Improving Mind/Body Health and Functioning With Integrative Exercise
Condition: Stress Disorders, Post-Traumatic
MeSH terms: Stress Disorders, Traumatic; Stress Disorders, Post-Traumatic
Study type: Interventional

Summary: 
      There is evidence demonstrating that aerobic exercise improves many symptoms of Posttraumatic
      Stress Disorder (PTSD) including; anxiety, depression, insomnia, and cognition. With the goal
      of using exercise as a rehabilitation therapy for Veterans with PTSD, a team of scientists
      and doctors developed a 12-week exercise program, combining aerobic and strength training
      with concentration training and mindful breathing techniques. The initial pilot study
      suggested that Integrative Exercise may improve overall quality of life, sleep quality,
      cardiovascular fitness, and PTSD symptoms. This new study will help determine the
      effectiveness of Integrative Exercise compared to health education classes. The overall goal
      is to determine if integrative exercise is an effective rehabilitation intervention for
      combat Veterans with PTSD.
    

Detailed description: 
      Despite the considerable efforts of the VA to improve awareness of mental health problems and
      access to care, many returning Veterans still report substantial barriers to seeking
      traditional mental health care. There is a large body of evidence demonstrating that aerobic
      exercise effectively improves many outcomes relevant to Posttraumatic Stress Disorder (PTSD)
      including; anxiety, depression, insomnia, cognition, and cardiovascular disease. In addition,
      there is a rapidly growing evidence base showing that aerobic exercise produces an increase
      in the growth of new neurons (e.g., neurogenesis) and increases the volume of the hippocampus
      which underscores the potential value of exercise for producing broad benefits to
      psychological health. Recognizing the promise that exercise might hold for attracting more
      Veterans into care and improving overall health in Veterans with PTSD, a team of
      investigators at the San Francisco Veterans Administration Medical Center (SFVAMC) with
      funding from the Department of Defense developed a treatment protocol and completed a pilot
      study of Integrative Exercise (Aerobic exercise and Breath Training 3 weekly sessions over 12
      weeks) versus a waitlist control condition. Promising results from this trial have led us to
      the next step which is to conduct a definitive efficacy study of Integrative Exercise versus
      an active health education control condition: Illness Management and Recovery (IMR). The
      control condition will be matched on contact hours with treatment personnel. The goal of this
      revised proposal is to test if Integrative Exercise improves overall quality of life, PTSD
      symptoms, sleep quality, and measures of cardiovascular health in combat Veterans with
      chronic PTSD relative to the IMR condition. Another goal is to test if improvements in
      quality of life are predicted by improvements in cardiovascular fitness as measured by
      exercise capacity on treadmill testing. Finally, the proposal will test if Integrative
      Exercise versus IMR will produce greater improvements in additional health outcomes,
      including mood, subjective sleep quality, and PTSD symptoms.
    

Intervention name(s): Veterans Group Exercise (VGX); Illness Management and Recovery
Intervention type(s): Other; Other
Intervention description(s): Integrative Exercise incorporates elements of strength training, flexibility, cardiovascular training, and controlled breathing exercises.; Illness Management and Recovery is an educational program focused on helping individuals more effectively manage their illnesses to pursue their personal recovery goals. The classes include the following topic areas which have been adapted for use in PTSD: recovery, practical facts about PTSD, stress-vulnerability, building social support, medications for PTSD, drug and alcohol use, reducing relapse, coping with stress, coping with persistent symptoms, getting needs met in the VA healthcare system, and living a healthy lifestyle.
Other intervention name(s): VGX, Exercise Classes; IMR, Health Education Classes, PTSD Recovery Classes
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Stress Disorders, Post-Traumatic; Exercise; Mindfulness