ARTICLE INFO

Article Type

Original Research

Authors

Mandani   B. (* )
Hosseini   S.A. (1 )
Saadat Abadi   M. (2 )
Farahbod   M. (2 )






(* ) “Musculoskeletal Rehabilitation Research Center” and “Occupational Therapy Department. Rehabilitation School”, Jundishapour University of Medical Sciences, Ahvaz, Iran
(1 ) Pediatric Neuro Rehabilitation Research Center, University of Welfare Sciences & Rehabilitation, Tehran , Iran
(2 ) Special Education Department, Exceptional Children Research Center and Institute, Tehran, Iran

Correspondence

Address: Occupational Therapy Department, Musculoskeletal Rehabilitation Research Center, Jundishapour University of Medical Sciences, Golestan Boulevard, Ahvaz, Iran. Postal Code: 61357-33133
Phone: +986113743101
Fax: +986113743506
ghazal.mandani@gmail.com

Article History

Received:  December  10, 2014
Accepted:  February 24, 2015
ePublished:  April 20, 2015

BRIEF TEXT


… [1] Quality of life is described as the perception of people from their situation in life. Also, it includes the goals, expectations, standards and concerns in the cultural context and value system [2, 3]. Post-traumatic stress disorder (PTSD) is occurred following a war injury and pressures. It is in connection with the intensity and extent of these injuries and it progresses within few months [4, 5]. ... [6-14].

One of the non-medication therapies that could improve the quality of life of these veterans, is exercise and physical activity [15]. ... [16-19]. Sports play an important role to improve general health [20], making positive changes in the life style [20, 21] and improving life satisfaction [19, 22-24], mood [25], self- confidence [26] and cognitive performance [16-19], while reducing the symptoms of anxiety and depression [16, 18, 26-30], increasing the ability to cope with stress [31] and improving and strengthening the social skills [32].

The Purpose of this study was to investigate the effect of group exercise on the quality of life of a group of veterans with post-traumatic stress disorder.

This is an one-way blind randomized clinical trial study.

Veterans with post-traumatic stress disorder were studied in the city of Ahvaz in 2014.

Among veterans with post-traumatic stress disorder who received medical care in the Bustan Psychiatric Hospital in Ahvaz as outpatients, 30 veterans were selected by convenience sampling method.

Inclusion criteria included: lack of participation in sport and physical activities regularly, post-traumatic stress disorder after stressful events and the pressures of war, lack of psychotic symptoms, lack of other problems such as mood disorder, drug addiction, etc. All samples were evaluated in three sessions. One evaluation session was before the start of interventions and two evaluation sessions were after the intervention on the day after the completion of treatment and a month after that. To collect data, a demographic questionnaire developed by the researcher and 36-item Short Form (SF36) of Quality of Life were used. SF36 Questionnaire measures the quality of life in two scales of physical health and mental health, and gives the mean of the total score of the two scales. Physical health scale measures physical functioning domains, physical role performance, bodily pain and general health. Mental health scale measures social role performance, mental health, vitality, and emotional role performance. Veterans in experimental group were exposed to the group exercise (12-week aerobic exercise with two 40min-sessions per week). Both groups maintained their normal process of treatment. Statistical analysis was performed using SPSS 16 statistical software. In order to determine the difference between the two evaluation sessions before the start of exercises in both groups, as well as age, education level, marital status and disability percent homogeneity of the groups, one-way ANOVA was used. To determine the effect of interventions, also, Repeated Measure ANOVA was used in two groups and three sessions.

The average age of the veterans in experimental group was 46.10 ± 5.40years and it was 45.50 ± 4.30years in control group. In experimental group, 21 participants (70.5%) were under diploma and 9 participants (29.5%) had diploma. In control group, 20 participants (66.5%) were under diploma and 10 participants (33.5%) had diploma. In experimental group, 14 patients (47.5%) were married, 12 (38.4%) were single and 4 (14.1%) were divorced and in control group, 18 patients (60.5%) were married, 9 (29.3%) were single and 3 (10.2%) were divorced. The results of the mental health scores, the scale of physical health and mean of total scores of the veterans’ quality of life showed a significant effect of group exercise program on the veterans’ quality of life (Table 1). In the follow-up session, there was a significant difference between the results of the meeting after the intervention and the follow-up session for both groups.

