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 determine whether multiple-task training of walking is feasible and worthwhile in people with mild to moderate Parkinson 's disease . Design : Baseline-controlled pilot study with three-week baseline , training and retention phases . Setting : University research laboratory . Subjects : Five people aged 61 ±8 years with mild to moderate Parkinson 's disease ( Hoehn and Yahr stages II — III ) . Interventions : Multiple-task training was performed for 30 minutes once a week during the three-week training phase . Main measures : Participants were tested and trained during the ` on ' phase of medication . Feasibility of training was examined using 10 cm visual analogue scales to measure participant perception of mental fatigue , physical fatigue , difficulty , anxiety and confidence . Walking velocity , stride length and cadence under multiple-task conditions were measured . Results : Participants reported low levels of mental fatigue , physical fatigue , difficulty and anxiety as well as high levels of confidence associated with multiple-task training . No adverse effects of training were reported . Multiple-task walking velocity increased by 0.09 ± 0.06 m/s ( 95 % confidence interval ( CI ) 0.02 to 0.16 ) between the baseline and training phase and this increase was maintained in the retention phase . Conclusion : Multiple-task training is feasible in people with mild to moderate Parkinson 's disease . The data suggest sustained benefits on multiple-task walking velocity are possible . A r and omized controlled trial of multiple-task training efficacy is warranted Gait and balance problems result ing from Parkinson 's disease ( PD ) are more common in people with PD and dementia ( PDD ) , yet , it is unknown whether the benefits of cueing therapy for mobility generalize to them . We aim ed to determine the feasibility and effectiveness of auditory cues to improve gait in PD and cognitive impairment ( PD-CI ) . Nine participants with PD-CI walked with and without auditory cues using two different strategies : ( 1 ) Cue with temporal instruction to " step in time to the beat , " ( 2 ) Cue with spatiotemporal instruction to " take a big step in time to the beat . " Cues were delivered with a metronome at preferred stepping frequency while on medication during single and dual-task gait . Gait was assessed using GAITRite and walking speed , stride amplitude , step frequency , and variability ( CV% ) of step and double limb support time were measured . Data were analyzed in SPSS version 16 using fixed-effect linear mixed models . An adjusted , P value of 0.01 was considered significant . Participants were men , aged 74.89 ( + /-6.45 ) years with median MMSE of 22 ( range 20.5 - 25 ) and UPDRS III score of 44 ( 35.5 - 47.0 ) . Participants complied with testing and instructions . The cue that focused attention on both temporal and spatial parameters of gait significantly improved single and dual-task walking speed and stride amplitude . This study provides evidence for the potential of cueing to improve gait in PD-CI . Only individuals with mild CI were included , and the effect with increased CI and different types of dementia requires further evaluation Purpose To assess immediate and near-term effects of an instructional set on select gait parameters in people living with Parkinson disease ( PD ) . Subjects Five individuals with early stage PD participated in a within subject design in Part One . Eleven individuals with early stage PD were r and omly assigned to a treatment group ( n = 5 ) or a control group ( n = 6 ) in Part Two . Methods The treatment consisted of a 10-day training program of walking 1800 feet per day and with the instructions to “ take long steps . ” Testing occurred before treatment ( baseline ) , immediately after treatment , one week after treatment , and one month after treatment . Measurements of step length , velocity , and cadence were taken without the use of the instructional set . Results There was a significant increase in step length and velocity and a significant decrease in cadence between baseline and all post-test measures for part one . For part 2 , step length of the treatment group significantly increased between baseline and all 3 post-tests and there was a significant difference between the treatment group and control group at all post-tests for step length . Conclusions : The instructional set was effective in improving parameters of gait for at least 4 weeks . These data support the concept that people with Parkinson disease have a potential for motor learning We examined the effects of a simultaneous verbal fluency task on  walking in Parkinson 's disease ( PD ) patients with freezing of gait ( PD-F ) compared to nonfreezing patients ( PD-NF ) or control subjects ( C ) . Effects of antiparkinsonian