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Trials
Published in: Trials 1/2015

Open Access 01-12-2015 | Study protocol

Treatment of traumatised refugees with basic body awareness therapy versus mixed physical activity as add-on treatment: Study protocol of a randomised controlled trial

Authors: Maja Sticker Nordbrandt, Jessica Carlsson, Laura Glahder Lindberg, Hinuga Sandahl, Erik Lykke Mortensen

Published in: Trials | Issue 1/2015

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Abstract

Background

Treatment of traumatised refugees is one of the fields within psychiatry, which has received little scientific attention. Evidence based treatment and knowledge on the efficiency of the treatment for this complex patient group is therefore scarce. This leads to uncertainty as to which treatment should be offered and potentially lowers the quality of life for the patients.
Chronic pain is very common among traumatised refugees and it is believed to maintain the mental symptoms of trauma. Hence, treating chronic pain is believed to be of high clinical value for this patient group.
In clinical studies, physical activity has shown a positive effect on psychiatric illnesses such as depression and anxiety and for patients with chronic pain. However, scientific knowledge about physical activity as part of the treatment for traumatised refugees is very limited and no guidelines exist on this topic.

Methods/design

This study will include approximately 310 patients, randomised into three groups. All three groups receive psychiatric treatment as usual for the duration of 6–7 months, consisting of consultations with a medical doctor including pharmacological treatment and manual-based Cognitive Behavioural Therapy. The first group only receives treatment as usual while the second and the third groups receive either Basic-Body Awareness Therapy or mixed physical activity as add-on treatments. Each physical activity is provided for an individual 1-hour consultation per week, for the duration of 20 weeks. The study is being conducted at the Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup in the Capital Region of Denmark.
The primary endpoint of the study is symptoms of Post Traumatic Stress Disorder; the secondary endpoints are depression and anxiety as well as quality of life, functional capacity, coping with pain, body awareness and physical fitness.

Discussion

This study will examine the effect of physical activity for traumatised refugees. This has not yet been done in a randomised controlled setting on such a large scale before. Hereby the study will contribute to important knowledge that is expected to be used in future clinical guidelines and reference programs.

Trial registration

ClinicalTrials.gov NCT01955538. Date of registration: 18 September 2013.
Appendix
Available only for authorised users
Footnotes
1
Trial Sponsor: Jessica Carlsson, jessica.carlsson@regionh.dk. Competence Centre for Transcultural Psychiatry, Mental Health Centre Ballerup
Maglevænget 2, 2750 Ballerup
Denmark
 
