Trauma-affected refugees treated with basic body awareness therapy or mixed physical activity as augmentation to treatment as usual—A pragmatic randomised controlled trial

Nordbrandt, Maja Sticker; Sonne, Charlotte; Mortensen, Erik Lykke; Carlsson, Jessica

doi:10.1371/journal.pone.0230300

Cited by 45 publications

(73 citation statements)

References 44 publications

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“…This had an impact on attendance at the PAAI sessions, which was relatively low, reducing the power in our analyses and eventually introducing a potential selection bias. A low attendance rate, even lower than ours, is common in this type of study [ 38 , 42 ]. To overcome these limitations, future studies should try to tailor interventions to refugees’ lives even more and should ensure longer intervention periods.…”

Section: Discussionmentioning

confidence: 77%

The Effect of Physiotherapy Group Intervention in Reducing Pain Disorders and Mental Health Symptoms among Syrian Refugees: A Randomized Controlled Trial

Hasha

Igland

Kumar

et al. 2020

IJERPH

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Chronic pain is common among refugees, and often related to mental health problems. Its management, however, is often challenging. A randomized waitlist-controlled trial was designed to study the effect of group physiotherapy activity and awareness intervention (PAAI) on reducing pain disorders, and secondarily improving mental health, among Syrian refugees. A total of 101 adult Syrian refugees suffering from chronic pain were randomized to either the intervention group or the control group, which thereafter also received PAAI after a waiting period. Pain intensity measured by the Brief Pain Inventory (BPI) was the primary outcome. Scores from the Impact of Events Scale-Revised (IES-R 22) and the General Health Questionnaire (GHQ-12) were secondary outcomes. Intention-to-treat analyses (ITT) showed no effect of the intervention on either pain levels (regression coefficient [B {95% CI} of 0.03 {−0.91, 0.96}], IESR scores [4.8 {−3.7, 13.4}] or GHQ-12 scores [−0.4 {−3.1, 2.3}]). Yet, participants highly appreciated the intervention. Despite the negative findings, our study contributes to the evidence base necessary to plan targeted and effective health care services for refugees suffering from chronic pain and highlights the challenge of evaluating complex interventions adapted to a specific group.

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Section: Discussionmentioning

confidence: 77%

The Effect of Physiotherapy Group Intervention in Reducing Pain Disorders and Mental Health Symptoms among Syrian Refugees: A Randomized Controlled Trial

Hasha

Igland

Kumar

et al. 2020

IJERPH

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“…We reviewed two types of group physical exercise interventions: dance and movement therapy (DMT) (Kirk, 2014) and Basic Body Awareness Therapy (BBAT) (Madsen et al, 2016;Nordbrandt et al, 2020). In Kirk's (2014) study, DMT was delivered over eight weeks to the intervention group.…”

Section: Physical Exercise (Number Of Included Studies = 3)mentioning

confidence: 99%

Reintegration interventions for CPTSD: a systematic review

Purnell

Graham

Bloomfield

et al. 2021

European Journal of Psychotraumatology

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Background: Clinical guidelines recommend a phase-based approach to treatment for complex post-traumatic stress disorder (CPTSD), yet little is known about what interventions are being offered and which may be effective in the final 'reintegration' phase. Objective: To systematically review literature on reintegration interventions for CPTSD, describing the nature and effectiveness of interventions. Method: We searched four electronic databases (Medline, PsycINFO, Embase, and PTSDpubs) for interventions aiming to facilitate reintegration for participants with probable CPTSD. We had two aims: firstly, to describe the interventions and secondly, to describe their effectiveness as measured through measures of reintegration, PTSD and/or disturbances in self-organization (DSO), or qualitative data describing changes experienced. Results are presented using narrative synthesis. Results: Fifteen studies met our inclusion criteria. Interventions included yoga, exercise, use of service dogs, residential treatment, education, self-defence and patient research involvement. Overall study quality was low, as assessed by critical appraisal tools. Of the six studies including a control group, two reported a statistically significant improvement in the measure of reintegration between the intervention and control group, four studies reported a statistically significant difference in the measure of PTSD symptoms, but none reported any significant differences between intervention and control groups in DSO. Of all eight quantitative studies, three reported a statistically significant difference in the reintegration measure pre-to post-intervention for the intervention group, five a statistically significant improvement in the measure of PTSD symptoms, and three a significant difference in the DSO measure. From eight studies reporting qualitative date we synthesized themes into eight categories, within which facilitation of connection with others was the most commonly reported benefit. Conclusions: The interventions outlined may facilitate reintegration, however, research in this area is still in its infancy and quality research is lacking. Further research is needed to establish whether reintegration interventions enhance treatment for CPTSD. Intervenciones de reintegración para TEPTC: una revisión sistemáticaAntecedentes: Las guías clínicas recomiendan un enfoque basado en fases para el tratamiento del trastorno de estrés postraumático complejo (TEPTC), aunque se sabe poco acerca de las intervenciones que se ofrecen y cuáles pueden ser efectivas en la fase final de 'reintegración'. Objetivo: Revisar la literatura en forma sistemática acerca de intervenciones de reintegración para el TEPTC, describiendo la naturaleza y efectividad de las intervenciones. Método: Para las intervenciones cuyo objetivo era facilitar la reintegración de los participantes con probable TEPTC, buscamos en cuatro bases de datos electrónicas (Medline, PsycINFO, Embase, y PTSDpubs). Teníamos dos objetivos: en primer lugar, describir las intervenciones y, en s...

