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 adults with Down syndrome ( DS ) could improve their submaximal and peak exercise capacity , as for adults without disabilities , after 12 weeks of combined ( aerobic and resistance ) exercise training . DESIGN Prospect i ve study comparing the effects of a 12-week combined exercise program on submaximal and peak exercise capacity of adults with and without DS . SETTING University facilities . PARTICIPANTS Participants with DS ( n=13 ; mean ± SD age , 36.5±5.5y ) and participants without disabilities ( n=12 ; mean age , 38.7±8.3y ) . INTERVENTIONS Combined exercise training for 12 weeks . Endurance training was performed 3 days a week for 30 minutes at 65 % to 85 % of peak oxygen consumption ( Vo₂peak ) . Resistance training was prescribed for 2 days a week and consisted of 2 rotations in a circuit of 9 exercises at 12-repetition maximum . MAIN OUTCOME MEASURES Submaximal and maximal grade d exercise tests with metabolic and heart rate measurements . Walking economy and Vo₂peak were considered the main outcomes . RESULTS Participants with DS and those without disabilities showed similar values for body mass index and relative fat mass at pre- and posttraining periods . Walking economy and Vo₂peak overall were lower in participants with DS than participants without disabilities ( P<.05 ) . Training improved walking economy and Vo₂peak in participants with DS and those without disabilities ( P<.05 ) ; additionally , the magnitude of changes induced by training was similar between groups . CONCLUSIONS Overall , a 12-week combined exercise regimen induced gains of similar magnitude between adults with and without DS for submaximal and peak exercise capacity Background Many adults with intellectual disabilities have poor dietary habits , low physical activity and weight disturbances . This study protocol describes the design and evaluation of a health intervention aim ing to improve diet and physical activity in this target group . In Sweden , adults with intellectual disabilities often live in community residences where the staff has insufficient education regarding the special health needs of residents . No published lifestyle interventions have simultaneously targeted both residents and staff . Methods / Design The intervention is design ed to suit the ordinary work routines of community residences . It is based on social cognitive theory and takes 12 - 15 months to complete . The intervention includes three components : 1 ) Ten health education sessions for residents in their homes ; 2 ) the appointment of a health ambassador among the staff in each residence and formation of a network ; and 3 ) a study circle for staff in each residence . The intervention is implemented by consultation with managers , training of health educators , and coaching of health ambassadors . Fidelity is assessed based on the participation of residents and staff in the intervention activities . The study design is a cluster-r and omised trial with physical activity as primary outcome objective ly assessed by pedometry . Secondary outcomes are dietary quality assessed by digital photography , measured weight , height and waist circumference , and quality of life assessed by a quality of life scale . Intermediate outcomes are changes in work routines in the residences assessed by a question naire to managers . Adults with mild to moderate intellectual disabilities living in community residences in Stockholm County are eligible for inclusion .  Multilevel analysis is used to evaluate effects on primary and secondary outcomes . The impact of the intervention on work routines in community residences is analysed by ordinal regression analysis . Barriers and facilitators of implementation are identified in an explorative qualitative study through observations and semi-structured interviews . Discussion Despite several challenges it is our hope that the results from this intervention will lead to new and improved health promotion programs to the benefit of the target group . Trial registration numberIS RCT Adults with intellectual disability ( ID ) have decreased cardiovascular fitness and strength present with lower rates of physical activity ( PA ) , and often have balance and functional impairments . The purpose of this study was to investigate the effect of a combined PA program ( CPAP ) utilizing aerobic , strength and balance training on cardiovascular fitness , strength , balance and functional measures in a controlled clinical trial . Adults with mild to moderate ID were assigned into either the intervention group ( IG ; n=37 ) or the control group ( CG ; n=29 ) . The IG trained 3 day/week , 1 h/day over 14 weeks , while the CG did not participate in any exercise program .  