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 The aims of this pilot study were the following : 1 ) to examine patterns of adherence to a brisk walking program in women receiving adjuvant chemotherapy or radiation therapy for newly diagnosed breast cancer using a prospect i ve , r and omized , controlled experimental design ; 2 ) to examine the influence of disease symptoms and treatment side effects on exercise levels ; and 3 ) to suggest methods that may improve future clinical trials of moderate-intensity exercise in similar population s. DESCRIPTION OF STUDY Fifty-two patients with newly diagnosed breast cancer were r and omly assigned to one of two treatment arms : usual care or usual care plus exercise . Those assigned to the exercise group received a st and ardized , self-administered , home-based brisk walking intervention in addition to usual care . Each day subjects completed self-report diary forms that elicited information about activity levels , and the occurrence of symptoms and side effects during cancer treatment . RESULTS Analyses of self-reported daily activity levels revealed a diffusion of treatment effect . Fifty percent of the usual-care group reported maintaining or increasing their physical activity to a moderate-intensity level , while 33 % of the exercise group did not exercise at the prescribed levels . Analyses of self-reported disease symptoms and treatment side effects did not reveal clinical ly meaningful differences between the two groups . CLINICAL IMPLICATION S The results of this study suggest that women who exercised regularly before receiving a breast cancer diagnosis attempted to maintain their exercise programs . Women who lead sedentary lifestyles may benefit from a structured exercise program that includes information and support related to exercise adherence strategies Background : This r and omized controlled trial assessed the safety and effects of twice-weekly weight training among recent breast cancer survivors . Outcomes included body size and biomarkers hypothesized to link exercise and breast cancer risk . Methods : A convenience sample of 85 recent survivors was r and omized into immediate and delayed treatment groups . The immediate group trained from months 0 to 12 ; the delayed treatment group served as a no exercise parallel comparison group from months 0 to 6 and trained from months 7 to 12 . Measures at baseline , 6 and 12 months included body weight , height , body fat , lean mass , body fat % , and waist circumference , as well as fasting glucose , insulin , insulin resistance , insulin-like growth factor-I ( IGF-I ) , IGF-II , and IGF-binding protein-1 , IGFBP-2 , and IGFBP-3 . Injury reporting was st and ardized . Results : The intervention result ed in significant increases in lean mass ( 0.88 versus 0.02 kg , P < 0.01 ) , as well as significant decreases in body fat % ( −1.15 % versus 0.23 % , P = 0.03 ) and IGF-II ( −6.23 versus 28.28 ng/mL , P = 0.02 ) comparing immediate with delayed treatment from baseline to 6 months . Within-person changes experienced by delayed treatment group participants during training versus no training were similar . Only one participant experienced a study related injury that prevented continued participation . Conclusion : Twice-weekly weight training is a safe exercise program for recent breast cancer survivors that may result in increased muscle mass , as well as decreased body fat % and IGF-II . The implication s of these results on cancer recurrence or survival may become more evident with longer exercise intervention trials among breast cancer survivors PURPOSE / OBJECTIVES To evaluate the effects of 10 weeks of aerobic exercise on depressive and anxiety symptoms and self-esteem of breast cancer survivors . DESIGN Experimental , crossover . SETTING Midwestern university town . SAMPLE Twenty-four breast cancer survivors ( mean time following surgery 41.8 months ; ranging from 1 to 99 months ) recruited via mail and cancer support groups . The mean age of the sample was 48.9 years . METHODS Subjects were assigned r and omly into exercise ( EX ) , exercise-plus-behavior modification ( EX + BM ) , and control groups . EX and EX + BM groups exercised aerobically four days/week at > or = 60 % of age-predicted maximum heart rate for 10 weeks . Data were collected pretest , post-test , and crossover ( 12 weeks following post-test ) . Because pretest or post-test scores showed no statistical differences between EX and EX + BM groups , data were combined to form one group . MAIN RESEARCH VARIABLES Aerobic exercise ( four days/ week ; 30 - 40 minutes/session ) , depression , ( Beck