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: PURPOSE Self-directed and supervised exercise were compared with usual care in a clinical trial design ed to evaluate the effect of structured exercise on physical functioning and other dimensions of health-related quality of life in women with stages I and II breast cancer . PATIENTS AND METHODS One hundred twenty-three women with stages I and II breast cancer completed baseline evaluations of generic and disease- and site-specific health-related quality of life , aerobic capacity , and body weight . Participants were r and omly allocated to one of three intervention groups : usual care ( control group ) , self-directed exercise , or supervised exercise .  Quality of life , aerobic capacity , and body weight measures were repeated at 26 weeks . The primary outcome was the change in the Short Form-36 physical functioning scale between baseline and 26 weeks . RESULTS Physical functioning in the control group decreased by 4.1 points , whereas it increased by 5.7 points and 2.2 points in the self-directed and supervised exercise groups , respectively ( P = .04 ) . Post hoc analysis showed a moderately large ( and clinical ly important ) difference between the self-directed and control groups ( 9.8 points ; P = .01 ) and a more modest difference between the supervised and control groups ( 6.3 points ; P = .09 ) . No significant differences between groups were observed for changes in quality of life scores . In a secondary analysis of participants stratified by type of adjuvant therapy , supervised exercise improved aerobic capacity ( + 3.5 mL/kg/min ; P = .01 ) and reduced body weight ( -4.8 kg ; P < .05 ) compared with usual care only in participants not receiving chemotherapy . CONCLUSION Physical exercise can blunt some of the negative side effects of breast cancer treatment , including reduced physical functioning .  Self-directed exercise is an effective way to improve physical functioning compared with usual care . In participants not receiving chemotherapy  , supervised exercise may increase aerobic capacity and reduce body weight compared with usual care To evaluate the efficacy and economic efficiency of a multimedia , multimodal physical activity program for women undergoing adjuvant therapy following surgery for breast cancer . We conducted a r and omized trial with concurrent incremental cost-effectiveness analysis and blinded baseline , 3 , 6 and 12-month follow-up assessment s amongst women undergoing adjuvant therapy following surgery for breast cancer ( n = 89 ) . The intervention was a multimedia , multimodal exercise program comprising strength , balance and endurance training elements . The control was sham flexibility and relaxation program delivered using similar material s. The primary outcome was health-related quality of life ( EQ-5D & VAS , EORTC C30 , BR23 ) . Economic outcomes included direct health care costs and productivity gains and losses . Participants in the intervention group demonstrated greater improvement in health-related quality of life between baseline and the 3-month assessment [ mean ( sd ) EQ-5D VAS ( 0–100 ) baseline : 72.6 ( 15.6 ) , 3 month : 80.6 ( 11.6 ) ] when compared to control group participants [ baseline : 77.5 ( 13.5 ) , 3 month : 74.1 ( 20.6 ) , P = 0.006 ] and also improved more in terms of physical function [ mean ( sd ) EORTC C30 physical function scale intervention ( 0–100 ) baseline : 84.9 ( 14.8 ) , 3 month : 86.9 ( 10.7 ) , control baseline : 91.3 ( 9.6 ) , 3 month : 86.7 ( 14.9 ) , P = 0.02 ] . These improvements were not sustained beyond this point . Upper limb volumes were also lower amongst intervention group participants . However , there was low probability that the intervention would be both less costly and more effective than the control condition ( range probability = 0.05–50.02 % depending on approach ) . Provision of multimodal exercise programs will improve the short-term health of women undergoing adjuvant therapy for breast cancer but are of question able economic efficiency While physical activity during cancer treatment is found beneficial for breast cancer patients , evidence indicates ambiguous findings concerning effects of scheduled exercise programs on treatment-related symptoms . This study investigated effects of a scheduled home-based exercise intervention in breast cancer patients during adjuvant chemotherapy  , on cancer-related fatigue , physical fitness , and activity level .  