Cardiovascular fitness , strength , balance , flexibility and functional ability were assessed pre-post training . The IG increased cardiovascular fitness ( 26.8 vs. 29.3 ml kg(-1 ) min(-1 ) ) , h and grip strength ( 19.2 vs. 21.9 kg ) , leg strength , and balance following the training period ( p<.05 ) . Body weight ( 70.1 vs. 68.1 kg ) and body mass index ( 27.4 vs. 26.6 kg m(-2 ) ) decreased ( p<.05 ) in the IG group . The CG showed no changes in any parameter . These data suggest a combined aerobic , strength and balance exercise training program is beneficial among individuals with ID Objective : Although there are evaluation and effectiveness studies of health promotion interventions for adults with intellectual disabilities ( ID ) , r and omized efficacy trials of such interventions are lacking . Design : A r and omized active control intervention trial . Setting : The participants attended the health promotion classes in local disability agency service facilities . Method : We enrolled 443 individuals and r and omly assigned them to one of two eight-week participatory classes . The ‘ Steps to Your Health ’ ( STYH ) classes emphasized moderate to vigorous physical activity ( MVPA ) , healthy eating and  body mass index ( BMI )  reduction . The control intervention focused on hygiene and safety . Results : We did not find a statistically significant difference in mean MVPA or BMI change between completers of the STYH group compared to the control group one year after the intervention was completed . We did find that participation in STYH classes had a non-significant association with odds of reduction in BMI ( odds ratio [ OR ] 2.87 , 95 % confidence interval [ CI ] 0.91–9.11 ) and completers who lived in group homes were more likely than their counterparts who lived with families or in apartments to decrease their BMI ( OR 4.61 ; 95 % CI 1.14–18.64 ) . Conclusions : This trial did not demonstrate a significant effect of STYH participation on change in mean minutes of MVPA or mean BMI 12 months after classes ended , although there was a non-significant association with odds of reduction of BMI ( p = 0.07 ) . This study has implication s for design of intervention studies in people with intellectual disability ( ID ) Little information is available on the provision of physical fitness and intervention program among people with intellectual disabilities . The aim of this study is to provide information of examining the effectiveness of healthy physical fitness programs on people with intellectual disabilities living in a disability institution . There were 146 participants with intellectual disabilities ( age 19 - 67 years ) were recruited in the study . We collected information on disability condition ( type and level ) , height , weight , BMI , and physical fitness status ( includes V-shape sit and reach test , sit-up 30s , sit-up 60s , and shuttle run ) at the beginning and 6 months later of the program intervention . The results show that there were statistical decreases in individual 's weight , BMI score , BMI category , and positive improvement in V-shape sit and reach test , sit-up in 30s and 60s tests after 6-month interventions . However , the shuttle run test did not improve at the post-test among people with intellectual disabilities . The results also showed that the mild disability level group has the highest effectiveness on the healthy fitness program on decreasing body weight . Generally speaking , the preliminary study found the healthy exercise program has positive fitness effects on people with intellectual disabilities . To maximize the benefits of regular physical activity on people with ID , there is a need to evaluate the long-term effect of the intervention program and then to initiate the healthy exercise strategies in institution for this group of people Two groups of cerebral palsied , mentally retarded , overweight adults received training in seven behavioral self-control techniques for reducing caloric intake and increasing activity levels over the course of 19 weeks . One group 's parents/caretakers had frequent contacts from the diet leader , ( Home-Help Group ) ; the other group , balanced with the first for degree of h and icap , had no caretaker-directed communications other than initial notification ( No Help Group ) . Measures of adherence were included to assess the process of behavioral change during the diet program . A significant treatment effect accrued for all participants in the diet program , with the Home-Help Group of dieters showing clinical ly , though not statistically superior weight loss at treatment end and at follow-ups through one year . Specific behaviors taught , such as replacing utensils after each bite and eating slowly , showed significant changes in the expected directions with weight change . Implication s of the data for future treatment programs are discussed 
