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 Sedentary activities such as video gaming are independently associated with obesity .  Active video games , in which players physically interact with images on screen , may help increase physical activity and improve body composition . OBJECTIVE The aim of this study was to evaluate the effect of active video games over a 6-mo period on weight , body composition , physical activity , and physical fitness . DESIGN We conducted a 2-arm , parallel , r and omized controlled trial in Auckl and , New Zeal and . A total of 322 overweight and obese children aged 10 - 14 y , who were current users of sedentary video games , were r and omly assigned at a 1:1 ratio to receive either an active video game up grade package ( intervention , n = 160 ) or to have no change ( control group , n = 162 ) . The primary outcome was the change from baseline in body mass index ( BMI ; in kg/m(2 ) ) . Secondary outcomes were changes in percentage body fat , physical activity , cardiorespiratory fitness , video game play , and food snacking . RESULTS At 24 wk , the treatment effect on BMI ( -0.24 ; 95 % CI : -0.44 , -0.05 ; P = 0.02 ) favored the intervention group . The change ( ±SE ) in BMI from baseline increased in the control group ( 0.34 ± 0.08 ) but remained the same in the intervention group ( 0.09 ± 0.08 ) . There was also evidence of a reduction in body fat in the intervention group ( -0.83 % ; 95 % CI : -1.54 % , -0.12 % ; P = 0.02 ) . The change in daily time spent playing active video games at 24 wk increased ( 10.03 min ; 95 % CI : 6.26 , 13.81 min ; P < 0.0001 ) with the intervention accompanied by a reduction in the change in daily time spent playing nonactive video games ( -9.39 min ; 95 % CI : -19.38 , 0.59 min ; P = 0.06 ) . CONCLUSION An active video game intervention has a small but definite effect on BMI and body composition in overweight and obese children . This trial was registered in the Australian New Zeal and Clinical Trials Registry at http://www.anzctr.org.au/ as ACTRN12607000632493 BACKGROUND Dementia cases may reach 100 million by 2050 . Interventions are sought to curb or prevent cognitive decline . Exercise yields cognitive benefits , but few older adults exercise .  Virtual reality-enhanced exercise or " exergames " may elicit greater participation . PURPOSE To test the following hypotheses : ( 1 ) stationary cycling with virtual reality tours ( " cybercycle " ) will enhance executive function and clinical status more than traditional exercise ; ( 2 ) exercise effort will explain improvement ; and ( 3 ) brain-derived neurotrophic growth factor ( BDNF ) will increase . DESIGN Multi-site cluster r and omized clinical trial ( RCT ) of the impact of 3 months of cybercycling versus traditional exercise , on cognitive function in older adults . Data were collected in 2008 - 2010 ; analyses were conducted in 2010 - 2011 . SETTING / PARTICIPANTS 102 older adults from eight retirement communities enrolled ; 79 were r and omized and 63 completed . INTERVENTIONS A recumbent stationary ergometer was utilized ; virtual reality tours and competitors were enabled on the cybercycle . MAIN OUTCOME MEASURES Executive function ( Color Trails Difference , Stroop C , Digits Backward ) ; clinical status ( mild cognitive impairment ; MCI ) ; exercise effort/fitness ; and plasma BDNF . RESULTS Intent-to-treat analyses , controlling for age , education , and cluster r and omization , revealed a significant group X time interaction for composite executive function ( p=0.002 ) . Cybercycling yielded a medium effect over  traditional exercise  ( d=0.50 ) . Cybercyclists had a 23 % relative risk reduction in clinical progression to MCI . Exercise effort and fitness were comparable , suggesting another underlying mechanism . A significant group X time interaction for BDNF ( p=0.05 ) indicated enhanced neuroplasticity among cybercyclists . CONCLUSIONS Cybercycling older adults achieved better cognitive function than traditional exercisers , for the same effort , suggesting that simultaneous cognitive and physical exercise has greater potential for preventing cognitive decline . TRIAL REGISTRATION This study is registered at Clinical trials.gov NCT01167400 Exergames have been suggested as an innovative approach to enhance physical activity in the elderly . The objective of this review was to determine the effectiveness of exergames on vali date d quantitative physical outcomes in healthy elderly individuals . We