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: 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 Background Rheumatoid arthritis ( RA ) has been known to be associated with increased risk of cardiovascular disease ( CVD ) . The aim of this study was to investigate the effects of Tai Chi exercise on CVD risk in elderly women with RA . Method In total , 56 female patients with RA were assigned to either a Tai Chi exercise group ( 29 patients ) receiving a 3-month exercise intervention once a week or a control group ( 27 patients ) receiving general information about the benefits of exercise . All participants were assessed at baseline and at 3 months for RA disease activity ( Disease Activity Score 28 and Routine Assessment of Patient Index Data 3 ) , functional disability ( Health Assessment Question naire ) , CVD risk factors ( blood pressure , lipids profile , body composition , and smoking ) , and three atherosclerotic measurements : carotid intima-media thickness , flow-mediated dilatation ( FMD ) , and brachial-ankle pulse wave velocity ( baPWV ) . Results FMD , representative of endothelial function , significantly increased in the Tai Chi exercise group ( initial 5.85 ± 2.05 versus 3 months 7.75 ± 2.53 % ) compared with the control group ( initial 6.31 ± 2.12 versus 3 months 5.78 ± 2.13 % ) ( P = 1.76 × 10−3 ) . Moreover , baPWV , representative of arterial stiffness , significantly decreased in the Tai Chi exercise group ( initial 1693.7 ± 348.3 versus 3 months 1600.1 ± 291.0 cm/s ) compared with the control group ( initial 1740.3 ± 185.3 versus 3 months 1792.8 ± 326.1 cm/s ) ( P = 1.57 × 10−2 ) . In addition , total cholesterol decreased significantly in the Tai Chi exercise group compared with the control group ( −7.8 ± 15.5 versus 2.9 ± 12.2 mg/dl , P = 2.72 × 10−2 ) ; other changes in RA-related characteristics were not significantly different between the two groups . Tai Chi exercise remained significantly associated with improved endothelial function ( FMD ; P = 4.32 × 10−3 ) and arterial stiffness ( baPWV ; P = 2.22 × 10−2 ) after adjustment for improvement in total cholesterol level . Conclusion Tai Chi exercise  improved endothelial dysfunction and arterial stiffness in elderly women with RA , suggesting that it can be a useful behavioral strategy for CVD prevention in patients with RA This study was design ed to determine whether a 6-month Tai Chi exercise program can improve self-reported physical functioning limitations among healthy , physically inactive older individuals . Ninety-four community residents ages 65 to 96 ( M age = 72.8 years , SD = 5.1 ) volunteered to participate in the study . Participants were r and omly assigned to either a 6-month experimental ( Tai Chi ) group ( n = 49 ) , which exercised twice per week for 60 min , or a wait-list control group ( n = 45 ) . A 6-item self-report physical functioning scale , assessing the extent of behavioral dysfunction caused by health problems , was used to evaluate change in physical functioning limitations as a result of Tai Chi intervention . Results indicated that compared to the control group , participants in the Tai Chi group experienced significant improvements in all aspects of physical functioning over the course of the 6-month intervention . Overall , the experimental group had 65 % improvement across all 6 functional status measures ranging from daily activities such as walking and lifting to moderate-vigorous activities such as running . It was concluded that the 6-month Tai Chi exercise program was effective for improving functional status in healthy , physically inactive older adults . A self-paced and self-controlled activity such as Tai Chi has the potential to be an effective , low-cost means of improving functional status in older persons Abstract Objectives To determine the effectiveness of tai chi interventions compared with aerobic exercise , a current core st and ard treatment in patients with fibromyalgia , and to test whether the effectiveness of tai chi depends on its dosage or duration . Design Prospect i ve , r and omized , 52 week , single blind comparative effectiveness trial . Setting Urban tertiary care academic hospital in the United States between March 2012 and September 2016 . Participants 226 adults with fibromyalgia ( as defined by the American College of Rheumatology 1990 and 2010 criteria ) were included in the intention to treat analyses : 151 were assigned to one of four tai chi groups and 75 to an aerobic exercise group . Interventions Participants were r and omly assigned to either supervised aerobic exercise ( 24 weeks , twice weekly ) or one of four classic Yang style supervised tai chi interventions ( 12 or 24 weeks , once or twice weekly ) . Participants were followed for 52 weeks . Adherence was rigorously encouraged in person and by telephone . Main outcome measures The primary outcome