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 evaluate the effect of hippotherapy ( physical therapy utilizing the movement of a horse ) on muscle activity in children with spastic cerebral palsy . DESIGN Pretest/post-test control group . SETTING /LOCATION Therapeutic Riding of Tucson ( TROT ) , Tucson , AZ . SUBJECTS Fifteen ( 15 ) children ranging from 4 to 12 years of age diagnosed with spastic cerebral palsy . INTERVENTIONS Children meeting inclusion criteria were r and omized to either 8 minutes of hippotherapy or 8 minutes astride a stationary barrel . OUTCOME MEASURES Remote surface electromyography ( EMG ) was used to measure muscle activity of the trunk and upper legs during sitting , st and ing , and walking tasks before and after each intervention . RESULTS After hippotherapy , significant improvement in symmetry of muscle activity was noted in those muscle groups displaying the highest asymmetry prior to hippotherapy . No significant change was noted after sitting astride a barrel . CONCLUSIONS Eight minutes of hippotherapy , but not stationary sitting astride a barrel , result ed in improved symmetry in muscle activity in children with spastic cerebral palsy . These results suggest that the movement of the horse rather than passive stretching accounts for the measured improvements The aim of the present study was to examine the effects of balance training with visual feedback on stance and gait in school-age children with hemiplegic cerebral palsy . Ten participants between 5 and 11 years of age were assigned to either the training or the control group according to an aged-stratified r and omization . The training corresponded to three sessions per week during six weeks . Stance and gait parameters- based on force plate data , were assessed three times in both groups : ( a ) at the beginning of the study ( before training ) ; ( b ) after six weeks ; ( c ) after ten weeks . Spatial and temporal parameters were calculated . The results for stance showed that the training improved the performances on the tasks that were trained . More interesting , the results for gait showed that the walking pattern became more symmetrical after the training Legislatively m and ated programs for early intervention on behalf of h and icapped infants often stipulate the inclusion of physical therapy as a major component of treatment for cerebral palsy . To evaluate the effects of physical therapy , we r and omly assigned 48 infants ( 12 to 19 months of age ) with mild to severe spastic diplegia to receive either 12 months of physical therapy ( Group A ) or 6 months of physical therapy preceded by 6 months of infant stimulation ( Group B ) . The infant-stimulation program included motor , sensory , language , and cognitive activities of increasing complexity . Masked outcome assessment was performed after both 6 and 12 months of therapy to evaluate motor quotient , motor ability , and mental quotient . After six months , the infants in Group A had a lower mean motor quotient than those in Group B ( 49.1 vs. 58.1 , P = 0.02 ) and were less likely to walk ( 12 vs. 35 percent , P = 0.07 ) . These differences persisted after 12 months of therapy ( 47.9 vs. 63.3 , P less than 0.01 , and 36 vs. 73 percent , P = 0.01 , respectively ) . We noted no significant differences between the groups in the incidence of contractures or the need for bracing or orthopedic surgery . Group A also had a lower mean mental quotient than Group B after six months of therapy ( 65.6 vs. 75.5 , P = 0.05 ) . The routine use of physical therapy in infants with spastic diplegia offered no short-term advantage over infant stimulation . Because of the limited scope of the trial , our conclusions favoring infant stimulation are preliminary . The results suggest that further study of the effects of both physical therapy and infant stimulation is indicated Objective : To evaluate the impact of an eight-week strength training program targeting multiple muscle groups using basic inexpensive free weights and resistance devices , on gait and perceptions of body image and functional competence . Design : A r and omized control trial . Setting : A school for children with special needs in a disadvantaged suburb in Cape Town . Subjects : Thirty-one independently ambulant senior learners with spastic cerebral palsy ( 19 males , 12 females ; aged 13 - 18 years ; 15 diplegics and 16 hemiplegics ) . Intervention : Eight-week strength training programme in circuit format executed during school hours , one to three times per week for 40 - 60 min per session . Programmes were individually design ed and included 8 - 12 exercises selected from a 28-station circuit to target upper and lower limbs and trunk . Twenty-one subjects took part in the strength training programme and were compared with 10 control subjects . Main outcome measures : Three-dimensional gait analysis and a question naire were used to evaluate the various parameters of gait and perceptions of body image and functional competence respectively . Results were analysed using repeated measures ANOVA and bootstrap analysis . Results : The experimental group differed significantly from the control group for measure of crouch gait ( sum of the ankle , knee and hip angles at midstance ) ( P = 0.05 ) and perceptions of body image ( P = 0.01 ) . Walking velocity , cadence and stride length as well as perceptions of functional ability did not change significantly after training . Conclusion : Participation in a school-based strength training programme targeting multiple muscle groups can lead to improved degree of crouch gait and improve perception of body image This study aim ed to determine whether motor function and performance is better enhanced by intensive physiotherapy or collaborative goal - setting in children with cerebral palsy ( CP ) . Participants were a convenience sample of 56 children with bilateral CP classified at level III or below on the Gross Motor Function Classification System ( GMFCS ) , aged between 3 and 12 years . A 2 x 2 factorial design was used to compare the effects of routine amounts of physiotherapy with intensive amounts , and to compare the use of generalized aims set by the child 's physiotherapist with the use of specific , measurable goals negotiated by the child 's physiotherapist with each child , carer , and teacher . Following the six-month treatment period there was a further six-month period of observation . Changes in motor function and performance were assessed by a masked assessor using the Gross Motor Function Measure ( GMFM ) and the Gross Motor Performance Measure ( GMPM ) at three-month intervals . There was no statistically significant difference in the scores achieved between intensive and routine amounts of therapy or between aim -directed and goal -directed therapy  in either function or performance . Inclusion of additional covariates of age and severity levels showed a trend towards a statistically significant difference in children receiving intensive therapy during the treatment period . This advantage declined over the subsequent six months during which therapy had reverted to its usual amount . Differences in goal - setting procedures did not produce any detectable effect on the acquisition of gross motor function or performance This r and omized clinical trial evaluated the effects of a home-based , six-week strength-training programme on lower limb strength and physical activity of 21 young people ( 11 females , 10 males ; mean age 13 years 1 month , SD 3 years 1 month ; range 8 to 18 years ) with spastic diplegic cerebral palsy ( CP ) with independent ambulation , with or without gait aids ; ( Gross Motor Function Classification System levels I to III ) . Compared with the 10 controls , the 11 participants in the strength-training programme increased their lower limb strength ( combined ankle plantarflexor and knee extensor strength as measured by a h and -held dynamometer ) at 6 weeks ( F(1,19)=4.58 , p=0.046 ) and at a follow-up 12 weeks later ( F(1,18)=6.25 , p=0.041 ) . At 6 weeks , trends were also evident for improved scores in Gross Motor Function Measure dimensions D and E for st and ing , running and jumping , and faster stair climbing . A relatively short clinical ly feasible home-based training programme can lead to lasting changes in the strength of key lower-limb muscles that may impact on the daily function of young people with CP Purpose : This study was design ed to evaluate the effect of a home-based progressive resistance strength-training program on the self-concept of children with cerebral palsy . Methods : A r and omized , controlled trial was used to evaluate the effects of a six-week strength-training program on self-concept immediately after completion of the program ( week six ) and at a follow-up session held 18 weeks after the initial assessment . Seventeen children [ eight boys , nine girls ; mean age 12.1 years ( SD 2.5 ) ] with spastic diplegic cerebral palsy were recruited . Participants in the experimental group completed a home-based progressive resistance strength-training program using three exercises to strengthen the major support muscles of the lower limb . Participants in the control group undertook their normal daily activities .  