Aerobic Exercise for PTSD

Overseen By Kevin Crombie, PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Alabama, Tuscaloosa

Must not be taking: Water pills

Disqualifiers: Substance use disorder, Bipolar, Neurological disorders, Physical disabilities, others

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

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 4

120 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether aerobic exercise can improve mental processes related to overcoming fear in individuals who have experienced trauma, with or without posttraumatic stress disorder (PTSD). Participants will engage in varying intensities of aerobic exercise after learning techniques to reduce fear responses. Individuals who have experienced interpersonal violence, such as physical or sexual assault, and either have PTSD or do not, might be suitable for this study. As an unphased trial, this study offers a unique opportunity to contribute to understanding how exercise can aid trauma recovery.

Will I have to stop taking my current medications?

The trial does not specify if you must stop taking your current medications, but you cannot participate if you've changed or added psychiatric medications in the past 4 weeks (6 weeks for fluoxetine). Also, medications affecting neurovascular properties, like water pills, may exclude you from participating.

What prior data suggests that this exercise protocol is safe for participants?

Research has shown that exercise, whether intense, moderate, or light, is generally safe and beneficial for people with PTSD.

High-intensity exercise can reduce anxiety and improve sleep for those with PTSD. Studies indicate it is safe for young and healthy individuals, with few serious side effects.

Light-intensity exercise significantly reduces symptoms of PTSD, anxiety, and depression, and most people can engage in it without issues.

Moderate-intensity exercise is also safe and helps reduce PTSD symptoms. It has been shown to improve mental health for those experiencing stress and anxiety.

Overall, aerobic exercise at any level is considered safe and is often recommended by health professionals to support mental well-being. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about using aerobic exercise as a treatment for PTSD because it offers a non-drug approach that could enhance mental health through physical activity. Unlike standard treatments such as psychotherapy or medication, aerobic exercise can improve cardiovascular health while potentially reducing PTSD symptoms. The trial explores different intensities—light, moderate, and high—allowing researchers to determine the most effective level of physical activity. This could lead to a more personalized and accessible treatment option that empowers individuals to manage their symptoms through exercise.

What evidence suggests that this trial's exercise treatments could be effective for PTSD?

This trial will compare different intensities of aerobic exercise for managing PTSD symptoms. Research has shown that aerobic exercise can help reduce symptoms of posttraumatic stress disorder (PTSD). Participants will be assigned to one of three groups: high-intensity, moderate-intensity, or light-intensity aerobic exercise. High-intensity exercise appears more effective than moderate-intensity exercise in reducing these symptoms. Studies suggest that any type of aerobic exercise—light, moderate, or high-intensity—can help decrease anxiety and depression and improve sleep for people with PTSD. Moderate-intensity exercise is also known to boost stress resilience by enhancing brain function. Overall, regular physical activity appears to be a promising way to manage PTSD symptoms. ^{5 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for right-handed men and women aged 18-64 who have experienced interpersonal violence. It's specifically for those with PTSD, but also includes a control group without PTSD. Participants must not have other conditions that could interfere with the study.

Inclusion Criteria

I am right-handed, aged 18-64, and have PTSD from violence like assault.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 day

1 visit (in-person)

Fear Conditioning

Participants undergo fear conditioning to establish baseline responses

1 day

1 visit (in-person)

Fear Extinction + Activity

Participants engage in fear extinction learning followed by aerobic exercise

1 day

1 visit (in-person)

Fear Extinction Recall

Participants are assessed for extinction recall to evaluate the effects of exercise

1 day

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after the intervention

1-2 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Exercise

Trial Overview

The study tests if aerobic exercise after fear extinction learning can help people with PTSD recall how to manage their fear better. Over three days, participants will undergo conditioning, perform exercises, and then be tested on recalling these techniques.

How Is the Trial Designed?

Group I: Moderate-intensity aerobic exercise Experimental Treatment 1 Intervention

Group II: Light-intensity aerobic exercise Experimental Treatment 1 Intervention

Group III: High-intensity aerobic exercise Experimental Treatment 1 Intervention

Who Is Running the Clinical Trial?

University of Alabama, Tuscaloosa

Lead Sponsor

Trials

49

Recruited

17,900+

Published Research Related to This Trial

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]

In a study involving 35 women with PTSD, moderate-intensity aerobic exercise performed after fear extinction training significantly reduced threat expectancy ratings during fear reinstatement compared to light-intensity exercise, suggesting a potential benefit of exercise in managing PTSD symptoms.

While the exercise did not show significant differences in physiological measures of fear response (skin conductance responses) or in spontaneous recovery, the findings indicate that aerobic exercise may enhance the effectiveness of exposure-based therapies for PTSD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Aerobic exercise and consolidation of fear extinction learning among women with posttraumatic stress disorder. Crombie, KM., Sartin-Tarm, A., Sellnow, K., et al.[2021]

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]

A pilot trial involving 54 veterans aged 60 and older with PTSD showed that supervised exercise training is safe and well-accepted, with high adherence rates of 82% and minimal attrition of 14%.

Participants experienced clinically significant improvements in PTSD symptoms and related conditions after 12 weeks of exercise, suggesting that exercise could be an effective intervention for older adults with PTSD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pilot randomized controlled trial of exercise training for older veterans with PTSD. Hall, KS., Morey, MC., Bosworth, HB., et al.[2021]

Physical activity (PA) is an effective adjunct therapy for reducing PTSD symptoms, particularly in individuals with subsyndromal symptoms or those resistant to standard treatments, as highlighted by the review of existing literature.

There is a need for further research to determine the most effective types, doses, and durations of exercise for PTSD treatment, as findings from observational and controlled studies have been inconsistent.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effect of Physical Activity on PTSD. Oppizzi, LM., Umberger, R.[2019]

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]

This randomized controlled trial will assess the impact of a 12-week structured exercise program on PTSD symptoms and overall physical health in 80 participants diagnosed with PTSD, aiming to fill a gap in research regarding exercise as a treatment for this condition.

The study will evaluate multiple outcomes, including PTSD symptoms, depression, anxiety, and physical health measures, using standardized assessments to provide a comprehensive understanding of how exercise can benefit individuals with PTSD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Exercise augmentation compared to usual care for post traumatic stress disorder: a randomised controlled trial (the REAP study: Randomised Exercise Augmentation for PTSD). Rosenbaum, S., Nguyen, D., Lenehan, T., et al.[2023]

A systematic review and meta-analysis of four randomized controlled trials involving 200 participants found that physical activity significantly reduces PTSD and depressive symptoms, suggesting it can be an effective intervention for individuals with PTSD.

No major adverse events were reported during the studies, indicating that physical activity is a safe adjunct to usual care for improving health in people with PTSD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical activity in the treatment of Post-traumatic stress disorder: A systematic review and meta-analysis. Rosenbaum, S., Vancampfort, D., Steel, Z., et al.[2018]

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]

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]

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