medications on gait in PD-F were examined . PD-F patients exhibited a greater increase in the number of steps to complete the walk with verbal fluency , even when the effect of medication was taken into account ( mean increase ± SD ) : PD-F = 4.2 ± 4.6 , n = 10 ; PD-NF = 0.1 ± 1.6 , n = 9 ; C = 1.5 ± 1.5 , n = 19 ; P = .007 . Medications improved walking in PD-F patients by decreasing the number of steps , the time to walk , and freezing . PD-F patients may be more dependent on attention for walking OBJECTIVE To compare the effect of rhythmic auditory and attentional cues , and a combination of both cues on  gait  , in people with Parkinson 's disease ( PD ) during single and dual tasks . DESIGN A repeated- measures study requiring participants to perform single and dual-motor tasks under different cueing conditions . SETTING Human movement analysis laboratory . PARTICIPANTS Fifteen participants with idiopathic PD and a comparison group of 12 healthy participants . INTERVENTIONS Three cueing strategies were compared : a rhythmic auditory cue ( walking in time to a metronome beat ) , an attentional strategy ( asked to focus on taking big step ) , and a combination cue ( asked to walk in time to a metronome beat while taking big steps ) . MAIN OUTCOME MEASURES Walking speed , step amplitude , and step frequency . RESULTS Walking speed of PD participants improved significantly compared with noncued walking in the single- and dual-task condition with the attentional ( P<.001 , P=.037 ) and combination cue strategies ( P=.013 , P=.028 ) . Step amplitude also increased significantly with the attentional and combination cue strategies in single- ( P<.001 , P<.001 ) and dual-task ( P<.001 , P<.001 ) conditions . Step frequency was reduced significantly with the attentional strategy ( P=.042 ) in the single and dual tasks ( P<.001 ) and combination cue strategy ( P=.009 ) in the dual task . The rhythmic auditory cue alone did not alter significantly any parameter of gait in the single or dual tasks . CONCLUSIONS The attentional strategy and the combination of a rhythmic auditory cue with an attentional strategy were equally effective , and improved walking speed and step amplitude significantly during both single and dual tasks . The combination cue , however , may still be a useful alternative in situations of increased attentional dem and , or where problems exist with executive function 
    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 determine whether multiple-task training of walking is feasible and worthwhile in people with mild to moderate Parkinson 's disease . Design : Baseline-controlled pilot study with three-week baseline , training and retention phases . Setting : University research laboratory . Subjects : Five people aged 61 ±8 years with mild to moderate Parkinson 's disease ( Hoehn and Yahr stages II — III ) . Interventions : Multiple-task training was performed for 30 minutes once a week during the three-week training phase . Main measures : Participants were tested and trained during the ` on ' phase of medication . Feasibility of training was examined using 10 cm visual analogue scales to measure participant perception of mental fatigue , physical fatigue , difficulty , anxiety and confidence . Walking velocity , stride length and cadence under multiple-task conditions were measured . Results : Participants reported low levels of mental fatigue , physical fatigue , difficulty and anxiety as well as high levels of confidence associated with multiple-task training . No adverse effects of training were reported . Multiple-task walking velocity increased by 0.09 ± 0.06 m/s ( 95 % confidence interval ( CI ) 0.02 to 0.16 ) between the baseline and training phase and this increase was maintained in the retention phase . Conclusion : Multiple-task training is feasible in people with mild to moderate Parkinson 's disease . The data suggest sustained benefits on multiple-task walking velocity are possible . A r and omized controlled trial of multiple-task training efficacy is warranted Gait and balance problems result ing from Parkinson 's disease ( PD ) are more common in people with PD and dementia ( PDD ) , yet , it is unknown whether the benefits of cueing therapy for mobility generalize to them . We aim ed to determine the feasibility and effectiveness of auditory cues to improve gait in PD and cognitive impairment ( PD-CI ) . Nine participants with PD-CI walked with and without auditory cues using two different strategies : ( 1 ) Cue with temporal instruction to " step in time to the beat , " ( 2 ) Cue with spatiotemporal instruction to " take a big step in time to the beat . " Cues were delivered with a metronome at preferred stepping frequency while on medication during single and dual-task gait . Gait was assessed using GAITRite and walking speed , stride amplitude , step frequency , and variability ( CV% ) of step and double limb support time were measured . Data were analyzed in SPSS version 16 using fixed-effect linear mixed models . An adjusted , P value of 0.01 was considered significant . Participants were men , aged 74.89 ( + /-6.45 ) years with median MMSE of 22 ( range 20.5 - 25 ) and UPDRS III score of 44 ( 35.5 - 47.0 ) . Participants complied with testing and instructions . The cue that focused attention on both temporal and spatial parameters of gait significantly improved single and dual-task walking speed and stride amplitude . This study provides evidence for the potential of cueing to improve gait in PD-CI . Only individuals with mild CI were included , and the effect with increased CI and different types of dementia requires further evaluation Purpose To assess immediate and near-term effects of an instructional set on select gait parameters in people living with Parkinson disease ( PD ) . Subjects Five individuals with early stage PD participated in a within subject design in Part One . Eleven individuals with early stage PD were r and omly assigned to a treatment group ( n = 5 ) or a control group ( n = 6 ) in Part Two . Methods The treatment consisted of a 10-day training program of walking 1800 feet per day and with the instructions to “ take long steps . ” Testing occurred before treatment ( baseline ) , immediately after treatment , one week after treatment , and one month after treatment . Measurements of step length , velocity , and cadence were taken without the use of the instructional set . Results There was a significant increase in step length and velocity and a significant decrease in cadence between baseline and all post-test measures for part one . For part 2 , step length of the treatment group significantly increased between baseline and all 3 post-tests and there was a significant difference between the treatment group and control group at all post-tests for step length . Conclusions : The instructional set was effective in improving parameters of gait for at least 4 weeks . These data support the concept that people with Parkinson disease have a potential for motor learning We examined the effects of a simultaneous verbal fluency task on  walking in Parkinson 's disease ( PD ) patients with freezing of gait ( PD-F ) compared to nonfreezing patients ( PD-NF ) or control subjects ( C ) . Effects of antiparkinsonian medications on gait in PD-F were examined . PD-F patients exhibited a greater increase in the number of steps to complete the walk with verbal fluency , even when the effect of medication was taken into account ( mean increase ± SD ) : PD-F = 4.2 ± 4.6 , n = 10 ; PD-NF = 0.1 ± 1.6 , n = 9 ; C = 1.5 ± 1.5 , n = 19 ; P = .007 . Medications improved walking in PD-F patients by decreasing the number of steps , the time to walk , and freezing . PD-F patients may be more dependent on attention for walking OBJECTIVE To compare the effect of rhythmic auditory and attentional cues , and a combination of both cues on  gait  , in people with Parkinson 's disease ( PD ) during single and dual tasks . DESIGN A repeated- measures study requiring participants to perform single and dual-motor tasks under different cueing conditions . SETTING Human movement analysis laboratory . PARTICIPANTS Fifteen participants with idiopathic PD and a comparison group of 12 healthy participants . INTERVENTIONS Three cueing strategies were compared : a rhythmic auditory cue ( walking in time to a metronome beat ) , an attentional strategy ( asked to focus on taking big step ) , and a combination cue ( asked to walk in time to a metronome beat while taking big steps ) . MAIN OUTCOME MEASURES Walking speed , step amplitude , and step frequency . RESULTS Walking speed of PD participants improved significantly compared with noncued walking in the single- and dual-task condition with the attentional ( P<.001 , P=.037 ) and combination cue strategies ( P=.013 , P=.028 ) . Step amplitude also increased significantly with the attentional and combination cue strategies in single- ( P<.001 , P<.001 ) and dual-task ( P<.001 , P<.001 ) conditions . Step frequency was reduced significantly with the attentional strategy ( P=.042 ) in the single and dual tasks ( P<.001 ) and combination cue strategy ( P=.009 ) in the dual task . The rhythmic auditory cue alone did not alter significantly any parameter of gait in the single or dual tasks . CONCLUSIONS The attentional strategy and the combination of a rhythmic auditory cue with an attentional strategy were equally effective , and improved walking speed and step amplitude significantly during both single and dual tasks . The combination cue , however , may still be a useful alternative in situations of increased attentional dem and , or where problems exist with executive function 
    Output:
    