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 . Impaired trunk motor control is common after stroke . Combining transcutaneous electrical nerve stimulation ( TENS ) with task-related trunk training ( TRTT ) has been shown to enhance the recovery of lower limb motor function . Objective . This study investigated whether combining TENS with TRTT would enhance trunk control after stroke . Methods . Thirty-seven subjects with stroke were recruited into a r and omized controlled clinical trial . Subjects were r and omly assigned to any one of the three 6-week home-based training groups : ( 1 ) TENS + TRTT , ( 2 ) placebo TENS + TRTT , or ( 3 ) control without active training . The outcome measures included isometric peak trunk flexion torque and extension torque ; forward seated and lateral seated reaching distance to the affected and unaffected side ; and Trunk Impairment Scale ( TIS ) scores . All outcome measures were assessed at baseline , after 3 and 6 weeks of training , and 4 weeks after training ended at follow-up . Results . Both the TENS + TRTT and the placebo-TENS + TRTT groups had significantly greater improvements in isometric peak trunk flexion torque and extension torque , lateral seated reaching distance to affected and unaffected side , and TIS score than the control group after 3 weeks of training . The TENS + TRTT group had significantly greater and earlier improvement in its mean TIS score than the other 2 groups . Conclusions . Home-based TRTT is effective for improving trunk muscle strength , sitting functional reach and trunk motor control after stroke in subjects without somatosensory deficits . The addition of TENS to the trunk augments the effectiveness of the exercise in terms of TIS scores within the first 3 weeks of training Objective To investigate an additive effect of core muscle strengthening ( CMS ) and trunk neuromuscular electrical stimulation ( tNEMS ) on trunk balance in stroke patients . Methods Thirty patients with acute or subacute stroke who were unable to maintain static sitting balance for > 5 minutes were enrolled and r and omly assigned to 3 groups , i.e. , patients in the CMS ( n=10 ) group received additional CMS program ; the tNMES group ( n=10 ) received additional tNMES over the posterior back muscles ; and the combination ( CMS and tNMES ) group ( n=10 ) received both treatments . Each additional treatment was performed 3 times per week for 20 minutes per day over 3 weeks . Korean version of Berg Balance Scale ( K-BBS ) , total score of postural assessment scale for stroke patients ( PASS ) , Trunk Impairment Scale ( TIS ) , and Korean version of Modified Barthel Index ( K-MBI ) were evaluated before and after 3 weeks of therapeutic intervention . Results All 3 groups showed improvements in K-BBS , PASS , TIS , and K-MBI after therapeutic interventions , with some differences . The combination group showed more improvements in K-BBS and the dynamic sitting balance of TIS , as compared to the CMS group ; and more improvement in K-BBS , as compared to the tNMES group . Conclusion The results indicated an additive effect of CMS and tNMES on the recovery of trunk balance in patients with acute or subacute stroke who have poor sitting balance . Simultaneous application of CMS and tNMES should be considered when design ing a rehabilitation program to improve trunk balance in stroke patients [ Purpose ] The purpose of this study was to determine the effects of core stabilization exercise on dynamic balance and gait function in stroke patients . [ Subjects ] The subjects were 16 stroke patients , who were r and omly divided into two groups : a core stabilization exercise group  of eight subjects and  control group of eight subjects . [ Methods ] Subjects in both groups received general training five times per week . Subjects in the core stabilization exercise group practice d an additional core stabilization exercise program , which was performed for 30 minutes , three times per week , during a period of four weeks . All subjects were evaluated for dynamic balance ( Timed Up and Go test , TUG ) and gait parameters ( velocity , cadence , step length , and stride length ) . [ Results ] Following intervention , the core exercise group showed a significant change in TUG , velocity , and cadence . The only significant difference observed between the core group and control group was in velocity . [ Conclusion ] The results of this study suggest the feasibility and suitability of core stabilization exercise for stroke patients [ Purpose ] The aim of this study was to determine which is better in the rehabilitation of stroke patients , core stability exercises or conventional exercises . [ Subjects and Methods ] Forty participants with hemiplegia were recruited in the Department of Neurology of Yidu Central Hospital of Weifang between January 2014 and February 2015 and r and omly divided into either an