Sixty-seven women were r and omized to an exercise intervention group ( n = 33 , performed strength training 3x/week and 30 minutes brisk walking/day ) and a control group ( n = 34 , performed their regular physical activity level ) . Data collection was performed at baseline , at completion of chemotherapy ( Post1 ) , and 6-month postchemotherapy ( Post2 ) . Exercise levels were slightly higher in the scheduled exercise group than in the control group . In both groups , cancer-related fatigue increased at Post1 but returned to baseline at Post2 . Physical fitness and activity levels decreased at Post1 but were significantly improved at Post2 . Significant differences between intervention and control groups were not found . The findings suggest that generally recommended physical activity levels are enough to relief cancer-related fatigue and restore physical capacity in breast cancer patients during adjuvant chemotherapy , although one can not rule out that results reflect diminishing treatment side effects over time PURPOSE The purpose of this study was to identify the effects of a home based exercise program for patients with stomach cancer who were undergoing oral chemotherapy . METHODS The home-based exercise program was developed from the study findings of Winningham ( 1990 ) and data from the Korea Athletic Promotion Association ( 2007 ) . The home-based exercise program consisted of 8 weeks of individual exercise education and exercise adherence strategy . Participants were 24 patients with stomach cancer who were undergoing oral chemotherapy following surgery in 2007 or 2008 at a university hospital in Seoul . Patients were r and omly assigned to either the experimental group ( 11 ) or control group ( 13 ) . The effects of the home-based exercise program were measured by level of cancer related fatigue , NK cell ratio , anxiety , and quality of life . Data were analyzed using SPSS/WIN 13.0 version . RESULTS The degree of cancer related fatigue and anxiety in the experimental group decreased compared to the control group . The NK cell ratio and the degree of quality of life of experimental group increased while that of the control group decreased . CONCLUSION This study result indicate the importance of exercise and provide empirical evidence for continuation of safe exercise for patients with cancer during their chemotherapy Background : Few studies have evaluated an individualized home-based exercise prescription during and after cancer treatment . Objective : The purpose of this study was to evaluate the effectiveness of a home-based exercise training intervention , the Pro-self Fatigue Control Program on the management of cancer-related fatigue . Interventions / Methods : Participants ( N = 119 ) were r and omized into 1 of 3 groups : group 1 received the exercise prescription throughout the study ; group 2 received their exercise prescription after completing cancer treatment ; and group 3 received usual care . Patients completed the Piper Fatigue Scale , General Sleep Disturbance Scale , Center for Epidemiological Studies -Depression Scale , and Worst Pain Intensity Scale . Results : All groups reported mild fatigue levels , sleep disturbance , and mild pain , but not depression . Using multilevel regression analysis , significant linear and quadratic trends were found for change in fatigue and pain ( ie , scores increased , then decreased over time ) . No group differences were found in the changing scores over time . A significant quadratic effect for the trajectory of sleep disturbance was found , but no group differences were detected over time . No significant time or group effects were found for depression . Conclusions : Our home-based exercise intervention had no effect on fatigue or related symptoms associated with cancer treatment . The optimal timing of exercise remains to be determined . Implication s for Practice : Clinicians need to be aware that some physical activity is better than none , and there is no harm in exercise as tolerated during cancer treatment . Further analysis is needed to examine the adherence to exercise . More frequent assessment s of fatigue , sleep disturbance , depression , and pain may capture the effect of exercise Purpose This r and omized controlled trial tested the effects of a specially design ed strength and endurance training on the independence and quality of life in lung cancer patients in stages IIIA/IIIB/IV during palliative chemotherapy . Methods Between August 2010 and December 2011 , 46 patients were r and omized into two groups receiving either conventional physiotherapy or special physiotherapeutic training . The Barthel Index served as primary endpoint . The secondary endpoints were the European Organization for Research and Treatment of Cancer Quality of Life Question naire Core-30 ( EORTC QLQ C-30/LC-13 ) question naire , the 6-Minute Walk Test ( 6MWT ) , stair walking , the Modified Borg Scale , and muscle strength . Nonparametrical data were analyzed with the Wilcoxon and Mann – Whitney U test . For parametric , data student t tests were used . A p value of ≤.05 was accepted . Results Twenty-nine patients completed the trial ( Intervention group ( IG ) , n = 18 ; control group ( CG ) , n = 11 ) . Significant differences were detectable in the Barthel Index ( IGmean = 92.08 ; CGmean = 81.67 ; p = .041 ) , in single scores of the EORTC QLQ C-30/LC-13 question naire ( physical functioning , p = .025 ; hemoptysis , p = .019 ; pain in arms or shoulder , p = .048 ; peripheral neuropathy , p = .050 ; cognitive functioning , p = .050 ) , in the 6MWT , stair walking , strength capacity , and in the patient ’s dyspnoea perception during submaximal walking activities ( IG > CG ) . Conclusion According to these findings , lung cancer patients should receive enhanced physical activity intervention during palliative chemotherapy To investigate the impact of exercise on adult allogeneic hematopoietic cell transplant recipients , we r and omized 100 patients to either a  structured walking regimen  or to a  control group with no formal exercise program . Starting on the day of admission for transplant , patients in the exercise arm were asked to walk on a treadmill twice a day for 15 minutes while in the hospital . After discharge , they were asked to walk once a day for 30 minutes . The effect of the exercise program was primarily measured by the change in the Karnofsky score ( KPS ) from transplant admission to day 100 posttransplant , which was scored by the attending physician who was blinded to the assigned exercise regimen . The decline in KPS was smaller in the exercise group than in the control group : 10 points versus 20 points . This difference was not statistically significant in the total study population ( P=.21 ) but was statistically significant among the subset of older and less fit patients receiving nonmyeloablative pretransplant conditioning ( P=.04 ) . Sixty-four percent of patients on the exercise arm who had a baseline KPS<90 had a score > or=90 by day 100 compared to 18 % of the control arm ( P=.03 ) . Thirty-two percent of patients with a baseline score > or=90 had a score > or=90 by day 100 in both groups ( P=.99 ) . Analyses of patients ' self reported scores at the time of discharge for physical and emotional well-being showed that the exercise arm had better scores for physical well-being ( P<.01 ) . Among the subset of nonmyeloablative patients , scores for physical and emotional well-being were both higher in the exercise arm ( P=.02 ) . Length of hospitalization and survival were not different between the 2 study arms . We conclude that assignment of a structured walking regimen to patients can lead to better physical performance during the recovery period and by patient assessment , a better perceived physical and emotional state . In addition , exercise has a greater impact among patients who are less fit coming into transplant .  Structured exercise may have a positive impact on physical and emotional recovery following transplant therapy and may accelerate patients ' return to health and function Abstract Background . Physical activity during chemotherapy has been shown in several studies to reduce fatigue , improve symptoms and impact positively on health-related quality of life ( HRQoL ) . Challenges associated with intervention studies on physical activity during cancer treatment relate to consistent adherence . The primary objective was to study feasibility and adherence of physical activity intervention among patients with cancer during adjuvant chemotherapy treatment . The secondary objective was to investigate the effects of physical activity on health aspects , including HRQoL , symptoms and surrogate markers for cardiovascular disease . Material and methods . This r and omized controlled trial included patients with breast cancer ( BRCA ) and colorectal cancer ( CRC ) during adjuvant chemotherapy .  The intervention continued for 10 weeks and included daily walks of 10 000 steps and a weekly supervised group walk . Adherence was assessed by a pedometer and the number of participants who reported step counts every week and percentage of participants who achieved the target steps every week . Results . Adherence average reached 91 % during the intervention period ; in total 74 % completed the exercise intervention . The majority of the participants achieved an average of 83 % of the target of 10 000 steps per day for 10 weeks . There was a significant increase in daily physical activity ( p = 0.016 ) in the intervention group . Significant differences were also found for some breast cancer-specific symptoms [ swelling , mobility and pain ( p = 0.045 ) ] . The study showed a relatively small weight gain an average of 0.9 kg in the intervention group and 1.3 kg in the control group . Conclusion . Physical activity in the form of walking is feasible during adjuvant chemotherapy treatment despite increasing symptoms . The physical activity increased in the intervention group during the study time and had a positive impact on breast symptoms and the weight gain was lower in comparison to previous studies The purpose of this study was to examine the effects of an exercise intervention on the total caloric intake ( TCI ) of breast cancer patients undergoing treatment . A secondary purpose was to determine whether or not a relationship existed between changes in TCI 
