human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND : Regular aerobic exercise in patients with cystic fibrosis ( CF ) improves aerobic conditioning and delays disease progression , result ing in better quality of life . The purpose of this study was to evaluate the effect of an aerobic exercise program based on verbal and written guidelines on maximum exercise capacity using a cardiopulmonary exercise test , quality of life , and the self-reported aerobic exercise practice of children and adolescents with CF . METHODS : This r and omized controlled trial followed guidelines for physical exercise in a CF center . Subjects were assigned to 2 groups : intervention ( group 1 ) , with 17 subjects ; and control ( group 2 ) , also with 17 subjects . Data were collected from October 2010 to October 2011 , and the study population comprised 7–20-y-old children and adolescents with CF . The intervention consisted of h and ing out a manual with guidelines for aerobic physical exercises and reinforcing recommendations in telephone calls every 2 weeks . RESULTS : Thirty-four subjects were included in the study , 20 of whom were boys ( 58.5 % ) . The groups were similar at baseline . In group 1 , 6 subjects ( 35.2 % ) reported practicing physical exercises regularly . The mean age was 13.4 ± 2.8 y , the  mean percent-of-predicted FEV1 was 95.5 ± 17.9 % , and the mean peak oxygen uptake ( V̇O2 ) relative to body mass was 34.9 ± 9.0 mL/kg/min . In group 2 , 4 subjects ( 23.5 % ) reported practicing physical exercises regularly . The mean age was 12.7 ± 3.3 y , the mean percent-of-predicted FEV1 was 100.1 ± 21.2 % , and the mean peak V̇O2 was 33.2 ± 8.2 mL/kg/min . In group 1 , there was a significant increase in physical exercise practice as reported by subjects after 3 months of intervention compared with group 2 ( P = .01 ) . No statistically significant differences were found for the other variables . CONCLUSIONS : Verbal and written guidelines for aerobic exercise , together with supervision over the telephone , had a positive impact on the self-reported regular physical exercise practice of children and adolescents . However , no improvement was found in lung function and maximum exercise capacity or domains of the quality of life question naire Evidence -based practice involves the use of evidence from systematic review s and r and omised controlled trials , but the extent of this evidence in physiotherapy has not previously been surveyed . The aim of this survey is to describe the quantity and quality of r and omised controlled trials and the quantity of systematic review s relevant to physiotherapy . The Physiotherapy Evidence Data base ( PEDro ) was search ed . The quality of trials was assessed with the PEDro scale . The search identified a total of 2,376 r and omised controlled trials and 332 systematic review s. The first trial was published in 1955 and the first review was published in 1982 . Since that time , the number of trials and review s has grown exponentially . The mean PEDro quality score has increased from 2.8 in trials published between 1955 and 1959 to 5.0 for trials published between 1995 and 1999 . There is a substantial body of evidence about the effects of physiotherapy . However , there remains scope for improvements in the quality of the conduct and reporting of clinical trials CONTEXT Rates of  obesity  and other childhood chronic conditions  have increased over recent decades . Patterns of how conditions change over time have not been widely examined . OBJECTIVE To evaluate change in prevalence of obesity and other chronic conditions  in US children , including incidence , remission , and prevalence . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve study using the National Longitudinal Survey of Youth-Child Cohort ( 1988 - 2006 ) of 3 nationally representative cohorts of children . Children were aged 2 through 8 years at the beginning of each study period , and cohorts were followed up for 6 years , from 1988 to 1994 ( cohort 1 , n = 2337 ) , 1994 to 2000 ( cohort 2 , n = 1759 ) , and 2000 to 2006 ( n = 905 ) . MAIN OUTCOME MEASURES Parent report of a child having a health condition that limited activities or schooling or required medicine , special equipment , or specialized health services and that lasted at least 12 months . Obesity was defined as a body mass index at or above the 95th percentile for age . Chronic conditions were grouped into 4 categories : obesity , asthma , other physical conditions , and behavior/learning problems . RESULTS The end- study prevalence of any chronic health condition was 12.8 % ( 95 % confidence interval [ CI ] , 11.2%-14.5 % ) for cohort 1 in 1994 , 25.1 % ( 95 % CI , 22.7%-27.6 % ) for cohort 2 in 2000 , and 26.6 % ( 95 % CI , 23.5%-29.9 % ) for cohort 3 in 2006 . There