Improving Mind/Body Health and Functioning with Integrative Exercise

尽管退伍军人事务部作出了相当大的努力，以提高人们对心理健康问题的认识， 尽管如此，许多返回的退伍军人仍然报告在寻求传统的精神卫生保健方面存在重大障碍。有 大量的证据表明，有氧运动有效地改善了许多相关的结果， 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，有氧运动可以产生 新神经元生长的增加（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益处的潜在价值。 认识到锻炼可能会吸引更多的退伍军人接受护理，并提高整体水平， 弗朗西斯科退伍军人管理局医疗中心的一组调查人员说， 该中心（SFVAMC）在国防部的资助下制定了一项治疗方案， 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）与等待列表对照条件相比。这次试验的可喜结果使我们进入了下一步， 目的：对综合锻炼与积极健康教育对照组的疗效进行比较研究 疾病管理和恢复（IMR）对照条件将在接触时间上匹配 治疗人员。本修订提案的目标是测试综合练习是否整体有所改善 生活质量，创伤后应激障碍症状，睡眠质量和心血管健康的措施，在战斗退伍军人与 慢性创伤后应激障碍相对于IMR条件。另一个目标是测试生活质量的改善是否 通过在跑步机测试中测量的运动能力来预测心血管健康的改善。 最后，该提案将测试综合练习与IMR相比是否会在其他方面产生更大的改善。 健康结果，包括情绪，主观睡眠质量和PTSD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.