Depression inventory ) , anxiety ( Speilberger State-Trait Anxiety Inventory ) , and self-esteem ( Rosenberg Self-Esteem Inventory ) . FINDINGS Pre- to post-test analyses revealed that women who exercised had significantly less depression and state and trait anxiety over time compared to controls . After the crossover , the control group demonstrated comparable improvements in both depressive and state anxiety scores . Self-esteem did not change significantly . Subjects who received exercise recommendations from their physicians exercised significantly more than subjects who received no recommendation . CONCLUSIONS Mild to moderate aerobic exercise may be of therapeutic value to breast cancer survivors with respect to depressive and anxiety symptoms but not to self-esteem . A physician 's recommendation to exercise appears to be an important factor in a patient 's exercise adherence . IMPLICATION S FOR NURSING PRACTICE To Improve depressive and anxiety symptoms following breast cancer surgery , healthcare professionals should consider recommending mild to moderate exercise This pilot study examined the efficacy of two home-based exercise programs on alleviating fatigue and improving functional capacity in breast cancer survivors . Participants were r and omly assigned into one of three groups : aerobic exercise ( AE ) , resistance exercise ( RE ) , or usual care control ( CON ) . After receiving individualized instruction and training , participants assigned to the AE and RE groups were asked to perform the prescribed exercise(s ) 3 times per week for 12 weeks at home . Both groups were instructed to keep their perceived exercise intensity in the " fairly light " to " somewhat hard " range using the Borg Perceived Exertion Scale . All participants completed the revised Piper Fatigue Scale ( PFS ) and the 6-minute walk test ( 6MWT ) at baseline and 12-week post-exercise program . Analysis of pre- and post-training data revealed a significant reduction in fatigue levels on the PFS among participants in the AE group ( Z=2.521 , one-tailed P=0.006 ) , and a significant improvement in the distance of the 6MWT for the RE group ( Z=2.366 , one-tailed P=0.009 ) at the end of 12-week study period . No significant changes in fatigue or functional status were observed in the CON group . Findings provide preliminary support for RE as a viable strategy for improving functional capacity in breast cancer survivors , while AE may be more effective in attenuating cancer-related fatigue . Incorporating RE training for future research may help advance the growing body of knowledge in symptom management for breast cancer survivors Goals of workOur aim was to compare the effects of l and versus water multimodal exercise programs on body composition and breast cancer-specific quality of life in breast cancer survivors . Patients and methods Ninety-eight breast cancer survivors were assigned to three groups : control , l and exercise , and water exercise . Both exercise groups participated in an 8-week multimodal program . Adiposity was measured by anthropometry ( body mass index , waist circumference ) and bioelectrical impedance ( body fat and muscle lean body mass ) . Incidence of clinical ly significant secondary lymphedema was also assessed . Finally , specific quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life BR-23.Main Results Using ANCOVA , significant group × time interactions for body fat percentage ( F = 3.376 ; P = 0.011 ) and lean body mass ( F = 3.566 ; P = 0.008 ) were found . Breast cancer survivors in the l and exercise group exhibited a greater decrease in percentage of body fat than those in the water exercise ( P < 0.001 ) and control ( P = 0.002 ) groups . The ANCOVA revealed a significant group × time interaction for waist circumference ( F = 4.553 ; P = 0.002 ) : breast cancer survivors in the control group showed a greater waist circumference when compared to water ( P = 0.003 ) and l and ( P < 0.001 ) exercise groups . A significant group × time interaction was also found for breast symptoms ( F = 9.048 ; P < 0.001 ) : participants in the water exercise group experienced a greater decrease of breast symptoms than those in the l and exercise ( P < 0.01 ) and control ( P < 0.05 ) groups . Conclusion L and exercise produced a greater decrease in body fat and an increase in lean body mass , whereas water exercise was better for improving breast symptoms PURPOSE The primary purpose of this study was to examine the effect of aerobic exercise on physiological and psychological function in patients rehabilitating from cancer treatment . A second purpose was to evaluate the