Self-concept was measured by the Self-Perception Profile for Children . Results : Overall , the self-concept of both groups was positive at baseline and at six and 18 weeks . However , compared with controls , the experimental group showed decreased self-concept in the domain of scholastic competence and a trend for a decrease in social acceptance at six weeks . At follow-up , the experimental group had reduced self-concept in the domains of scholastic competence and social acceptance compared with the control group . Conclusion : These unexpected results suggest that participation in a relatively short home-based strength-training program may have an inhibitory effect on the self-concept of children with cerebral palsy . Despite the inhibitory effect , self-concept in the experimental group remained positive after strength training , suggesting that clinicians should not be overly concerned about the psychological effects of the intervention Purpose : This study was planned to investigate the effects of individual and group approaches to sensory-perceptual-motor ( SPM ) training on children with cerebral palsy . Method : This study was carried out at the School of Physical Therapy and Rehabilitation of Hacettepe University , Occupational Therapy Unit . Forty-one children who were diagnosed as having spastic diplegic cerebral palsy by the Department of Paediatric Neurology of Hacettepe University were assessed . Forty-one children with cerebral palsy were r and omly divided into three groups . Individual and group SPM training were given to first group ( IND ) ( n 16 ) and second group ( GRP ) ( n 16 ) respectively . The third group was determined as a control group ( n 9 ) and only the home programme was given . All children were evaluated with Ayres Southern California Sensory Integration Test and Physical Ability Test before and after training . The SPM training programmes were applied for 1.5 hours , 3 days per week for 3 months . Results : Estimates of effect sizes were calculated for group , individual and control treatments . Results indicated that both group and individual treatments had a measurable effect that was consistently greater than that of controls . Conclusions : This study shows that programmes of SPM training in individuals and group treatments affect children with cerebral palsy . It was concluded that SPM training in children with cerebral palsy will be applied to combined programmes and the relationship with individual and group treatments developed Forty-four children aged 3 to 11 years with quadriplegic cerebral palsy were prospect ively stratified and r and omised into four treatment groups . The acquisition of motor skills was assessed in a 2 x 2 factorial design using the Gross Motor Function Measure . The two factors were conventional amounts of physiotherapy vs intensive amounts of physiotherapy , and the use of broad , generalised aims vs the use of specific measurable goals directed at motor skill acquisition . 82 % of the children improved . Over the two-week period , intensive physiotherapy produced a slightly greater effect than conventional physiotherapy but the factor more strongly associated with increased motor skill acquisition was the use of specific measurable goals This study compared the efficacy of Adeli suit treatment ( AST ) with neurodevelopmental treatment ( NDT ) in children with cerebral palsy ( CP ) . Twenty-four children with CP , Levels II to IV according to the Gross Motor Function Classification System ( GMFCS ) , were matched by age and functional status and r and omly assigned to the AST or  NDT treatment groups . In the AST group ( n=12 ; eight males , four females ; mean age 8.3 y [ SD 2.0 ] ) , six children had spastic/ataxic diplegia , one triplegia and five spastic/mixed quadriplegia . In the NDT group ( n=12 ; nine males , three females ; mean age 8.1 y [ SD 2.2 ] ) , five children had spastic diplegia and seven had spastic/mixed quadriplegia . Both groups were treated for 4 weeks ( 2 hours daily , 5 days per week , 20 sessions ) . To compare treatments , the Gross Motor Function Measure ( GMFM-66 ) and the mechanical efficiency index ( EIHB ) during stair-climbing were measured at baseline , immediately after 1 month of treatment , and 10 months after baseline . The small but significant time effects for GMFM-66 and EIHB that were noted after 1 month of both intensive physiotherapy courses were greater than expected from natural maturation of children with CP at this age . Improvements in motor skills and their retention 9 months after treatment were not significantly different between the two treatment modes . Post hoc analysis indicated a greater increase in EIHB after 1 month ( p=0.16 ) and 10 months ( p=0.004 ) in AST than that in NDT , predominantly in the children with higher motor function ( GMFCS Levels II and III ) . The results suggest that AST might improve mechanical efficiency without a corresponding gain in gross motor skills , especially in children with higher levels of motor function OBJECTIVE Constraint-Induced Movement ( CI ) therapy has been found to be a promising treatment for substantially increasing the use of extremities affected by such neurologic injuries as stroke and traumatic brain injury in adults . The 
