FITNESS

10 minutes of aerobic exercise with exposure therapy found to reduce symptoms of PTSD

Overview: Intensifying exposure therapy with 10 minutes of aerobic exercise reduces the severity of PTSD symptoms for up to 6 months after a 9-week treatment course is completed.

sauce: University of New South Wales

Exposure therapy is one of the main treatments for post-traumatic stress disorder (PTSD), but up to half of all patients do not respond to it.

However, a study led by psychologists at UNSW Sydney found that intensifying treatment with 10 minutes of aerobic exercise significantly reduced the severity of PTSD symptoms six months after completing nine weeks of treatment. It turns out that the patient reported

In the first known single-blind, randomized, controlled trial of its kind, researchers in Sydney recruited 130 adults with a clinical diagnosis of PTSD and assigned them to two groups. People received nine 90-minute exposure therapy sessions. At the end of each session, one group had him perform 10 minutes of aerobic exercise, and members of the control group he performed 10 minutes of passive stretching.

People in the aerobic exercise group reported, on average, less severe PTSD symptoms as measured by the CAPS-2 scale than those whose exposure therapy was augmented by stretching exercise at 6-month follow-up. Interestingly, one week after the treatment program ended, there was no clear difference between the two groups, suggesting that the effects take longer to appear.

The survey results are lancet psychiatry.

extinction learning

Scientia Professor Richard Bryant oversaw the clinical study conducted from 2012 to 2018. He states that the goal of exposure therapy in treating PTSD is extinction learning. In this learning, the patient learns to equate feelings with something previously associated with trauma. Safe.

For example, a person who has experienced sexual violence may associate some of the stimuli that were present at the time of the trauma (e.g., nighttime, sex, smell after shaving) with threat. Exposure therapy focuses on these triggers and attempts to demonstrate that they pose no threat.

“Extinction learning is not about forgetting bad experiences,” says Professor Bryant. “It is new learning that inhibits old learning.

“Previous studies have shown that very brief aerobic exercise is helpful because it actually enhances extinction learning in rats, and it has been shown to enhance it in humans under experimental conditions. I have.”

However, this theory has not been tested in clinical conditions until now.Professor Bryant and colleagues believe that short periods of intense exercise promote a specific growth molecule in the brain called brain-derived neurotrophic factor (BDNF). says he is thinking.

People in the aerobic exercise group reported, on average, less severe PTSD symptoms as measured by the CAPS-2 scale than those whose exposure therapy was augmented by stretching exercise at 6-month follow-up. I did. The image is in the public domain

“The reason it’s really important is because it actually promotes synaptic plasticity in the brain, which is really important for learning. And we know that this underpins extinction learning. So this If we can make BDNF more active in the brain, it should theoretically lead to better erasure during exposure therapy.”

more research needed

To Professor Bryant’s knowledge, this is the first time that the benefits of combined aerobic exercise and exposure therapy have been observed in a clinical setting. But despite being pleasantly surprised by the results, he noted that before fine-tuning this treatment was recommended, standard practice, or used to treat other psychological conditions, He said the research needs to be repeated over and over again.

“I would like to emphasize that this is the first trial to show this in anxiety disorders. I don’t think you should get too excited.

“But like all these things, it always takes multiple tries to really believe it. That said, it’s very encouraging.”

Professor Bryant says there are now large-scale trials replicating the method in Melbourne that he and his colleagues are watching with interest.

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About this PTSD and exercise research news

author: Lachlan Gilbert
sauce: University of New South Wales
contact: Lachlan Gilbert – University of New South Wales
image: image is public domain

Original research: closed access.
“Intensifying Trauma-Focused Psychotherapy for Post-Traumatic Stress Disorder with Brief Aerobic Exercise in Australia: A Randomized Clinical Trial.” Richard A. Bryant, et al. Lancet Psychiatry


Overview

Augmenting Trauma-Focused Psychotherapy for Post-Traumatic Stress Disorder with Brief Aerobic Exercise in Australia: A Randomized Clinical Trial

Background

Exposure therapy is central to most front-line psychotherapy for post-traumatic stress disorder (PTSD), but many patients do not respond to this treatment. We aimed to investigate the effect of brief aerobic exercise on the efficacy of exposure therapy to reduce the severity of PTSD.

method

A single-blind, parallel, randomized, controlled trial was conducted in Sydney, New South Wales, Australia. We included adults (18 years and older) with clinician-diagnosed PTSD. Imminent risk of suicide (reporting suicide plans), presence of psychosis or substance dependence, history of moderate to severe traumatic brain injury, or physical disability that may be exacerbated by or Participants aged 70 years and older with the presence of functional impairment were excluded. Aerobic exercise (such as back pain). Participants were randomized (1:1) to nine weekly 90-minute exposure therapy sessions for her PTSD with 10 minutes of aerobic exercise, or an exposure therapy control group with 10 minutes of passive stretching. were assigned to a group that performed The primary outcome was his PTSD severity, as measured by the clinician-administered PTSD scale 2 (CAPS-2), at baseline, 1 week post-treatment, and 6 months post-treatment (at the time of the primary outcome) evaluated individually.

findings

Between December 12, 2012 and July 25, 2018, 130 participants with PTSD were enrolled and 65 (50%) participants were randomly assigned to exposure therapy with exercise. People (50%) were randomly assigned to exposure therapy with passive stretching. %) females and 51 (39%) males, mean age 39.1 years (SD 14.4; range 18-69). Of his participants, 99 (76%) were listed as Caucasian, 14 (11%) as Asian, and 17 (13%) as other. At the 6-month follow-up evaluation, participants in the exposure therapy with exercise group showed significantly lower CAPS-2 scores compared to participants in the exposure therapy with stretching group (mean difference 12.1 [95% CI 2·4–21·8]p=0.023), resulting in a moderate effect size of 0.6 (0.1–1.1). No adverse events related to the intervention were reported. The trial was prospectively registered in the Australian and New Zealand Clinical Trials Registry ACTRN12612000185864.

interpretation

Brief aerobic exercise has the potential to increase the long-term benefits of exposure therapy for PTSD. This is consistent with evidence from animal and human studies on the role of locomotion in regulating extinction learning processes. This strategy may provide a simple and affordable means to enhance the therapeutic efficacy of exposure therapy in people with PTSD.

fundraising

Australian National Health and Medical Research Council.

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