differential effects of low- and moderate-intensity exercise on these variables . METHODS Eighteen survivors of breast or colon cancer ( 15 female and 3 male , 40 - 65 yr of age ) served as subjects . The subjects were matched by aerobic capacity and scores on a Quality of Life question naire , and then r and omly assigned to a control , low- ( 25 - 35 % heart rate reserve ( HRR ) ) , or a moderate- ( 40 - 50 % HRR ) intensity exercise group . The exercise groups performed lower-body aerobic exercise three times a week for 10 wk . After the exercise training , there were no statistically significant differences between the two exercise groups on any of the physiological variables . Therefore , the exercise groups were combined into one group for the final analysis . RESULTS The results revealed statistically significant increases in aerobic capacity ( P < 0.001 ) and lower-body flexibility ( P = 0.027 ) , a significant decrease in body fat ( P < 0.001 ) , and a significant increase in quality of life ( P < 0.001 ) and a measure of energy ( P = 0.038 ) in the exercise group when compared with the control group . CONCLUSION Low- and moderate-intensity aerobic-exercise programs were equally effective in improving physiological and psychological function in this population of cancer survivors .  Aerobic exercise appears to be a valuable and well-tolerated component of the cancer-rehabilitation process PURPOSE The purpose of our study was to evaluate the effect of cognitive behavioral therapy ( CBT ) , physical exercise ( PE ) , and of these two interventions combined ( CBT/PE ) on menopausal symptoms ( primary outcome ) , body image , sexual functioning , psychological well-being , and health-related quality of life ( secondary outcomes ) in patients with breast cancer experiencing treatment-induced menopause . PATIENTS AND METHODS Patients with breast cancer reporting treatment-induced menopausal symptoms ( N=422 ) were r and omly assigned to CBT ( n=109 ) , PE ( n=104 ) , CBT/PE ( n=106 ) , or to a waiting list control group ( n=103 ) . Self-report question naires were completed at baseline , 12 weeks , and 6 months . Multilevel procedures were used to compare the intervention groups with the control group over time . RESULTS Compared with the control group , the intervention groups had a significant decrease in levels of endocrine symptoms ( Functional Assessment of Cancer Therapy-Endocrine Symptoms ; P<.001 ; effect size , 0.31 - 0.52 ) and urinary symptoms ( Bristol Female Lower Urinary Tract Symptoms Question naire ; P=.002 ; effect size , 0.29 - 0.33 ) , and they showed an improvement in physical functioning ( 36-Item Short Form Health Survey physical functioning subscale ; P=.002 ; effect size , 0.37 - 0.46 ) . The groups that included CBT also showed a significant decrease in the perceived burden of hot flashes and night sweats ( problem rating scale of the Hot Flush Rating Scale ; P<.001 ; effect size , 0.39 - 0.56 ) and an increase in sexual activity ( Sexual Activity Question naire habit subscale ; P=.027 ; effect size , 0.65 ) . Most of these effects were observed at both the 12-week and 6-month follow-ups . CONCLUSION CBT and PE can have salutary effects on endocrine symptoms and , to a lesser degree , on sexuality and physical functioning of patients with breast cancer experiencing treatment-induced menopause . Future work is needed to improve the design and the planning of these interventions to improve program adherence This study examined the effect of an integrated yoga programme on chemotherapy-related nausea and emesis in early operable breast cancer out patients . Sixty-two subjects were r and omly allocated to receive yoga ( n = 28 ) or supportive therapy intervention ( n = 34 ) during the course of their chemotherapy . Both groups had similar socio-demographic and medical characteristics . Intervention consisted of both supervised and home practice of yoga sessions lasting for 60 min daily , while the control group received supportive therapy and coping preparation during their hospital visits over a complete course of chemotherapy . The primary outcome measure was the Morrow Assessment of Nausea and Emesis ( MANE ) assessed after the fourth cycle of chemotherapy . Secondary outcomes included measures for anxiety , depression , quality of life , distressful symptoms and treatment-related toxicity assessed before and during the course of chemotherapy . Following yoga , there was a significant decrease in post-chemotherapy-induced nausea frequency ( P = 0.01 ) and nausea intensity ( P = 0.01 ) , and intensity of anticip 