    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 evaluate the effect of hippotherapy ( physical therapy utilizing the movement of a horse ) on muscle activity in children with spastic cerebral palsy . DESIGN Pretest/post-test control group . SETTING /LOCATION Therapeutic Riding of Tucson ( TROT ) , Tucson , AZ . SUBJECTS Fifteen ( 15 ) children ranging from 4 to 12 years of age diagnosed with spastic cerebral palsy . INTERVENTIONS Children meeting inclusion criteria were r and omized to either 8 minutes of hippotherapy or 8 minutes astride a stationary barrel . OUTCOME MEASURES Remote surface electromyography ( EMG ) was used to measure muscle activity of the trunk and upper legs during sitting , st and ing , and walking tasks before and after each intervention . RESULTS After hippotherapy , significant improvement in symmetry of muscle activity was noted in those muscle groups displaying the highest asymmetry prior to hippotherapy . No significant change was noted after sitting astride a barrel . CONCLUSIONS Eight minutes of hippotherapy , but not stationary sitting astride a barrel , result ed in improved symmetry in muscle activity in children with spastic cerebral palsy . These results suggest that the movement of the horse rather than passive stretching accounts for the measured improvements The aim of the present study was to examine the effects of balance training with visual feedback on stance and gait in school-age children with hemiplegic cerebral palsy . Ten participants between 5 and 11 years of age were assigned to either the training or the control group according to an aged-stratified r and omization . The training corresponded to three sessions per week during six weeks . Stance and gait parameters- based on force plate data , were assessed three times in both groups : ( a ) at the beginning of the study ( before training ) ; ( b ) after six weeks ; ( c ) after ten weeks . Spatial and temporal parameters were calculated . The results for stance showed that the training improved the performances on the tasks that were trained . More interesting , the results for gait showed that the walking pattern became more symmetrical after the training Legislatively m and ated programs for early intervention on behalf of h and icapped infants often stipulate the inclusion of physical therapy as a major component of treatment for cerebral palsy . To evaluate the effects of physical therapy , we r and omly assigned 48 infants ( 12 to 19 months of age ) with mild to severe spastic diplegia to receive either 12 months of physical therapy ( Group A ) or 6 months of physical therapy preceded by 6 months of infant stimulation ( Group B ) . The infant-stimulation program included motor , sensory , language , and cognitive activities of increasing complexity . Masked outcome assessment was performed after both 6 and 12 months of therapy to evaluate motor quotient , motor ability , and mental quotient . After six months , the infants in Group A had a lower mean motor quotient than those in Group B ( 49.1 vs. 58.1 , P = 0.02 ) and were less likely to walk ( 12 vs. 35 percent , P = 0.07 ) . These differences persisted after 12 months of therapy ( 47.9 vs. 63.3 , P less than 0.01 , and 36 vs. 73 percent , P = 0.01 , respectively ) . We noted no significant differences between the groups in the incidence of contractures or the need for bracing or orthopedic surgery . Group A also had a lower mean mental quotient than Group B after six months of therapy ( 65.6 vs. 75.5 , P = 0.05 ) . The routine use of physical therapy in infants with spastic diplegia offered no short-term advantage over infant stimulation . Because of the limited scope of the trial , our conclusions favoring infant stimulation are preliminary . The results suggest that further study of the effects of both physical therapy and infant stimulation is indicated Objective : To evaluate the impact of an eight-week strength training program targeting multiple muscle groups using basic inexpensive free weights and resistance devices , on gait and perceptions of body image and functional competence . Design : A r and omized control trial . Setting : A school for children with special needs in a disadvantaged suburb in Cape Town . Subjects : Thirty-one independently ambulant senior learners with spastic cerebral palsy ( 19 males , 12 females ; aged 13 - 18 years ; 15 diplegics and 16 hemiplegics ) . Intervention : Eight-week strength training programme in circuit format executed during school hours , one to three times per week for 40 - 60 min per session . Programmes were individually design ed and included 8 - 12 exercises selected from a 28-station circuit to target upper and lower limbs and trunk . Twenty-one subjects took part in the strength training programme and were compared with 10 control subjects . Main outcome measures : Three-dimensional gait analysis and a question naire were used to evaluate the various parameters of gait and perceptions of body image and functional competence respectively . Results were analysed using repeated measures ANOVA and bootstrap analysis . Results : The experimental group differed significantly from the control group for measure of crouch gait ( sum of the ankle , knee and hip angles at midstance ) ( P = 0.05 ) and perceptions of body image ( P = 0.01 ) . Walking velocity , cadence and stride length as well as perceptions of functional ability did not change significantly after training . Conclusion : Participation in a school-based strength training programme targeting multiple muscle groups can lead to improved degree of crouch gait and improve perception of body image This study aim ed to determine whether motor function and performance is better enhanced by intensive physiotherapy or collaborative goal - setting in children with cerebral palsy ( CP ) . Participants were a convenience sample of 56 children with bilateral CP classified at level III or below on the Gross Motor Function Classification System ( GMFCS ) , aged between 3 and 12 years . A 2 x 2 factorial design was used to compare the effects of routine amounts of physiotherapy with intensive amounts , and to compare the use of generalized aims set by the child 's physiotherapist with the use of specific , measurable goals negotiated by the child 's physiotherapist with each child , carer , and teacher . Following the six-month treatment period there was a further six-month period of observation . Changes in motor function and performance were assessed by a masked assessor using the Gross Motor Function Measure ( GMFM ) and the Gross Motor Performance Measure ( GMPM ) at three-month intervals . There was no statistically significant difference in the scores achieved between intensive and routine amounts of therapy or between aim -directed and goal -directed therapy  in either function or performance . Inclusion of additional covariates of age and severity levels showed a trend towards a statistically significant difference in children receiving intensive therapy during the treatment period . This advantage declined over the subsequent six months during which therapy had reverted to its usual amount . Differences in goal - setting procedures did not produce any detectable effect on the acquisition of gross motor function or performance This r and omized clinical trial evaluated the effects of a home-based , six-week strength-training programme on lower limb strength and physical activity of 21 young people ( 11 females , 10 males ; mean age 13 years 1 month , SD 3 years 1 month ; range 8 to 18 years ) with spastic diplegic cerebral palsy ( CP ) with independent ambulation , with or without gait aids ; ( Gross Motor Function Classification System levels I to III ) . Compared with the 10 controls , the 11 participants in the strength-training programme increased their lower limb strength ( combined ankle plantarflexor and knee extensor strength as measured by a h and -held dynamometer ) at 6 weeks ( F(1,19)=4.58 , p=0.046 ) and at a follow-up 12 weeks later ( F(1,18)=6.25 , p=0.041 ) . At 6 weeks , trends were also evident for improved scores in Gross Motor Function Measure dimensions D and E for st and ing , running and jumping , and faster stair climbing . A relatively short clinical ly feasible home-based training programme can lead to lasting changes in the strength of key lower-limb muscles that may impact on the daily function of young people with CP Purpose : This study was design ed to evaluate the effect of a home-based progressive resistance strength-training program on the self-concept of children with cerebral palsy . Methods : A r and omized , controlled trial was used to evaluate the effects of a six-week strength-training program on self-concept immediately after completion of the program ( week six ) and at a follow-up session held 18 weeks after the initial assessment . Seventeen children [ eight boys , nine girls ; mean age 12.1 years ( SD 2.5 ) ] with spastic diplegic cerebral palsy were recruited . Participants in the experimental group completed a home-based progressive resistance strength-training program using three exercises to strengthen the major support muscles of the lower limb . Participants in the control group undertook their normal daily activities .  