Effect of Exercise on Post-traumatic Growth Among Health Care Providers With Post-traumatic Stress

NCT ID: NCT04592770

Last Updated: 2023-02-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

246 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-01

Study Completion Date

2021-08-10

Brief Summary

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The purpose of designing this randomized control trial is to observe the effect of nature-based walk on post-traumatic growth and Psychophysiological alterations associated with it, in traumatic stress among health care providers of Karachi Pakistan. This study is planned to investigate the recreational exposure to the natural environment for the promotion of PTG, in the traumatic stress subjects and to determine whether PTG is associated with psychophysiological alterations, i.e. C-Reactive Protein, Brain Derived Neurotropic Factor, Interleukin-6, Cortisol, and Heart Rate Variability. Subjects who had experienced any traumatic event in the last 12 months will be recruited, and at baseline, the participant will be assessed with Trauma Symptom Checklist 40 to evaluate trauma intensity. Moreover, subjects who had developed PTG or did not have any trauma intensity will be excluded from the study. Blinded treatment will be provided to subjects meeting eligibility criteria and will be randomized into two groups sequentially as they agree to participate. The nature-based walk will be used as intervention vs the control (relax in nature). The study outcomes will be monitored in subjects of both groups at different intervals, i.e. at baseline and 3-month follow-up (post-interventional).

Detailed Description

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Plan of work

* Enrollment: Those subjects who had experienced any traumatic event in the last 12 months will be enrolled.
* Assessment of eligibility: Subject meeting eligibility criteria will be included in the study.
* Baseline assessment: All the variables, i.e. Post-traumatic growth inventory (PTGI), Trauma symptom checklist-40 (TSC-40), Traumatic stress scale (TSS), C-Reactive protein (CRP), Brain-derived neurotrophic factor (BDNF), Interleukin-6 (IL-6), Cortisol and Heart rate variability (HRV) will be measured at baseline.
* Randomization: Subjects based on eligibility criteria will be randomly allocated to the experimental or control group sequentially as they agree to participate.
* Allocation: A booklet with detailed instructions will be provided to the study subjects according to the groups allocated.
* Follow-up assessment: After 3 months, all the variables measured at the baseline phase will be measured again.
* Statistical Analysis: Pre \& post-analysis will be conducted in this phase.

Participants Subjects for the present study will be recruited from 5 Health care organizations based in Karachi, Pakistan. The targeted population includes subjects from diverse ethnicity and considered eligible for participation in the study if they indicated in a pre-screening form that they had experienced a traumatic event. These subjects will be invited to participate in the study through advertisements on the notice board of each center. Written informed consent will be obtained from each study subject after providing detailed information regarding the objectives of the study and its duration.

Randomization Subjects based on eligibility criteria will be randomly allocated to the experimental or control group in the 1:1 ratio. Computer-generated random numbers will be used for randomization. After taking the subject's basic information, a unique code will be provided to each included subject by the study center. The code will be mentioned in each form of each subject.

Interventions • The experimental intervention: In this group, the nature walk will take place in a conserved and by far the largest recreational area of Karachi city. The safari park covering an area of 148 acres (0.60 km2), It has a zoo, geared with woodland, mountain viewing, safari tracks, as well as two natural lakes. The experiment will take place in the afternoon on a 5 km marked area. The duration of the stretching exercise sessions will be of 10 minutes followed by 50 minutes' walk session five times per week (total 12 weeks). participants will be asked to walk at moderate pace.

• The control intervention: Subjects will undergo 12 weeks of nature therapy that includes exposure to natural landscapes. The duration of the sessions will be 60 minutes five times per week. The subjects will be asked to sit and relax in the evening, in the same recreational area which is used for the experimental group.