    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 The aims of this pilot study were the following : 1 ) to examine patterns of adherence to a brisk walking program in women receiving adjuvant chemotherapy or radiation therapy for newly diagnosed breast cancer using a prospect i ve , r and omized , controlled experimental design ; 2 ) to examine the influence of disease symptoms and treatment side effects on exercise levels ; and 3 ) to suggest methods that may improve future clinical trials of moderate-intensity exercise in similar population s. DESCRIPTION OF STUDY Fifty-two patients with newly diagnosed breast cancer were r and omly assigned to one of two treatment arms : usual care or usual care plus exercise . Those assigned to the exercise group received a st and ardized , self-administered , home-based brisk walking intervention in addition to usual care . Each day subjects completed self-report diary forms that elicited information about activity levels , and the occurrence of symptoms and side effects during cancer treatment . RESULTS Analyses of self-reported daily activity levels revealed a diffusion of treatment effect . Fifty percent of the usual-care group reported maintaining or increasing their physical activity to a moderate-intensity level , while 33 % of the exercise group did not exercise at the prescribed levels . Analyses of self-reported disease symptoms and treatment side effects did not reveal clinical ly meaningful differences between the two groups . CLINICAL IMPLICATION S The results of this study suggest that women who exercised regularly before receiving a breast cancer diagnosis attempted to maintain their exercise programs . Women who lead sedentary lifestyles may benefit from a structured exercise program that includes information and support related to exercise adherence strategies Background : This r and omized controlled trial assessed the safety and effects of twice-weekly weight training among recent breast cancer survivors . Outcomes included body size and biomarkers hypothesized to link exercise and breast cancer risk . Methods : A convenience sample of 85 recent survivors was r and omized into immediate and delayed treatment groups . The immediate group trained from months 0 to 12 ; the delayed treatment group served as a no exercise parallel comparison group from months 0 to 6 and trained from months 7 to 12 . Measures at baseline , 6 and 12 months included body weight , height , body fat , lean mass , body fat % , and waist circumference , as well as fasting glucose , insulin , insulin resistance , insulin-like growth factor-I ( IGF-I ) , IGF-II , and IGF-binding protein-1 , IGFBP-2 , and IGFBP-3 . Injury reporting was st and ardized . Results : The intervention result ed in significant increases in lean mass ( 0.88 versus 0.02 kg , P < 0.01 ) , as well as significant decreases in body fat % ( −1.15 % versus 0.23 % , P = 0.03 ) and IGF-II ( −6.23 versus 28.28 ng/mL , P = 0.02 ) comparing immediate with delayed treatment from baseline to 6 months . Within-person changes experienced by delayed treatment group participants during training versus no training were similar . Only one participant experienced a study related injury that prevented continued participation . Conclusion : Twice-weekly weight training is a safe exercise program for recent breast cancer survivors that may result in increased muscle mass , as well as decreased body fat % and IGF-II . The implication s of these results on cancer recurrence or survival may become more evident with longer exercise intervention trials among breast cancer survivors PURPOSE / OBJECTIVES To evaluate the effects of 10 weeks of aerobic exercise on depressive and anxiety symptoms and self-esteem of breast cancer survivors . DESIGN Experimental , crossover . SETTING Midwestern university town . SAMPLE Twenty-four breast cancer survivors ( mean time following surgery 41.8 months ; ranging from 1 to 99 months ) recruited via mail and cancer support groups . The mean age of the sample was 48.9 years . METHODS Subjects were assigned r and omly into exercise ( EX ) , exercise-plus-behavior modification ( EX + BM ) , and control groups . EX and EX + BM groups exercised aerobically four days/week at > or = 60 % of age-predicted maximum heart rate for 10 weeks . Data were collected pretest , post-test , and crossover ( 12 weeks following post-test ) . Because pretest or post-test scores showed no statistical differences between EX and EX + BM groups , data were combined to form one group . MAIN RESEARCH VARIABLES Aerobic exercise ( four days/ week ; 30 - 40 minutes/session ) , depression , ( Beck Depression inventory ) , anxiety ( Speilberger State-Trait Anxiety Inventory ) , and self-esteem ( Rosenberg Self-Esteem Inventory ) . FINDINGS Pre- to post-test analyses revealed that women who exercised had significantly less depression and state and trait anxiety over time compared to controls . After the crossover , the control group demonstrated comparable improvements in both depressive and state anxiety scores . Self-esteem did not change significantly . Subjects who received exercise recommendations from their physicians exercised significantly more than subjects who received no recommendation . CONCLUSIONS Mild to moderate aerobic exercise may be of therapeutic value to breast cancer survivors with respect to depressive and anxiety symptoms but not to self-esteem . A physician 's recommendation to exercise appears to be an important factor in a patient 's exercise adherence . IMPLICATION S FOR NURSING PRACTICE To Improve depressive and anxiety symptoms following breast cancer surgery , healthcare professionals should consider recommending mild to moderate exercise This pilot study examined the efficacy of two home-based exercise programs on alleviating fatigue and improving functional capacity in breast cancer survivors . Participants were r and omly assigned into one of three groups : aerobic exercise ( AE ) , resistance exercise ( RE ) , or usual care control ( CON ) . After receiving individualized instruction and training , participants assigned to the AE and RE groups were asked to perform the prescribed exercise(s ) 3 times per week for 12 weeks at home . Both groups were instructed to keep their perceived exercise intensity in the " fairly light " to " somewhat hard " range using the Borg Perceived Exertion Scale . All participants completed the revised Piper Fatigue Scale ( PFS ) and the 6-minute walk test ( 6MWT ) at baseline and 12-week post-exercise program . Analysis of pre- and post-training data revealed a significant reduction in fatigue levels on the PFS among participants in the AE group ( Z=2.521 , one-tailed P=0.006 ) , and a significant improvement in the distance of the 6MWT for the RE group ( Z=2.366 , one-tailed P=0.009 ) at the end of 12-week study period . No significant changes in fatigue or functional status were observed in the CON group . Findings provide preliminary support for RE as a viable strategy for improving functional capacity in breast cancer survivors , while AE may be more effective in attenuating cancer-related fatigue . Incorporating RE training for future research may help advance the growing body of knowledge in symptom management for breast cancer survivors Goals of workOur aim was to compare the effects of l and versus water multimodal exercise programs on body composition and breast cancer-specific quality of life in breast cancer survivors . Patients and methods Ninety-eight breast cancer survivors were assigned to three groups : control , l and exercise , and water exercise . Both exercise groups participated in an 8-week multimodal program . Adiposity was measured by anthropometry ( body mass index , waist circumference ) and bioelectrical impedance ( body fat and muscle lean body mass ) . Incidence of clinical ly significant secondary lymphedema was also assessed . Finally , specific quality of life was assessed using the European Organization for Research and Treatment of Cancer Quality of Life BR-23.Main Results Using ANCOVA , significant group × time interactions for body fat percentage ( F = 3.376 ; P = 0.011 ) and lean body mass ( F = 3.566 ; P = 0.008 ) were found . Breast cancer survivors in the l and exercise group exhibited a greater decrease in percentage of body fat than those in the water exercise ( P < 0.001 ) and control ( P = 0.002 ) groups . The ANCOVA revealed a significant group × time interaction for waist circumference ( F = 4.553 ; P = 0.002 ) : breast cancer survivors in the control group showed a greater waist circumference when compared to water ( P = 0.003 ) and l and ( P < 0.001 ) exercise groups . A significant group × time interaction was also found for breast symptoms ( F = 9.048 ; P < 0.001 ) : participants in the water exercise group experienced a greater decrease of breast symptoms than those in the l and exercise ( P < 0.01 ) and control ( P < 0.05 ) groups . Conclusion L and exercise produced a greater decrease in body fat and an increase in lean body mass , whereas water exercise was better for improving breast symptoms PURPOSE The primary purpose of this study was to examine the effect of aerobic exercise on physiological and psychological function in patients rehabilitating from cancer treatment . A second purpose