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 Osteoporosis usually develops gradually and progresses without significant signs and symptoms . It is one of the most common musculoskeletal conditions associated with aging . OBJECTIVES To evaluate the effects of whole body vibration ( WBV ) or magnetic therapy in addition to st and ard pharmacological treatment on bone mineral density ( BMD ) in elderly individuals being treated for osteoporosis . METHODS Eighty-five participants , 60 - 75 years of age , were r and omly divided into three groups . All three groups received the same st and ard pharmacological treatment comprised of vitamin D , calcium , and alendronate sodium . In Group I , thirty participants were also exposed to WBV for 25 minutes in each session with two sessions per week for 4 months . In Group II , thirty participants were exposed to magnetic therapy for 50 minutes in each session with two sessions per week for 4 months . In Group III , twenty-five participants received only pharmacological treatment . Dual-energy X-ray absorptiometry was used to measure BMD of the lumbar spine and femoral heads before and after interventions . Venus blood sample was drawn for analysis of calcium and vitamin D. RESULTS An ANOVA test detected significant ( p < 0.05 ) differences in BMD after treatment among the three groups with no significant difference was detected between patients receiving WBV and magnetic therapy . Statistical t-tests detected significant ( p < 0.05 ) increases in BMD after application of WBV or magnetic therapy in combination with pharmacological treatment , but no significant increase after pharmacological treatment alone . CONCLUSIONS Addition of either WBV or magnetic therapy to st and ard pharmacological treatment for osteoporosis significantly increased BMD in elderly subjects . No significant difference in effectiveness was detected between these two alternative therapy modalities . Consequently , either WBV or magnetic therapy could be effectively applied in conjunction with pharmacological treatment to increase BMD in elderly osteoporotic patients Background Stroke is characterized by an asymmetrical gait pattern that causes poor stability and reduces overall activity levels . The aim of this study was to investigate the effect of whole-body vibration combined with treadmill training ( WBV-TT ) on walking performance in patients with chronic stroke . Material / Methods Thirty ambulatory chronic stroke patients were r and omly allocated to the WBV-TT group or the treadmill training ( TT ) group . The participants in the WBV-TT group performed 6 types of exercises on a vibrating platform for 4.5 minutes and then walked on the treadmill for 20 minutes . The participants in the TT group conducted the same exercise on a platform without vibration and then walked on the treadmill in the same manner . The vibration lasted for 45 seconds in each exercise , and the intervention was performed 3 times weekly for 6 weeks . The treadmill walking speed was gradually increased by 5 % in both groups . The outcome measures included the temporospatial parameter of gait ( GAITRite ® ) and 6-minute walk test . Results The WBV-TT group showed significant improvements in walking performance with respect to walking speed , cadence , step length , stride length , single-limb support , double-limb support , and 6-minute walk test compared with baseline ( p<0.05 ) . Significant improvements were also seen in walking speed , step length , stride length , and double-limb support compared with the TT group ( p<0.05 ) . Conclusions These findings indicate that WBV-TT is more effective than TT for improving walking performance of patients with chronic stroke The Modified Ashworth Scale ( MAS ) is a clinical scale used to assess muscle spasticity . While the evidence indicates that the reliability of the MAS is better in the upper limb and in certain distal muscle groups , no investigation has compared the effect of limbs and muscle groups on the MAS reliability . This study aim ed to evaluate the effect of limb and muscle group on the reliability of the MAS in patients with spastic hemiplegia . Thirty subjects with upper and lower limb muscle spasticity were recruited for this trial . Two female experienced physiotherapists participated in this examination of reliability , and rated each patient in a r and omized order in a single session . For the intrarater reliability , the second rater repeated the test 1 week later . Shoulder adductor , elbow flexor , wrist flexor , hip adductor , knee extensor , and ankle plantar flexor were tested on the hemiplegic side . Results demonstrated moderate inter ( kappa=0.514 , SE=0.046 , p < 0.001 ) and intrarater ( kappa=0.590 , SE=0.051 , p<0.001 ) reliability . For the inter and intrarater reliability , the agreement obtained for the upper and lower limb was similar . In the upper limb , the