was change in the revised fibromyalgia impact question naire ( FIQR ) scores at 24 weeks compared with baseline . Secondary outcomes included changes of scores in patient ’s global assessment , anxiety , depression , self efficacy , coping strategies , physical functional performance , functional limitation , sleep , and health related quality of life . Results FIQR scores improved in all five treatment groups , but the combined tai chi groups improved statistically significantly more than the aerobic exercise group in FIQR scores at 24 weeks ( difference between groups=5.5 points , 95 % confidence interval 0.6 to 10.4 , P=0.03 ) and several secondary outcomes ( patient ’s global assessment = 0.9 points , 0.3 to 1.4 , P=0.005 ; anxiety=1.2 points , 0.3 to 2.1 , P=0.006 ; self efficacy=1.0 points , 0.5 to 1.6 , P=0.0004 ; and coping strategies , 2.6 points , 0.8 to 4.3 , P=0.005 ) . Tai chi treatment compared with aerobic exercise administered with the same intensity and duration ( 24 weeks , twice weekly ) had greater benefit ( between group difference in FIQR scores=16.2 points , 8.7 to 23.6 , P<0.001 ) . The groups who received tai chi for 24 weeks showed greater improvements than those who received it for 12 weeks ( difference in FIQR scores=9.6 points , 2.6 to 16.6 , P=0.007 ) . There was no significant increase in benefit for groups who received tai chi twice weekly compared with once weekly . Participants attended the tai chi training sessions more often than participants attended aerobic exercise . The effects of tai chi were consistent across all instructors . No serious adverse events related to the interventions were reported . Conclusion Tai chi mind-body treatment results in similar or greater improvement in symptoms than aerobic exercise , the current most commonly prescribed non-drug treatment , for a variety of outcomes for patients with fibromyalgia . Longer duration of tai chi showed greater improvement . This mind-body approach may be considered a therapeutic option in the multidisciplinary management of fibromyalgia . Trial registration Clinical Trials.gov NCT01420640 OBJECTIVE To evaluate the effects of two exercise approaches , Tai Chi ( TC ) and computerized balance training ( BT ) , on specified primary outcomes ( biomedical , functional , and psychosocial indicators of frailty ) and secondary outcomes ( occurrence of falls ) . DESIGN The Atlanta FICSIT ( Frailty and Injuries : Cooperative Studies of Intervention Techniques ) , a prospect i ve , r and omized , controlled clinical trial with three arms ( TC , BT , and education [ ED ] . Intervention length was 15 weeks , with primary outcomes measured before and after intervention and at 4-month follow-up . Falls were monitored continuously throughout the study . SETTING Persons aged 70 and older living in the community . PARTICIPANTS A total of 200 participants , 162 women and 38 men ; mean age was 76.2 . MEASUREMENTS Biomedical ( strength , flexibility , cardiovascular endurance , body composition ) , functional ( IADL ) , and psychosocial well-being ( CES-D scale , fear of falling question naire , self-perception of present and future health , mastery index , perceived quality of sleep , and intrusiveness ) variables . RESULTS Grip strength declined in all groups , and lower extremity range of motion showed limited but statistically significant changes . Lowered blood pressure before and after a 12-minute walk was seen following TC participation . Fear of falling responses and intrusiveness responses were reduced after the TC intervention compared with the ED group ( P = .046 and P = .058 , respectively ) . After adjusting for fall risk factors , TC was found to reduce the risk of multiple falls by 47.5 % . CONCLUSIONS A moderate TC intervention can impact favorably on defined biomedical and psychosocial indices of frailty . This intervention can also have favorable effects upon the occurrence of falls .  Tai Chi warrants further study as an exercise treatment to improve the health of older people OBJECTIVE Evaluate effectiveness of the Arthritis Foundation Tai Chi Program for community participants with arthritis . METHODS 343 individuals were r and omized to either the intervention or wait-list control group .  