Exercise

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Category: Life Style Options

What is it?

Exercise is the activity of exerting your muscles in various ways to improve or maintain physical fitness. Exercise for PTSD can include flexibility, aerobic and strength training, tai chi and yoga. This can be done individually, one-on-one with a personal trainer or within a group. Exercise typically has effects on the cardiovascular, musculoskeletal and neurological systems of our body.

How does it work?

It is thought that exercise can help improve flexibility, function, and physical fitness. It is thought to help improve and maintain muscle strength and endurance, coordination, balance, and control. In addition it is thought to improve patient satisfaction and quality of life through its effect on the musculoskeletal, cardiovascular and neurological systems. Exercise is also thought to promote the production of endorphins, naturally occurring opioid hormones, commonly termed happy hormones, by the brain that can help promote well being.

Is it effective?

Evidence does exist that exercise is beneficial for depression and anxiety in the treatment of mental health issues. Indeed various forms of exercise such as aerobic and anaerobic have been shown to provide general benefits for physical and mental health. Consequently, there may be both direct and indirect benefits from exercise in the treatment of PTSD. However the use of exercise as treatment for PTSD has not been research adequately to identify its effectiveness.

Are there any disadvantages?

Usually exercise is quite safe but you should always seek advice from your doctor or health professional regarding exercise in reference to PTSD. It is not uncommon to feel muscle soreness or stiffness after exercise that can persist for up to 48 hours post exercise and is termed delayed onset of muscle soreness (DOMS). This is particularly relevant at the beginning of a new exercise program or after a dramatic increase in the duration or intensity of exercise. DOMS is a normal response to unusual exertion and is part of an adaptation process that leads to greater stamina and strength as the muscles recover and build.

Where do you get it?

Specific exercises may be prescribed to you by your doctor or treating therapist. These may be performed under their direct supervision, or in a number of settings including at home, in a gym, or as part of an exercise group with other people in the wider community. It is best to seek advice from your doctor or health provider before starting up an exercise program. While these strategies are pursued, it is also important that the person with PTSD is under the care of a certified health professional.

What are the evidence limitations?

One study assessed exercise as a treatment for PTSD but did not use the DSM-IV for inclusion criteria into their PTSD sample. To date evidence for its use is minimal, and there is no explicit support for its use as an independent intervention for PTSD. Much of the evidence base is derived from lower levels of evidence such as expert opinion and clinical experiences. Therefore interpreting this evidence should be undertaken with caution.

Recommendations

The role of exercise intervention may have greater benefits in combination with other treatment strategies typically used to address PTSD, such as psychological interventions and drug therapies. The use of exercise as a sole intervention for PTSD cannot be recommended based on the current research evidence.

Key References

Australian Centre for Posttraumatic Mental Health 2007, ‘Australian guidelines for the treatment of adults with Acute Stress Disorder and Posttraumatic Stress Disorder. Practitioner Guide’ National Health and Medical research Council, viewed 11 December 2008,
http://www.nhmrc.gov.au/publications/synopses/_files/mh13.pdf

Manger, TA & Motta, RW, 2005, ‘The impact of an exercise program on posttraumatic stress disorder, anxiety, and depression’, International Journal of Emergency Mental Health, vol. 7, no. 1, pp. 49-57.

Stathopoulou, G, Powers, MB, Berry, AC et al. 2006, ‘Exercise interventions for mental health: a quantitative and qualitative review’, Clinical Psychology: Science and Practice, Vol. 13. No. 2, pp. 179-193

Sjosten, N & Kivela, SL, 2006, ‘The effects of physical exercise on depressive symptoms among the aged: a systematic review’, International Journal of Geriatric Psychiatry, vol. 21, pp. 410-418.

Thachil, A, Mohan, R, Bhugra, D, 2007, ‘The evidence base of complementary and alternative therapies in depression’, Journal of Affective Disorders , Vol. 97, no. 3, pp. 23-35.

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