agreement between raters on the distal wrist flexor was significantly higher than the agreement on the proximal shoulder adductor . In the lower limb , there was a similar agreement between raters on the distal ankle plantar flexor and proximal hip adductor . For within rater , the agreement on the proximal and distal muscles of both limbs was not statistically significant . The Modified Ashworth Scale had moderate reliability . The limbs had no effect on the reliability . The agreement on distal wrist flexor in the upper limb was significantly higher between rater than in the proximal shoulder adductor . The agreement obtained with the MAS was not good , which questions the validity of the measurements Aim of this preliminary work is to study the effects of the vibration board on the strength of dorsal and plantar flexor muscles of the ankle through a r and omized and controlled observation . Sixteen sedentary right-h and ed females , ranged from 20 to 30 years of age , were selected ; they were not affected by previous ankle sprains and were divided into two r and omized groups . The study group followed a vibration board training in the orthostatic position with a 60 degrees flexion of the knee in order to direct its mechanical impulses to the inferior limbs . Each patient of the study group performed daily , for 2 weeks , 10 repetitions that lasted 1 minute each ( 25 hertz of frequency ) . The control group followed a training protocol including 10 daily sessions for 2 weeks . Each session included 3 series of 10 repetitions of flexi-extension of the foot versus an opposite resistance of an elastic b and , 60 centimetres long , that was stretched till 100 cm . Both groups were tested before and after these training programmes by Biodex isokinetic dynamometer in order to quantify the strength of the plantar and dorsal flexor muscles of the dominant ankle . Peak torque , power and total work of the dorsal and plantar flexor muscles were assessed . A power test at an angular velocity of 60 degrees/sec for five repetitions and a resistance test at an angular velocity of 180 degrees/sec . for 20 repetitions were performed . After the final isokinetic test , the results were su bmi tted to a statistic evaluation ( T test of Student ) in order to analyze any possible significant differences ( p < 0.05 ) among the initial and final values before and after the treatment . The results of the study group compared to the control group showed a significant increase in the power of the dorsal flexor muscles at an angular velocity of 60 degrees/sec and in the peak torque , power and total work of the plantar flexor muscles at an angular velocity of 60 degrees/sec and 180 degrees/sec . We conclude that the use of the vibration board causes a continuous proprioceptive stimulation which increases neuromuscular receptivity determining a prevailing reinforcement of the plantar flexor muscles of the ankle Objective The authors examined the impacts of whole-body vibration ( WBV ) applications on balance control in postmenopausal women using clinical balance tests and computerized static posturography . Design Patients were r and omly divided into two groups and treated with WBV and /or home-based balance coordination exercises ( BCEs ) . Patients in the WBV-BCE group were asked to st and on the platform in st and ing , squat , and deep squat positions . During each position , 30-sec vibration ( 30–35 Hz ) and 60-sec rest periods were applied twice ( 20 sessions in total ) . The BCE program was performed by subjects twice per day . All subjects were evaluated before and after treatment using the Timed Up and Go test and the Berg Balance Scale ( BBS ) . The fall index and the Fourier index were assessed via computerized static posturography . Results Sixty patients were recruited for the study , but only 42 patients ( 21 in each group ) completed it .  Fall index and the total values of the Fourier index 2–4 and Fourier index 5–6 frequencies indicated a significant improvement in the WBV-BCE group ( P < 0.05 ) . Both groups showed significant improvements in the Berg Balance Scale and Timed Up and Go test ( P < 0.05 ) . Conclusions The ease of applying WBV furthermore supports its inclusion in daily treatment protocol s for age-related decline in balance performance in women and improved balance and mobility measures associated with increased fall risk The objective of the study was to investigate the chronic effect of low frequency whole body vibration ( WBV ) on isometric and eccentric strength of knee extensors with different force exertion capacity . It was hypothesized that ( 1 ) four-week WBV intervention with the low frequency domain would enhance muscle strength and ( 2 ) the improvement would be more pronounced in the weaker muscle . To test our hypothesis twenty patients with acute stroke were recruited . Ten patients were r and omly assigned to