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: Experimental and control groups of 10 hemiparetic stroke patients each underwent a 6 week , twice daily gait training program . The control group participated in a conventional physical therapy gait program . The experimental group trained in the same basic program with the addition of rhythmic auditory stimulation ( RAS ) .  Patients entered the study as soon as they could complete 5 strides with h and -held assistance . The training program had to be completed within 3 months of the patients ' stroke . In the experimental group RAS was used as a timekeeper to synchronize step patterns and gradually entrain higher stride frequencies . Study groups were equated by gender , lesion site , and age . Motor function was assessed at pretest using Barthel , Fugl-Meyer , and Berg Scales . Walking patterns were assessed during pre- and post-test without RAS present . Pre- vs post-test measures revealed a statistically significant ( P<0.05 ) increase in velocity ( 164 % vs 107 % ) , stride length ( 88 % vs 34 % ) , and reduction in EMG amplitude variability of the gastrocnemius muscle ( 69 % vs 33 % ) for the RAS-training group compared to the control group . The difference in stride symmetry improvement ( 32 % in the RAS-group vs 16 % in the control group ) was statistically not significant . The data offer evidence that RAS is an efficient tool to enhance efforts in gait rehabilitation with acute stroke patients Guidelines in stroke rehabilitation recommend the use of a multidisciplinary approach . Different approaches and techniques with music are used in the stroke rehabilitation to improve motor and cognitive functions but also psychological outcomes . In this r and omized controlled pilot trial , relational active music therapy approaches were tested in the post-acute phase of disease . Thirty-eight hospitalized patients with ischemic and hemorrhagic stroke were recruited and allocated in two groups . The experimental group underwent the st and ard of care ( physiotherapy and occupational therapy daily sessions ) and relational active music therapy treatments . The control group underwent the st and ard of care only .  Motor functions and psychological aspects were assessed before and after treatments . Music therapy process was also evaluated using a specific rating scale . All groups showed a positive trend in quality of life , functional and disability levels , and gross mobility . The experimental group showed a decrease of anxiety and , in particular , of depression ( p = 0.016 ) . In addition , the strength of non-dominant h and ( grip ) significantly increased in the experimental group ( p = 0.041 ) . Music therapy assessment showed a significant improvement over time of non-verbal and sonorous-music relationships . Future studies , including a greater number of patients and follow-up evaluations , are needed to confirm promising results of this study In previous studies , it was shown that there is a need for efficient motor rehabilitation approaches . For this purpose , we evaluated a music-supported training program design ed to induce an auditory – sensorimotor co-representation of movements in 20 stroke patients ( 10 affected in the left and 10 in the right upper extremity ) . Patients without any previous musical experience participated in an intensive step by step training , first of the paretic extremity , followed by training of both extremities . Training was applied 15 times over 3 weeks in addition to conventional treatment . Fine as well as gross motor skills were addressed by using either a MIDI-piano or electronic drum pads . As a control , 20 stroke patients ( 10 affected left and 10 right ) undergoing exclusively conventional therapies were recruited . Assignment to the training and control groups was done pseudo-r and omly to achieve an equal number of left- and right-affected patients in each group . Pre- and post-treatment motor functions were monitored using a computerized movement analysis system ( Zebris ) and an established array of motor tests ( e. g. , Action Research Arm Test , Box & Block Test ) . Patients showed significant improvement after treatment with respect to speed , precision and smoothness of movements as shown by 3D movement analysis and clinical motor tests . Furthermore , compared to the control subjects , motor control in everyday activities improved significantly . In conclusion , this innovative therapeutic strategy is an effective approach for the motor skill neurorehabilitation of stroke patients [ Purpose ] The purpose of this study was to determine if an inclined treadmill with rhythmic auditory stimulation gait training can improve balance and gait ability in stroke patients . [ Subjects and Methods ] Thirty participants were r and omly divided into three groups : inclined treadmill with rhythmic auditory stimulation training group ( n=10 ) , inclined treadmill training group ( n=10 ) , and treadmill training group ( n=10 ) . For all groups , the training was conducted for 4 weeks , 30 minutes per session , 5 times per week . Two subjects dropped out before study