Results of other researches are also consistent with the results of this research. The results of Cohort and experimental studies between 1980 and 2010 have shown a significant positive correlation between physical activity and the domains of SF36 test. In these studies, physical functioning, vitality and mental health have shown a higher correlation with physical exercises [33]. 40-week exercise program has had positive effects on the quality of life of PTSD Australian veterans of the Vietnam War and has led to physiological changes such as reducing the level of anger and aggression, increasing mental and cognitive abilities, increasing energy levels and daily activities, and increasing social support [21]. … [34-46] 16-week physical activities and exercises have had a significant positive effect on the ability to perform daily activities, the level of physical activity and quality of life of outpatients with a diagnosis of schizophrenia [47]. 20 sessions of physical activity have had a significant and positive impact on the quality of life in patients with schizophrenia in the cities of Semnan and Shahrood (Iran) [48]. Group exercise program significantly increased the quality of life in elderly people in the city of Borujen (Iran) in the domains of SF36 test [49].

As an effective and cost-effective additional therapy, sport programs should be used in the rehabilitation of veterans.

Lack of access to all the veterans with post-traumatic stress disorder in the city of Ahvaz was of the limitations for the present study.

Group exercise program can improve the quality of life of the veterans with post-traumatic stress disorder. In order to prevent and reduce the problems and needs of these veterans, the utilization of sport programs is needed.

The sincere cooperation and assistance of the officials of the hospital and participating veterans in this survey is appreciated.

Non-declared

This study was approved by the Ethics Committee of Jondi Shapour University of Medical Sciences of Ahwaz and it was recorded in Iranian Registry of Clinical Trials (Code: IRCT2012122911922N1).

The research project approved at the Jondi Shapour University of Medical Sciences in Ahwaz and implemented at Musculoskeletal Rehabilitation Research Center ( no. ph-91-02).