experimental or control group . The patients in the control group performed conventional exercises for six weeks , and those in the experiment group performed core stability exercises for six weeks . The outcomes were evaluated using Modified Barthel Index and Berg Balance Scale . [ Results ] After treatment , the Modified Barthel Index and Berg Balance Scale were significantly increased in both groups when compared with the baseline . The Modified Barthel Index was significantly lower in the control group compared with the experimental group . The Berg Balance Scale scores in the control group were relatively lower than those in the experimental group , but there was no significant difference between the two groups . [ Conclusion ] Core stability exercises have a better effect on patients with hemiplegia than conventional exercises OBJECTIVE The study objective was to examine the efficacy of plinth and Swiss ball-based trunk exercise regimes on balance , mobility , physical function , and community reintegration compared with st and ard physiotherapy in chronic stroke . SUBJECTS AND METHODS This observer-blinded parallel-group r and omized trial was conducted in outpatient stroke units . People with chronic stroke aged between 30 and 75 years , first onset of unilateral cortical lesion , poor trunk performance , 10 m independent walking ability with or without walking aids , and absence of pusher syndrome were included .  Trunk Impairment Scale 2.0 , Brunel Balance Assessment , Tinetti scale , gait speed , Stroke Impact Scale-16 , and Reintegration to Normal Living Index were the measures . Experimental interventions involved the practice of selective upper and lower trunk movements using either plinth or Swiss ball . Control group received st and ard physiotherapy . All the patients practice d 1 hour exercise session , 3 sessions a week over a duration of 6 weeks and followed up after 3 and 12 months . RESULTS Of 108 patients allocated into 3 groups , baseline characteristics were similar . Postintervention compared with control group , the plinth , and Swiss ball groups showed significant mean changes in the outcome measures : trunk impairment scale 2.0 ( 3.6;4.1 points ) , Brunel Balance Assessment ( 1-level ) , Tinetti scale ( 5;5.2 points ) , gait speed ( .06;.08 m/s ) , Stroke Impact Scale-16 ( 8.7;7.2 points ) , and community reintegration ( 7.6;8.8 points ) . These improvements were retained during 3 - 12 months ' follow-up . Statistical significant was set at P < .05 . CONCLUSION Plinth and Swiss ball-based trunk exercise regimes showed significant improvements in balance , mobility , physical function , and community reintegration in chronic stroke as against st and ard physiotherapy Background . Trunk function is important for st and ing balance , mobility , and functional outcome after stroke , but few studies have evaluated the effects of exercises aim ed at improving core stability in stroke patients . Objective . To investigate the effectiveness of core stability training on trunk function , st and ing balance , and mobility in stroke patients . Methods . An assessor-blinded , r and omized controlled trial was undertaken in a stroke rehabilitation ward , with 32 participants r and omly assigned to an experimental group or a control group ( n = 16 each ) . The experimental group received 400 minutes of core stability training in place of conventional programs within total training time , while the control group received only conventional programs . Primary outcome measures were evaluated using the Trunk Impairment Scale ( TIS ) , which reflects trunk function . Secondary outcome measures were evaluated by pelvic tilt active range of motion in the sagittal plane , the Balance Evaluation Systems Test – brief version ( Brief-BESTest ) , Functional Reach test , Timed Up- and -Go test ( TUG ) , and Functional Ambulation Categories ( FAC ) . A general linear repeated- measures model was used to analyze the results . Results . A treatment effect was found for the experimental group on the dynamic balance subscale and total score of the TIS ( P = .002 and P < .001 , respectively ) , pelvic tilt active range of motion ( P < .001 ) , Brief-BESTest ( P < .001 ) , TUG ( P = .008 ) , and FAC ( P = .022 ) . Conclusions . Core stability training has beneficial effects on trunk function , st and ing balance , and mobility in stroke patients . Our findings might provide support for introducing core stability training in stroke rehabilitation This study investigated the effects of weight-shifting exercise ( WSE ) combined with transcutaneous electrical nerve stimulation ( TENS ) , applied to the erector spinae and external oblique ( EO ) muscles , on muscle activity and trunk control in patients with hemiparetic stroke . Sixty patients with stroke were recruited to this study and r and omly distributed into three treatment groups : ( 1 ) WSE + TENS , ( 2 ) WSE + placebo TENS , and ( 3 ) control . All participants underwent 30 sessions of training ( 30 minutes five times per week for 6 weeks ) and received 1 hour of conventional physical therapy five times per week for 6 weeks . Muscle activity , maximum reaching distance and trunk impairment scale scores were assessed in all patients before and after the training . After training , the WSE + TENS group showed significant increase in the EO activity , maximum reaching distance and trunk impairment scale scores compared with the WSE + placebo TENS and control groups . These findings suggest that WSE with TENS applied to the erector spinae and EO muscles increased the trunk muscle activity and improved trunk control . Therefore , WSE with TENS could be a beneficial intervention in clinical setting s for individuals with hemiparetic stroke . Copyright © 2016 John Wiley & Sons , Trunk instability is one of main problems in survivors following stroke . We investigated the effects of weight-shift training ( WST ) on an unstable surface in sitting position on trunk control , proprioception , and balance in individuals with chronic hemiparetic stroke . Eighteen participants with chronic hemiparetic stroke were recruited and were allocated to either WST or control group . The WST group received a weight-shift training program for 30 min and then received a conventional exercise program for 30 min , while the control group received conventional exercise program for 60 min , five times a week for four weeks for both groups . In this r and omized control study , we used three outcome measures : trunk reposition error ( TRE ) , Trunk Impairment Scale ( TIS ) , and Timed Up and Go ( TUG ) test . TRE was measured by each participant 's reposition error to the target angle during his/her active trunk movement . TIS and TUG were examined for trunk control abilities and dynamic balance abilities , respectively . After training , TRE showed significantly greater improvement in the WST group ( mean change , 1.67 ± 1.45˚ ) than the control group ( mean change , 0.08 ± 1.05˚ ) . The TIS score was significantly higher in the WST group ( mean change , 2.33 ± 1.50 ) than the control group ( mean change , 0.13 ± 0.83 ) . The TUG test also showed a significant improvement in the WST group ( mean change , 5.03 ± 1.88 sec ) than the control group ( mean change , 2.59 ± 1.86 sec ) . Our findings indicate that weight-shift training is beneficial for improving trunk control and proprioception in patients with chronic hemiparetic stroke Background . Sitting balance and the ability to perform selective trunk movements are important predictors of functional outcome after stroke . However , studies evaluating the effect of exercises aim ed at improving trunk performance are sparse . Objective . To examine the effect of additional trunk exercises on trunk performance after stroke . Methods . An assessor-blinded r and omized controlled trial was carried out at an inpatient stroke rehabilitation center . In total 33 participants were assigned to an experimental group ( n = 17 ) or a control group ( n = 16 ) . In addition to conventional therapy , the experimental group received 10 hours of individual and supervised trunk exercises ; 30 minutes , 4 times a week , for 5 weeks . Trunk performance was evaluated by the Trunk Impairment Scale ( TIS ) and its subscales of static and dynamic sitting balance and coordination . A general linear repeated measures model was used to analyze the results of our study . Results . No significant differences were found pretreatment between the 2 groups for the collected demographic variables , stroke-related parameters , clinical measures , number of therapy sessions received , and primary outcome measure used . Posttreatment , a significantly better improvement was noted in the experimental group compared to the control group for the dynamic sitting balance subscale only ; measuring selective lateral flexion initiated from the upper and lower part of the trunk , ( P = .002 , post hoc power calculation = .90 , effect size = 1.16 ) . Conclusions . Our results suggest that , in addition to conventional therapy , trunk exercises aim ed at improving sitting balance and selective trunk movements have a beneficial effect on the selective performance of lateral flexion of the trunk after stroke BACKGROUND AND PURPOSE After stroke , the ability to balance in sitting is critical to independence . Although impairments in sitting balance are common , little is known about the effectiveness of rehabilitation strategies design ed to improve it . The purpose of this r and omized placebo-controlled study was to evaluate the effect of a 2-week task-related training program aim ed at increasing distance reached and the contribution of the affected lower leg to support and balance . METHODS Twenty subjects at least 1 year after stroke were r 