completion . [ Results ] All variables of balance and gait , except for the timed up and go test in the treadmill group , significantly improved in all groups . Moreover , all variables showed a more significant improvement in the inclined treadmill with rhythmic auditory stimulation group when compared with the other groups . Timed up and go test , Berg balance scale , 6 m walking test , walking speed , and symmetric index were significantly improved in the inclined treadmill group when compared with the treadmill group . [ Conclusion ] Thus , for stroke patients receiving gait training , inclined treadmill with rhythmic auditory stimulation training was more effective in maintaining balance and gait than inclined treadmill without rhythmic auditory stimulation or only treadmill training Purpose To investigate the effects of music therapy on depressive mood and anxiety in post-stroke patients and evaluate satisfaction levels of patients and caregivers . Material s and Methods Eighteen post-stroke patients , within six months of onset and mini mental status examination score of over 20 , participated in this study . Patients were divided into music and control groups . The experimental group participated in the music therapy program for four weeks . Psychological status was evaluated with the Beck Anxiety Inventory ( BAI ) and Beck Depression Inventory ( BDI ) before and after music therapy . Satisfaction with music therapy was evaluated by a question naire . Results BAI and BDI scores showed a greater decrease in the music group than the control group after music therapy , but only the decrease of BDI scores were statistically significant ( p=0.048 ) . Music therapy satisfaction in patients and caregivers was affirmative . Conclusion Music therapy has a positive effect on mood in post-stroke patients and may be beneficial for mood improvement with stroke . These results are encouraging , but further studies are needed in this field We know from animal studies that a stimulating and enriched environment can enhance recovery after stroke , but little is known about the effects of an enriched sound environment on recovery from neural damage in humans . In humans , music listening activates a wide-spread bilateral network of brain regions related to attention , semantic processing , memory , motor functions , and emotional processing .  Music exposure also enhances emotional and cognitive functioning in healthy subjects and in various clinical patient groups . The potential role of music in neurological rehabilitation , however , has not been systematic ally investigated . This single-blind , r and omized , and controlled trial was design ed to determine whether everyday music listening can facilitate the recovery of cognitive functions and mood after stroke . In the acute recovery phase , 60 patients with a left or right hemisphere middle cerebral artery ( MCA ) stroke were r and omly assigned to a music group , a language group , or a control group . During the following two months , the music and language groups listened daily to self-selected music or audio books , respectively , while the control group received no listening material . In addition , all patients received st and ard medical care and rehabilitation . All patients underwent an extensive neuropsychological assessment , which included a wide range of cognitive tests as well as mood and quality of life question naires , one week ( baseline ) , 3 months , and 6 months after the stroke . Fifty-four patients completed the study . Results showed that recovery in the domains of verbal memory and focused attention improved significantly more in the music group than in the language and control groups . The music group also experienced less depressed and confused mood than the control group . These findings demonstrate for the first time that music listening during the early post-stroke stage can enhance cognitive recovery and prevent negative mood . The neural mechanisms potentially underlying these effects are discussed OBJECTIVE Positive results have been reported with melodic intonation therapy ( MIT ) in nonfluent aphasia patients with damage to their left-brain speech processes , using the patient 's intact ability to sing to promote functional language . This pilot study sought to determine the immediate effects of introducing modified melodic intonation therapy ( MMIT ) , a modification of MIT , as an early intervention in stroke patients presenting with Broca 's aphasia . METHOD After a r and omized controlled single-blind design , 30 acute stroke survivors with nonfluent aphasia were r and omly assigned to receive MIT treatment or no treatment . A pre/post test , based on the responsive and repetition subsections of the Western Aphasia Battery , was developed for this study . RESULTS After 1 session , a significant within-subject change was observed for the treatment group 's adjusted total score ( p = .02 ) , and a significant difference between groups was found for adjusted total score ( p = .02 ) favoring the treatment group . The treatment group also showed a significant change in their responsive