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

Trial Summary

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 data supports the effectiveness of the treatment Exercise, Physical Activity, Workout, Fitness Training for PTSD?

Research shows that aerobic exercise can significantly reduce symptoms of PTSD, anxiety, and depression, and these improvements can last for at least a month after the exercise program ends. Exercise is also found to be a safe and effective way to improve mental health in older adults with PTSD, with high adherence and satisfaction rates. ^{1 2 3 4 5}

Is aerobic exercise safe for humans?

Aerobic exercise is generally considered safe for humans and has been shown to improve both mental and physical health, including reducing symptoms of PTSD, anxiety, and depression. ^{3 5 6 7 8}

How does aerobic exercise differ from other treatments for PTSD?

Aerobic exercise is unique for PTSD treatment because it not only helps reduce PTSD symptoms but also improves physical health, which is often neglected in traditional therapies. It works by enhancing cognitive function, reducing anxiety sensitivity, and potentially improving the effectiveness of exposure therapies through better fear extinction learning. ^{5 6 7 9 10}

What is the purpose of this trial?

This study aims to test whether aerobic exercise performed after fear extinction learning improves cognitive, physiological, and neural indices of extinction recall in a sample of trauma-exposed men and women with and without posttraumatic stress disorder (PTSD). Participants will complete a clinical intake visit (Day 0), followed by a three-day fear conditioning (day 1), fear extinction + activity (day 2), and fear extinction recall (day 3) protocol.

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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 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]

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 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]

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]

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 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]

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]

References

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

Pilot randomized controlled trial of exercise training for older veterans with PTSD. [2021]

2. Ireland pubmed.ncbi.nlm.nih.gov

Physical activity in the treatment of Post-traumatic stress disorder: A systematic review and meta-analysis. [2018]

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

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

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

The Effect of Physical Activity on PTSD. [2019]

5. Switzerland pubmed.ncbi.nlm.nih.gov

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

6. England pubmed.ncbi.nlm.nih.gov

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

7. 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]

8. England 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). [2023]

9. 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]

10. England pubmed.ncbi.nlm.nih.gov

Aerobic exercise and consolidation of fear extinction learning among women with posttraumatic stress disorder. [2021]