Physical Activity in People With Posttraumatic Stress Disorder: A Systematic Review of Correlates

Vancampfort, Davy; Richards, Justin; Stubbs, Brendon; Akello, Grace; Gbiri, Caleb Ademola; Ward, Philip B.; Rosenbaum, Simon

doi:10.1123/jpah.2015-0436

Cited by 51 publications

(41 citation statements)

References 51 publications

(78 reference statements)

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“…For example, individuals with PTSD may be less likely to exercise given a heightened concern for safety, which is common in PTSD, 35 or fear of trauma-relevant bodily arousal symptoms triggered by exercise, such as shortness of breath, increased heart rate, and perspiration. 36 This possibility is supported by recent evidence that PTSD hyperarousal symptoms (as opposed to re-experiencing or avoidance symptoms) show a particularly robust inverse relationship with exercise. 35–37 Additionally, PTSD symptoms may undermine motivation to engage in PA and make it more difficult to start and maintain an exercise program.…”

Section: Discussionmentioning

confidence: 85%

Post-traumatic Stress Disorder and 20-Year Physical Activity Trends Among Women

Winning

Gilsanz

Koenen

et al. 2017

American Journal of Preventive Medicine

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Introduction Post-traumatic stress disorder (PTSD) may be associated with physical inactivity, a modifiable lifestyle factor that contributes to risk of cardiovascular and other chronic diseases; however, no study has evaluated the association between PTSD onset and subsequent physical activity (PA) changes. Method Analyses were conducted between October 2014 and April 2016, using data from the ongoing Nurses' Health Study II (N=50,327). Trauma exposure and PTSD symptoms were assessed using two previously validated measures, the Brief Trauma Questionnaire and Short Screening Scale for DSM-IV PTSD. Average PA (hours/week) was assessed using self-report measures at six time points across 20 years (1989–2009). Linear mixed models with time-updated PTSD assessed differences in PA trajectories by trauma/PTSD status. Among a subsample of women whose trauma/PTSD onset during follow-up, group differences in PA patterns before and after onset were assessed using linear spline models. Results PA decreased more steeply over time among trauma-exposed women reporting four to five (β= −2.5E−3, SE=1.0E−3, p=0.007) or six to seven PTSD symptoms (β= −6.7E−3, SE=1.1E−3, p<0.001) versus women without trauma exposure, adjusting for potential confounders. Among a subsample of women whose trauma/PTSD symptoms onset during follow-up, no differences in PA were observed prior to onset; after onset, women with six to seven PTSD symptoms had a steeper decline (β= −17.1E−3, SE=4.2E−3, p<0.001) in PA over time than trauma-exposed women without PTSD. Conclusions Decreases in PA associated with PTSD symptoms may be a pathway through which PTSD influences cardiovascular and other chronic diseases.

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Section: Discussionmentioning

confidence: 85%

Post-traumatic Stress Disorder and 20-Year Physical Activity Trends Among Women

Winning

Gilsanz

Koenen

et al. 2017

American Journal of Preventive Medicine

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“…However, we did not specifically examine other mechanisms linking PTSD to functional performance. A number of possible mediators exist, including, for example, changing levels of physical activity (Vancampfort et al., ), pain and comorbid anxiety disorders including PTSD (Asmundson, Coons, Taylor, & Katz, ; Asmundson & Katz, ), or increased fatigue or fatigability that may co‐occur with PTSD (Keller‐Ross, Schlinder‐Delap, Doyel, Larson, & Hunter, ), potentially signifying targets for intervention.…”

Section: Discussionmentioning

confidence: 99%

Functional Limitations Among Responders to the World Trade Center Attacks 14 Years After the Disaster: Implications of Chronic Posttraumatic Stress Disorder

Clouston

Guralnik

Kotov

et al. 2017

Journal of Traumatic Stress

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Posttraumatic stress disorder (PTSD) is associated with self-reported difficulties navigating the social and physical world and may also be associated with risk of functional limitations. The Short Physical Performance Battery (SPPB), an objective functional assessment, was administered during monitoring exams between January and December 2015 to a consecutive sample of 1,268 rescue workers, volunteers, and other responders who aided in response, recovery, and cleanup efforts at the World Trade Center (WTC) in New York after the September 11, 2011 attacks. Data were linked with diagnostic and longitudinal data from the WTC monitoring study. Multivariable analyses were used to examine predictors of functional limitations. Prevalence estimates weighted to the general responder population revealed a relatively high prevalence of functional limitations, SPPB ≤ 9; 16.0%, 95% CI [13.7, 18.4]. Current PTSD was associated with a two-fold increased risk of functional limitations after controlling for predisposing factors, trauma severity, behavioral factors, and WTC-related medical conditions, Adjusted Risk Ratio (aRR) = 2.11, 95% CI [1.48, 3.01]. Exposure to ergonomic risk factors at the WTC also increased the risk of functional impairments, aRR=1.34 95% CI [1.05, 1.70]. Longitudinal results suggest that individuals with current functional limitations experienced high baseline PTSD severity, B = 2.94, SE=1.33, and increasing PTSD symptom severity, B = 0.29, SE = 0.10, since September 11, 2001. This study identified a cross-sectional relationship between functional limitations and PTSD and a worsening of PTSD symptoms in persons who eventually demonstrate functional limitations. Results highlight the potential role of chronic PTSD in functional limitations.