used Centre for Review and Disseminations guidance to conduct systematic review s. Four electronic data bases were search ed . We included r and omized controlled trials ( RCTs ) , the study participants were healthy elderly individuals , and the intervention of interest was exergaming . The title and abstract screening of the 1861 citations identified 36 studies as potentially eligible for this review , and an additional nine were identified from reference lists . The full text screening identified seven studies with a total of 311 participants , all reporting RCTs with low-to-moderate method ological quality . Six of the seven studies found a positive effect of exergaming on the health of the elderly . However , the variation of intervention approaches and outcome data collected limited the extent to which studies could be compared . This review demonstrates how exergames have a potential to improve physical health in the elderly . However , there is a need for additional and better- design ed studies that assess the effectiveness and long-term adherence of exergames design ed specifically for the elderly Background This r and omized controlled pilot study aim ed to explore whether a cognitive-motor exercise program that combines traditional physical exercise with dance video gaming can improve the voluntary stepping responses of older adults under attention dem and ing dual task conditions . Methods Elderly subjects received twice weekly cognitive-motor exercise that included progressive strength and balance training supplemented by dance video gaming for 12 weeks ( intervention group ) . The control group received no specific intervention . Voluntary step execution under single and dual task conditions was recorded at baseline and post intervention ( Week 12 ) . Results After intervention between-group comparison revealed significant differences for initiation time of forward steps under dual task conditions ( U = 9 , P = 0.034 , r = 0.55 ) and backward steps under dual task conditions ( U = 10 , P = 0.045 , r = 0.52 ) in favor of the intervention group , showing altered stepping levels in the intervention group compared to the control group . Conclusion A cognitive-motor intervention based on strength and balance exercises with additional dance video gaming is able to improve voluntary step execution under both single and dual task conditions in older adults The primary objective of this pilot study was to evaluate the effect of active video games on  children 's physical activity levels . Twenty children ( mean ± SD age = 12 ± 1.5 years ; 40 % female ) were r and omised to receive either an active video game up grade package or to a control group ( no intervention ) . Effects on physical activity over the 12-week intervention period were measured using objective  ( Actigraph accelerometer ) and subjective ( Physical Activity Question naire for Children [ PAQ-C ] ) measures . An activity log was used to estimate time spent playing active and non-active video games . Children in the intervention group spent less mean time over the total 12-week intervention period playing all video games compared to those in the control group ( 54 versus 98 minutes/day [ difference = -44 minutes/day , 95 % CI [ -92 , 2 ] ] , p = 0.06 ) . Average time spent in all physical activities measured with an accelerometer was higher in the active video game intervention group compared to the control group ( difference at 6 weeks = 194 counts/min , p = 0.04 , and at 12 weeks = 48 counts/min , p = 0.06).This preliminary study suggests that playing active video games on a regular basis may have positive effects on children 's overall physical activity levels . Further research is needed to confirm if playing these games over a longer period of time could also have positive effects on children 's body weight and body mass index . Trial Registration OBJECTIVES The effects of a  Boy Scout Five-A-Day Badge program on fruit juice ( FJ ) and low-fat vegetable ( LV ) consumption were evaluated using a two-condition ( treatment , active-attention-placebo-control ) group r and omized trial , with three data collection periods ( baseline , immediate post , 6-month post ) . METHODS Forty-two Boy Scout troops ( n=473 , 10- to 14-year-old Scouts ) in Houston , TX , were r and omly assigned to condition . The 9-week program included approximately 30 min of weekly troop time , plus approximately 25 min of weekly Internet programming . The intervention was delivered in two waves ( Spring and Fall ) . Data were collected in 2003 - 2004 , and analyses were completed in 2008 . Main outcomes were FJ and LV consumption ( vali date d food frequency question naire ) . FV self-efficacy , preferences , and home availability were also measured . RESULTS Significant increases in FJ consumption ( p=.003 ) , FJ home availability ( p=.009 ) , and LV self-efficacy ( p=.004 ) were observed among the intervention group immediately following the intervention but were not maintained 6 months later . CONCLUSION A Boy Scout troop-plus-Internet intervention promoting FJ and LV consumption result ed in short-term changes in FJ consumption among U.S. Boy Scouts . Future research should investigate ways to extend these results to LV and maintain the increases over time Objective : To compare the effectiveness of three protocol s ( Adapted Physical Activities , Wii Fit ® , Adapted Physical Activities + Wii Fit ® ) on the balance of independent senior subjects . Design : Case comparison study . Setting s : Healthy elderly subjects living in independent community dwellings . Subjects : Thirty-six subjects , average age 75.09 ± 10.26 years , took part in this study , and were r and omly assigned to one of the four experimental groups : G1 followed an Adapted Physical Activities training programme , while the second group ( G2 ) participated in Wii Fit ® training and the third one ( G3 ) combined both methods . There was no training for the fourth group ( G4 ) . All subjects trained once a week ( 1 hour ) for 20 weeks and were assessed before and after treatment . Main measures : The Tinetti test , unipedal tests and the Wii Fit ® tests . Results : After training , the scores in the Tinetti test decreased significantly ( P < 0.05 ) for G1 , G2 and G3 respectively in static conditions and for G1 and G3 in dynamic conditions . After training , the performance in the unipedal tests decreased significantly ( P < 0.05 ) for G1 and G3 . The position of the centre of gravity was modified significantly ( P < 0.05 ) for G2 and G3 . Conclusion : After 20 training sessions , G1 ( Adapted Physical Activities ) , G2 ( Wii Fit ® ) and G3 ( Adapted Physical Activities and Wii Fit ® ) improved their balance . In addition , G1 and G3 increased their dynamic balance . The findings suggest that Adapted Physical Activities training limits the decline in sensorial functions in the elderly Objective . To evaluate the efficacy and feasibility of a multifaceted , community-based weight intervention program for children using exergaming technology ( activity-promoting video gaming ) .  Design and Methods . This is a prospect i ve observational pilot study . Forty-eight children , between the ages of 8 and 16 years , who are overweight or obese , enrolled in Exergaming for Health , a multidisciplinary weight management program , which used active video gaming . Primary outcome measures were change in body mass index ( BMI ) z scores . Results . Most children ( n = 40 , 83 % ) completed the program and participated in outcome evaluations . The average BMI change was −0.48 kg/m2 ( SD = 0.93 ) , P < .002 ( BMI z-score change was −0.072 , SD = 0.14 , P < .0001 ) . The average Global Self-Worth score improved , screen time and soda intake reduced , and exercise hours per week increased . Conclusions . The Exergaming for Health program may be an effective weight management intervention that is feasible with high participation rates . A larger r and omized controlled trial is needed to confirm these results OBJECTIVE We examined the feasibility of Dance Dance Revolution ( DDR ) , a dance video game , in participants ' homes , to increase physical activity ( PA ) and to decrease sedentary screen time ( SST ) . METHODS AND PROCEDURES Sixty children ( 7.5 + /- 0.5 years ) were r and omized in a 2:1 ratio to DDR or to wait-list control ( 10-week delay ) . DDR use was logged , PA was measured objective ly by accelerometry . SST was self-reported at weeks 0 and 10 . At week 28 , after both groups had access to DDR , accelerometry and SST were repeated . RESULTS Mean use of DDR was 89 + /- 82 ( range 0 - 660 min ) min per week ( mpw ) . The DDR group showed increased vigorous PA and a reduction in light PA ; the control group showed no increase in moderate and /or vigorous PA ( MVPA ) although they also had a reduction in light PA . Differences between the groups were not observed . The DDR group also reported a decrease in SST of -1.2 + /- 3.7 h per week ( hpw ) ( P < 0. 