was substantial turnover in chronic conditions : 7.4 % ( 95 % CI , 6.5%-8.3 % ) of participants in all cohorts had a chronic condition at the beginning of the study that persisted to the end , 9.3 % ( 95 % CI , 8.3%-10.3 % ) reported conditions at the beginning that resolved within 6 years , and 13.4 % ( 95 % CI , 12.3%-14.6 % ) had new conditions that arose during the 6-year study period . The prevalence of having a chronic condition during any part of the 6-year study period was highest for cohort 3 ( 51.5 % ; 95 % CI , 47.3%-55.0 % ) , and there were higher rates among male ( adjusted odds ratio [ AOR ] , 1.24 ; 95 % CI , 1.07 - 1.42 ) , Hispanic ( AOR , 1.36 ; 95 % CI , 1.11 - 1.67 ) , and black ( AOR , 1.60 ; 95 % CI , 1.35 - 1.90 ) youth . CONCLUSIONS Prevalence of chronic conditions among children and youth increased from 1988 to 2006 . However , presence of these conditions was dynamic over each 6-year cohort Little is known about the long-term persistence of positive effects induced by a physical conditioning programme in cystic fibrosis . Therefore , this study determined the effects of a 6-month conditioning programme on peak oxygen uptake ( primary outcome ) and other markers of fitness , physical activity , anthropometry , lung function and quality of life ( secondary outcomes ) , 18 and 24 months after the programme was initiated . Patients with cystic fibrosis aged 12–40 yrs were r and omly assigned to an  intervention ( n = 23 ) and a  control ( n = 15 ) group . The intervention group consented to add 3 h of sports per week for ≥6 months to their previous activities . Controls were asked to maintain their level of activity for 12 months . Patients were seen at baseline and after 3 , 6 , 12 , 18 and 24 months . There was no significant difference between groups at baseline . The intervention induced positive effects on peak oxygen uptake ( difference in changes from baseline to the 18- and 24-month assessment s between groups : 3.72±1.23 mL·min−1·kg−1 ; p<0.01 ) , maximal workload ( 0.37±0.11 W·kg−1 ; p<0.01 ) , vigorous physical activity ( 1.63±0.82 h·week−1 ; p<0.05 ) , forced vital capacity ( 6.06±2.87 % predicted ; p<0.05 ) and perceived health ( 9.89±4.72 ; p<0.05 ) . A home-based partially supervised physical conditioning programme  can improve physical fitness , lung function and perceived health long after the intervention has ended Few studies have been conducted on the effects of aerobic exercise in children with asthma , particularly on the inflammatory component and functional outcomes . This study evaluated the effect of aerobic exercise on inflammation , functional capacity , respiratory muscle strength , quality of life and symptoms scores in asthmatic children . This was a 6-week r and omized trial ( NCT0192052 ) of 33 moderately asthmatic children ( 6 - 17 years ) . Patients were r and omized aerobic training ( exercise group ; n = 14 ) , while another group did not exercise ( control ; n = 19 ) . Primary endpoint was evaluations serum cytokines ( IL-17 , IFN , TNF , IL-10 , IL-6 , IL-4 and IL-2 ) assessed by flow cytometry . The six-minute walk test , pulmonary function , quality of life and symptoms ( asthma-free days ) were secondary endpoint . The Mann-Whitney test was used to evaluate the independent variables and the Wilcoxon test for paired variables . The t-test was used for the remaining calculations . Significance was determined at 5 % . Aerobic training failed to modify the inflammatory component . In the exercise group , an increase occurred in functional capacity ( p < 0.01 ) and peak expiratory flow ( p = 0.002 ) , and maximal inspiratory ( p = 0.005 ) and expiratory pressure ( p < 0.01 ) improved . Furthermore , there was a significant increase in all the domains of the PAQLQ . The children who exercised had more asthma-free days than the controls ( p = 0.012 ) and less sensation of dyspnea at the end of the study ( p < 0.01 ) . In conclusion , six weeks of aerobic exercise no changes in plasma cytokine patterns in asthmatic children and adolescents ; however , an improvement was found in functional capacity , maximal respiratory pressure , quality of life and asthma-related symptoms . Clinical Trials.gov Identifier : NCT0192052 Abstract Objective : The objective of this study is to analyze the effects of a 12-week indoor intermittent training program on lung function , physical capacity , body composition and quality of life in children with asthma . Methods : Participants were r and omized in an experimental group ( EG , 58 children , age = 11.55 ± 1.01 years ) and in a control group ( CG , 47 children , age = 11.51 ± 1.42 years ) . The training program was conducted indoors and consisted of alternating high- and low-intensity stimuli , for three sessions of 60 min/week , for 12 weeks . Physical