygen uptake and /or anaerobic threshold increment > 10 % and 100 ml ) was inversely related to the baseline level of fitness and was independent of disease severity . Although the clinical score and the occurrence of EIB did not change after training , aerobic improvement was associated with a significant reduction in the medication score and the daily use of both inhaled and oral steroids ( p<0.05 ) . CONCLUSIONS Aerobic improvement with training in less fit asthmatic children is related to a short term decrease in the daily use of inhaled and oral steroids , independent of the severity of the disease Background . Supervised exercise leads to significant improvements in asthma control and quality -of-life in adults with partly controlled asthma ; however , the role of unsupervised exercise is unknown . Methods . The purpose of this study was to determine the impact of self-directed exercise on subjective and objective indices of asthma-related health .  Participants ( n = 24 ) were assigned to an exercise group or a control group for a 12-week period . Those in the exercise group were provided with exercise programs by a qualified exercise professional . These programs were up date d through electronic mail every 3 weeks to ensure progression . Controls maintained their current lifestyle habits for the intervention period . Assessment s of aerobic fitness , lung function , and subjective and objective asthma measures were conducted at baseline and after completion of the 12-week intervention period for both groups . Analysis of covariance was used to detect differences between groups from baseline to week 12 . Qualitative analyses were used to assess responses to open-ended questions . Results . Adherence to the program was poor . Perceived asthma control and self-reported frequency and severity of asthma improved significantly in the exercise group at week 12 compared with that in the control group . Objective measures of asthma such as asthma control , quality -of-life , and lung function , as well as peak and submaximal aerobic fitness did not change relative to controls . Responses to open-ended questions revealed improvements in three areas : asthma management , perceived fitness , and well-being . Conclusion . Adults with partly controlled asthma are able to improve perceived control and subjective measures of asthma-related health with 12 weeks of self-directed exercise ; however , supervision may be required to make significant improvements to measured asthma control , quality of life , and aerobic fitness . Future research should focus on the means to improve adherence of self-directed exercise programs  in this population The present multicentre study evaluates the differences in efficacy between a 3 month rehabilitation programme including drug treatment , and a 3 month control period of drug treatment only , for asthmatic patients and patients with chronic obstructive pulmonary disease ( COPD ) . The programme was run by physiotherapists in eight local practice s , and included exercise training , patient education , breathing retraining , evacuation of mucus , relaxation techniques , and recreational activities . In a r and omized controlled trial with a cross-over design , the effects of rehabilitation were evaluated 3 and 6 months after baseline measurements in terms of exercise tolerance and quality of life ( QOL ) . Exercise tolerance was assessed using submaximal cycle ergometer tests and 6 min walking tests .  QOL was evaluated by means of the Chronic Respiratory Disease Question naire ( CRDQ ) . After 3 months , the patients who started with rehabilitation showed significant improvements in endurance time ( 421 s ) and cardiac frequency ( 6 beats.min-1 ) during cycling , walking distance ( 39 m ) , and total CRDQ score ( 17 points ) compared to the control group . These improvements were still significant after 6 months . Additional analysis indicated that the asthmatic patients and the patients with COPD responded to rehabilitation in a similar way , with the exception that there was a greater improvement in walking distance for asthmatics . Improvements in exercise tolerance were not significantly correlated with improvements in QOL .  Rehabilitation of patients with asthma or chronic obstructive pulmonary disease in local physiotherapy practice s improves exercise tolerance and quality of life OBJECTIVE To investigate the medium-term benefits of a swimming program in schoolchildren and adolescents with moderate persistent atopic asthma ( MPAA ) . METHODS A r and omized , prospect i ve study of children and adolescents ( age 7 - 18 years ) with MPAA was carried out at the Hospital de Clínicas of Universidade Estadual de Campinas ( UNICAMP ) , Campinas , Brazil . After a 1-month run-in period , 61 patients ( 34 female ) were r and omized into two groups , a swimming group ( n = 30 ) and a control group ( n = 31 ) , and followed for 3 months . Both patient groups received inhaled fluticasone ( dry powder , 250 mcg twice a day ) and salbutamol as needed . The swim training program consisted of two weekly classes over a 3-month period for a total of 24 sessions . Both groups underwent  spirometric assessment  and methacholine challenge test -- provocative concentration of methacholine