TABLES and CHARTS

Show attach file


CITIATION LINKS

[1]Liddle J, McKenna K. Quality of life: An overview of issues for use in occupational therapy outcome measurement. Aust Occup Ther J. 2000;47(2):77-85.
[2]Schnurr PP, Lunny CA, Bovin MJ, Marx BP. Post traumatic stress disorder and quality of life: extension of findings to veterans of the wars in Iraq and Afghanistan. Clin Psychol Rev. 2009;29(8):275-35.
[3]Mogotsi M, Kaminer D, Stein DJ. Quality of life in the anxiety disorders. Harv Rev Psychiatry. 2000;8(6):273-82.
[4]Peraica T, Vidovic A, Petrovic ZK, Kozaric-Kovacic D. Quality of life of Croatian veterans, wives and veterans with post traumatic stress disorder. Health Qual Life Outcomes. 2014;12(1):136.
[5]Grieger T, Cozza S, Ursano R, Hoge C, Martinez P, Engel C, et al. Posttraumatic stress disorder and depression in battle-injured soldiers. Am J Psychiatry. 2006;163(10):1777-83.
[6]Ahmadizade MJ, Ahmadi K, Eskandari H, Falsafinejad MR, Borjali A, Anisi J, et al. Improvement in quality of life after exposure therapy, problem solving and combined therapy in chronic war-related post traumatic stress disorder. Proc Soc Behav Sci. 2010;5:262-6.
[7]Herman N, Eryarec G. Post traumatic stress disorder in institutionalized world war II veterans. Am J Geriatr Psychiatry. 1994;2(4):324-31.
[8]Spiro A 3rd, Schnurr PP, Aldwin CM. Combat-related posttraumatic stress disorder symptoms in older men. Psychol Aging. 1994;9(1):17-26.
[9]Zatzick DF, Marmar CR, Weiss DS, Browner WS, Metzler TJ, Golding JM, et al. Posttraumatic stress disorder and functioning and quality of life outcomes in a nationally representative sample of male Vietnam veterans. Am J Psychiatry. 1997;154(12): 1690-5.
[10]Rapaport MH, Clary C, Fayyad R, Endicott J. Quality-of-life impairment in depressive and anxiety disorders. Am J Psychiatry. 2005;162(6):1171-8.
[11]Azad Marzabadi E, Hashemi Zade SM. The effectiveness of mindfulness training in improving the quality of life the war victims with post-traumatic stress disorder. Iran J Psychiatry. 2014; 9(4): 228-36.
[12]Pell JP, Donnan PT, Fowkes FG, Ruckly CV. Quality of life following lower limb amputation for peripheral anterior disease. Eur J Vasc Surg. 1993;7(4):448-51.
[13]Faulkner G, Biddle S. Exercise and mental health: It's just not psychology!. J Sports Sci. 2001;19(6):433-44.
[14]Faulkner G, Carless D. Physical activity in the process of psychiatric rehabilitation: Theoretical and methodological issues. Psychiatr Rehabil J. 2006;29(4):258-66.
[15]Sahlin KB, Lexell J. Impact of organized sports on activity, participation, and quality of life in people with neurologic disabilities. PM R. 2015;pii:S1934-1482(15)00171-9.
[16]Dimeo F, Bauer M, Varahram I, Proest G, Halter U. Benefits from aerobic exercise in patients with major depression: A pilot study. Br J Sports Med. 2001;35(2):114-7.
[17]Petrozzello SJ, Landers DM, Hatfield BD, Kubitz KA, Salazar W. A meta analysis on the anxiety-reducing effects of acute and chronic exercise outcome and mechanisms. Sports Med. 1991;11(3):143-82.
[18]Rehor PR, Dunnagan T, Stewart C, Cooley D. Alteration of mood state after a single bout of noncompetitive and competitive exercise programs. Percept Motor Skills. 2001;93(1):249-56.
[19]Meyer T, Broocks A. Therapeutic impact of exercise on psychiatric diseases. Sports Med. 2000;30(4):269-79.
[20]de Assis MAd, de Mello MF, Scorza FA, Cadrobbi MP, Schooedl AF, Gomes da Silva S, et al. Evaluation of physical activity habits in patients with posttraumatic stress disorder. Clinics. 2008;63(4):473-8.
[21]Otter L, Currie J. A long time getting home: Vietnam Veterans' experiences in a community exercise rehabilitation programme. Disabil Rehabil. 2004;26(1):27-34.
[22]Dunn AL, Trivedi MH, O'Neal HA. Physical activity dose–response effects on outcomes of depression and anxiety. Med Sci Sports Exerc. 2001;33(Suppl. 6):S587-97.
[23]Paffenbarger RS, Lee IM, Leung R. Physical activity and personal characteristics associated with depression and suicide in American college men. Acta Psychiatr Scand Suppl. 1994;377:16-22.
[24]Collingwood TR, Sunderlin J, Reynolds R, Kohl HW. Physical training as a substance abuse prevention intervention for youth. J Drug Educ. 2000;30(4):435-52.