vibration and the remaining ten patients served for control . The patients in the vibration group received WBV with 20 Hz frequency three times per week st and ing on a vibration platform in half squat position meanwhile flexing and extending the joints and placing the weight from one leg to the other . Knee extensor strength was determined under isometric and eccentric contraction before and after WBV intervention . Myoelectrical activity ( EMG ) of the vastus lateralis muscle was also measured . Significant improvement was revealed in the vibration group only . The maximum isometric torque and EMG activity increased significantly for both paretic and non-paretic leg , but the improvement was threefold greater in the vibration group . No significant alteration was found in rate of torque development . Maximum eccentric torque and EMG increased significantly for the paretic leg only . Mechanical work enhanced significantly in the paretic side only . The results of our study indicate that the selection of the effective vibration frequency depends upon the physical condition of neuromuscular system . Low vibration frequency intervention can increase the strength in weak muscles due to neuromuscular impairment and restricted physical activity Background and Purpose — The long-term effects of 6-weeks whole-body vibration , as a novel method of somatosensory stimulation , on postural control and activities of daily living were compared with those of 6 weeks of exercise therapy on music of the same intensity in the postacute phase of stroke . Methods — Fifty-three patients with moderate to severe functional disabilities were r and omized within 6 weeks poststroke and within 3 days after admission to a rehabilitation center to either whole-body vibration or exercise therapy on music in addition to a regular inpatient rehabilitation program . The whole-body vibration group received 4 × 45-second stimulation on the Galileo 900 ( 30-Hz frontal plane oscillations of 3-mm amplitude ) for 5 days per week during 6 weeks . The exercise therapy on music group received the same amount of exercise therapy on music . Outcome variables included the Berg Balance Scale , Trunk Control Test , Rivermead Mobility Index , Barthel Index , Functional Ambulation Categories , Motricity Index , and somatosensory threshold at 0 , 6 , and 12 weeks follow up . Results — At baseline , both groups were comparable in terms of prognostic factors and outcome measures . Both at 6 and 12 weeks follow up , no clinical ly relevant or statistical differences in outcome were observed between the groups . No side effects were reported . Conclusions — Daily sessions of whole-body vibration during 6 weeks are not more effective in terms of recovery of balance and activities of daily living than the same amount of exercise therapy on music in the postacute phase of stroke [ Purpose ] The objective of this study was to investigate the effects of whole-body vibration ( WBV ) in the horizontal direction on the motor function and balance of chronic stroke survivors . [ Subjects and Methods ] This study was a r and omized controlled trial . Twenty-one individuals with chronic stroke from an inpatient rehabilitation center participated in the study . The participants were allocated to either the WBV training group or the control group . The WBV training group ( n = 12 ) received whole-body vibration delivered in the horizontal direction ( 15 min/day , 3 times/week , 6 wks ) followed by conventional rehabilitation ( 30 min/day , 5 times/week , 6 wks ) ; the control group ( n = 9 ) received conventional rehabilitation only ( 30 min/day , 5 times/week , 6 wks ) . Motor function was measured by using the Fugl-Meyer assessment , and balance was measured by using the Berg Balance Scale ( BBS ) and the Timed Up and Go ( TUG ) test before and after the interventions . [ Results ] After the interventions , all variables improved significantly compared with the baseline values in the WBV training group . In the control group , no significant improvements in any variables were noted . In addition , the BBS score in the WBV training group increased significantly compared with that in the control group . [ Conclusion ] WBV training with whole-body vibration delivered in the horizontal direction may be a potential intervention for improvement of motor function and balance in patients who previously experienced a stroke [ Purpose ] The purpose of this study was to determine the effects of task-oriented training with whole body vibration ( WBV ) on the sitting balance of stroke patients . [ Subjects ] The subjects were 30 stroke patients who were r and omly divided into experimental ( n1=15 ) and control ( n2=15 ) groups . [ Methods ] Subjects in both groups received general training five times per week . Subjects in the experimental group practice d an additional task-oriented training program 