Conditions

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Post Traumatic Stress Disorder

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Participants

Study Groups

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The experimental intervention (walk):

In this group, the nature walk will take place in a conserved and by far the largest recreational area of Karachi city. The safari park covering an area of 148 acres (0.60 km2), It has a zoo, geared with woodland, mountain viewing, safari tracks, as well as two natural lakes. The experiment will take place in the afternoon on a 5 km marked area. The duration of the stretching exercise sessions will be of 10 minutes followed by 50 minutes' walk session five times per week (total 12 weeks). participants will be asked to walk at moderate pace.

Group Type EXPERIMENTAL

Nature based walk therapy

Intervention Type BEHAVIORAL

10 minutes stretching exercises followed by walk in nature for 50 minutes

The control intervention (sit & relax):

Subjects will undergo 12 weeks of nature therapy that includes exposure to natural landscapes. The duration of the sessions will be 60 minutes five times per week. The subjects will be asked to sit and relax in the evening, in the same recreational area which is used for the experimental group.

Group Type PLACEBO_COMPARATOR

Sit in nature

Intervention Type BEHAVIORAL

Sit in nature for 60 minutes

Interventions

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Nature based walk therapy

10 minutes stretching exercises followed by walk in nature for 50 minutes

Intervention Type BEHAVIORAL

Sit in nature

Sit in nature for 60 minutes

Intervention Type BEHAVIORAL

Other Intervention Names

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Experimental Control

Eligibility Criteria

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Inclusion Criteria

1. Both genders, aged 16-50 years
2. Must be disease free (by their reports), there must be no evidence of any metastatic disease.
3. Fluent in written and spoken the Urdu language (National Language of Pakistan).
4. Experienced any traumatic event in the last 12 months.
5. Informed written consent
6. Being able to walk five times per week. (Participants will be asked to complete the Physical Activity Readiness Questionnaire)

Exclusion Criteria

1. Subjects who received a structured psychological intervention for at least six months during the last three years performed by a psychologist or psychiatrist will be excluded.
2. Those with a codified psychiatric disorder (according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) who received Psychopharmacological treatment during the last three years will also be excluded from the study sample.
3. Those subjects who had developed Post Traumatic Growth. (will be evaluated from Post Traumatic Growth Inventory)
4. Those subjects who do not have any trauma intensity. (will be evaluated from Trauma Symptom Checklist 40)
5. Subjects who are at high risk for physical injury during exercise.
6. Self-reported current and regular exercise in nature
Minimum Eligible Age

16 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Karachi

OTHER

Sponsor Role lead

Responsible Party

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Shamoon Noushad

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Basit Ansari, Ph.D

Role: STUDY_CHAIR

University of Karachi

Sadaf Ahmed, Ph.D

Role: STUDY_DIRECTOR

University of Karachi

Locations

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Shamoon Noushad

Karachi, Sindh, Pakistan

Site Status

Countries

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Pakistan

References

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Alper B, Erdogan B, Erdogan MO, Bozan K, Can M. Associations of Trauma Severity with Mean Platelet Volume and Levels of Systemic Inflammatory Markers (IL1beta, IL6, TNFalpha, and CRP). Mediators Inflamm. 2016;2016:9894716. doi: 10.1155/2016/9894716. Epub 2016 Apr 5.

Reference Type BACKGROUND
PMID: 27127347 (View on PubMed)

Brown DK, Barton JL, Gladwell VF. Viewing nature scenes positively affects recovery of autonomic function following acute-mental stress. Environ Sci Technol. 2013 Jun 4;47(11):5562-9. doi: 10.1021/es305019p. Epub 2013 May 16.

Reference Type BACKGROUND
PMID: 23590163 (View on PubMed)

Gladwell VF, Brown DK, Barton JL, Tarvainen MP, Kuoppa P, Pretty J, Suddaby JM, Sandercock GR. The effects of views of nature on autonomic control. Eur J Appl Physiol. 2012 Sep;112(9):3379-86. doi: 10.1007/s00421-012-2318-8. Epub 2012 Jan 21.