subsection scores ( p = .01 ) when their pre-tests from Visit 1 to Visit 2 were compared , whereas the control group showed no change , suggesting a possible carry-over effect of MIT treatment . CONCLUSION This study provides preliminary data supporting the possible benefits of utilizing MMIT treatment early in the recovery of nonfluent aphasia patients Aim of the study : The aim of this research is to evaluate the effects of active music therapy ( MT ) based on free-improvisation ( relational approach ) in addition to speech language therapy ( SLT ) compared with SLT alone ( communicative-pragmatic approach : Promoting Aphasic 's Communicative Effectiveness ) in stroke patients with chronic aphasia . Material s and methods : The experimental group ( n = 10 ) was r and omized to 30 MT individual sessions over 15 weeks in addition to 30  SLT individual sessions while the control group ( n = 10 ) was r and omized to only 30  SLT sessions during the same period . Psychological and speech language assessment were made before ( T0 ) and after ( T1 ) the treatments . Results : The study shows a significant improvement in spontaneous speech in the experimental group ( Aachener Aphasie subtest : p = 0.020 ; Cohen 's d = 0.35 ) ; the 50 % of the experimental group showed also an improvement in vitality scores of Short Form Health Survey ( chi-square test = 4.114 ; p = 0.043 ) . Conclusions : The current trial highlights the possibility that the combined use of MT and SLT can lead to a better result in the rehabilitation of patients with aphasia than SLT alone Many countries lack effective community-based rehabilitation programs despite the increasing numbers of stroke survivors . Therefore , we have conducted a pilot investigation in South Korea of a newly constructed community-based intervention program combining rhythmic music and specialized rehabilitation movement . The 8-week program was based on rhythmic auditory stimulation ( RAS ) theory , which uses rhythm to enhance stroke survivors ' movements . Thirty-three stroke survivors were r and omized into one of two groups : The experimental group ( n = 16 ) carried out an 8-week RAS music-movement exercise intervention ; the control group  ( n = 17 ) received referral information about available usual care services . Participants in the experimental group gained a wider range of motion and flexibility , had more positive moods , and reported increased frequency and quality of interpersonal relationships Adults aged 55 to 80 years participated voluntarily in a wait-list control study during in-patient physical therapy following first stroke . All participants ( N = 15 ) received conventional physical therapy gait training throughout 30 treatment sessions . Rhythmic auditory stimulation (RAS)-enhanced gait training was nested within conventional treatments in three conditions : ( 1 ) RAS throughout 30 treatments ( N = 5 ) ; ( 2 ) RAS in the last 20 treatments ( N = 5 ) ; and ( 3 ) RAS in the last 10 treatments ( N = 5 ) . Cadence and balance outcome measurements were taken at baseline , and following 10 , 20 , and 30 treatment sessions . Improvements across time were statistically significant in all conditions for one-limb stance , cadence , velocity , stride length , and posture head tilt with no statistically significant improvements for the Timed Up and Go Test and the Functional Reach Test . Statistically significant gains were made in the one-limb stance and cadence with earlier implementations of RAS . Results of the study demonstrate the feasibility of RAS to enhance gait training that warrants further investigation of the protocol to demonstrate the effects of RAS in stroke rehabilitation Patients with left-sided visual neglect fail to copy the left part of drawings or the drawings on the left side of a sheet of paper . Our aim was to study the variations in copying drawings induced by passive stimulation in patients with left-sided visual neglect .  No stimulation at all , tactile unilateral and bilateral , binaural auditory verbal , and nonverbal stimuli were r and omly applied to 14 patients with right-hemisphere strokes . Only nonverbal stimuli decreased the neglect . As nonverbal stimuli mainly activate the right hemisphere , the decrease in neglect suggests right-hemispheric hypoactivity at rest in these patients . The absence of modification of neglect during verbal stimulation suggests a bilateral hemispheric activation and the persistence of interhemispheric imbalance . Our results showed that auditory pathways take part in the network involved with neglect . Passive nonverbal auditory stimuli may be of interest in the rehabilitation of patients with left visual neglect The purpose of this study was to determine the effects of music therapy on pain perception of stroke patients during upper extremity joint exercises . Ten stroke patients ( 1 male and 9 females ) ranging in age from 61 to 73 participated in the study . Music conditions used in the study consisted of : ( a ) song , ( b ) karaoke accompaniment ( same music to condition A except singers ' voices ) , and ( c ) no music . Exercise movements in 