    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 Osteoporosis usually develops gradually and progresses without significant signs and symptoms . It is one of the most common musculoskeletal conditions associated with aging . OBJECTIVES To evaluate the effects of whole body vibration ( WBV ) or magnetic therapy in addition to st and ard pharmacological treatment on bone mineral density ( BMD ) in elderly individuals being treated for osteoporosis . METHODS Eighty-five participants , 60 - 75 years of age , were r and omly divided into three groups . All three groups received the same st and ard pharmacological treatment comprised of vitamin D , calcium , and alendronate sodium . In Group I , thirty participants were also exposed to WBV for 25 minutes in each session with two sessions per week for 4 months . In Group II , thirty participants were exposed to magnetic therapy for 50 minutes in each session with two sessions per week for 4 months . In Group III , twenty-five participants received only pharmacological treatment . Dual-energy X-ray absorptiometry was used to measure BMD of the lumbar spine and femoral heads before and after interventions . Venus blood sample was drawn for analysis of calcium and vitamin D. RESULTS An ANOVA test detected significant ( p < 0.05 ) differences in BMD after treatment among the three groups with no significant difference was detected between patients receiving WBV and magnetic therapy . Statistical t-tests detected significant ( p < 0.05 ) increases in BMD after application of WBV or magnetic therapy in combination with pharmacological treatment , but no significant increase after pharmacological treatment alone . CONCLUSIONS Addition of either WBV or magnetic therapy to st and ard pharmacological treatment for osteoporosis significantly increased BMD in elderly subjects . No significant difference in effectiveness was detected between these two alternative therapy modalities . Consequently , either WBV or magnetic therapy could be effectively applied in conjunction with pharmacological treatment to increase BMD in elderly osteoporotic patients Background Stroke is characterized by an asymmetrical gait pattern that causes poor stability and reduces overall activity levels . The aim of this study was to investigate the effect of whole-body vibration combined with treadmill training ( WBV-TT ) on walking performance in patients with chronic stroke . Material / Methods Thirty ambulatory chronic stroke patients were r and omly allocated to the WBV-TT group or the treadmill training ( TT ) group . The participants in the WBV-TT group performed 6 types of exercises on a vibrating platform for 4.5 minutes and then walked on the treadmill for 20 minutes . The participants in the TT group conducted the same exercise on a platform without vibration and then walked on the treadmill in the same manner . The vibration lasted for 45 seconds in each exercise , and the intervention was performed 3 times weekly for 6 weeks . The treadmill walking speed was gradually increased by 5 % in both groups . The outcome measures included the temporospatial parameter of gait ( GAITRite ® ) and 6-minute walk test . Results The WBV-TT group showed significant improvements in walking performance with respect to walking speed , cadence , step length , stride length , single-limb support , double-limb support , and 6-minute walk test compared with baseline ( p<0.05 ) . Significant improvements were also seen in walking speed , step length , stride length , and double-limb support compared with the TT group ( p<0.05 ) . Conclusions These findings indicate that WBV-TT is more effective than TT for improving walking performance of patients with chronic stroke The Modified Ashworth Scale ( MAS ) is a clinical scale used to assess muscle spasticity . While the evidence indicates that the reliability of the MAS is better in the upper limb and in certain distal muscle groups , no investigation has compared the effect of limbs and muscle groups on the MAS reliability . This study aim ed to evaluate the effect of limb and muscle group on the reliability of the MAS in patients with spastic hemiplegia . Thirty subjects with upper and lower limb muscle spasticity were recruited for this trial . Two female experienced physiotherapists participated in this examination of reliability , and rated each patient in a r and omized order in a single session . For the intrarater reliability , the second rater repeated the test 1 week later . Shoulder adductor , elbow flexor , wrist flexor , hip adductor , knee extensor , and ankle plantar flexor were tested on the hemiplegic side . Results demonstrated moderate inter ( kappa=0.514 , SE=0.046 , p < 0.001 ) and intrarater ( kappa=0.590 , SE=0.051 , p<0.001 ) reliability . For the inter and intrarater reliability , the agreement obtained for the upper and lower limb was similar . In the upper limb , the