causing a 20 % fall in FEV1 (PC₂₀)--before and after the study period . Maximal inspiratory pressure ( MIP ) and maximal expiratory pressure ( MEP ) were measured only in the swimming group . RESULTS Significant increases in PC₂₀ ( pre-training , 0.31±0.25 ; post-training , 0.63±0.78 ; p = 0.008 ) , MIP ( pre-training , 67.08±17.13 cm H₂O ; post-training 79.46±18.66 ; p < 0.001 ) , and MEP ( pre-training , 71.69±20.01 cm H₂O ; post-training , 78.92±21.45 cm H₂O ; p < 0.001 ) were found in the swimming group . CONCLUSION Children and adolescents with MPAA subjected to a swim training program experienced a significant decrease in bronchial hyperresponsiveness , as determined by increased PC₂₀ values , when compared with asthmatic controls who did not undergo swim training . Participants in the swimming group also showed improvement in elastic recoil of the chest wall In a programme to examine the effect of 5 months of swimming training on school-children with asthma , 46 children swam a total distance of 3608 km ( 2242 miles ) during 2806 training sessions . On post-training re-examination , nonspecific effects of physical conditioning were detected including improved posture and fitness , reduced fat folds , and enhanced swimming ability . Continuous monitoring of asthma and medication showed significant decreases in both parameters during the final phases of the study between children who continued to swim regularly and those who did not . The frequency and severity of exercise-induced asthma ( after running ) was unchanged by swimming training . Post-training question naires indicated a high degree of enthusiasm and acceptance of the programme by children and parents . No significant adverse effects were observed or reported during the study The aim of this study was to evaluate the long-term outcome of an outpatient pulmonary rehabilitation programme ( PRP ) in patients with chronic airway obstruction ( CAO ) . In 61 CAO patients ( 35 asthmatics and 26 chronic obstructive pulmonary disease ( COPD ) ) lung and respiratory muscle function , exercise tolerance ( by symptom limited cycloergometer and walking tests ) , dyspnoea ( Borg scale , visual analogue scale ( VAS ) , baseline and transitional dyspnoea index ( BDI and TDI , respectively ) ) and quality of life ( St George 's Respiratory Question naire ( SGRQ ) ) were assessed at baseline ( to ) , at discharge ( t1 ) and 12 months postdischarge ( t2 ) . Preprogramme and post-programme hospital admissions and exacerbations of disease were also recorded . In comparison with baseline , no significant change was observed in lung function tests in either diagnostic group , either at t1 or at t2 . In both groups improvements in respiratory muscle strength , exercise tolerance , Borg scale and VAS reported at t1 were partially reduced at t2 . Analysis of variance showed that these changes over time were similar in the two groups . Mean values of SGRQ and BDI/TDI improved at t1 , and , unlike exercise tolerance , did not worsen at t2 . However , a clinical ly relevant difference in SGRQ between t2 and to was reported only in 56 % of asthmatics and 52 % of COPD patients . Compared with the preceding 2 yrs , in the year following PRP , hospital admissions and disease exacerbations decreased significantly in both diagnostic groups . Regardless of diagnosis , patients with chronic airway obstruction who underwent an outpatient pulmonary rehabilitation programme maintained an improved quality of life 12 months postdischarge despite a partial loss of the improvement in exercise tolerance The aim of the present study was to examine the effects of a course of aerobic exercise on pulmonary function and tolerance of activity in asthmatic patients . Among the asthmatic patients , 36 patients ( M= 16 , F= 20 ) were chosen after clinical examinations , pulmonary function test , skin prick test ( SPT ) for aeroallergen and a six minute walk test ( 6MWT ) on their own free will . A patient was said to have Exercise Induced Asthma ( EIA ) when he/she fulfilled the following criteria ; ( 1 ) FEV1 less than 80 % , ( 2 ) 12 % increase or more in FEV1 or PEF after short-acting ss2 agonist prescription and ( 3 ) 15 % decrease in FEV1 or PEF after 6MWT with 70 % or 80 % of maximum heart rate . The patients were r and omly put into two groups of case ( M=8 , F=10 , Mean age=27 ) and control ( M=8 , F=10 , Mean age=29 ) . Case group participated in eight-week aerobic exercise plan , while control group had no plan of exercise .  Pulmonary function tests were done before and after the course of exercise . There were significant changes in FEV1 , FVC , PEF , FEF25 - 75 % , MVV , RF and 6MWT between asthmatic patients of the two groups ( P less than or equal to 0.05 ) , but FEV1/FVC showed no significant change . Mean of changes in FEV1 , FVC , PEF , FEF25 - 75 % , MVV , RF and 6MWT were -25.56 , -17.19 , 32.09 , -27.93 , -22.18 , 5.63 and -307.5 in case group respectively while they were 6.2 , 4.67 , 1.96 , 6.65 , 15.56,-2.87 and 18.78 in the control group . This study shows that aerobic exercises in asthmatic patients lead to an improvement in pulmonary functions .  Aerobic exercise rehabilitation can be a complement to medical treatment of asthma The effects of a  
    Output:
    