    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: Experimental and control groups of 10 hemiparetic stroke patients each underwent a 6 week , twice daily gait training program . The control group participated in a conventional physical therapy gait program . The experimental group trained in the same basic program with the addition of rhythmic auditory stimulation ( RAS ) .  Patients entered the study as soon as they could complete 5 strides with h and -held assistance . The training program had to be completed within 3 months of the patients ' stroke . In the experimental group RAS was used as a timekeeper to synchronize step patterns and gradually entrain higher stride frequencies . Study groups were equated by gender , lesion site , and age . Motor function was assessed at pretest using Barthel , Fugl-Meyer , and Berg Scales . Walking patterns were assessed during pre- and post-test without RAS present . Pre- vs post-test measures revealed a statistically significant ( P<0.05 ) increase in velocity ( 164 % vs 107 % ) , stride length ( 88 % vs 34 % ) , and reduction in EMG amplitude variability of the gastrocnemius muscle ( 69 % vs 33 % ) for the RAS-training group compared to the control group . The difference in stride symmetry improvement ( 32 % in the RAS-group vs 16 % in the control group ) was statistically not significant . The data offer evidence that RAS is an efficient tool to enhance efforts in gait rehabilitation with acute stroke patients Guidelines in stroke rehabilitation recommend the use of a multidisciplinary approach . Different approaches and techniques with music are used in the stroke rehabilitation to improve motor and cognitive functions but also psychological outcomes . In this r and omized controlled pilot trial , relational active music therapy approaches were tested in the post-acute phase of disease . Thirty-eight hospitalized patients with ischemic and hemorrhagic stroke were recruited and allocated in two groups . The experimental group underwent the st and ard of care ( physiotherapy and occupational therapy daily sessions ) and relational active music therapy treatments . The control group underwent the st and ard of care only .  Motor functions and psychological aspects were assessed before and after treatments . Music therapy process was also evaluated using a specific rating scale . All groups showed a positive trend in quality of life , functional and disability levels , and gross mobility . The experimental group showed a decrease of anxiety and , in particular , of depression ( p = 0.016 ) . In addition , the strength of non-dominant h and ( grip ) significantly increased in the experimental group ( p = 0.041 ) . Music therapy assessment showed a significant improvement over time of non-verbal and sonorous-music relationships . Future studies , including a greater number of patients and follow-up evaluations , are needed to confirm promising results of this study In previous studies , it was shown that there is a need for efficient motor rehabilitation approaches . For this purpose , we evaluated a music-supported training program design ed to induce an auditory – sensorimotor co-representation of movements in 20 stroke patients ( 10 affected in the left and 10 in the right upper extremity ) . Patients without any previous musical experience participated in an intensive step by step training , first of the paretic extremity , followed by training of both extremities . Training was applied 15 times over 3 weeks in addition to conventional treatment . Fine as well as gross motor skills were addressed by using either a MIDI-piano or electronic drum pads . As a control , 20 stroke patients ( 10 affected left and 10 right ) undergoing exclusively conventional therapies were recruited . Assignment to the training and control groups was done pseudo-r and omly to achieve an equal number of left- and right-affected patients in each group . Pre- and post-treatment motor functions were monitored using a computerized movement analysis system ( Zebris ) and an established array of motor tests ( e. g. , Action Research Arm Test , Box & Block Test ) . Patients showed significant improvement after treatment with respect to speed , precision and smoothness of movements as shown by 3D movement analysis and clinical motor tests . Furthermore , compared to the control subjects , motor control in everyday activities improved significantly . In conclusion , this innovative therapeutic strategy is an effective approach for the motor skill neurorehabilitation of stroke patients [ Purpose ] The purpose of this study was to determine if an inclined treadmill with rhythmic auditory stimulation gait training can improve balance and gait ability in stroke patients . [ Subjects and Methods ] Thirty participants were r and omly divided into three groups : inclined treadmill with rhythmic auditory stimulation training group ( n=10 ) , inclined treadmill training group ( n=10 ) , and treadmill training group ( n=10 ) . For all groups , the training was conducted for 4 weeks , 30 minutes per session , 5 times per week . Two subjects dropped out before study completion . [ Results ] All variables of balance and gait , except for the timed up and go test in the treadmill group , significantly improved in all groups . Moreover , all variables showed a more significant improvement in the inclined treadmill with rhythmic auditory stimulation group when compared with the other groups . Timed up and go test , Berg balance scale , 6 m walking test , walking speed , and symmetric index were significantly improved in the inclined treadmill group when compared with the treadmill group . [ Conclusion ] Thus , for stroke patients receiving gait training , inclined treadmill with rhythmic auditory stimulation training was more effective in maintaining balance and gait than inclined treadmill without rhythmic auditory stimulation or only treadmill training Purpose To investigate the effects of music therapy on depressive mood and anxiety in post-stroke patients and evaluate satisfaction levels of patients and caregivers . Material s and Methods Eighteen post-stroke patients , within six months of onset and mini mental status examination score of over 20 , participated in this study . Patients were divided into music and control groups . The experimental group participated in the music therapy program for four weeks . Psychological status was evaluated with the Beck Anxiety Inventory ( BAI ) and Beck Depression Inventory ( BDI ) before and after music therapy . Satisfaction with music therapy was evaluated by a question naire . Results BAI and BDI scores showed a greater decrease in the music group than the control group after music therapy , but only the decrease of BDI scores were statistically significant ( p=0.048 ) . Music therapy satisfaction in patients and caregivers was affirmative . Conclusion Music therapy has a positive effect on mood in post-stroke patients and may be beneficial for mood improvement with stroke . These results are encouraging , but further studies are needed in this field We know from animal studies that a stimulating and enriched environment can enhance recovery after stroke , but little is known about the effects of an enriched sound environment on recovery from neural damage in humans . In humans , music listening activates a wide-spread bilateral network of brain regions related to attention , semantic processing , memory , motor functions , and emotional processing .  Music exposure also enhances emotional and cognitive functioning in healthy subjects and in various clinical patient groups . The potential role of music in neurological rehabilitation , however , has not been systematic ally investigated . This single-blind , r and omized , and controlled trial was design ed to determine whether everyday music listening can facilitate the recovery of cognitive functions and mood after stroke . In the acute recovery phase , 60 patients with a left or right hemisphere middle cerebral artery ( MCA ) stroke were r and omly assigned to a music group , a language group , or a control group . During the following two months , the music and language groups listened daily to self-selected music or audio books , respectively , while the control group received no listening material . In addition , all patients received st and ard medical care and rehabilitation . All patients underwent an extensive neuropsychological assessment , which included a wide range of cognitive tests as well as mood and quality of life question naires , one week ( baseline ) , 3 months , and 6 months after the stroke . Fifty-four patients completed the study . Results showed that recovery in the domains of verbal memory and focused attention improved significantly more in the music group than in the language and control groups . The music group also experienced less depressed and confused mood than the control group . These findings demonstrate for the first time that music listening during the early post-stroke stage can enhance cognitive recovery and prevent negative mood . The neural mechanisms potentially underlying these effects are discussed OBJECTIVE Positive results have been reported with melodic intonation therapy ( MIT ) in nonfluent aphasia patients with damage to their left-brain speech processes , using the patient 's intact ability to sing to promote functional language . This pilot study sought to determine the immediate effects of introducing modified melodic intonation therapy ( MMIT ) , a modification of MIT , as an early intervention in stroke patients presenting with Broca 's aphasia . METHOD After a r and omized controlled single-blind design , 30 acute stroke survivors with nonfluent aphasia were r and omly assigned to receive MIT treatment or no treatment . A pre/post test , based on the responsive and repetition subsections of the Western Aphasia Battery , was developed for this study . RESULTS After 1 session , a significant within-subject change was observed for the treatment group 's adjusted total score ( p = .02 ) , and a significant difference between groups was found for adjusted total score ( p = .02 ) favoring the treatment group . The treatment group also showed a significant change in their responsive subsection