Performance and self-reported outcome ( SRO ) measures were assessed at baseline and eight weeks . At one year , SROs only were assessed . Adjusted means were determined using regression models adjusting for covariates , and effect sizes ( ES ) were calculated . RESULTS Average participant age was 66 years , 87 % were female , and 87 % were Caucasian . Among 284 ( 83 % ) participants who returned at eight weeks , balance by reach ( ES = 0.30 ) and helplessness , sleep , and role participation satisfaction ( ES = 0.24 - 0.54 ) improved significantly ; pain , fatigue , and stiffness improvement ( ES = 0.15 - 0.23 ) approached significance . No change was noted in mobility , lower extremity strength , or single-leg stance balance . At one year , improvements in pain , fatigue , stiffness , helplessness , and role participation satisfaction at eight weeks were maintained ; 30 % continued tai chi practice . CONCLUSION Moderate effectiveness of the Arthritis Foundation Tai Chi Program was confirmed Previous research ers have found that 10-form Tai chi yields symptomatic benefit in patients with fibromyalgia ( FM ) . The purpose of this study was to further investigate earlier findings and add a focus on functional mobility . We conducted a parallel-group r and omized controlled trial FM-modified 8-form Yang-style Tai chi program compared to an education control . Participants met in small groups twice weekly for 90 min over 12 weeks . The primary endpoint was symptom reduction and improvement in self-report physical function , as measured by the Fibromyalgia Impact Question naire ( FIQ ) , from baseline to 12 weeks . Secondary endpoints included pain severity and interference ( Brief Pain Inventory ( BPI ) , sleep ( Pittsburg sleep Inventory ) , self-efficacy , and functional mobility . Of the 101 r and omly assigned subjects ( mean age 54 years , 93 % female ) , those in the Tai chi condition compared with the education condition demonstrated clinical ly and statistically significant improvements in FIQ scores ( 16.5 vs. 3.1 , p = 0.0002 ) , BPI pain severity ( 1.2 vs. 0.4 , p = 0.0008 ) , BPI pain interference ( 2.1 vs. 0.6 , p = 0.0000 ) , sleep ( 2.0 vs. −0.03 , p = 0.0003 ) , and self-efficacy for pain control ( 9.2 vs. −1.5 , p = 0.0001 ) . Functional mobility variables including timed get up and go ( −.9 vs. −.3 , p = 0.0001 ) , static balance ( 7.5 vs. −0.3 , p = 0.0001 ) , and dynamic balance ( 1.6 vs. 0.3 , p = 0.0001 ) were significantly improved with Tai chi compared with education control . No adverse events were noted . Twelve weeks of Tai chi , practice twice weekly , provided worthwhile improvement in common FM symptoms including pain and physical function including mobility .  Tai chi appears to be a safe and an acceptable exercise modality that may be useful as adjunctive therapy in the management of FM patients . ( Clinical Trials.gov Identifier , NCT01311427 The effects of hydroxychloroquine and sulphasalazine on progression of joint damage shown by X-rays were compared in a double-blind , r and omised trial in  
    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: 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 Background Rheumatoid arthritis ( RA ) has been known to be associated with increased risk of cardiovascular disease ( CVD ) . The aim of this study was to investigate the effects of Tai Chi exercise on CVD risk in elderly women with RA . Method In total , 56 female patients with RA were assigned to either a Tai Chi exercise group ( 29 patients ) receiving a 3-month exercise intervention once a week or a control group ( 27 patients ) receiving general information about the benefits of exercise . All participants were assessed at baseline and at 3 months for RA disease activity ( Disease Activity Score 28 and Routine Assessment of Patient Index Data 3 ) , functional disability ( Health Assessment Question naire ) , CVD risk factors ( blood pressure , lipids profile , body composition , and smoking ) , and three atherosclerotic measurements : carotid intima-media thickness , flow-mediated dilatation ( FMD ) , and brachial-ankle pulse wave velocity ( baPWV ) . Results FMD , representative of endothelial function , significantly increased in the Tai Chi exercise group ( initial 5.85 ± 2.05 versus 3 months 7.75 ± 2.53 % ) compared with the control group ( initial 6.31 ± 2.12 versus 3 months 5.78 ± 2.13 % ) ( P = 1.76 × 10−3 ) . Moreover , baPWV , representative of arterial stiffness , significantly decreased in the Tai Chi exercise group ( initial 1693.7 ± 348.3 versus 3 months 1600.1 ± 291.0 cm/s ) compared with the control group ( initial 1740.3 ± 185.3 versus 3 months 1792.8 ± 326.1 cm/s ) ( P = 1.57 × 10−2 ) . In addition , total cholesterol decreased significantly in the Tai Chi exercise group compared with the control group ( −7.8 ± 15.5 versus 2.9 ± 12.2 mg/dl , P = 2.72 × 10−2 ) ; other changes in RA-related characteristics were not significantly different between the two groups . Tai Chi exercise remained significantly associated with improved endothelial function ( FMD ; P = 4.32 × 10−3 ) and arterial stiffness ( baPWV ; P = 2.22 × 10−2 ) after adjustment for improvement in total cholesterol level . Conclusion Tai Chi exercise  improved endothelial dysfunction and arterial stiffness in elderly women with RA , suggesting that it can be a useful behavioral strategy for CVD prevention in patients with RA This study was design ed to determine whether a 6-month Tai Chi exercise program can improve self-reported