    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 . Impaired trunk motor control is common after stroke . Combining transcutaneous electrical nerve stimulation ( TENS ) with task-related trunk training ( TRTT ) has been shown to enhance the recovery of lower limb motor function . Objective . This study investigated whether combining TENS with TRTT would enhance trunk control after stroke . Methods . Thirty-seven subjects with stroke were recruited into a r and omized controlled clinical trial . Subjects were r and omly assigned to any one of the three 6-week home-based training groups : ( 1 ) TENS + TRTT , ( 2 ) placebo TENS + TRTT , or ( 3 ) control without active training . The outcome measures included isometric peak trunk flexion torque and extension torque ; forward seated and lateral seated reaching distance to the affected and unaffected side ; and Trunk Impairment Scale ( TIS ) scores . All outcome measures were assessed at baseline , after 3 and 6 weeks of training , and 4 weeks after training ended at follow-up . Results . Both the TENS + TRTT and the placebo-TENS + TRTT groups had significantly greater improvements in isometric peak trunk flexion torque and extension torque , lateral seated reaching distance to affected and unaffected side , and TIS score than the control group after 3 weeks of training . The TENS + TRTT group had significantly greater and earlier improvement in its mean TIS score than the other 2 groups . Conclusions . Home-based TRTT is effective for improving trunk muscle strength , sitting functional reach and trunk motor control after stroke in subjects without somatosensory deficits . The addition of TENS to the trunk augments the effectiveness of the exercise in terms of TIS scores within the first 3 weeks of training Objective To investigate an additive effect of core muscle strengthening ( CMS ) and trunk neuromuscular electrical stimulation ( tNEMS ) on trunk balance in stroke patients . Methods Thirty patients with acute or subacute stroke who were unable to maintain static sitting balance for > 5 minutes were enrolled and r and omly assigned to 3 groups , i.e. , patients in the CMS ( n=10 ) group received additional CMS program ; the tNMES group ( n=10 ) received additional tNMES over the posterior back muscles ; and the combination ( CMS and tNMES ) group ( n=10 ) received both treatments . Each additional treatment was performed 3 times per week for 20 minutes per day over 3 weeks . Korean version of Berg Balance Scale ( K-BBS ) , total score of postural assessment scale for stroke patients ( PASS ) , Trunk Impairment Scale ( TIS ) , and Korean version of Modified Barthel Index ( K-MBI ) were evaluated before and after 3 weeks of therapeutic intervention . Results All 3 groups showed improvements in K-BBS , PASS , TIS , and K-MBI after therapeutic interventions , with some differences . The combination group showed more improvements in K-BBS and the dynamic sitting balance of TIS , as compared to the CMS group ; and more improvement in K-BBS , as compared to the tNMES group . Conclusion The results indicated an additive effect of CMS and tNMES on the recovery of trunk balance in patients with acute or subacute stroke who have poor sitting balance . Simultaneous application of CMS and tNMES should be considered when design ing a rehabilitation program to improve trunk balance in stroke patients [ Purpose ] The purpose of this study was to determine the effects of core stabilization exercise on dynamic balance and gait function in stroke patients . [ Subjects ] The subjects were 16 stroke patients , who were r and omly divided into two groups : a core stabilization exercise group  of eight subjects and  control group of eight subjects . [ Methods ] Subjects in both groups received general training five times per week . Subjects in the core stabilization exercise group practice d an additional core stabilization exercise program , which was performed for 30 minutes , three times per week , during a period of four weeks . All subjects were evaluated for dynamic balance ( Timed Up and Go test , TUG ) and gait parameters ( velocity , cadence , step length , and stride length ) . [ Results ] Following intervention , the core exercise group showed a significant change in TUG , velocity , and cadence . The only significant difference observed between the core group and control group was in velocity . [ Conclusion ] The results of this study suggest the feasibility and suitability of core stabilization exercise for stroke patients [ Purpose ] The aim of this study was to determine which is better in the rehabilitation of stroke patients , core stability exercises or conventional exercises . [ Subjects and Methods ] Forty participants with hemiplegia were recruited in the Department of Neurology of Yidu Central Hospital of Weifang between January 2014 and February 2015 and r and omly divided into either an