Pilot randomized controlled trial of exercise training for older veterans with PTSD

Hall, Katherine S.; Morey, Miriam C.; Bosworth, Hayden B.; Beckham, Jean C.; Pebole, Michelle M.; Sloane, Richard; Pieper, Carl F.

doi:10.1007/s10865-019-00073-w

Cited by 48 publications

(58 citation statements)

References 54 publications

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“…The Warrior Wellness program was a 12-week individualized, progressive, multi-component program developed according to guidelines for older adults [28,29,30]. Exercise prescription was developed by the exercise physiologist (EP) with input from each participant and guided by RPE ratings and participant feedback.…”

Section: Methodsmentioning

confidence: 99%

“…The parent trial examined the feasibility and efficacy of supervised exercise versus a wait-list control. Clinically significant improvements in PTSD and related conditions (sleep, depressive symptoms, and mental health-related quality of life) were reported following 12 weeks of supervised exercise, compared to wait-list usual care [29]. The study reported here is an ancillary investigation of the prescription and implementation of the exercise program in this clinical trial.…”

Section: Methodsmentioning

confidence: 99%

“…Exercise Intensity: Exercise intensity was measured using rating of perceived exertion (RPE; 0–10 scale). RPE for the aerobic exercise session was recorded on the exercise card following completion of the entire aerobic exercise bout [29]. RPE is a valuable and valid measure of exercise intensity in populations such as older adults in which heart rate measures of exercise intensity are inaccurate due to heart rate limiting medications.…”

Section: Methodsmentioning

confidence: 99%

“…The Warrior Wellness program was a pilot randomized controlled trial of community-based exercise for older veterans with PTSD, and primary outcomes are reported elsewhere [28,29]. This study is an ancillary investigation of factors related to the exercise program, including programmatic factors related to exercise motivation, attendance barriers, exercise prescription and progression, and participant evaluations among those enrolled in the Warrior Wellness Program.…”

Section: Introductionmentioning

confidence: 99%

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

Pebole

Hall

2019

IJERPH

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Individuals with post-traumatic stress disorder (PTSD) face numerous barriers to exercise. Little is known about behavioral strategies to promote participation in this population. This is a secondary analysis of individual barriers and goals, exercise prescription characteristics, and patient perceptions of a 12-week, community-based, randomized controlled exercise trial targeting older adults with PTSD, (N = 45; mean age = 68; male = 91%). The most common cited goals for participating included weight loss (65%) and increasing strength (65%). Exercise mode varied among those who completed the program (n = 37), with 14 (38%) using exclusively treadmill; eight (22%) using only bike, and 15 (41%) utilizing a combination. Patient-reported exercise duration and intensity progressively increased over the 12 weeks, and duration differed by mode of exercise. We observed high rates of attendance (84%) and completion (88%) to the program. Patient-reported barriers to attendance most often included health problems (62%) and medical appointments (55%). Participant responses to a program evaluation revealed high levels of satisfaction, preferences for group-based programs, and insights about the acceptability of the exercise environment (physical and social). This study is the first to report on goals, barriers, exercise prescription needs, and individual responses to supervised exercise training in a unique population, that is, older veterans with PTSD. Results of this study can inform future health promotion programs targeting older veterans with PTSD.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Pebole

Hall

2019

IJERPH

Self Cite

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“…Whilst psychological therapies perform reasonably well for many patients, recent estimates suggest that up to 50% of people with PTSD who engage in treatment fail to respond adequately (Resick et al, 2017 ). Furthermore, 10%–20% of individuals from the general population and 20–40% of military veterans exposed to trauma, experience PTSD symptoms that persist and are associated with impairment despite treatment (Hall et al, 2019 ) (Rauch et al, 2018 ). It is not clear why treatments work more or less well for different people with PTSD and there is an urgent need to accurately identify factors that moderate treatment outcome in PTSD.…”

Section: Introductionmentioning

confidence: 99%

A systematic review of factors associated with outcome of psychological treatments for post-traumatic stress disorder

Barawi

Lewis

Simon

et al. 2020

European Journal of Psychotraumatology

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Objective: Psychological interventions for post-traumatic stress disorder (PTSD) are not always effective and can leave some individuals with enduring symptoms. Little is known about factors that are associated with better or worse treatment outcome. Our objective was to address this gap. Method: We undertook a systematic review following Cochrane Collaboration Guidelines. We included 126 randomized controlled trials (RCTs) of psychological interventions for PTSD and examined factors that were associated with treatment outcome, in terms of severity of PTSD symptoms post-treatment, and recovery or remission. Results: Associations were neither consistent nor strong. Two factors were associated with smaller reductions in severity of PTSD symptoms post-treatment: comorbid diagnosis of depression, and higher PTSD symptom severity at baseline assessment. Higher education, adherence to homework and experience of a more recent trauma were associated with better treatment outcome. Conclusion: Identifying and understanding why certain factors are associated with treatment outcome is vital to determine which individuals are most likely to benefit from particular treatments and to develop more effective treatments in the future. There is an urgent need for consistent and standardized reporting of factors associated with treatment outcome in all clinical trials.

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Body‐and movement‐oriented interventions for posttraumatic stress disorder: An updated systematic review and meta‐analysis

van de Kamp,

Scheffers,

Emck

et al. 2023

Journal of Traumatic Stress

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This study is an update of the meta‐analysis we published in 2019 on the effectiveness of body‐ and movement‐oriented interventions (BMOIs) for adults with posttraumatic stress disorder (PTSD) in decreasing PTSD symptoms and secondary outcomes of depressive symptoms, sleep disturbance, and interoceptive awareness. Search terms for BMOIs and PTSD were combined to identify eligible studies in four bibliographical databases. Articles were selected if they included adult participants with a primary diagnosis of PTSD, included BMOI as one of the investigated therapies, were designed as a comparative outcome trial with any control condition, and involved a standardized outcome measure for PTSD symptom severity. This resulted in the addition of 14 new studies compared to the 2019 study. The meta‐analysis, which included 29 studies in total, resulted in a mean Hedges’ g effect size of 0.50, 95% CI [0.22, 0.79], in decreasing PTSD symptoms, with very high heterogeneity, I2 = 89%. Meta‐analyses of secondary outcomes resulted in Hedges’ g effect sizes of 0.37, 95% CI [0.08, 0.66] for depressive symptoms; 0.62, 95% CI [0.42, 0.81] for sleep quality; and −0.10, 95% CI [−0.23, 0.43] for interoceptive awareness. The risk of bias analysis resulted in some concerns or high risk of bias in almost all included studies; only one study had a low risk of bias. We conclude that BMOIs may be valuable for patients with PTSD. There is, however, still a lack of high‐quality studies with proper control conditions and long‐term follow‐up periods from which to draw conclusions.

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Pilot randomized controlled trial of exercise training for older veterans with PTSD

Cited by 48 publications

References 54 publications

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

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

A systematic review of factors associated with outcome of psychological treatments for post-traumatic stress disorder

Body‐and movement‐oriented interventions for posttraumatic stress disorder: An updated systematic review and meta‐analysis

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