physical functioning limitations among healthy , physically inactive older individuals . Ninety-four community residents ages 65 to 96 ( M age = 72.8 years , SD = 5.1 ) volunteered to participate in the study . Participants were r and omly assigned to either a 6-month experimental ( Tai Chi ) group ( n = 49 ) , which exercised twice per week for 60 min , or a wait-list control group ( n = 45 ) . A 6-item self-report physical functioning scale , assessing the extent of behavioral dysfunction caused by health problems , was used to evaluate change in physical functioning limitations as a result of Tai Chi intervention . Results indicated that compared to the control group , participants in the Tai Chi group experienced significant improvements in all aspects of physical functioning over the course of the 6-month intervention . Overall , the experimental group had 65 % improvement across all 6 functional status measures ranging from daily activities such as walking and lifting to moderate-vigorous activities such as running . It was concluded that the 6-month Tai Chi exercise program was effective for improving functional status in healthy , physically inactive older adults . A self-paced and self-controlled activity such as Tai Chi has the potential to be an effective , low-cost means of improving functional status in older persons Abstract Objectives To determine the effectiveness of tai chi interventions compared with aerobic exercise , a current core st and ard treatment in patients with fibromyalgia , and to test whether the effectiveness of tai chi depends on its dosage or duration . Design Prospect i ve , r and omized , 52 week , single blind comparative effectiveness trial . Setting Urban tertiary care academic hospital in the United States between March 2012 and September 2016 . Participants 226 adults with fibromyalgia ( as defined by the American College of Rheumatology 1990 and 2010 criteria ) were included in the intention to treat analyses : 151 were assigned to one of four tai chi groups and 75 to an aerobic exercise group . Interventions Participants were r and omly assigned to either supervised aerobic exercise ( 24 weeks , twice weekly ) or one of four classic Yang style supervised tai chi interventions ( 12 or 24 weeks , once or twice weekly ) . Participants were followed for 52 weeks . Adherence was rigorously encouraged in person and by telephone . Main outcome measures The primary outcome was change in the revised fibromyalgia impact question naire ( FIQR ) scores at 24 weeks compared with baseline . Secondary outcomes included changes of scores in patient ’s global assessment , anxiety , depression , self efficacy , coping strategies , physical functional performance , functional limitation , sleep , and health related quality of life . Results FIQR scores improved in all five treatment groups , but the combined tai chi groups improved statistically significantly more than the aerobic exercise group in FIQR scores at 24 weeks ( difference between groups=5.5 points , 95 % confidence interval 0.6 to 10.4 , P=0.03 ) and several secondary outcomes ( patient ’s global assessment = 0.9 points , 0.3 to 1.4 , P=0.005 ; anxiety=1.2 points , 0.3 to 2.1 , P=0.006 ; self efficacy=1.0 points , 0.5 to 1.6 , P=0.0004 ; and coping strategies , 2.6 points , 0.8 to 4.3 , P=0.005 ) . Tai chi treatment compared with aerobic exercise administered with the same intensity and duration ( 24 weeks , twice weekly ) had greater benefit ( between group difference in FIQR scores=16.2 points , 8.7 to 23.6 , P<0.001 ) . The groups who received tai chi for 24 weeks showed greater improvements than those who received it for 12 weeks ( difference in FIQR scores=9.6 points , 2.6 to 16.6 , P=0.007 ) . There was no significant increase in benefit for groups who received tai chi twice weekly compared with once weekly . Participants attended the tai chi training sessions more often than participants attended aerobic exercise . The effects of tai chi were consistent across all instructors . No serious adverse events related to the interventions were reported . Conclusion Tai chi mind-body treatment results in similar or greater improvement in symptoms than aerobic exercise , the current most commonly prescribed non-drug treatment , for a variety of outcomes for patients with fibromyalgia . Longer duration of tai chi showed greater improvement . This mind-body approach may be considered a therapeutic option in the multidisciplinary management of fibromyalgia . Trial registration Clinical Trials.gov NCT01420640 OBJECTIVE To evaluate the effects of two exercise approaches , Tai Chi ( TC ) and computerized balance training ( BT ) , on specified primary outcomes ( biomedical , functional , and psychosocial indicators of frailty ) and secondary outcomes ( occurrence of falls ) . DESIGN The Atlanta FICSIT ( Frailty and Injuries : Cooperative