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“…Randomized controlled trials have demonstrated that exercise, the structured and planned form of PA, has anxiolytic effects in people with and without anxiety disorders (Herring, Lindheimer, & O'Connor, ; Herring, O'Connor, & Dishman, ; Stubbs, Vancampfort et al, , ). Previous reviews have also demonstrated that a single bout of exercise can help alleviate anxiety symptoms in people with anxiety disorders (Strohle, Ströhle, Graetz, & Scheel, ).…”

Section: Introductionmentioning

confidence: 99%

“…This is potentially due to shared etiological biological factors between anxiety and cardiovascular disorders (e.g., increased inflammation and oxidative stress; Belem da Silva et al, 2017), but also due to modifiable risk behaviors like lower physical activity (PA) levels and increased sedentary behavior (Stubbs, Koyanagi et al, 2017;Vancampfort, Stubbs, Herring, Hallgren, & Koyanagi, 2018). Although several previous cross-sectional studies suggest that people with anxiety disorders or higher levels of anxiety symptoms are more likely to engage in lower levels of PA (22.9% versus 16.6%; Dillon, McMahon, O'Regan, & Perry, 2018;Stubbs, Koyanagi et al, 2017) and spend more time in sedentary activities when compared with people without anxiety (Dillon et al, 2018;Teychenne, Costigan, & Parker, 2015;Vancampfort et al, 2016Vancampfort et al, , 2018, PA is not always inversely associated with anxiety symptoms (Nguyen et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Physical activity protects from incident anxiety: A meta‐analysis of prospective cohort studies

et al. 2019

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Background Prospective cohorts have suggested that physical activity (PA) can decrease the risk of incident anxiety. However, no meta‐analysis has been conducted. Aims To examine the prospective relationship between PA and incident anxiety and explore potential moderators. Methods Searches were conducted on major databases from inception to October 10, 2018 for prospective studies (at least 1 year of follow‐up) that calculated the odds ratio (OR) of incident anxiety in people with high PA against people with low PA. Methodological quality was assessed using the Newcastle‐Ottawa Scale (NOS). A random‐effects meta‐analysis was conducted and heterogeneity was explored using subgroup and meta‐regression analysis. Results Across 14 cohorts of 13 unique prospective studies (N = 75,831, median males = 50.1%) followed for 357,424 person‐years, people with high self‐reported PA (versus low PA) were at reduced odds of developing anxiety (adjusted odds ratio [AOR] = 0.74; 95% confidence level [95% CI] = 0.62, 0.88; crude OR = 0.80; 95% CI = 0.69, 0.92). High self‐reported PA was protective against the emergence of agoraphobia (AOR = 0.42; 95% CI = 0.18, 0.98) and posttraumatic stress disorder (AOR = 0.57; 95% CI = 0.39, 0.85). The protective effects for anxiety were evident in Asia (AOR = 0.31; 95% CI = 0.10, 0.96) and Europe (AOR = 0.82; 95% CI = 0.69, 0.97); for children/adolescents (AOR = 0.52; 95% CI = 0.29, 0.90) and adults (AOR = 0.81; 95% CI = 0.69, 0.95). Results remained robust when adjusting for confounding factors. Overall study quality was moderate to high (mean NOS = 6.7 out of 9). Conclusion Evidence supports the notion that self‐reported PA can confer protection against the emergence of anxiety regardless of demographic factors. In particular, higher PA levels protects from agoraphobia and posttraumatic disorder.

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Physical Activity in People With Posttraumatic Stress Disorder: A Systematic Review of Correlates

Cited by 51 publications

References 51 publications

Post-traumatic Stress Disorder and 20-Year Physical Activity Trends Among Women

Post-traumatic Stress Disorder and 20-Year Physical Activity Trends Among Women

Functional Limitations Among Responders to the World Trade Center Attacks 14 Years After the Disaster: Implications of Chronic Posttraumatic Stress Disorder

Physical activity protects from incident anxiety: A meta‐analysis of prospective cohort studies

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