agreement between raters on the distal wrist flexor was significantly higher than the agreement on the proximal shoulder adductor . In the lower limb , there was a similar agreement between raters on the distal ankle plantar flexor and proximal hip adductor . For within rater , the agreement on the proximal and distal muscles of both limbs was not statistically significant . The Modified Ashworth Scale had moderate reliability . The limbs had no effect on the reliability . The agreement on distal wrist flexor in the upper limb was significantly higher between rater than in the proximal shoulder adductor . The agreement obtained with the MAS was not good , which questions the validity of the measurements Aim of this preliminary work is to study the effects of the vibration board on the strength of dorsal and plantar flexor muscles of the ankle through a r and omized and controlled observation . Sixteen sedentary right-h and ed females , ranged from 20 to 30 years of age , were selected ; they were not affected by previous ankle sprains and were divided into two r and omized groups . The study group followed a vibration board training in the orthostatic position with a 60 degrees flexion of the knee in order to direct its mechanical impulses to the inferior limbs . Each patient of the study group performed daily , for 2 weeks , 10 repetitions that lasted 1 minute each ( 25 hertz of frequency ) . The control group followed a training protocol including 10 daily sessions for 2 weeks . Each session included 3 series of 10 repetitions of flexi-extension of the foot versus an opposite resistance of an elastic b and , 60 centimetres long , that was stretched till 100 cm . Both groups were tested before and after these training programmes by Biodex isokinetic dynamometer in order to quantify the strength of the plantar and dorsal flexor muscles of the dominant ankle . Peak torque , power and total work of the dorsal and plantar flexor muscles were assessed . A power test at an angular velocity of 60 degrees/sec for five repetitions and a resistance test at an angular velocity of 180 degrees/sec . for 20 repetitions were performed . After the final isokinetic test , the results were su bmi tted to a statistic evaluation ( T test of Student ) in order to analyze any possible significant differences ( p < 0.05 ) among the initial and final values before and after the treatment . The results of the study group compared to the control group showed a significant increase in the power of the dorsal flexor muscles at an angular velocity of 60 degrees/sec and in the peak torque , power and total work of the plantar flexor muscles at an angular velocity of 60 degrees/sec and 180 degrees/sec . We conclude that the use of the vibration board causes a continuous proprioceptive stimulation which increases neuromuscular receptivity determining a prevailing reinforcement of the plantar flexor muscles of the ankle Objective The authors examined the impacts of whole-body vibration ( WBV ) applications on balance control in postmenopausal women using clinical balance tests and computerized static posturography . Design Patients were r and omly divided into two groups and treated with WBV and /or home-based balance coordination exercises ( BCEs ) . Patients in the WBV-BCE group were asked to st and on the platform in st and ing , squat , and deep squat positions . During each position , 30-sec vibration ( 30–35 Hz ) and 60-sec rest periods were applied twice ( 20 sessions in total ) . The BCE program was performed by subjects twice per day . All subjects were evaluated before and after treatment using the Timed Up and Go test and the Berg Balance Scale ( BBS ) . The fall index and the Fourier index were assessed via computerized static posturography . Results Sixty patients were recruited for the study , but only 42 patients ( 21 in each group ) completed it .  Fall index and the total values of the Fourier index 2–4 and Fourier index 5–6 frequencies indicated a significant improvement in the WBV-BCE group ( P < 0.05 ) . Both groups showed significant improvements in the Berg Balance Scale and Timed Up and Go test ( P < 0.05 ) . Conclusions The ease of applying WBV furthermore supports its inclusion in daily treatment protocol s for age-related decline in balance performance in women and improved balance and mobility measures associated with increased fall risk The objective of the study was to investigate the chronic effect of low frequency whole body vibration ( WBV ) on isometric and eccentric strength of knee extensors with different force exertion capacity . It was hypothesized that ( 1 ) four-week WBV intervention with the low frequency domain would enhance muscle strength and ( 2 ) the improvement would be more pronounced in the weaker muscle . To test our hypothesis twenty patients with acute stroke were recruited . Ten patients were r and omly assigned to