Improving Mind/Body Health and Functioning with Integrative Exercise

尽管退伍军人管理局做出了相当大的努力来提高对精神健康问题的认识并获得 许多退伍军人表示，在寻求传统心理健康护理方面，仍存在巨大障碍。的确有 大量证据表明，有氧运动有效地改善了许多与 创伤后应激障碍(PTSD)包括焦虑、抑郁、失眠、认知和心血管疾病 疾病。此外，有越来越多的证据表明，有氧运动能产生 增加新神经元的生长(例如，神经发生)并增加海马体的体积 这强调了锻炼对心理健康产生广泛好处的潜在价值。 认识到锻炼可能有助于吸引更多退伍军人参加护理并全面改善 患有创伤后应激障碍的退伍军人的健康，旧金山退伍军人管理局医疗调查小组 中心(SFVAMC)在国防部的资助下开发了一种治疗方案，并 完成了综合运动(有氧运动和呼吸训练)的试点研究，每周3次 12周)与等待名单控制条件的对比。这项试验的有希望的结果使我们进入了下一步， 是进行一项明确的综合锻炼与积极健康教育控制的有效性研究 病情：疾病管理和康复(IMR)。控制条件将在接触时间上匹配 和治疗人员在一起。这项修订提案的目标是测试综合练习是否在整体上有所改善 退伍军人的生活质量、创伤后应激障碍症状、睡眠质量和心血管健康指标 慢性创伤后应激障碍与IMR病情相关。另一个目标是测试生活质量的改善是否 通过跑步机测试的运动能力来衡量心血管健康的改善来预测。 最后，该提案将测试综合练习与IMR是否会在更多的 健康结果，包括情绪、主观睡眠质量和创伤后应激障碍症状。

Despite the considerable efforts of the VA to improve awareness of mental health problems and access to care, many returning veterans still report substantial barriers to seeking traditional mental health care. There is a large body of evidence demonstrating that aerobic exercise effectively improves many outcomes relevant to Posttraumatic Stress Disorder (PTSD) including; anxiety, depression, insomnia, cognition, and cardiovascular disease. In addition, there is a rapidly growing evidence base showing that aerobic exercise produces an increase in the growth of new neurons (e.g., neurogenesis) and increases the volume of the hippocampus which underscores the potential value of exercise for producing broad benefits to psychological health. Recognizing the promise that exercise might hold for attracting more veterans into care and improving overall health in veterans with PTSD, a team of investigators at the San Francisco Veterans Administration Medical Center (SFVAMC) with funding from the Department of Defense developed a treatment protocol and completed a pilot study of Integrative Exercise (Aerobic exercise and Breath Training 3 weekly sessions over 12 weeks) versus a waitlist control condition. Promising results from this trial have led us to the next step which is to conduct a definitive efficacy study of Integrative Exercise versus an active health education control condition: Illness Management and Recovery (IMR). The control condition will be matched on contact hours with treatment personnel. The goal of this revised proposal is to test if Integrative Exercise improves overall quality of life, PTSD symptoms, sleep quality, and measures of cardiovascular health in combat Veterans with chronic PTSD relative to the IMR condition. Another goal is to test if improvements in quality of life are predicted by improvements in cardiovascular fitness as measured by exercise capacity on treadmill testing. Finally, the proposal will test if Integrative Exercise versus IMR will produce greater improvements in additional health outcomes, including mood, subjective sleep quality, and PTSD symptoms.