Physical activity counseling promotes physical and psychological resilience in older veterans with posttraumatic stress disorder

Abstract

Individuals with posttraumatic stress disorder (PTSD) have elevated rates of morbidity, and a sedentary lifestyle can cause and aggravate the physical health needs of adults with PTSD. The primary aim of this paper was to explore the impact of physical activity (PA) counseling (vs. usual care) on physical and psychological outcomes among individuals with PTSD. A secondary aim was to compare these arm effects between those with and without PTSD. Methods Older (>60 years) overweight veterans with impaired glucose tolerance were randomly assigned to an intervention or a usual care control arm. Of the 302 participants who underwent randomization, 67 (22%) had PTSD. Participants in the intervention arm received one in-person activity counseling session followed by regular PA telephone counseling over 12 months. Physical and psychological outcomes were assessed at baseline, 3, and 12 months. Results Primary Aim (intervention vs. usual care among those with PTSD): PA increased on average from 80 minutes/week to 161 minutes/week among participants in the intervention arm (p=0.01). Large, clinically meaningful improvements in six-minute walk test and psychological health were observed over the course of the intervention (p<0.01). Secondary Aim (PTSD/No PTSD, intervention/usual care): participants with PTSD responded equally well to the intervention compared to participants without PTSD, though we observed significantly greater improvements in vitality and six-minute walk compared to participants without PTSD (p<0.05). Conclusions Given the epidemic of comorbid psychological illness and lifestyle-related disease among persons with PTSD, our findings support development and implementation of targeted PA interventions in this high-risk population.

Insights Following Implementation of an Exercise Intervention in Older Veterans with PTSD

“…Yet, veterans with PTSD often have lower participation and enrollment in health promoting programs targeting veterans [20]. Recent exercise intervention studies among individuals with PTSD provide some evidence of the acceptability and efficacy of these programs [14,21,22,23], but specific exercise motivations, barriers, and prescriptions often go unreported. Individuals with PTSD face additional barriers to engaging in exercise and health promoting behavior.…”

The Warrior Wellness Study: A Randomized Controlled Exercise Trial for Older Veterans with PTSD

“…Previous research suggests that individuals with PTSD are less likely to engage in regular physical activity and spend more time in sedentary activities compared to individuals without PTSD (7, 19). Recent exercise intervention studies among individuals with PTSD provide some evidence of the acceptability and efficacy of these programs (14, 20–22). In two separate studies of in-patients receiving care for PTSD, Rosenbaum and Babson showed significant reductions in PTSD and depression symptoms and improvements in cardiometabolic risk factors.…”

Development of a Tailored Behavioral Weight Loss Program for Veterans With PTSD (MOVE!+UP): A Mixed-Methods Uncontrolled Iterative Pilot Study

“…for Veterans with PTSD could also potentially address PTSD symptoms, given physical activity and healthy eating can improve psychological well- being, 30 including PTSD. 31 -35 Veterans Affairs promotes evidence-based cognitive processing therapy (CPT), and prolonged exposure (PE) for PTSD, 36,37 but only one-third of Veterans who receive them reduce symptoms below the PTSD diagnostic threshold. 38 It is therefore important to offer various options as part of mental health treatment for chronic PTSD.…”