    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 Sedentary activities such as video gaming are independently associated with obesity .  Active video games , in which players physically interact with images on screen , may help increase physical activity and improve body composition . OBJECTIVE The aim of this study was to evaluate the effect of active video games over a 6-mo period on weight , body composition , physical activity , and physical fitness . DESIGN We conducted a 2-arm , parallel , r and omized controlled trial in Auckl and , New Zeal and . A total of 322 overweight and obese children aged 10 - 14 y , who were current users of sedentary video games , were r and omly assigned at a 1:1 ratio to receive either an active video game up grade package ( intervention , n = 160 ) or to have no change ( control group , n = 162 ) . The primary outcome was the change from baseline in body mass index ( BMI ; in kg/m(2 ) ) . Secondary outcomes were changes in percentage body fat , physical activity , cardiorespiratory fitness , video game play , and food snacking . RESULTS At 24 wk , the treatment effect on BMI ( -0.24 ; 95 % CI : -0.44 , -0.05 ; P = 0.02 ) favored the intervention group . The change ( ±SE ) in BMI from baseline increased in the control group ( 0.34 ± 0.08 ) but remained the same in the intervention group ( 0.09 ± 0.08 ) . There was also evidence of a reduction in body fat in the intervention group ( -0.83 % ; 95 % CI : -1.54 % , -0.12 % ; P = 0.02 ) . The change in daily time spent playing active video games at 24 wk increased ( 10.03 min ; 95 % CI : 6.26 , 13.81 min ; P < 0.0001 ) with the intervention accompanied by a reduction in the change in daily time spent playing nonactive video games ( -9.39 min ; 95 % CI : -19.38 , 0.59 min ; P = 0.06 ) . CONCLUSION An active video game intervention has a small but definite effect on BMI and body composition in overweight and obese children . This trial was registered in the Australian New Zeal and Clinical Trials Registry at http://www.anzctr.org.au/ as ACTRN12607000632493 BACKGROUND Dementia cases may reach 100 million by 2050 . Interventions are sought to curb or prevent cognitive decline . Exercise yields cognitive benefits , but few older adults exercise .  Virtual reality-enhanced exercise or " exergames " may elicit greater participation . PURPOSE To test the following hypotheses : ( 1 ) stationary cycling with virtual reality tours ( " cybercycle " ) will enhance executive function and clinical status more than traditional exercise ; ( 2 ) exercise effort will explain improvement ; and ( 3 ) brain-derived neurotrophic growth factor ( BDNF ) will increase . DESIGN Multi-site cluster r and omized clinical trial ( RCT ) of the impact of 3 months of cybercycling versus traditional exercise , on cognitive function in older adults . Data were collected in 2008 - 2010 ; analyses were conducted in 2010 - 2011 . SETTING / PARTICIPANTS 102 older adults from eight retirement communities enrolled ; 79 were r and omized and 63 completed . INTERVENTIONS A recumbent stationary ergometer was utilized ; virtual reality tours and competitors were enabled on the cybercycle . MAIN OUTCOME MEASURES Executive function ( Color Trails Difference , Stroop C , Digits Backward ) ; clinical status ( mild cognitive impairment ; MCI ) ; exercise effort/fitness ; and plasma BDNF . RESULTS Intent-to-treat analyses , controlling for age , education , and cluster r and omization , revealed a significant group X time interaction for composite executive function ( p=0.002 ) . Cybercycling yielded a medium effect over  traditional exercise  ( d=0.50 ) . Cybercyclists had a 23 % relative risk reduction in clinical progression to MCI . Exercise effort and fitness were comparable , suggesting another underlying mechanism . A significant group X time interaction for BDNF ( p=0.05 ) indicated enhanced neuroplasticity among cybercyclists . CONCLUSIONS Cybercycling older adults achieved better cognitive function than traditional exercisers , for the same effort , suggesting that simultaneous cognitive and physical exercise has greater potential for preventing cognitive decline . TRIAL REGISTRATION This study is registered at Clinical trials.gov NCT01167400 Exergames have been suggested as an innovative approach to enhance physical activity in the elderly . The objective of this review was to determine the effectiveness of exergames on vali date d quantitative physical outcomes in healthy elderly individuals . We used