Aerobic Exercise for PTSD

Overseen By Christopher T Webster, M.A.

Age: 18 - 65

Sex: Female

Trial Phase: Academic

Sponsor: Michigan State University

Disqualifiers: Cardiovascular, Metabolic, Orthopedic, Head trauma, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

50 Participants Needed

Trial Summary

What is the purpose of this trial?

The goal of this study is to investigate the effects of a single bout of aerobic exercise on neurophysiological indices of emotion regulation and cognitive control in individuals with clinically significant PTSD symptoms. In this proposed study, 50 adult females with clinically significant PTSD symptoms will be randomized into two groups: a 20-minute moderate-to-vigorous intensity aerobic exercise group, or a 20-minute silent sitting control group. Prior to and following the exercise/sitting session, participants will complete a letter flanker task and an emotion regulation picture viewing task while their electrical brain activity is continuously recorded via electroencephalogram (EEG). Utilizing a multimodal assessment approach, cognitive control will be measured using behavioral (i.e., accuracy, reaction time) and neurophysiology (i.e., error-related negativity; ERN). Emotion regulation will be measured using self-reported and neurophysiological indices of emotional reactivity (i.e., late positive potential; LPP).

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your healthcare provider.

What data supports the effectiveness of the treatment Aerobic Exercise for PTSD?

Research shows that aerobic exercise can significantly reduce symptoms of PTSD, anxiety, and depression. Studies found that participants experienced clinically significant reductions in PTSD severity after engaging in aerobic exercise, suggesting it may be a valuable treatment option. ^{1 2 3 4 5}

Is aerobic exercise safe for humans?

Research suggests that aerobic exercise is generally safe for humans and can have positive effects on mental health conditions like PTSD, anxiety, and depression. ^{1 2 3 5 6}

How does aerobic exercise differ from other treatments for PTSD?

Aerobic exercise is unique because it not only helps reduce PTSD symptoms but also improves physical health, which is often a concern for those with PTSD. Unlike traditional therapies that focus solely on mental health, aerobic exercise can enhance the effects of exposure therapies and address physical health issues like cardiovascular disease. ^{1 2 3 4 5}

Eligibility Criteria

This trial is for adult females with PTSD, scoring over 30 on the PCL-5 questionnaire indicating significant symptoms. They must be able to perform aerobic exercise without restrictions from cardiovascular, metabolic diseases or orthopedic limitations and have no history of severe head trauma, epilepsy, or impairments affecting neurocognitive data collection.

Inclusion Criteria

I scored over 30 on a PTSD screening test.

I am a woman currently experiencing severe PTSD symptoms.

Exclusion Criteria

I have no history of severe head injuries, epilepsy, or impairments that could affect brain function tests.

Using the Physical Activity Readiness Questionnaire (PAR-Q; Adams, 1999), participants will be excluded if they endorse any history of cardiovascular (e.g., Coronary Artery Disease, Heart Failure, High Blood Pressure) or metabolic disease (e.g., Diabetes), or any orthopedic limitations (e.g., Osteoporosis) that may interfere with participating in aerobic exercise.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Intervention

Participants undergo a single session of either 20-minute aerobic exercise or silent sitting, followed by cognitive and emotion regulation tasks

1 day

1 visit (in-person)

Follow-up

Participants are monitored for immediate effects on cognitive control and emotion regulation

Immediately after intervention

Treatment Details

Interventions

• Aerobic Exercise

Trial Overview The study tests how a single session of moderate-to-vigorous aerobic exercise affects emotion regulation and cognitive control in women with PTSD compared to a control group doing static stretching. Participants' brain activity will be recorded via EEG during tasks before and after the sessions.

Participant Groups

Group I: Aerobic Exercise Experimental Treatment 1 Intervention

During this single session, participants will walk on a treadmill at a moderate-vigorous intensity (65-75% age-predicted HRmax) for 20 minutes. While walking on the treadmill, participants will also watch a 20-minute video clip to match the control condition. Exercise intensity will be continuously monitored using a Polar OH1 heart rate monitor, which will be strapped to the participant's chest prior to starting the exercise session. Age-predicted HRmax will be calculated for each participant using the following formula: (HRmax = 220 - Age). Subjective units of distress related to their perceived exercise intensity will be measured in 3-minute intervals. Following the exercise session, participants will rest until their heart rate returns to within 10% of their resting heart rate (approximately 5 minutes) before starting the post-assessments.

Group II: Silent Sitting Active Control 1 Intervention

Participants will be guided by a research assistant through a single silent sitting session, which will serve as a time-matched control. During the sitting session, participants will watch a 20-minute video clip while sitting silently. Similar to the aerobic exercise group, participants' heart rate will be continuously monitored via a Polar OH1 heart rate monitor. Following the sitting session, participants will rest for 5 minutes to match the exercise group before starting the post-assessments.