exercise and sports activities were organized to follow the criteria of the American College of Sports Medicine ( 1999 ) and previous interventions ’ studies . Results : In EG , there was a significant improvement ( p < 0.05 ) in FEV1 , FEV6 , 6MWT , h and grip strength , CMJ and flexibility . Reductions in BMI and fat mass as well as an increase in quality of life were all shown . The dyspnea index decreased significantly and there were no episodes of EIA . There is a significant positive correlation ( p < 0.01 ) between the ΔFEV1 with Δh and grip strength and Δ6MWT and a negative correlation with Δfat mass . Conclusions : An indoor intermittent training program with these characteristics has improved lung function , physical capacity , body composition and quality of life in children with asthma . These training adaptations are particularly relevant for those patients suffering from asthma as a regular physical exercise routine will greatly improve their quality of life OBJECTIVE To investigate the medium-term benefits of a swimming program in schoolchildren and adolescents with moderate persistent atopic asthma ( MPAA ) . METHODS A r and omized , prospect i ve study of children and adolescents ( age 7 - 18 years ) with MPAA was carried out at the Hospital de Clínicas of Universidade Estadual de Campinas ( UNICAMP ) , Campinas , Brazil . After a 1-month run-in period , 61 patients ( 34 female ) were r and omized into two groups , a swimming group ( n = 30 ) and a control group ( n = 31 ) , and followed for 3 months . Both patient groups received inhaled fluticasone ( dry powder , 250 mcg twice a day ) and salbutamol as needed . The swim training program consisted of two weekly classes over a 3-month period for a total of 24 sessions . Both groups underwent  spirometric assessment  and methacholine challenge test -- provocative concentration of methacholine causing a 20 % fall in FEV1 (PC₂₀)--before and after the study period . Maximal inspiratory pressure ( MIP ) and maximal expiratory pressure ( MEP ) were measured only in the swimming group . RESULTS Significant increases in PC₂₀ ( pre-training , 0.31±0.25 ; post-training , 0.63±0.78 ; p = 0.008 ) , MIP ( pre-training , 67.08±17.13 cm H₂O ; post-training 79.46±18.66 ; p < 0.001 ) , and MEP ( pre-training , 71.69±20.01 cm H₂O ; post-training , 78.92±21.45 cm H₂O ; p < 0.001 ) were found in the swimming group . CONCL 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND : Regular aerobic exercise in patients with cystic fibrosis ( CF ) improves aerobic conditioning and delays disease progression , result ing in better quality of life . The purpose of this study was to evaluate the effect of an aerobic exercise program based on verbal and written guidelines on maximum exercise capacity using a cardiopulmonary exercise test , quality of life , and the self-reported aerobic exercise practice of children and adolescents with CF . METHODS : This r and omized controlled trial followed guidelines for physical exercise in a CF center . Subjects were assigned to 2 groups : intervention ( group 1 ) , with 17 subjects ; and control ( group 2 ) , also with 17 subjects . Data were collected from October 2010 to October 2011 , and the study population comprised 7–20-y-old children and adolescents with CF . The intervention consisted of h and ing out a manual with guidelines for aerobic physical exercises and reinforcing recommendations in telephone calls every 2 weeks . RESULTS : Thirty-four subjects were included in the study , 20 of whom were boys ( 58.5 % ) . The groups were similar at baseline . In group 1 , 6 subjects ( 35.2 % ) reported practicing physical exercises regularly . The mean age was 13.4 ± 2.8 y , the  mean percent-of-predicted FEV1 was 95.5 ± 17.9 % , and the mean peak oxygen uptake ( V̇O2 ) relative to body mass was 34.9 ± 9.0 mL/kg/min . In group 2 , 4 subjects ( 23.5 % ) reported practicing physical exercises regularly . The mean age was 12.7 ± 3.3 y , the mean percent-of-predicted FEV1 was 100.1 ± 21.2 % , and the mean peak V̇O2 was 33.2 ± 8.2 mL/kg/min . In group 1 , there was a significant increase in physical exercise practice as reported by subjects after 3 months of intervention compared with group 2 ( P = .01 ) . No statistically significant differences were found for the other variables . CONCLUSIONS : Verbal and written guidelines for aerobic exercise , together with supervision over the telephone , had a positive impact on the self-reported regular physical exercise practice of children and adolescents . However , no improvement was found in lung function and maximum exercise capacity or domains of the quality of life question naire Evidence -based practice involves the use of evidence from systematic review s and r and omised controlled trials , but the extent of this