Centre for Review and Disseminations guidance to conduct systematic review s. Four electronic data bases were search ed . We included r and omized controlled trials ( RCTs ) , the study participants were healthy elderly individuals , and the intervention of interest was exergaming . The title and abstract screening of the 1861 citations identified 36 studies as potentially eligible for this review , and an additional nine were identified from reference lists . The full text screening identified seven studies with a total of 311 participants , all reporting RCTs with low-to-moderate method ological quality . Six of the seven studies found a positive effect of exergaming on the health of the elderly . However , the variation of intervention approaches and outcome data collected limited the extent to which studies could be compared . This review demonstrates how exergames have a potential to improve physical health in the elderly . However , there is a need for additional and better- design ed studies that assess the effectiveness and long-term adherence of exergames design ed specifically for the elderly Background This r and omized controlled pilot study aim ed to explore whether a cognitive-motor exercise program that combines traditional physical exercise with dance video gaming can improve the voluntary stepping responses of older adults under attention dem and ing dual task conditions . Methods Elderly subjects received twice weekly cognitive-motor exercise that included progressive strength and balance training supplemented by dance video gaming for 12 weeks ( intervention group ) . The control group received no specific intervention . Voluntary step execution under single and dual task conditions was recorded at baseline and post intervention ( Week 12 ) . Results After intervention between-group comparison revealed significant differences for initiation time of forward steps under dual task conditions ( U = 9 , P = 0.034 , r = 0.55 ) and backward steps under dual task conditions ( U = 10 , P = 0.045 , r = 0.52 ) in favor of the intervention group , showing altered stepping levels in the intervention group compared to the control group . Conclusion A cognitive-motor intervention based on strength and balance exercises with additional dance video gaming is able to improve voluntary step execution under both single and dual task conditions in older adults The primary objective of this pilot study was to evaluate the effect of active video games on  children 's physical activity levels . Twenty children ( mean ± SD age = 12 ± 1.5 years ; 40 % female ) were r and omised to receive either an active video game up grade package or to a control group ( no intervention ) . Effects on physical activity over the 12-week intervention period were measured using objective  ( Actigraph accelerometer ) and subjective ( Physical Activity Question naire for Children [ PAQ-C ] ) measures . An activity log was used to estimate time spent playing active and non-active video games . Children in the intervention group spent less mean time over the total 12-week intervention period playing all video games compared to those in the control group ( 54 versus 98 minutes/day [ difference = -44 minutes/day , 95 % CI [ -92 , 2 ] ] , p = 0.06 ) . Average time spent in all physical activities measured with an accelerometer was higher in the active video game intervention group compared to the control group ( difference at 6 weeks = 194 counts/min , p = 0.04 , and at 12 weeks = 48 counts/min , p = 0.06).This preliminary study suggests that playing active video games on a regular basis may have positive effects on children 's overall physical activity levels . Further research is needed to confirm if playing these games over a longer period of time could also have positive effects on children 's body weight and body mass index . Trial Registration OBJECTIVES The effects of a  Boy Scout Five-A-Day Badge program on fruit juice ( FJ ) and low-fat vegetable ( LV ) consumption were evaluated using a two-condition ( treatment , active-attention-placebo-control ) group r and omized trial , with three data collection periods ( baseline , immediate post , 6-month post ) . METHODS Forty-two Boy Scout troops ( n=473 , 10- to 14-year-old Scouts ) in Houston , TX , were r and omly assigned to condition . The 9-week program included approximately 30 min of weekly troop time , plus approximately 25 min of weekly Internet programming . The intervention was delivered in two waves ( Spring