[25]Folkins CH, Sime WE. Physical fitness training and mental health. Am Psychol. 1981;36(4):373-89.
[26]Callaghan P. Exercise: A neglected intervention in mental health care? J Psychiatr Ment Health Nurs. 2004;11(4):476-83.
[27]Martinsen EW, Medhus A, Sandvik L. Effects of aerobic exercise on depression: A controled study. Br Med J (Clin Res Ed). 1985;291(6488):109.
[28]Paluska SA, Schwenk TL. Physical activity and mental health. Sports Med. 2000;29(3):167-80.
[29]Brooks A. Physical training in the treatment of psychological disorders. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2005;48(8):914-21.
[30]Goodwin RD. Association between physical activity and mental disorders among adults in the United States. Prev Med. 2003;36(6):698-703.
[31]Steptoe A, Edwards S, Moses J, Mathews A. The effects of exercise training on mood and perceived coping ability in anxious adults from the general population. J Psychosom Res. 1989;33(5):537-47.
[32]Chogahara MO, Brien Cousins S, Wankel LM. Social influence in physical activity in older adults. J Aging Phys Act. 1998;6(1):1-17.
[33]Pucci GC, Rech CR, Fermino RC, Reis RS. Association between physical activity and quality of life in adults. Rev Saude Publica. 2012;46(1):166-79.
[34]Spirduso WW, Cronin DL. Exercise does-dependent effects on quality of life and independent living in older adults. Med Sci Sports Exerc. 2001;33(Suppl. 6):609-33.
[35]Manger TA, Motta RW. The impact of an exercise program on posttraumatic stress disorder, anxiety, and depression. Int J Emerg Ment Health. 2005;7(1):49-57.
[36]Sale C, Guppy A, El-Sayed M. Individual differences, exercise and leisure activity in predicting affective well-being in young adults. Ergonomics. 2000;43(10):1689-97.
[37]Taghipour H, Moharamzad Y, Mafi AR, Amini A, Naghizadeh MM, Soroush MR, et al. Quality of life among veterans with war-related unilateral lower extremity amputation: A long-term survey in in a Prosthesis Center in Iran. J Orthop Trauma. 2009;23(7):525-30.
[38]Yazelkucuk K, Taska Y, Mehmet A, Guzelkucuk U, Tugeu L. Effect of playing football on balance strength and quality of life in unilateral below knee amputees. Am J Phys Med Rehab. 2007;86(10):800-5.
[39]Siddharthan K. The effect of post-traumatic stress disorder on rehabilitation among combat-wounded veterans. Stud Health Technol Inform. 2012;182:114-24.
[40]Dally AJ. Exercise therapy and mental health in clinical population: Is exercise therapy a worthwhile intervention?. Adv Psychiatr Treat. 2002;8(4):262-70.
[41]Brovold T, Skelton DA, Bergland A. Older adults recently discharged from the hospital: effect of aerobic interval exercise on health-related quality of life, physical fitness, and physical activity. J Am Geriatr Soc. 2013;61(9):1580-5.
[42]Diaz AB, Motta R. The effects of an aerobic exercise program on posttraumatic stress disorder symptom severity in adolescents. Int J Emerg Ment Health. 2008;10(1):49-59.
[43]Conn AM, Calais C, Szilagyi M, Baldwin C, Jee SH. Youth in out-of-home care: Relation of engagement in structured group activities with social and mental health measures. Child Youth Services Rev. 2014;36:201-5.
[44]Brauninger I. The efficacy of dance movement therapy group on improvement of quality of life: A randomized controlled trial. Art Psychother. 2012;39(4):296-303.
[45]Mahoney JL, Schweder AE, Stattin H. Structured after-school activities as a moderator of depressed mood for adolescents with detached relations to their parents. J Community Psychology. 2002;30(1):69-86.
[46]Bartko WT, Eccles JS. Adolescent participation in structured and unstructured activities: A person-oriented analysis. J Youth Adoles. 2003;32(4):233-41.
[47]Gomes E, Bastos T, Probst M, Riberio JC, Silva G, Corredeira R. Effects of a group physical activity program on physical fitness and quality of life in individuals with schizophrenia. Ment Health Phys Activ. 2014;7(3):155-62.
[48]Kalate Jari M, Bagheri H, Hasani MR. Effect of aerobic exercise program on quality of life in Schizophrenia. J Shahrekord Uni Med Sci. 2007;9(3):28-36. [Persian]
[49]Telenius EW, Engedel K, Bergland A. Effect of a high-intensity exercise program on physical function and mental health in nursing home residents with dementia: an assessor blinded randomized controlled trial. PLoS One. 2015;10(5):e0126102.