vibration and the remaining ten patients served for control . The patients in the vibration group received WBV with 20 Hz frequency three times per week st and ing on a vibration platform in half squat position meanwhile flexing and extending the joints and placing the weight from one leg to the other . Knee extensor strength was determined under isometric and eccentric contraction before and after WBV intervention . Myoelectrical activity ( EMG ) of the vastus lateralis muscle was also measured . Significant improvement was revealed in the vibration group only . The maximum isometric torque and EMG activity increased significantly for both paretic and non-paretic leg , but the improvement was threefold greater in the vibration group . No significant alteration was found in rate of torque development . Maximum eccentric torque and EMG increased significantly for the paretic leg only . Mechanical work enhanced significantly in the paretic side only . The results of our study indicate that the selection of the effective vibration frequency depends upon the physical condition of neuromuscular system . Low vibration frequency intervention can increase the strength in weak muscles due to neuromuscular impairment and restricted physical activity Background and Purpose — The long-term effects of 6-weeks whole-body vibration , as a novel method of somatosensory stimulation , on postural control and activities of daily living were compared with those of 6 weeks of exercise therapy on music of the same intensity in the postacute phase of stroke . Methods — Fifty-three patients with moderate to severe functional disabilities were r and omized within 6 weeks poststroke and within 3 days after admission to a rehabilitation center to either whole-body vibration or exercise therapy on music in addition to a regular inpatient rehabilitation program . The whole-body vibration group received 4 × 45-second stimulation on the Galileo 900 ( 30-Hz frontal plane oscillations of 3-mm amplitude ) for 5 days per week during 6 weeks . The exercise therapy on music group received the same amount of exercise therapy on music . Outcome variables included the Berg Balance Scale , Trunk Control Test , Rivermead Mobility Index , Barthel Index , Functional Ambulation Categories , Motricity Index , and somatosensory threshold at 0 , 6 , and 12 weeks follow up . Results — At baseline , both groups were comparable in terms of prognostic factors and outcome measures . Both at 6 and 12 weeks follow up , no clinical ly relevant or statistical differences in outcome were observed between the groups . No side effects were reported . Conclusions — Daily sessions of whole-body vibration during 6 weeks are not more effective in terms of recovery of balance and activities of daily living than the same amount of exercise therapy on music in the postacute phase of stroke [ Purpose ] The objective of this study was to investigate the effects of whole-body vibration ( WBV ) in the horizontal direction on the motor function and balance of chronic stroke survivors . [ Subjects and Methods ] This study was a r and omized controlled trial . Twenty-one individuals with chronic stroke from an inpatient rehabilitation center participated in the study . The participants were allocated to either the WBV training group or the control group . The WBV training group ( n = 12 ) received whole-body vibration delivered in the horizontal direction ( 15 min/day , 3 times/week , 6 wks ) followed by conventional rehabilitation ( 30 min/day , 5 times/week , 6 wks ) ; the control group ( n = 9 ) received conventional rehabilitation only ( 30 min/day , 5 times/week , 6 wks ) . Motor function was measured by using the Fugl-Meyer assessment , and balance was measured by using the Berg Balance Scale ( BBS ) and the Timed Up and Go ( TUG ) test before and after the interventions . [ Results ] After the interventions , all variables improved significantly compared with the baseline values in the WBV training group . In the control group , no significant improvements in any variables were noted . In addition , the BBS score in the WBV training group increased significantly compared with that in the control group . [ Conclusion ] WBV training with whole-body vibration delivered in the horizontal direction may be a potential intervention for improvement of motor function and balance in patients who previously experienced a stroke [ Purpose ] The purpose of this study was to determine the effects of task-oriented training with whole body vibration ( WBV ) on the sitting balance of stroke patients . [ Subjects ] The subjects were 30 stroke patients who were r and omly divided into experimental ( n1=15 ) and control ( n2=15 ) groups . [ Methods ] Subjects in both groups received general training five times per week . Subjects in the experimental group practice d an additional task-oriented training program 
    Output:
    