Improvements in cardiorespiratory fitness are not significantly associated with post-traumatic stress disorder symptom reduction in intensive treatment

Abstract

Background: Physical activity has been found to have positive effects on symptoms of posttraumatic stress disorder (PTSD). However, the importance and role of cardiorespiratory fitness (CRF) in relation to PTSD treatment outcome is not yet clear. Objective: The purpose of the present study was to test the hypothesis that CRF would increase following intensive trauma-focused treatment (TFT) of PTSD augmented with physical activity, and that improved CRF would be associated with a significant decline in PTSD symptoms. Method: One hundred-eight individuals with severe PTSD (72% women; mean age = 40.44, SD = 11.55) were enrolled in an intensive TFT programme of 8 days within 2 consecutive weeks that consisted of daily prolonged exposure (PE), eye movement desensitization and reprocessing (EMDR) therapy and 6 hours of physical activity each day. CRF levels were assessed at baseline and post-treatment with a 6-Minute Walk Test (6MWT) and, in a subsample, with a submaximal ergometer test (PWC 75% /kg). Severity of PTSD symptoms was measured with the PTSD Symptom Scale-Self Report (PSS-SR). Results: A significant increase in CRF from pre-to post-treatment and a significant decrease of PTSD-symptoms was found. However, CRF difference scores were not associated with treatment outcome. Conclusions: Although individuals with PTSD may show an increase in CRF following an intensive TFT programme augmented with physical activity and a decrease of PTSD-symptoms, the current findings do not support the notion that treatment outcome is related to CRF.

Posttraumatic Stress Disorder Treatment Effects on Cardiovascular Physiology: A Systematic Review and Agenda for Future Research

“…Another study showed no difference in HR or HRV for individuals engaged in mindfulness meditation or paced breathing compared to those in an active control condition (Wahbeh et al., 2016). The authors of another study found that a combination of prolonged exposure therapy, EMDR, and exercise reduced tonic BP (Voorendonk et al., 2019). A study of EMDR found improved tonic HRV but not tonic HR in a single‐arm treatment study (Sack et al., 2007).…”

Trauma-focused treatment outcome for complex PTSD patients: results of an intensive treatment programme

“…The intensive trauma-focused treatment format consisted of two consecutive weeks, with 4 days of treatment each week, in which patients went home for the weekend in between (De Jongh et al, 2020 ; Van Toorenburg et al, 2020 ; Van Woudenberg et al, 2018 ; Voorendonk, Sanches, De Jongh, & Van Minnen, 2019 ; Wagenmans, Van Minnen, Sleijpen, & De Jongh, 2018 ; Zoet, Wagenmans, Van Minnen, & De Jongh, 2018 ). The intensive treatment programme is developed to treat patients suffering from severe PTSD and is specifically designed to reduce the drop-out rates for PTSD patients.…”

Cardiorespiratory Fitness as Protection Against the Development of Memory Intrusions: a Prospective Trauma Analogue Study

“…Furthermore, we used traumatic films in a laboratory setting and relied on a mentally and physically healthy sample of participants. This is also reflected in our sample mean CRF (PWC 170 = 170.1, SD = 38.1), which is relatively high in comparison to other healthy samples (Bland et al, 2012), and compared to PTSD patients (Voorendonk, Sanches, De Jongh, & Van Minnen, 2019). This implies that our findings may not generalise to traumatised samples and individuals with impaired physical health, warranting complementary and more naturalistic studies, e. g., among patients with PTSD in clinical settings.…”