***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: Tai Chi , a moving meditation , is examined for its efficacy in post-stressor recovery . Forty-eight male and 48 female Tai Chi practitioners were r and omly assigned to four treatment groups : Tai Chi , brisk walking , mediation and neutral reading . Mental arithmetic and other difficult tests were chosen as mental challenges , and a stressful film was used to produce emotional disturbance . Tai Chi and the other treatments were applied after these stressors . After all treatments , the salivary cortisol level dropped significantly , and the mood states were also improved . In general the stress-reduction effect of Tai Chi characterized moderate physical exercise . Heart rate , blood pressure , and urinary catecholamine changes for Tai Chi were found to be similar to those for walking at a speed of 6 km/hr . Although Tai Chi appeared to be superior to neutral reading in the reduction of state anxiety and the enhancement of vigour , this effect could be partially accounted for by the subjects ' high expectations about gains from Tai Chi . Approaches controlling for expectancy level are recommended for further assessment Psychoneuroimmunology is a framework for mind-body practice and research that combines cutting-edge scientific exploration with holistic philosophy to appreciate and underst and stress responses . The rapidly growing research literature provides a foundation for building an integrative stress management model with the potential to positively influence the stress-disease relationship and , ultimately , health outcomes . This article introduces a novel tai chi intervention and provides quantitative and qualitative data from a r and omized clinical trial indicating its effects on psychosocial variables in individuals living with various stages of HIV disease BACKGROUND Stress can affect health . There is a growing need for the evaluation and application of professional stress management options , i.e , stress reduction . Mind/body medicine serves this goal , e.g , by integrating self-care techniques into medicine and health care . Tai Chi ( TC ) can be classified as such a mind/body technique , potentially reducing stress and affecting physical as well as mental health parameters , which , however , has to be examined further . MATERIAL / METHODS We conducted a prospect i ve , longitudinal pilot study over 18 weeks for the evaluation of subjective and objective clinical effects of a Yang style TC intervention  in young adults ( beginners ) by measuring physiological ( blood pressure , heart rate , saliva cortisol ) and psychological ( SF-36 , perceived stress , significant events ) parameters , i.e , direct or indirect indicators of stress and stress reduction , in a non-r and omised/-controlled , yet non-selected cohort ( n=21 ) by pre-to-post comparison and in follow-up . SF-36 values were also compared with the age-adjusted norm population , serving as an external control . Additionally , we measured diurnal cortisol profiles in a cross-sectional sub- study ( n=2 + 2 , pre-to-post ) , providing an internal r and om control sub- sample . RESULTS Only nine participants completed all measurements . Even so , we found significant ( p<0.05 ) reductions of saliva cortisol ( post and follow-up ) , which seems to be an indicator of general stress reduction . A significant decrease in perceived mental stress ( post ) proved even highly significant ( p<0.01 ) in the follow-up , whereas physical stress perception declined to a much lesser degree . Significant improvements were also detected for the SF-36 dimensions general health perception , social functioning , vitality , and mental health/psychological well-being . Thus , the summarized mental health measures all clearly improved , pointing towards a predominantly psychological impact of TC . CONCLUSIONS Subjective health increased , stress decreased ( objective ly and subjectively ) during TC practice . Future studies should confirm this observation by rigorous methodology and by further combining physical and psychological measurements with basic research , thereby also gaining knowledge of autoregulation and molecular physiology that possibly underlies mind/body medicine Abstract Anxiety sensitivity , or the belief that anxiety-related sensations can have negative consequences , has been shown to play an important role in the etiology and maintenance of panic disorder and other anxiety-related pathology . Aerobic exercise involves exposure to physiological cues similar to those experienced during anxiety reactions . The present study sought to investigate the efficacy of a brief aerobic exercise intervention for high anxiety sensitivity . Accordingly , 24 participants with high anxiety sensitivity scores ( Anxiety Sensitivity Index-Revised scores > 28 ) were r and omly assigned to complete either six 20-minute sessions of aerobic exercise or a no-exercise control condition . The results indicated that individuals assigned to the aerobic exercise condition reported significantly less anxiety sensitivity subsequent to exercise , whereas