Self-concept was measured by the Self-Perception Profile for Children . Results : Overall , the self-concept of both groups was positive at baseline and at six and 18 weeks . However , compared with controls , the experimental group showed decreased self-concept in the domain of scholastic competence and a trend for a decrease in social acceptance at six weeks . At follow-up , the experimental group had reduced self-concept in the domains of scholastic competence and social acceptance compared with the control group . Conclusion : These unexpected results suggest that participation in a relatively short home-based strength-training program may have an inhibitory effect on the self-concept of children with cerebral palsy . Despite the inhibitory effect , self-concept in the experimental group remained positive after strength training , suggesting that clinicians should not be overly concerned about the psychological effects of the intervention Purpose : This study was planned to investigate the effects of individual and group approaches to sensory-perceptual-motor ( SPM ) training on children with cerebral palsy . Method : This study was carried out at the School of Physical Therapy and Rehabilitation of Hacettepe University , Occupational Therapy Unit . Forty-one children who were diagnosed as having spastic diplegic cerebral palsy by the Department of Paediatric Neurology of Hacettepe University were assessed . Forty-one children with cerebral palsy were r and omly divided into three groups . Individual and group SPM training were given to first group ( IND ) ( n 16 ) and second group ( GRP ) ( n 16 ) respectively . The third group was determined as a control group ( n 9 ) and only the home programme was given . All children were evaluated with Ayres Southern California Sensory Integration Test and Physical Ability Test before and after training . The SPM training programmes were applied for 1.5 hours , 3 days per week for 3 months . Results : Estimates of effect sizes were calculated for group , individual and control treatments . Results indicated that both group and individual treatments had a measurable effect that was consistently greater than that of controls . Conclusions : This study shows that programmes of SPM training in individuals and group treatments affect children with cerebral palsy . It was concluded that SPM training in children with cerebral palsy will be applied to combined programmes and the relationship with individual and group treatments developed Forty-four children aged 3 to 11 years with quadriplegic cerebral palsy were prospect ively stratified and r and omised into four treatment groups . The acquisition of motor skills was assessed in a 2 x 2 factorial design using the Gross Motor Function Measure . The two factors were conventional amounts of physiotherapy vs intensive amounts of physiotherapy , and the use of broad , generalised aims vs the use of specific measurable goals directed at motor skill acquisition . 82 % of the children improved . Over the two-week period , intensive physiotherapy produced a slightly greater effect than conventional physiotherapy but the factor more strongly associated with increased motor skill acquisition was the use of specific measurable goals This study compared the efficacy of Adeli suit treatment ( AST ) with neurodevelopmental treatment ( NDT ) in children with cerebral palsy ( CP ) . Twenty-four children with CP , Levels II to IV according to the Gross Motor Function Classification System ( GMFCS ) , were matched by age and functional status and r and omly assigned to the AST or  NDT treatment groups . In the AST group ( n=12 ; eight males , four females ; mean age 8.3 y [ SD 2.0 ] ) , six children had spastic/ataxic diplegia , one triplegia and five spastic/mixed quadriplegia . In the NDT group ( n=12 ; nine males , three females ; mean age 8.1 y [ SD 2.2 ] ) , five children had spastic diplegia and seven had spastic/mixed quadriplegia . Both groups were treated for 4 weeks ( 2 hours daily , 5 days per week , 20 sessions ) . To compare treatments , the Gross Motor Function Measure ( GMFM-66 ) and the mechanical efficiency index ( EIHB ) during stair-climbing were measured at baseline , immediately after 1 month of treatment , and 10 months after baseline . The small but significant time effects for GMFM-66 and EIHB that were noted after 1 month of both intensive physiotherapy courses were greater than expected from natural maturation of children with CP at this age . Improvements in motor skills and their retention 9 months after treatment were not significantly different between the two treatment modes . Post hoc analysis indicated a greater increase in EIHB after 1 month ( p=0.16 ) and 10 months ( p=0.004 ) in AST than that in NDT , predominantly in the children with higher motor function ( GMFCS Levels II and III ) . The results suggest that AST might improve mechanical efficiency without a corresponding gain in gross motor skills , especially in children with higher levels of motor function OBJECTIVE Constraint-Induced Movement ( CI ) therapy has been found to be a promising treatment for substantially increasing the use of extremities affected by such neurologic injuries as stroke and traumatic brain injury in adults . The 
    Output:
    