    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 adults with Down syndrome ( DS ) could improve their submaximal and peak exercise capacity , as for adults without disabilities , after 12 weeks of combined ( aerobic and resistance ) exercise training . DESIGN Prospect i ve study comparing the effects of a 12-week combined exercise program on submaximal and peak exercise capacity of adults with and without DS . SETTING University facilities . PARTICIPANTS Participants with DS ( n=13 ; mean ± SD age , 36.5±5.5y ) and participants without disabilities ( n=12 ; mean age , 38.7±8.3y ) . INTERVENTIONS Combined exercise training for 12 weeks . Endurance training was performed 3 days a week for 30 minutes at 65 % to 85 % of peak oxygen consumption ( Vo₂peak ) . Resistance training was prescribed for 2 days a week and consisted of 2 rotations in a circuit of 9 exercises at 12-repetition maximum . MAIN OUTCOME MEASURES Submaximal and maximal grade d exercise tests with metabolic and heart rate measurements . Walking economy and Vo₂peak were considered the main outcomes . RESULTS Participants with DS and those without disabilities showed similar values for body mass index and relative fat mass at pre- and posttraining periods . Walking economy and Vo₂peak overall were lower in participants with DS than participants without disabilities ( P<.05 ) . Training improved walking economy and Vo₂peak in participants with DS and those without disabilities ( P<.05 ) ; additionally , the magnitude of changes induced by training was similar between groups . CONCLUSIONS Overall , a 12-week combined exercise regimen induced gains of similar magnitude between adults with and without DS for submaximal and peak exercise capacity Background Many adults with intellectual disabilities have poor dietary habits , low physical activity and weight disturbances . This study protocol describes the design and evaluation of a health intervention aim ing to improve diet and physical activity in this target group . In Sweden , adults with intellectual disabilities often live in community residences where the staff has insufficient education regarding the special health needs of residents . No published lifestyle interventions have simultaneously targeted both residents and staff . Methods / Design The intervention is design ed to suit the ordinary work routines of community residences . It is based on social cognitive theory and takes 12 - 15 months to complete . The intervention includes three components : 1 ) Ten health education sessions for residents in their homes ; 2 ) the appointment of a health ambassador among the staff in each residence and formation of a network ; and 3 ) a study circle for staff in each residence . The intervention is implemented by consultation with managers , training of health educators , and coaching of health ambassadors . Fidelity is assessed based on the participation of residents and staff in the intervention activities . The study design is a cluster-r and omised trial with physical activity as primary outcome objective ly assessed by pedometry . Secondary outcomes are dietary quality assessed by digital photography , measured weight , height and waist circumference , and quality of life assessed by a quality of life scale . Intermediate outcomes are changes in work routines in the residences assessed by a question naire to managers . Adults with mild to moderate intellectual disabilities living in community residences in Stockholm County are eligible for inclusion .  Multilevel analysis is used to evaluate effects on primary and secondary outcomes . The impact of the intervention on work routines in community residences is analysed by ordinal regression analysis . Barriers and facilitators of implementation are identified in an explorative qualitative study through observations and semi-structured interviews . Discussion Despite several challenges it is our hope that the results from this intervention will lead to new and improved health promotion programs to the benefit of the target group . Trial registration numberIS RCT Adults with intellectual disability ( ID ) have decreased cardiovascular fitness and strength present with lower rates of physical activity ( PA ) , and often have balance and functional impairments . The purpose of this study was to investigate the effect of a combined PA program ( CPAP ) utilizing aerobic , strength and balance training on cardiovascular fitness , strength , balance and functional measures in a controlled clinical trial . Adults with mild to moderate ID were assigned into either the intervention group ( IG ; n=37 ) or the control group ( CG ; n=29 ) . The IG trained 3 day/week , 1 h/day over 14 weeks , while the CG did not participate in any exercise program .  