    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: PURPOSE Self-directed and supervised exercise were compared with usual care in a clinical trial design ed to evaluate the effect of structured exercise on physical functioning and other dimensions of health-related quality of life in women with stages I and II breast cancer . PATIENTS AND METHODS One hundred twenty-three women with stages I and II breast cancer completed baseline evaluations of generic and disease- and site-specific health-related quality of life , aerobic capacity , and body weight . Participants were r and omly allocated to one of three intervention groups : usual care ( control group ) , self-directed exercise , or supervised exercise .  Quality of life , aerobic capacity , and body weight measures were repeated at 26 weeks . The primary outcome was the change in the Short Form-36 physical functioning scale between baseline and 26 weeks . RESULTS Physical functioning in the control group decreased by 4.1 points , whereas it increased by 5.7 points and 2.2 points in the self-directed and supervised exercise groups , respectively ( P = .04 ) . Post hoc analysis showed a moderately large ( and clinical ly important ) difference between the self-directed and control groups ( 9.8 points ; P = .01 ) and a more modest difference between the supervised and control groups ( 6.3 points ; P = .09 ) . No significant differences between groups were observed for changes in quality of life scores . In a secondary analysis of participants stratified by type of adjuvant therapy , supervised exercise improved aerobic capacity ( + 3.5 mL/kg/min ; P = .01 ) and reduced body weight ( -4.8 kg ; P < .05 ) compared with usual care only in participants not receiving chemotherapy . CONCLUSION Physical exercise can blunt some of the negative side effects of breast cancer treatment , including reduced physical functioning .  Self-directed exercise is an effective way to improve physical functioning compared with usual care . In participants not receiving chemotherapy  , supervised exercise may increase aerobic capacity and reduce body weight compared with usual care To evaluate the efficacy and economic efficiency of a multimedia , multimodal physical activity program for women undergoing adjuvant therapy following surgery for breast cancer . We conducted a r and omized trial with concurrent incremental cost-effectiveness analysis and blinded baseline , 3 , 6 and 12-month follow-up assessment s amongst women undergoing adjuvant therapy following surgery for breast cancer ( n = 89 ) . The intervention was a multimedia , multimodal exercise program comprising strength , balance and endurance training elements . The control was sham flexibility and relaxation program delivered using similar material s. The primary outcome was health-related quality of life ( EQ-5D & VAS , EORTC C30 , BR23 ) . Economic outcomes included direct health care costs and productivity gains and losses . Participants in the intervention group demonstrated greater improvement in health-related quality of life between baseline and the 3-month assessment [ mean ( sd ) EQ-5D VAS ( 0–100 ) baseline : 72.6 ( 15.6 ) , 3 month : 80.6 ( 11.6 ) ] when compared to control group participants [ baseline : 77.5 ( 13.5 ) , 3 month : 74.1 ( 20.6 ) , P = 0.006 ] and also improved more in terms of physical function [ mean ( sd ) EORTC C30 physical function scale intervention ( 0–100 ) baseline : 84.9 ( 14.8 ) , 3 month : 86.9 ( 10.7 ) , control baseline : 91.3 ( 9.6 ) , 3 month : 86.7 ( 14.9 ) , P = 0.02 ] . These improvements were not sustained beyond this point . Upper limb volumes were also lower amongst intervention group participants . However , there was low probability that the intervention would be both less costly and more effective than the control condition ( range probability = 0.05–50.02 % depending on approach ) . Provision of multimodal exercise programs will improve the short-term health of women undergoing adjuvant therapy for breast cancer but are of question able economic efficiency While physical activity during cancer treatment is found beneficial for breast cancer patients , evidence indicates ambiguous findings concerning effects of scheduled exercise programs on treatment-related symptoms . This study investigated effects of a scheduled home-based exercise intervention in breast cancer patients during adjuvant chemotherapy  , on cancer-related fatigue , physical fitness , and activity level .  