anxiety sensitivity scores among non-exercisers did not significantly change . The clinical research and public health implication s of these findings are discussed , and several potential directions for additional research are recommended Objective : Alternative approaches to weight control and physical activity are increasingly needed . Numerous factors influence weight management , including the choice of physical exercise . No study has previously examined the therapeutic effect of a multidisciplinary weight management program incorporating Tai Chi ( TC ) exercises among sedentary obese women . Design : R and omized intervention trial with blinded medical provider . Setting : In day hospital consultations . Participants : Twenty-one obese women . Intervention : All subjects participated in a 10-week weight management program that was part of usual care and included a hypocaloric balanced diet , a weekly physician/psychologist/dietician group session , and an exercise program . For the exercise component , subjects were r and omized to either a 2-hour weekly session of TC or a conventional structured exercise program . Main Outcome Measures : Changes in weight , body composition , heart rate , blood pressure , mobility scores , mood , Three Factor Eating Question naire scores , and General Self-Efficacy . Results : The TC arm improved in resting systolic blood pressure , chair rise test , mood , and reduced percent of fat at week 10 and at 6 months follow-up . General self-efficacy was enhanced in both groups and maintained at 30 weeks . Conclusion : The observed benefits over a 30-week period of a multidisciplinary weight management program incorporating TC exercises on physical functioning mood and dietary restraint need further underst and ing of how sedentary obese women adhere to physical activity like TC or other alternative exercises Older persons who are willing to begin exercise programs are often not willing to continue them . At the Atlanta FICSIT ( Frailty and Injuries : Cooperative Studies of Intervention Techniques ) site , individuals aged 70 + were r and omized to  Tai Chi ( TC ) , individualized balance training ( BT ) , and exercise control education ( ED ) groups for 15 weeks . In a follow-up assessment 4 months post-intervention , 130 subjects responded to exit interview questions asking about perceived benefits of participation . Both TC and BT subjects reported increased confidence in balance and movement , but only TC subjects reported that their daily activities and their overall life had been affected ; many of these subjects had changed their normal physical activity to incorporate ongoing TC practice . The data suggest that when mental as well as physical control is perceived to be enhanced , with a generalized sense of improvement in overall well-being , older persons ' motivation to continue exercising also increases Goals Health-related quality of life ( HRQL ) and self-esteem are often diminished among women diagnosed and treated for breast cancer .  Tai Chi is a moderate form of exercise that may be an effective therapy for improving HRQL and self-esteem among these women . We sought to compare the efficacy of Tai Chi Chuan ( TCC ) and psychosocial support ( PST ) for improving HRQL and self-esteem among breast cancer survivors . Patients and methods A group of 21 women diagnosed with breast cancer , who had completed treatment within the last 30 months were r and omized to receive 12 weeks of TCC or PST . Participants in both groups met three times a week for 60 minutes . HRQL and self-esteem were assessed at baseline , 6 weeks , and 12 weeks . Results The TCC group demonstrated significant improvements in HRQL , while the PST group reported declines in HRQL , with the differences between the two groups approaching significance at week 12 . Additionally , the TCC group exhibited improvements in self-esteem , while the PST group reported declines in self-esteem , with the differences between groups reaching statistical significance at week 12 . These findings , coupled with a visual inspection of the raw change scores , support the plausibility of a dose-response relationship concerning Tai Chi . Conclusions In this pilot investigation , the TCC group exhibited improvements in HRQL and self-esteem from baseline to 6 and 12 weeks , while the support group exhibited declines . R and omized , controlled clinical trials with larger sample sizes are needed AIM This paper reports a study to examine change in psychosocial status following a 12-week Tai Chi exercise intervention among ethnic Chinese people with cardiovascular disease risk factors living in the United States of America . BACKGROUND Regular participation in physical activity is associated with protection against cardioavascular disease , and improvements in physical and psychological health . Increasing amounts of scientific evidence suggests that mind-body exercise , such as Tai Chi , are related to improvements in mental health , emotional well-being , and stress reduction . No prior study has examined the effect of a Tai Chi exercise intervention on psychosocial