experimental or control group . The patients in the control group performed conventional exercises for six weeks , and those in the experiment group performed core stability exercises for six weeks . The outcomes were evaluated using Modified Barthel Index and Berg Balance Scale . [ Results ] After treatment , the Modified Barthel Index and Berg Balance Scale were significantly increased in both groups when compared with the baseline . The Modified Barthel Index was significantly lower in the control group compared with the experimental group . The Berg Balance Scale scores in the control group were relatively lower than those in the experimental group , but there was no significant difference between the two groups . [ Conclusion ] Core stability exercises have a better effect on patients with hemiplegia than conventional exercises OBJECTIVE The study objective was to examine the efficacy of plinth and Swiss ball-based trunk exercise regimes on balance , mobility , physical function , and community reintegration compared with st and ard physiotherapy in chronic stroke . SUBJECTS AND METHODS This observer-blinded parallel-group r and omized trial was conducted in outpatient stroke units . People with chronic stroke aged between 30 and 75 years , first onset of unilateral cortical lesion , poor trunk performance , 10 m independent walking ability with or without walking aids , and absence of pusher syndrome were included .  Trunk Impairment Scale 2.0 , Brunel Balance Assessment , Tinetti scale , gait speed , Stroke Impact Scale-16 , and Reintegration to Normal Living Index were the measures . Experimental interventions involved the practice of selective upper and lower trunk movements using either plinth or Swiss ball . Control group received st and ard physiotherapy . All the patients practice d 1 hour exercise session , 3 sessions a week over a duration of 6 weeks and followed up after 3 and 12 months . RESULTS Of 108 patients allocated into 3 groups , baseline characteristics were similar . Postintervention compared with control group , the plinth , and Swiss ball groups showed significant mean changes in the outcome measures : trunk impairment scale 2.0 ( 3.6;4.1 points ) , Brunel Balance Assessment ( 1-level ) , Tinetti scale ( 5;5.2 points ) , gait speed ( .06;.08 m/s ) , Stroke Impact Scale-16 ( 8.7;7.2 points ) , and community reintegration ( 7.6;8.8 points ) . These improvements were retained during 3 - 12 months ' follow-up . Statistical significant was set at P < .05 . CONCLUSION Plinth and Swiss ball-based trunk exercise regimes showed significant improvements in balance , mobility , physical function , and community reintegration in chronic stroke as against st and ard physiotherapy Background . Trunk function is important for st and ing balance , mobility , and functional outcome after stroke , but few studies have evaluated the effects of exercises aim ed at improving core stability in stroke patients . Objective . To investigate the effectiveness of core stability training on trunk function , st and ing balance , and mobility in stroke patients . Methods . An assessor-blinded , r and omized controlled trial was undertaken in a stroke rehabilitation ward , with 32 participants r and omly assigned to an experimental group or a control group ( n = 16 each ) . The experimental group received 400 minutes of core stability training in place of conventional programs within total training time , while the control group received only conventional programs . Primary outcome measures were evaluated using the Trunk Impairment Scale ( TIS ) , which reflects trunk function . Secondary outcome measures were evaluated by pelvic tilt active range of motion in the sagittal plane , the Balance Evaluation Systems Test – brief version ( Brief-BESTest ) , Functional Reach test , Timed Up- and -Go test ( TUG ) , and Functional Ambulation Categories ( FAC ) . A general linear repeated- measures model was used to analyze the results . Results . A treatment effect was found for the experimental group on the dynamic balance subscale and total score of the TIS ( P = .002 and P < .001 , respectively ) , pelvic tilt active range of motion ( P < .001 ) , Brief-BESTest ( P < .001 ) , TUG ( P = .008 ) , and FAC ( P = .022 ) . Conclusions . Core stability training has beneficial effects on trunk function , st and ing balance , and mobility in stroke patients . Our findings might provide support for introducing core stability training in stroke rehabilitation This study investigated the effects of weight-shifting exercise ( WSE ) combined with transcutaneous electrical nerve stimulation ( TENS ) , applied to the erector spinae and external oblique ( EO ) muscles , on muscle activity and trunk control in patients with hemiparetic stroke . Sixty patients with stroke were recruited to this study and r and omly distributed into three treatment groups : ( 1 ) WSE + TENS , ( 2 ) WSE + placebo TENS , and ( 3 ) control . All participants underwent 30 sessions of training ( 30 minutes five times per week for 6 weeks ) and received 1 hour of conventional physical therapy five times per week for 6 weeks . Muscle activity , maximum reaching distance and trunk impairment scale scores were assessed in all patients before and after the training . After training , the WSE + TENS group showed significant increase in the EO activity , maximum reaching distance and trunk impairment scale scores compared with the WSE + placebo TENS and control groups . These findings suggest that WSE with TENS applied to the erector spinae and EO muscles increased the trunk muscle activity and improved trunk control . Therefore , WSE with TENS could be a beneficial intervention in clinical setting s for individuals with hemiparetic stroke . Copyright © 2016 John Wiley & Sons , Trunk instability is one of main problems in survivors following stroke . We investigated the effects of weight-shift training ( WST ) on an unstable surface in sitting position on trunk control , proprioception , and balance in individuals with chronic hemiparetic stroke . Eighteen participants with chronic hemiparetic stroke were recruited and were allocated to either WST or control group . The WST group received a weight-shift training program for 30 min and then received a conventional exercise program for 30 min , while the control group received conventional exercise program for 60 min , five times a week for four weeks for both groups . In this r and omized control study , we used three outcome measures : trunk reposition error ( TRE ) , Trunk Impairment Scale ( TIS ) , and Timed Up and Go ( TUG ) test . TRE was measured by each participant 's reposition error to the target angle during his/her active trunk movement . TIS and TUG were examined for trunk control abilities and dynamic balance abilities , respectively . After training , TRE showed significantly greater improvement in the WST group ( mean change , 1.67 ± 1.45˚ ) than the control group ( mean change , 0.08 ± 1.05˚ ) . The TIS score was significantly higher in the WST group ( mean change , 2.33 ± 1.50 ) than the control group ( mean change , 0.13 ± 0.83 ) . The TUG test also showed a significant improvement in the WST group ( mean change , 5.03 ± 1.88 sec ) than the control group ( mean change , 2.59 ± 1.86 sec ) . Our findings indicate that weight-shift training is beneficial for improving trunk control and proprioception in patients with chronic hemiparetic stroke Background . Sitting balance and the ability to perform selective trunk movements are important predictors of functional outcome after stroke . However , studies evaluating the effect of exercises aim ed at improving trunk performance are sparse . Objective . To examine the effect of additional trunk exercises on trunk performance after stroke . Methods . An assessor-blinded r and omized controlled trial was carried out at an inpatient stroke rehabilitation center . In total 33 participants were assigned to an experimental group ( n = 17 ) or a control group ( n = 16 ) . In addition to conventional therapy , the experimental group received 10 hours of individual and supervised trunk exercises ; 30 minutes , 4 times a week , for 5 weeks . Trunk performance was evaluated by the Trunk Impairment Scale ( TIS ) and its subscales of static and dynamic sitting balance and coordination . A general linear repeated measures model was used to analyze the results of our study . Results . No significant differences were found pretreatment between the 2 groups for the collected demographic variables , stroke-related parameters , clinical measures , number of therapy sessions received , and primary outcome measure used . Posttreatment , a significantly better improvement was noted in the experimental group compared to the control group for the dynamic sitting balance subscale only ; measuring selective lateral flexion initiated from the upper and lower part of the trunk , ( P = .002 , post hoc power calculation = .90 , effect size = 1.16 ) . Conclusions . Our results suggest that , in addition to conventional therapy , trunk exercises aim ed at improving sitting balance and selective trunk movements have a beneficial effect on the selective performance of lateral flexion of the trunk after stroke BACKGROUND AND PURPOSE After stroke , the ability to balance in sitting is critical to independence . Although impairments in sitting balance are common , little is known about the effectiveness of rehabilitation strategies design ed to improve it . The purpose of this r and omized placebo-controlled study was to evaluate the effect of a 2-week task-related training program aim ed at increasing distance reached and the contribution of the affected lower leg to support and balance . METHODS Twenty subjects at least 1 year after stroke were r 
    Output:
    