Sixty-seven women were r and omized to an exercise intervention group ( n = 33 , performed strength training 3x/week and 30 minutes brisk walking/day ) and a control group ( n = 34 , performed their regular physical activity level ) . Data collection was performed at baseline , at completion of chemotherapy ( Post1 ) , and 6-month postchemotherapy ( Post2 ) . Exercise levels were slightly higher in the scheduled exercise group than in the control group . In both groups , cancer-related fatigue increased at Post1 but returned to baseline at Post2 . Physical fitness and activity levels decreased at Post1 but were significantly improved at Post2 . Significant differences between intervention and control groups were not found . The findings suggest that generally recommended physical activity levels are enough to relief cancer-related fatigue and restore physical capacity in breast cancer patients during adjuvant chemotherapy , although one can not rule out that results reflect diminishing treatment side effects over time PURPOSE The purpose of this study was to identify the effects of a home based exercise program for patients with stomach cancer who were undergoing oral chemotherapy . METHODS The home-based exercise program was developed from the study findings of Winningham ( 1990 ) and data from the Korea Athletic Promotion Association ( 2007 ) . The home-based exercise program consisted of 8 weeks of individual exercise education and exercise adherence strategy . Participants were 24 patients with stomach cancer who were undergoing oral chemotherapy following surgery in 2007 or 2008 at a university hospital in Seoul . Patients were r and omly assigned to either the experimental group ( 11 ) or control group ( 13 ) . The effects of the home-based exercise program were measured by level of cancer related fatigue , NK cell ratio , anxiety , and quality of life . Data were analyzed using SPSS/WIN 13.0 version . RESULTS The degree of cancer related fatigue and anxiety in the experimental group decreased compared to the control group . The NK cell ratio and the degree of quality of life of experimental group increased while that of the control group decreased . CONCLUSION This study result indicate the importance of exercise and provide empirical evidence for continuation of safe exercise for patients with cancer during their chemotherapy Background : Few studies have evaluated an individualized home-based exercise prescription during and after cancer treatment . Objective : The purpose of this study was to evaluate the effectiveness of a home-based exercise training intervention , the Pro-self Fatigue Control Program on the management of cancer-related fatigue . Interventions / Methods : Participants ( N = 119 ) were r and omized into 1 of 3 groups : group 1 received the exercise prescription throughout the study ; group 2 received their exercise prescription after completing cancer treatment ; and group 3 received usual care . Patients completed the Piper Fatigue Scale , General Sleep Disturbance Scale , Center for Epidemiological Studies -Depression Scale , and Worst Pain Intensity Scale . Results : All groups reported mild fatigue levels , sleep disturbance , and mild pain , but not depression . Using multilevel regression analysis , significant linear and quadratic trends were found for change in fatigue and pain ( ie , scores increased , then decreased over time ) . No group differences were found in the changing scores over time . A significant quadratic effect for the trajectory of sleep disturbance was found , but no group differences were detected over time . No significant time or group effects were found for depression . Conclusions : Our home-based exercise intervention had no effect on fatigue or related symptoms associated with cancer treatment . The optimal timing of exercise remains to be determined . Implication s for Practice : Clinicians need to be aware that some physical activity is better than none , and there is no harm in exercise as tolerated during cancer treatment . Further analysis is needed to examine the adherence to exercise . More frequent assessment s of fatigue , sleep disturbance , depression , and pain may capture the effect of exercise Purpose This r and omized controlled trial tested the effects of a specially design ed strength and endurance training on the independence and quality of life in lung cancer patients in stages IIIA/IIIB/IV during palliative chemotherapy . Methods Between August 2010 and December 2011 , 46 patients were r and omized into two groups receiving either conventional physiotherapy or special physiotherapeutic training . The Barthel Index served as primary endpoint . The secondary endpoints were the European Organization for Research and Treatment of Cancer Quality of Life Question naire Core-30 ( EORTC QLQ C-30/LC-13 ) question naire , the 6-Minute Walk Test ( 6MWT ) , stair walking , the Modified Borg Scale , and muscle strength . Nonparametrical data were analyzed with the Wilcoxon and Mann – Whitney U test . For parametric , data student t tests were used . A p value of ≤.05 was accepted . Results Twenty-nine patients completed the trial ( Intervention group ( IG ) , n = 18 ; control group ( CG ) , n = 11 ) . Significant differences were detectable in the Barthel Index ( IGmean = 92.08 ; CGmean = 81.67 ; p = .041 ) , in single scores of the EORTC QLQ C-30/LC-13 question naire ( physical functioning , p = .025 ; hemoptysis , p = .019 ; pain in arms or shoulder , p = .048 ; peripheral neuropathy , p = .050 ; cognitive functioning , p = .050 ) , in the 6MWT , stair walking , strength capacity , and in the patient ’s dyspnoea perception during submaximal walking activities ( IG > CG ) . Conclusion According to these findings , lung cancer patients should receive enhanced physical activity intervention during palliative chemotherapy To investigate the impact of exercise on adult allogeneic hematopoietic cell transplant recipients , we r and omized 100 patients to either a  structured walking regimen  or to a  control group with no formal exercise program . Starting on the day of admission for transplant , patients in the exercise arm were asked to walk on a treadmill twice a day for 15 minutes while in the hospital . After discharge , they were asked to walk once a day for 30 minutes . The effect of the exercise program was primarily measured by the change in the Karnofsky score ( KPS ) from transplant admission to day 100 posttransplant , which was scored by the attending physician who was blinded to the assigned exercise regimen . The decline in KPS was smaller in the exercise group than in the control group : 10 points versus 20 points . This difference was not statistically significant in the total study population ( P=.21 ) but was statistically significant among the subset of older and less fit patients receiving nonmyeloablative pretransplant conditioning ( P=.04 ) . Sixty-four percent of patients on the exercise arm who had a baseline KPS<90 had a score > or=90 by day 100 compared to 18 % of the control arm ( P=.03 ) . Thirty-two percent of patients with a baseline score > or=90 had a score > or=90 by day 100 in both groups ( P=.99 ) . Analyses of patients ' self reported scores at the time of discharge for physical and emotional well-being showed that the exercise arm had better scores for physical well-being ( P<.01 ) . Among the subset of nonmyeloablative patients , scores for physical and emotional well-being were both higher in the exercise arm ( P=.02 ) . Length of hospitalization and survival were not different between the 2 study arms . We conclude that assignment of a structured walking regimen to patients can lead to better physical performance during the recovery period and by patient assessment , a better perceived physical and emotional state . In addition , exercise has a greater impact among patients who are less fit coming into transplant .  Structured exercise may have a positive impact on physical and emotional recovery following transplant therapy and may accelerate patients ' return to health and function Abstract Background . Physical activity during chemotherapy has been shown in several studies to reduce fatigue , improve symptoms and impact positively on health-related quality of life ( HRQoL ) . Challenges associated with intervention studies on physical activity during cancer treatment relate to consistent adherence . The primary objective was to study feasibility and adherence of physical activity intervention among patients with cancer during adjuvant chemotherapy treatment . The secondary objective was to investigate the effects of physical activity on health aspects , including HRQoL , symptoms and surrogate markers for cardiovascular disease . Material and methods . This r and omized controlled trial included patients with breast cancer ( BRCA ) and colorectal cancer ( CRC ) during adjuvant chemotherapy .  The intervention continued for 10 weeks and included daily walks of 10 000 steps and a weekly supervised group walk . Adherence was assessed by a pedometer and the number of participants who reported step counts every week and percentage of participants who achieved the target steps every week . Results . Adherence average reached 91 % during the intervention period ; in total 74 % completed the exercise intervention . The majority of the participants achieved an average of 83 % of the target of 10 000 steps per day for 10 weeks . There was a significant increase in daily physical activity ( p = 0.016 ) in the intervention group . Significant differences were also found for some breast cancer-specific symptoms [ swelling , mobility and pain ( p = 0.045 ) ] . The study showed a relatively small weight gain an average of 0.9 kg in the intervention group and 1.3 kg in the control group . Conclusion . Physical activity in the form of walking is feasible during adjuvant chemotherapy treatment despite increasing symptoms . The physical activity increased in the intervention group during the study time and had a positive impact on breast symptoms and the weight gain was lower in comparison to previous studies The purpose of this study was to examine the effects of an exercise intervention on the total caloric intake ( TCI ) of breast cancer patients undergoing treatment . A secondary purpose was to determine whether or not a relationship existed between changes in TCI 
    Output:
    