evidence in physiotherapy has not previously been surveyed . The aim of this survey is to describe the quantity and quality of r and omised controlled trials and the quantity of systematic review s relevant to physiotherapy . The Physiotherapy Evidence Data base ( PEDro ) was search ed . The quality of trials was assessed with the PEDro scale . The search identified a total of 2,376 r and omised controlled trials and 332 systematic review s. The first trial was published in 1955 and the first review was published in 1982 . Since that time , the number of trials and review s has grown exponentially . The mean PEDro quality score has increased from 2.8 in trials published between 1955 and 1959 to 5.0 for trials published between 1995 and 1999 . There is a substantial body of evidence about the effects of physiotherapy . However , there remains scope for improvements in the quality of the conduct and reporting of clinical trials CONTEXT Rates of  obesity  and other childhood chronic conditions  have increased over recent decades . Patterns of how conditions change over time have not been widely examined . OBJECTIVE To evaluate change in prevalence of obesity and other chronic conditions  in US children , including incidence , remission , and prevalence . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve study using the National Longitudinal Survey of Youth-Child Cohort ( 1988 - 2006 ) of 3 nationally representative cohorts of children . Children were aged 2 through 8 years at the beginning of each study period , and cohorts were followed up for 6 years , from 1988 to 1994 ( cohort 1 , n = 2337 ) , 1994 to 2000 ( cohort 2 , n = 1759 ) , and 2000 to 2006 ( n = 905 ) . MAIN OUTCOME MEASURES Parent report of a child having a health condition that limited activities or schooling or required medicine , special equipment , or specialized health services and that lasted at least 12 months . Obesity was defined as a body mass index at or above the 95th percentile for age . Chronic conditions were grouped into 4 categories : obesity , asthma , other physical conditions , and behavior/learning problems . RESULTS The end- study prevalence of any chronic health condition was 12.8 % ( 95 % confidence interval [ CI ] , 11.2%-14.5 % ) for cohort 1 in 1994 , 25.1 % ( 95 % CI , 22.7%-27.6 % ) for cohort 2 in 2000 , and 26.6 % ( 95 % CI , 23.5%-29.9 % ) for cohort 3 in 2006 . There was substantial turnover in chronic conditions : 7.4 % ( 95 % CI , 6.5%-8.3 % ) of participants in all cohorts had a chronic condition at the beginning of the study that persisted to the end , 9.3 % ( 95 % CI , 8.3%-10.3 % ) reported conditions at the beginning that resolved within 6 years , and 13.4 % ( 95 % CI , 12.3%-14.6 % ) had new conditions that arose during the 6-year study period . The prevalence of having a chronic condition during any part of the 6-year study period was highest for cohort 3 ( 51.5 % ; 95 % CI , 47.3%-55.0 % ) , and there were higher rates among male ( adjusted odds ratio [ AOR ] , 1.24 ; 95 % CI , 1.07 - 1.42 ) , Hispanic ( AOR , 1.36 ; 95 % CI , 1.11 - 1.67 ) , and black ( AOR , 1.60 ; 95 % CI , 1.35 - 1.90 ) youth . CONCLUSIONS Prevalence of chronic conditions among children and youth increased from 1988 to 2006 . However , presence of these conditions was dynamic over each 6-year cohort Little is known about the long-term persistence of positive effects induced by a physical conditioning programme in cystic fibrosis . Therefore , this study determined the effects of a 6-month conditioning programme on peak oxygen uptake ( primary outcome ) and other markers of fitness , physical activity , anthropometry , lung function and quality of life ( secondary outcomes ) , 18 and 24 months after the programme was initiated . Patients with cystic fibrosis aged 12–40 yrs were r and omly assigned to an  intervention ( n = 23 ) and a  control ( n = 15 ) group . The intervention group consented to add 3 h of sports per week for ≥6 months to their previous activities . Controls were asked to maintain their level of activity for 12 months . Patients were seen at baseline and after 3 , 6 , 12 , 18 and 24 months . There was no significant difference between groups at baseline . The intervention induced positive effects on peak oxygen uptake ( difference in changes from baseline to the 18- and 24-month assessment s between groups : 3.72±1.23 mL·min−1·kg−1 ; p<0.01 ) , maximal workload ( 0.37±0.11 W·kg−1 ; p<0.01 ) , vigorous physical activity ( 1.63±0.82 h·week−1 ; p<0.05 ) , forced vital capacity ( 6.06±2.87 % predicted ; p<0.05 ) and perceived health ( 9.89±4.72 ; p<0.05 ) . A home-based partially supervised physical conditioning programme  can improve physical fitness , lung function and perceived health long after the intervention has ended Few studies have been conducted