Cardiovascular fitness , strength , balance , flexibility and functional ability were assessed pre-post training . The IG increased cardiovascular fitness ( 26.8 vs. 29.3 ml kg(-1 ) min(-1 ) ) , h and grip strength ( 19.2 vs. 21.9 kg ) , leg strength , and balance following the training period ( p<.05 ) . Body weight ( 70.1 vs. 68.1 kg ) and body mass index ( 27.4 vs. 26.6 kg m(-2 ) ) decreased ( p<.05 ) in the IG group . The CG showed no changes in any parameter . These data suggest a combined aerobic , strength and balance exercise training program is beneficial among individuals with ID Objective : Although there are evaluation and effectiveness studies of health promotion interventions for adults with intellectual disabilities ( ID ) , r and omized efficacy trials of such interventions are lacking . Design : A r and omized active control intervention trial . Setting : The participants attended the health promotion classes in local disability agency service facilities . Method : We enrolled 443 individuals and r and omly assigned them to one of two eight-week participatory classes . The ‘ Steps to Your Health ’ ( STYH ) classes emphasized moderate to vigorous physical activity ( MVPA ) , healthy eating and  body mass index ( BMI )  reduction . The control intervention focused on hygiene and safety . Results : We did not find a statistically significant difference in mean MVPA or BMI change between completers of the STYH group compared to the control group one year after the intervention was completed . We did find that participation in STYH classes had a non-significant association with odds of reduction in BMI ( odds ratio [ OR ] 2.87 , 95 % confidence interval [ CI ] 0.91–9.11 ) and completers who lived in group homes were more likely than their counterparts who lived with families or in apartments to decrease their BMI ( OR 4.61 ; 95 % CI 1.14–18.64 ) . Conclusions : This trial did not demonstrate a significant effect of STYH participation on change in mean minutes of MVPA or mean BMI 12 months after classes ended , although there was a non-significant association with odds of reduction of BMI ( p = 0.07 ) . This study has implication s for design of intervention studies in people with intellectual disability ( ID ) Little information is available on the provision of physical fitness and intervention program among people with intellectual disabilities . The aim of this study is to provide information of examining the effectiveness of healthy physical fitness programs on people with intellectual disabilities living in a disability institution . There were 146 participants with intellectual disabilities ( age 19 - 67 years ) were recruited in the study . We collected information on disability condition ( type and level ) , height , weight , BMI , and physical fitness status ( includes V-shape sit and reach test , sit-up 30s , sit-up 60s , and shuttle run ) at the beginning and 6 months later of the program intervention . The results show that there were statistical decreases in individual 's weight , BMI score , BMI category , and positive improvement in V-shape sit and reach test , sit-up in 30s and 60s tests after 6-month interventions . However , the shuttle run test did not improve at the post-test among people with intellectual disabilities . The results also showed that the mild disability level group has the highest effectiveness on the healthy fitness program on decreasing body weight . Generally speaking , the preliminary study found the healthy exercise program has positive fitness effects on people with intellectual disabilities . To maximize the benefits of regular physical activity on people with ID , there is a need to evaluate the long-term effect of the intervention program and then to initiate the healthy exercise strategies in institution for this group of people Two groups of cerebral palsied , mentally retarded , overweight adults received training in seven behavioral self-control techniques for reducing caloric intake and increasing activity levels over the course of 19 weeks . One group 's parents/caretakers had frequent contacts from the diet leader , ( Home-Help Group ) ; the other group , balanced with the first for degree of h and icap , had no caretaker-directed communications other than initial notification ( No Help Group ) . Measures of adherence were included to assess the process of behavioral change during the diet program . A significant treatment effect accrued for all participants in the diet program , with the Home-Help Group of dieters showing clinical ly , though not statistically superior weight loss at treatment end and at follow-ups through one year . Specific behaviors taught , such as replacing utensils after each bite and eating slowly , showed significant changes in the expected directions with weight change . Implication s of the data for future treatment programs are discussed 
    Output:
    