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“…There is evidence to support the need for PTs and other members of the team working with SoT and other forms of trauma to teach survivors about mind-body connections, including the role of breath, relaxation and practices of mindfulness (Gard & Gyllensten, 2018;. It has been proposed that patients be allowed opportunities to practice these approaches (Andersen et al, 2020;Buczynski et al, 2018;Nordbrandt et al, 2020;O'Sullivan, 2015;Persson et al, 2008;Price & Hooven, 2018). Because of these complex needs and frequent co-morbidities, many have argued that an interdisciplinary approach to treatment, including PS and counseling, is ideal (de Ruiter et al, 2018;Stammel et al, Wang et al, 2016).…”

Section: Interdisciplinary Needsmentioning

confidence: 99%

“…Group PS is as effective as individual PS, for both those with mental health (Skjaerven et al, 2018) and physical health concerns (Andersen et al, 2019;O'Keeffe et al, 2017). There are few studies that demonstrate the efficacy of group PS for survivors of torture (Harlacher et al, 2019;Nordbrandt et al, 2020). In a study, where survivors were randomly assigned to either treatment as usual (with no PS), Basic Body Awareness Therapy or mixed physical activities, subjects in all groups showed similar improvement.…”

Section: Rationale For Group Model Developmentmentioning

confidence: 99%

Group physiotherapy with survivors of torture in urban and camp settings in Jordan and Kenya

Gueron

Amoyi

Chao

et al. 2021

torture

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Introduction: In this paper we report provisional field results on the impact of CVT’s (the Center for Victims of Torture) interdisciplinary group treatment on physiotherapy indicators in refugees living in urban and camp settings in Kenya and Jordan. The physiotherapy component of this model includes pain neuroscience education, sleep hygiene, posture and body mechanics instruction and healing of pain and trauma from a biopsychosocial perspective, in a program of ten weekly sessions. This program is supported by a clinical assessment that records a broad set of indicators of participant experience and functioning. In addition, some survivors report having pelvic floor dysfunction and data will be offered about a subset of survivors looking at prevalence of these issues. Methods: Survivors are identified through referral systems, community education and sensitization campaigns, contacts and trainings with other NGOs and health care providers. Prospective survivors are screened into CVT services or referred to other agencies that can better meet their needs. CVT focuses its services on refugees with physical and emotional difficulties that may be effectively treated through its interdisciplinary treatment model and who have survived torture or related human rights violations. Following an informed consent process, survivors participate in a comprehensive individual assessment and then progress to the 10-week program. Wherever possible, follow-up assessments are conducted 2 weeks after the sessions end, and at 3, and 9 months following completion of the 10-week long intervention. Results: On average, participants who completed 3-month follow-up assessments showed statistically and clinically significant improvements on physiotherapy indicators. Discussion: Provisional results are encouraging and suggest that the model is adaptable to the needs of different populations and settings. As nearly all participants receive both counseling and physiotherapy, it is difficult to know which benefits can be attributed to physiotherapy alone.

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Trauma-affected refugees treated with basic body awareness therapy or mixed physical activity as augmentation to treatment as usual—A pragmatic randomised controlled trial

Cited by 45 publications

References 44 publications

The Effect of Physiotherapy Group Intervention in Reducing Pain Disorders and Mental Health Symptoms among Syrian Refugees: A Randomized Controlled Trial

The Effect of Physiotherapy Group Intervention in Reducing Pain Disorders and Mental Health Symptoms among Syrian Refugees: A Randomized Controlled Trial

Reintegration interventions for CPTSD: a systematic review

Group physiotherapy with survivors of torture in urban and camp settings in Jordan and Kenya

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