scores ( p = .01 ) when their pre-tests from Visit 1 to Visit 2 were compared , whereas the control group showed no change , suggesting a possible carry-over effect of MIT treatment . CONCLUSION This study provides preliminary data supporting the possible benefits of utilizing MMIT treatment early in the recovery of nonfluent aphasia patients Aim of the study : The aim of this research is to evaluate the effects of active music therapy ( MT ) based on free-improvisation ( relational approach ) in addition to speech language therapy ( SLT ) compared with SLT alone ( communicative-pragmatic approach : Promoting Aphasic 's Communicative Effectiveness ) in stroke patients with chronic aphasia . Material s and methods : The experimental group ( n = 10 ) was r and omized to 30 MT individual sessions over 15 weeks in addition to 30  SLT individual sessions while the control group ( n = 10 ) was r and omized to only 30  SLT sessions during the same period . Psychological and speech language assessment were made before ( T0 ) and after ( T1 ) the treatments . Results : The study shows a significant improvement in spontaneous speech in the experimental group ( Aachener Aphasie subtest : p = 0.020 ; Cohen 's d = 0.35 ) ; the 50 % of the experimental group showed also an improvement in vitality scores of Short Form Health Survey ( chi-square test = 4.114 ; p = 0.043 ) . Conclusions : The current trial highlights the possibility that the combined use of MT and SLT can lead to a better result in the rehabilitation of patients with aphasia than SLT alone Many countries lack effective community-based rehabilitation programs despite the increasing numbers of stroke survivors . Therefore , we have conducted a pilot investigation in South Korea of a newly constructed community-based intervention program combining rhythmic music and specialized rehabilitation movement . The 8-week program was based on rhythmic auditory stimulation ( RAS ) theory , which uses rhythm to enhance stroke survivors ' movements . Thirty-three stroke survivors were r and omized into one of two groups : The experimental group ( n = 16 ) carried out an 8-week RAS music-movement exercise intervention ; the control group  ( n = 17 ) received referral information about available usual care services . Participants in the experimental group gained a wider range of motion and flexibility , had more positive moods , and reported increased frequency and quality of interpersonal relationships Adults aged 55 to 80 years participated voluntarily in a wait-list control study during in-patient physical therapy following first stroke . All participants ( N = 15 ) received conventional physical therapy gait training throughout 30 treatment sessions . Rhythmic auditory stimulation (RAS)-enhanced gait training was nested within conventional treatments in three conditions : ( 1 ) RAS throughout 30 treatments ( N = 5 ) ; ( 2 ) RAS in the last 20 treatments ( N = 5 ) ; and ( 3 ) RAS in the last 10 treatments ( N = 5 ) . Cadence and balance outcome measurements were taken at baseline , and following 10 , 20 , and 30 treatment sessions . Improvements across time were statistically significant in all conditions for one-limb stance , cadence , velocity , stride length , and posture head tilt with no statistically significant improvements for the Timed Up and Go Test and the Functional Reach Test . Statistically significant gains were made in the one-limb stance and cadence with earlier implementations of RAS . Results of the study demonstrate the feasibility of RAS to enhance gait training that warrants further investigation of the protocol to demonstrate the effects of RAS in stroke rehabilitation Patients with left-sided visual neglect fail to copy the left part of drawings or the drawings on the left side of a sheet of paper . Our aim was to study the variations in copying drawings induced by passive stimulation in patients with left-sided visual neglect .  No stimulation at all , tactile unilateral and bilateral , binaural auditory verbal , and nonverbal stimuli were r and omly applied to 14 patients with right-hemisphere strokes . Only nonverbal stimuli decreased the neglect . As nonverbal stimuli mainly activate the right hemisphere , the decrease in neglect suggests right-hemispheric hypoactivity at rest in these patients . The absence of modification of neglect during verbal stimulation suggests a bilateral hemispheric activation and the persistence of interhemispheric imbalance . Our results showed that auditory pathways take part in the network involved with neglect . Passive nonverbal auditory stimuli may be of interest in the rehabilitation of patients with left visual neglect The purpose of this study was to determine the effects of music therapy on pain perception of stroke patients during upper extremity joint exercises . Ten stroke patients ( 1 male and 9 females ) ranging in age from 61 to 73 participated in the study . Music conditions used in the study consisted of : ( a ) song , ( b ) karaoke accompaniment ( same music to condition A except singers ' voices ) , and ( c ) no music . Exercise movements in 
    Output:
    