and Fall ) . Data were collected in 2003 - 2004 , and analyses were completed in 2008 . Main outcomes were FJ and LV consumption ( vali date d food frequency question naire ) . FV self-efficacy , preferences , and home availability were also measured . RESULTS Significant increases in FJ consumption ( p=.003 ) , FJ home availability ( p=.009 ) , and LV self-efficacy ( p=.004 ) were observed among the intervention group immediately following the intervention but were not maintained 6 months later . CONCLUSION A Boy Scout troop-plus-Internet intervention promoting FJ and LV consumption result ed in short-term changes in FJ consumption among U.S. Boy Scouts . Future research should investigate ways to extend these results to LV and maintain the increases over time Objective : To compare the effectiveness of three protocol s ( Adapted Physical Activities , Wii Fit ® , Adapted Physical Activities + Wii Fit ® ) on the balance of independent senior subjects . Design : Case comparison study . Setting s : Healthy elderly subjects living in independent community dwellings . Subjects : Thirty-six subjects , average age 75.09 ± 10.26 years , took part in this study , and were r and omly assigned to one of the four experimental groups : G1 followed an Adapted Physical Activities training programme , while the second group ( G2 ) participated in Wii Fit ® training and the third one ( G3 ) combined both methods . There was no training for the fourth group ( G4 ) . All subjects trained once a week ( 1 hour ) for 20 weeks and were assessed before and after treatment . Main measures : The Tinetti test , unipedal tests and the Wii Fit ® tests . Results : After training , the scores in the Tinetti test decreased significantly ( P < 0.05 ) for G1 , G2 and G3 respectively in static conditions and for G1 and G3 in dynamic conditions . After training , the performance in the unipedal tests decreased significantly ( P < 0.05 ) for G1 and G3 . The position of the centre of gravity was modified significantly ( P < 0.05 ) for G2 and G3 . Conclusion : After 20 training sessions , G1 ( Adapted Physical Activities ) , G2 ( Wii Fit ® ) and G3 ( Adapted Physical Activities and Wii Fit ® ) improved their balance . In addition , G1 and G3 increased their dynamic balance . The findings suggest that Adapted Physical Activities training limits the decline in sensorial functions in the elderly Objective . To evaluate the efficacy and feasibility of a multifaceted , community-based weight intervention program for children using exergaming technology ( activity-promoting video gaming ) .  Design and Methods . This is a prospect i ve observational pilot study . Forty-eight children , between the ages of 8 and 16 years , who are overweight or obese , enrolled in Exergaming for Health , a multidisciplinary weight management program , which used active video gaming . Primary outcome measures were change in body mass index ( BMI ) z scores . Results . Most children ( n = 40 , 83 % ) completed the program and participated in outcome evaluations . The average BMI change was −0.48 kg/m2 ( SD = 0.93 ) , P < .002 ( BMI z-score change was −0.072 , SD = 0.14 , P < .0001 ) . The average Global Self-Worth score improved , screen time and soda intake reduced , and exercise hours per week increased . Conclusions . The Exergaming for Health program may be an effective weight management intervention that is feasible with high participation rates . A larger r and omized controlled trial is needed to confirm these results OBJECTIVE We examined the feasibility of Dance Dance Revolution ( DDR ) , a dance video game , in participants ' homes , to increase physical activity ( PA ) and to decrease sedentary screen time ( SST ) . METHODS AND PROCEDURES Sixty children ( 7.5 + /- 0.5 years ) were r and omized in a 2:1 ratio to DDR or to wait-list control ( 10-week delay ) . DDR use was logged , PA was measured objective ly by accelerometry . SST was self-reported at weeks 0 and 10 . At week 28 , after both groups had access to DDR , accelerometry and SST were repeated . RESULTS Mean use of DDR was 89 + /- 82 ( range 0 - 660 min ) min per week ( mpw ) . The DDR group showed increased vigorous PA and a reduction in light PA ; the control group showed no increase in moderate and /or vigorous PA ( MVPA ) although they also had a reduction in light PA . Differences between the groups were not observed . The DDR group also reported a decrease in SST of -1.2 + /- 3.7 h per week ( hpw ) ( P < 0. 
    Output:
    