status among people with cardiovascular disease risk factors . METHODS This was a quasi-experimental study . Participants attended a 60-minute Tai Chi exercise class three times per week for 12 weeks . Data were collected at baseline , 6 and 12 weeks following the intervention . Psychosocial status was assessed using Chinese versions of Cohen 's Perceived Stress Scale , Profile of Mood States , Multidimensional Scale of Perceived Social Support , and Tai Chi exercise self-efficacy . RESULTS A total of 39 participants , on average 66-year-old ( + /-8.3 ) , married ( 85 % ) , Cantonese-speaking ( 97 % ) , immigrants participated . The majority were women ( 69 % ) , with < or = 12 years education ( 87 % ) . Statistically significant improvements in all measures of psychosocial status were found ( P < or = 0.05 ) following the intervention . Improvement in mood state ( eta2 = 0.12 ) , and reduction in perceived stress ( eta2 = 0.13 ) were found . In addition , Tai Chi exercise statistically significantly increased self-efficacy to overcome barriers to Tai Chi ( eta2 = 0.19 ) , confidence to perform Tai Chi ( eta2 = 0.27 ) , and perceived social support ( eta2 = 0.12 ) . CONCLUSIONS Tai Chi was a culturally appropriate mind-body exercise for these older adults , with statistically significant psychosocial benefits observed over 12-weeks . Further research examining Tai Chi exercise using a r and omized clinical trial design with an attention-control group may reduce potential confounding effects , while exploring potential mechanisms underlying the relaxation response associated with mind-body exercise . In addition , future studies with people with other chronic illnesses in all ethnic groups are recommended to determine if similar benefits can be achieved OBJECTIVES To determine whether an intense tai chi exercise program could reduce fear of falling better than a wellness education ( WE ) program in older adults who had fallen previously and meet criteria for transitioning to frailty . DESIGN Cluster-r and omized , controlled trial of 48 weeks ' duration . SETTING Ten matched pairs of congregate living facilities in the greater Atlanta area . PARTICIPANTS Sample of 291 women and 20 men , aged 70 to 97 . MEASUREMENTS Activity-related fear of falling using the Activities-Specific Balance Confidence Scale ( ABC ) and the Fall Efficacy Scale at baseline and every 4 months for 1 year . Demographics , time to first fall and all subsequent falls , functional measures , Centers for Epidemiologic Studies Depression Scale , medication use , level of physical activity , comorbidities , and adherence to interventions . RESULTS Mean ABC was similar in both cohort groups at the time of r and omization but became significantly higher ( decreased fear ) in the tai chi cohort at 8 months ( 57.9 vs 49.0 , P<.001 ) and at study end ( 59.2 vs 47.9 , P<.001 ) . After adjusting for covariates , the mean ABC after 12 months of intervention was significantly greater in the tai chi group than in the WE group , with the differences increasing with time ( mean difference at 12 months=9.5 points , 95 % confidence interval=4.8 - 14.2 , P<.001 ) . CONCLUSION Tai chi led to a significantly greater reduction in fear of falling than a WE program in transitionally frail older adults . The mean percentage change in ABC scores widened between tai chi and WE participants over the trial period . Tai chi should be considered in any program design ed to reduce falling and fear of falling in transitionally frail older adults Background Fibromyalgia ( FM ) , one of the most common musculoskeletal disorders , is associated with high levels of impaired health and inadequate or limited symptom relief . The cause of this complex syndrome is unknown , and there is no known cure . Numerous research results indicate that a combination of physical exercise and mind-body therapy is effective in symptom management .  T’ai Chi , an ancient Chinese exercise , combines physical exercise with mind-body therapy . Purpose To investigate the effects of T’ai Chi exercise on FM symptoms and health-related quality of life . Design Pilot study , one group pre-to-post posttest design . Methods Participants with FM ( n = 39 ) formed a single group for 6 weeks of 1-hour , twice weekly T’ai Chi exercise classes .  FM symptoms and health-related quality of life were measured before and after exercise . Findings Twenty-one participants completed at least 10 of the 12 exercise sessions . Although the dropout rate was higher than expected , measurements on both the Fibromyalgia Impact Question naire ( FIQ ) ( Buckhardt , Clark , & Bennett , 1991 ) and the Short Form-36 ( SF-36 ) ( Ware & Sherbourne , 1992 ) revealed statistically significant improvement in symptom management and health-related quality of life . Implication s for Nursing Research Knowledge of interventions to enhance health for the patient with mus 
    Output:
    
Conclusions Tai Chi appears to be associated with improvements in psychological well-being including reduced stress , anxiety , depression and mood disturbance , and increased self-esteem .