was to evaluate the differential effects of low- and moderate-intensity exercise on these variables . METHODS Eighteen survivors of breast or colon cancer ( 15 female and 3 male , 40 - 65 yr of age ) served as subjects . The subjects were matched by aerobic capacity and scores on a Quality of Life question naire , and then r and omly assigned to a control , low- ( 25 - 35 % heart rate reserve ( HRR ) ) , or a moderate- ( 40 - 50 % HRR ) intensity exercise group . The exercise groups performed lower-body aerobic exercise three times a week for 10 wk . After the exercise training , there were no statistically significant differences between the two exercise groups on any of the physiological variables . Therefore , the exercise groups were combined into one group for the final analysis . RESULTS The results revealed statistically significant increases in aerobic capacity ( P < 0.001 ) and lower-body flexibility ( P = 0.027 ) , a significant decrease in body fat ( P < 0.001 ) , and a significant increase in quality of life ( P < 0.001 ) and a measure of energy ( P = 0.038 ) in the exercise group when compared with the control group . CONCLUSION Low- and moderate-intensity aerobic-exercise programs were equally effective in improving physiological and psychological function in this population of cancer survivors .  Aerobic exercise appears to be a valuable and well-tolerated component of the cancer-rehabilitation process PURPOSE The purpose of our study was to evaluate the effect of cognitive behavioral therapy ( CBT ) , physical exercise ( PE ) , and of these two interventions combined ( CBT/PE ) on menopausal symptoms ( primary outcome ) , body image , sexual functioning , psychological well-being , and health-related quality of life ( secondary outcomes ) in patients with breast cancer experiencing treatment-induced menopause . PATIENTS AND METHODS Patients with breast cancer reporting treatment-induced menopausal symptoms ( N=422 ) were r and omly assigned to CBT ( n=109 ) , PE ( n=104 ) , CBT/PE ( n=106 ) , or to a waiting list control group ( n=103 ) . Self-report question naires were completed at baseline , 12 weeks , and 6 months . Multilevel procedures were used to compare the intervention groups with the control group over time . RESULTS Compared with the control group , the intervention groups had a significant decrease in levels of endocrine symptoms ( Functional Assessment of Cancer Therapy-Endocrine Symptoms ; P<.001 ; effect size , 0.31 - 0.52 ) and urinary symptoms ( Bristol Female Lower Urinary Tract Symptoms Question naire ; P=.002 ; effect size , 0.29 - 0.33 ) , and they showed an improvement in physical functioning ( 36-Item Short Form Health Survey physical functioning subscale ; P=.002 ; effect size , 0.37 - 0.46 ) . The groups that included CBT also showed a significant decrease in the perceived burden of hot flashes and night sweats ( problem rating scale of the Hot Flush Rating Scale ; P<.001 ; effect size , 0.39 - 0.56 ) and an increase in sexual activity ( Sexual Activity Question naire habit subscale ; P=.027 ; effect size , 0.65 ) . Most of these effects were observed at both the 12-week and 6-month follow-ups . CONCLUSION CBT and PE can have salutary effects on endocrine symptoms and , to a lesser degree , on sexuality and physical functioning of patients with breast cancer experiencing treatment-induced menopause . Future work is needed to improve the design and the planning of these interventions to improve program adherence This study examined the effect of an integrated yoga programme on chemotherapy-related nausea and emesis in early operable breast cancer out patients . Sixty-two subjects were r and omly allocated to receive yoga ( n = 28 ) or supportive therapy intervention ( n = 34 ) during the course of their chemotherapy . Both groups had similar socio-demographic and medical characteristics . Intervention consisted of both supervised and home practice of yoga sessions lasting for 60 min daily , while the control group received supportive therapy and coping preparation during their hospital visits over a complete course of chemotherapy . The primary outcome measure was the Morrow Assessment of Nausea and Emesis ( MANE ) assessed after the fourth cycle of chemotherapy . Secondary outcomes included measures for anxiety , depression , quality of life , distressful symptoms and treatment-related toxicity assessed before and during the course of chemotherapy . Following yoga , there was a significant decrease in post-chemotherapy-induced nausea frequency ( P = 0.01 ) and nausea intensity ( P = 0.01 ) , and intensity of anticip 
    Output:
    