Investigation of the biopsychosocial effectiveness of different exercise trainings in earthquake victims with post-traumatic stress disorder

The aim of this study was to investigate the biopsychosocial effects of different exercise modalities in individuals with post-traumatic stress disorder (PTSD) symptoms. A mixed-methods research design was employed. A total of 38 individuals with PTSD symptoms were randomly assigned into three groups: control (n=11), combined exercise (n=13), and aerobic exercise (n=14). The combined exercise group participated in Cognitive Exercise Therapy Approach (BETY) sessions twice a week and aerobic exercise sessions three times a week for 8 weeks. The aerobic exercise group engaged in aerobic exercise three times a week for 8 weeks. In the quantitative phase, participants were assessed before and after the intervention using the 6-Minute Walk Test for functional capacity, an algometer for pressure pain threshold, PTSD Checklist for DSM-5 (PCL-5), PTSD Diagnostic Scale, and the Impact of Event Scale-Revised for PTSD symptoms. Depression, anxiety, and stress levels were measured with the Depression Anxiety and Stress Scale, sleep quality with the Pittsburgh Sleep Quality Index, quality of life with the Short Form-36, biopsychosocial status with the BETY Biopsychosocial Questionnaire (BETY-BQ), and treatment effectiveness with the Global Rating of Change (GROC) scale. Qualitative data were collected through semi-structured focus group interviews. Quantitative findings revealed that PTSD symptoms, levels of depression and stress, quality of life, biopsychosocial status, and perceived treatment change significantly improved in both the combined and aerobic exercise groups compared to the control group (p<0.05). The combined exercise group showed significantly greater improvement in treatment change measured by the GROC compared to the aerobic group (p<0.05). Qualitative findings supported and enriched the quantitative results. It was concluded that aerobic and combined exercises can be prescribed to improve functional capacity, PTSD symptoms, sleep quality, quality of life, and biopsychosocial status in individuals with PTSD symptoms. BETY was found to be a usable biopsychosocial approach for individuals with PTSD. Further research is needed to demonstrate the effectiveness of exercise in individuals experiencing stress symptoms other than PTSD.