on the effects of aerobic exercise in children with asthma , particularly on the inflammatory component and functional outcomes . This study evaluated the effect of aerobic exercise on inflammation , functional capacity , respiratory muscle strength , quality of life and symptoms scores in asthmatic children . This was a 6-week r and omized trial ( NCT0192052 ) of 33 moderately asthmatic children ( 6 - 17 years ) . Patients were r and omized aerobic training ( exercise group ; n = 14 ) , while another group did not exercise ( control ; n = 19 ) . Primary endpoint was evaluations serum cytokines ( IL-17 , IFN , TNF , IL-10 , IL-6 , IL-4 and IL-2 ) assessed by flow cytometry . The six-minute walk test , pulmonary function , quality of life and symptoms ( asthma-free days ) were secondary endpoint . The Mann-Whitney test was used to evaluate the independent variables and the Wilcoxon test for paired variables . The t-test was used for the remaining calculations . Significance was determined at 5 % . Aerobic training failed to modify the inflammatory component . In the exercise group , an increase occurred in functional capacity ( p < 0.01 ) and peak expiratory flow ( p = 0.002 ) , and maximal inspiratory ( p = 0.005 ) and expiratory pressure ( p < 0.01 ) improved . Furthermore , there was a significant increase in all the domains of the PAQLQ . The children who exercised had more asthma-free days than the controls ( p = 0.012 ) and less sensation of dyspnea at the end of the study ( p < 0.01 ) . In conclusion , six weeks of aerobic exercise no changes in plasma cytokine patterns in asthmatic children and adolescents ; however , an improvement was found in functional capacity , maximal respiratory pressure , quality of life and asthma-related symptoms . Clinical Trials.gov Identifier : NCT0192052 Abstract Objective : The objective of this study is to analyze the effects of a 12-week indoor intermittent training program on lung function , physical capacity , body composition and quality of life in children with asthma . Methods : Participants were r and omized in an experimental group ( EG , 58 children , age = 11.55 ± 1.01 years ) and in a control group ( CG , 47 children , age = 11.51 ± 1.42 years ) . The training program was conducted indoors and consisted of alternating high- and low-intensity stimuli , for three sessions of 60 min/week , for 12 weeks . Physical exercise and sports activities were organized to follow the criteria of the American College of Sports Medicine ( 1999 ) and previous interventions ’ studies . Results : In EG , there was a significant improvement ( p < 0.05 ) in FEV1 , FEV6 , 6MWT , h and grip strength , CMJ and flexibility . Reductions in BMI and fat mass as well as an increase in quality of life were all shown . The dyspnea index decreased significantly and there were no episodes of EIA . There is a significant positive correlation ( p < 0.01 ) between the ΔFEV1 with Δh and grip strength and Δ6MWT and a negative correlation with Δfat mass . Conclusions : An indoor intermittent training program with these characteristics has improved lung function , physical capacity , body composition and quality of life in children with asthma . These training adaptations are particularly relevant for those patients suffering from asthma as a regular physical exercise routine will greatly improve their quality of life OBJECTIVE To investigate the medium-term benefits of a swimming program in schoolchildren and adolescents with moderate persistent atopic asthma ( MPAA ) . METHODS A r and omized , prospect i ve study of children and adolescents ( age 7 - 18 years ) with MPAA was carried out at the Hospital de Clínicas of Universidade Estadual de Campinas ( UNICAMP ) , Campinas , Brazil . After a 1-month run-in period , 61 patients ( 34 female ) were r and omized into two groups , a swimming group ( n = 30 ) and a control group ( n = 31 ) , and followed for 3 months . Both patient groups received inhaled fluticasone ( dry powder , 250 mcg twice a day ) and salbutamol as needed . The swim training program consisted of two weekly classes over a 3-month period for a total of 24 sessions . Both groups underwent  spirometric assessment  and methacholine challenge test -- provocative concentration of methacholine causing a 20 % fall in FEV1 (PC₂₀)--before and after the study period . Maximal inspiratory pressure ( MIP ) and maximal expiratory pressure ( MEP ) were measured only in the swimming group . RESULTS Significant increases in PC₂₀ ( pre-training , 0.31±0.25 ; post-training , 0.63±0.78 ; p = 0.008 ) , MIP ( pre-training , 67.08±17.13 cm H₂O ; post-training 79.46±18.66 ; p < 0.001 ) , and MEP ( pre-training , 71.69±20.01 cm H₂O ; post-training , 78.92±21.45 cm H₂O ; p < 0.001 ) were found in the swimming group . CONCL 
    Output:
    