Studies of Intervention Techniques ) , a prospect i ve , r and omized , controlled clinical trial with three arms ( TC , BT , and education [ ED ] . Intervention length was 15 weeks , with primary outcomes measured before and after intervention and at 4-month follow-up . Falls were monitored continuously throughout the study . SETTING Persons aged 70 and older living in the community . PARTICIPANTS A total of 200 participants , 162 women and 38 men ; mean age was 76.2 . MEASUREMENTS Biomedical ( strength , flexibility , cardiovascular endurance , body composition ) , functional ( IADL ) , and psychosocial well-being ( CES-D scale , fear of falling question naire , self-perception of present and future health , mastery index , perceived quality of sleep , and intrusiveness ) variables . RESULTS Grip strength declined in all groups , and lower extremity range of motion showed limited but statistically significant changes . Lowered blood pressure before and after a 12-minute walk was seen following TC participation . Fear of falling responses and intrusiveness responses were reduced after the TC intervention compared with the ED group ( P = .046 and P = .058 , respectively ) . After adjusting for fall risk factors , TC was found to reduce the risk of multiple falls by 47.5 % . CONCLUSIONS A moderate TC intervention can impact favorably on defined biomedical and psychosocial indices of frailty . This intervention can also have favorable effects upon the occurrence of falls .  Tai Chi warrants further study as an exercise treatment to improve the health of older people OBJECTIVE Evaluate effectiveness of the Arthritis Foundation Tai Chi Program for community participants with arthritis . METHODS 343 individuals were r and omized to either the intervention or wait-list control group .  Performance and self-reported outcome ( SRO ) measures were assessed at baseline and eight weeks . At one year , SROs only were assessed . Adjusted means were determined using regression models adjusting for covariates , and effect sizes ( ES ) were calculated . RESULTS Average participant age was 66 years , 87 % were female , and 87 % were Caucasian . Among 284 ( 83 % ) participants who returned at eight weeks , balance by reach ( ES = 0.30 ) and helplessness , sleep , and role participation satisfaction ( ES = 0.24 - 0.54 ) improved significantly ; pain , fatigue , and stiffness improvement ( ES = 0.15 - 0.23 ) approached significance . No change was noted in mobility , lower extremity strength , or single-leg stance balance . At one year , improvements in pain , fatigue , stiffness , helplessness , and role participation satisfaction at eight weeks were maintained ; 30 % continued tai chi practice . CONCLUSION Moderate effectiveness of the Arthritis Foundation Tai Chi Program was confirmed Previous research ers have found that 10-form Tai chi yields symptomatic benefit in patients with fibromyalgia ( FM ) . The purpose of this study was to further investigate earlier findings and add a focus on functional mobility . We conducted a parallel-group r and omized controlled trial FM-modified 8-form Yang-style Tai chi program compared to an education control . Participants met in small groups twice weekly for 90 min over 12 weeks . The primary endpoint was symptom reduction and improvement in self-report physical function , as measured by the Fibromyalgia Impact Question naire ( FIQ ) , from baseline to 12 weeks . Secondary endpoints included pain severity and interference ( Brief Pain Inventory ( BPI ) , sleep ( Pittsburg sleep Inventory ) , self-efficacy , and functional mobility . Of the 101 r and omly assigned subjects ( mean age 54 years , 93 % female ) , those in the Tai chi condition compared with the education condition demonstrated clinical ly and statistically significant improvements in FIQ scores ( 16.5 vs. 3.1 , p = 0.0002 ) , BPI pain severity ( 1.2 vs. 0.4 , p = 0.0008 ) , BPI pain interference ( 2.1 vs. 0.6 , p = 0.0000 ) , sleep ( 2.0 vs. −0.03 , p = 0.0003 ) , and self-efficacy for pain control ( 9.2 vs. −1.5 , p = 0.0001 ) . Functional mobility variables including timed get up and go ( −.9 vs. −.3 , p = 0.0001 ) , static balance ( 7.5 vs. −0.3 , p = 0.0001 ) , and dynamic balance ( 1.6 vs. 0.3 , p = 0.0001 ) were significantly improved with Tai chi compared with education control . No adverse events were noted . Twelve weeks of Tai chi , practice twice weekly , provided worthwhile improvement in common FM symptoms including pain and physical function including mobility .  Tai chi appears to be a safe and an acceptable exercise modality that may be useful as adjunctive therapy in the management of FM patients . ( Clinical Trials.gov Identifier , NCT01311427 The effects of hydroxychloroquine and sulphasalazine on progression of joint damage shown by X-rays were compared in a double-blind , r and omised trial in  
    Output:
    