Reference Type BACKGROUND
PMID: 22270487 (View on PubMed)

Gladwell VF, Brown DK, Wood C, Sandercock GR, Barton JL. The great outdoors: how a green exercise environment can benefit all. Extrem Physiol Med. 2013 Jan 3;2(1):3. doi: 10.1186/2046-7648-2-3.

Reference Type BACKGROUND
PMID: 23849478 (View on PubMed)

Hartig T, Mitchell R, de Vries S, Frumkin H. Nature and health. Annu Rev Public Health. 2014;35:207-28. doi: 10.1146/annurev-publhealth-032013-182443. Epub 2014 Jan 2.

Reference Type BACKGROUND
PMID: 24387090 (View on PubMed)

Kerai SM, Khan UR, Islam M, Asad N, Razzak J, Pasha O. Post-traumatic stress disorder and its predictors in emergency medical service personnel: a cross-sectional study from Karachi, Pakistan. BMC Emerg Med. 2017 Aug 29;17(1):26. doi: 10.1186/s12873-017-0140-7.

Reference Type BACKGROUND
PMID: 28851280 (View on PubMed)

Kondo MC, Fluehr JM, McKeon T, Branas CC. Urban Green Space and Its Impact on Human Health. Int J Environ Res Public Health. 2018 Mar 3;15(3):445. doi: 10.3390/ijerph15030445.

Reference Type BACKGROUND
PMID: 29510520 (View on PubMed)

Britton E, Kindermann G, Domegan C, Carlin C. Blue care: a systematic review of blue space interventions for health and wellbeing. Health Promot Int. 2020 Feb 1;35(1):50-69. doi: 10.1093/heapro/day103.

Reference Type BACKGROUND
PMID: 30561661 (View on PubMed)

Li Q, Otsuka T, Kobayashi M, Wakayama Y, Inagaki H, Katsumata M, Hirata Y, Li Y, Hirata K, Shimizu T, Suzuki H, Kawada T, Kagawa T. Acute effects of walking in forest environments on cardiovascular and metabolic parameters. Eur J Appl Physiol. 2011 Nov;111(11):2845-53. doi: 10.1007/s00421-011-1918-z. Epub 2011 Mar 23.

Reference Type BACKGROUND
PMID: 21431424 (View on PubMed)

Michopoulos V, Norrholm SD, Jovanovic T. Diagnostic Biomarkers for Posttraumatic Stress Disorder: Promising Horizons from Translational Neuroscience Research. Biol Psychiatry. 2015 Sep 1;78(5):344-53. doi: 10.1016/j.biopsych.2015.01.005. Epub 2015 Jan 30.

Reference Type BACKGROUND
PMID: 25727177 (View on PubMed)

Ohly H, White MP, Wheeler BW, Bethel A, Ukoumunne OC, Nikolaou V, Garside R. Attention Restoration Theory: A systematic review of the attention restoration potential of exposure to natural environments. J Toxicol Environ Health B Crit Rev. 2016;19(7):305-343. doi: 10.1080/10937404.2016.1196155. Epub 2016 Sep 26.

Reference Type BACKGROUND
PMID: 27668460 (View on PubMed)

Valtchanov D, Barton KR, Ellard C. Restorative effects of virtual nature settings. Cyberpsychol Behav Soc Netw. 2010 Oct;13(5):503-12. doi: 10.1089/cyber.2009.0308. Epub 2010 Feb 25.

Reference Type BACKGROUND
PMID: 20950174 (View on PubMed)

Noushad S, Ahmed S, Ansari B, Mustafa UH, Saleem Y, Hazrat H. Physiological biomarkers of chronic stress: A systematic review. Int J Health Sci (Qassim). 2021 Sep-Oct;15(5):46-59.

Reference Type BACKGROUND
PMID: 34548863 (View on PubMed)

Related Links

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Other Identifiers

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KU-DoHPESS-5

Identifier Type: -

Identifier Source: org_study_id

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