Who Is Running the Clinical Trial?

Michigan State University

Lead Sponsor

Trials

202

Recruited

687,000+

Findings from Research

A two-week aerobic exercise program involving 33 participants with PTSD led to clinically significant reductions in PTSD severity for 89% of the participants, indicating that aerobic exercise can be an effective treatment for PTSD symptoms.

While all exercise groups experienced reduced PTSD symptoms, those focusing on their bodily sensations during exercise showed less improvement compared to those who were distracted or had no specific focus, suggesting that distraction may enhance the therapeutic effects of exercise.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Aerobic Exercise Reduces Symptoms of Posttraumatic Stress Disorder: A Randomized Controlled Trial. Fetzner, MG., Asmundson, GJ.[2022]

A review of 19 studies suggests that aerobic exercise can effectively reduce PTSD symptoms, either on its own or alongside standard treatments.

Potential mechanisms for this improvement include helping individuals cope with internal stress cues, enhancing brain function, promoting neuroplasticity, normalizing stress hormone levels, and lowering inflammation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise Intervention in PTSD: A Narrative Review and Rationale for Implementation. Hegberg, NJ., Hayes, JP., Hayes, SM.[2023]

Aerobic exercise may serve as a beneficial addition to traditional PTSD treatments, like exposure therapy, by improving both physical health and enhancing the effectiveness of fear extinction learning, which is crucial for reducing anxiety symptoms.

The review highlights emerging evidence from preclinical and clinical studies that suggest exercise can improve the consolidation and recall of fear extinction memories, indicating a potential new approach to treating PTSD more effectively.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Aerobic exercise in the treatment of PTSD: An examination of preclinical and clinical laboratory findings, potential mechanisms, clinical implications, and future directions. Crombie, KM., Adams, TG., Dunsmoor, JE., et al.[2023]

A study involving 130 adults with PTSD found that adding 10 minutes of aerobic exercise to exposure therapy significantly reduced PTSD severity compared to exposure therapy with passive stretching, with a moderate effect size of 0.6 after 6 months.

No adverse events were reported, suggesting that brief aerobic exercise is a safe and effective way to enhance the benefits of exposure therapy for PTSD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Augmenting trauma-focused psychotherapy for post-traumatic stress disorder with brief aerobic exercise in Australia: a randomised clinical trial. Bryant, RA., Dawson, KS., Azevedo, S., et al.[2022]

A 12-session aerobic exercise program significantly reduced symptoms of PTSD, anxiety, and depression in participants, indicating its potential as an effective intervention.

The positive effects of the exercise program were maintained for at least one month after the intervention, suggesting lasting benefits for individuals with treatment-resistant PTSD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of an exercise program on posttraumatic stress disorder, anxiety, and depression. Manger, TA., Motta, RW.[2005]

In a study of 108 individuals with severe PTSD undergoing an intensive 8-day trauma-focused treatment program, participants showed significant improvements in cardiorespiratory fitness (CRF) and a reduction in PTSD symptoms.

Despite the observed increase in CRF, the study found no direct link between improvements in fitness levels and the effectiveness of PTSD treatment, suggesting that other factors may play a more critical role in symptom reduction.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Improvements in cardiorespiratory fitness are not significantly associated with post-traumatic stress disorder symptom reduction in intensive treatment. Voorendonk, EM., Sanches, SA., De Jongh, A., et al.[2020]

References

1. England pubmed.ncbi.nlm.nih.gov

Aerobic Exercise Reduces Symptoms of Posttraumatic Stress Disorder: A Randomized Controlled Trial. [2022]

2. Switzerland pubmed.ncbi.nlm.nih.gov

Exercise Intervention in PTSD: A Narrative Review and Rationale for Implementation. [2023]

3. Netherlands pubmed.ncbi.nlm.nih.gov

Aerobic exercise in the treatment of PTSD: An examination of preclinical and clinical laboratory findings, potential mechanisms, clinical implications, and future directions. [2023]

4. England pubmed.ncbi.nlm.nih.gov

Augmenting trauma-focused psychotherapy for post-traumatic stress disorder with brief aerobic exercise in Australia: a randomised clinical trial. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

The impact of an exercise program on posttraumatic stress disorder, anxiety, and depression. [2005]

6. United States pubmed.ncbi.nlm.nih.gov

Improvements in cardiorespiratory fitness are not significantly associated with post-traumatic stress disorder symptom reduction in intensive treatment. [2020]