Literature
1.
Hetrick SE, Purcell R, Garner B, Parslow R. Combined pharmacotherapy and psychological therapies for post traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2010;7(7):CD007316.PubMed
2.
Lawrence S, De Silva M, Henley R. Sports and games for post-traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2010;20(1):CD007171.
3.
4.
Stein DJ, Ipser JC, Seedat S. Pharmacotherapy for post traumatic stress disorder (PTSD). Cochrane Database Syst Rev. 2006;25(1):CD002795.
5.
Lund M, Sørensen J, Christensen J, Ølholm AM: MTV Om Behandling Og Rehabilitering Af PTSD–herunder Traumatiserede Flygtninge. Region Syddanmark. 2008;54:9–375.
6.
Olsen D, Olsen DR. Prevalent musculoskeletal pain as a correlate of previous exposure to torture. Scand J Public Health. 2006;34:496–503.CrossRefPubMed
7.
Olsen DR, Montgomery E, Bøjholm S, Foldspang A. Prevalence of pain in the head, back and feet in refugees previously exposed to torture: a ten-year follow-up study. Disabil Rehabil. 2007;29:163–71.CrossRefPubMed
8.
Sharp TJ, Harvey AG. Chronic pain and posttraumatic stress disorder: mutual maintenance? Clin Psychol Rev. 2001;21:857–77.CrossRefPubMed
9.
Morasco BJ, Lovejoy TI, Lu M, Turk DC, Lewis L, Dobscha SK. The relationship between PTSD and chronic pain: mediating role of coping strategies and depression. Pain. 2013;154:609–16.CrossRefPubMedPubMedCentral
10.
Buhmann CB. Traumatized refugees: morbidity, treatment and predictors of outcome. Dan Med J. 2014;61:B4871.PubMed
11.
Gyllensten AL, Hansson L, Ekdahl C. Outcome of Basic Body Awareness Therapy. A Randomized Controlled Study of Patients in Psychiatric Outpatient Care. Adv Physiother. 2003;5:179–90.CrossRef
12.
Cabral P, Meyer HB, Ames D. Effectiveness of yoga therapy as a complementary treatment for major psychiatric disorders: a meta-analysis. Prim Care Companion CNS Disord. 2011;13.
13.
Brown RP, Gerbarg PL. Sudarshan Kriya yogic breathing in the treatment of stress, anxiety, and depression: part I-neurophysiologic model. J Altern Complement Med. 2005;11:189–201.CrossRefPubMed
14.
Hedlund L, Gyllensten AL. The experiences of basic body awareness therapy in patients with schizophrenia. J Bodyw Mov Ther. 2010;14:245–54.CrossRefPubMed
15.
De Moor MHM, Boomsma DI, Stubbe JH, Willemsen G, de Geus EJC. Testing causality in the association between regular exercise and symptoms of anxiety and depression. Arch Gen Psychiatry. 2008;65:897–905.CrossRefPubMed
16.
Friis S, Skatteboe UB, Hope MK, Vaglum P. Body awareness group therapy for patients with personality disorders. 2. Evaluation of the Body Awareness Rating Scale. Psychother Psychosom. 1989;51:18–24.CrossRefPubMed
17.
Bräuninger I. The efficacy of dance movement therapy group on improvement of quality of life: A randomized controlled trial. Arts Psychother. 2012;39:296–303.CrossRef
18.
Porges SW. The polyvagal theory: phylogenetic substrates of a social nervous system. Int J Psychophysiol. 2001;42:123–46.CrossRefPubMed
19.
Manger TA, Motta RW. The impact of an exercise program on posttraumatic stress disorder, anxiety, and depression. Int J Emerg Ment Health. 2005;7:49–57.PubMed
20.
Krogh J, Saltin B, Gluud C, Nordentoft M. The DEMO trial: a randomized, parallel-group, observer-blinded clinical trial of strength versus aerobic versus relaxation training for patients with mild to moderate depression. J Clin Psychiatry. 2009;70:790–800.CrossRefPubMed
21.
Krogh J, Nordentoft M, Sterne JC, Lawlor DA. The effect of exercise in clinically depressed adults: systematic review and meta-analysis of randomized controlled trials. J Clin Psychiatry. 2011;72:529–38.CrossRefPubMed
22.
23.
Dunn AL, Trivedi MH, Kampert JB, Clark CG, Chambliss HO. Exercise treatment for depression: efficacy and dose response. Am J Prev Med. 2005;28:1–8.CrossRefPubMed
24.
25.
26.
Danielsson L, Noras AM, Waern M, Carlsson J. Exercise in the treatment of major depression: a systematic review grading the quality of evidence. Physiother Theory Pract. 2013;29:573–85.CrossRefPubMed
27.
Trial AR, Garfinkel MS, Singhal A, Katz WA, Allan DA, Reshetar R, et al. Yoga-Based Intervention for Carpal Tunnel Syndrome. Am Med Assoc. 1998;280.
28.
Williams KA, Petronis J, Smith D, Goodrich D, Wu J, Ravi N, et al. Effect of Iyengar yoga therapy for chronic low back pain. Pain. 2005;115:107–17.CrossRefPubMed
29.
Gard G. Body awareness therapy for patients with fibromyalgia and chronic pain. Disabil Rehabil. 2005;27:725–8.CrossRefPubMed
30.
Malmgren-Olsson E, Armelius B, Armelius K. A Comparative outcome study of body awareness therapy, feldenkrais, and conventional physiotherapy for patients with nonspecific musculoskeletal disorders: changes in phychological symptoms, pain and self-image. Physiother Theory Pract. 2001;17:77–95.CrossRef
31.
Malmgren-Olsson E-B, Bränholm I-B. A comparison between three physiotherapy approaches with regard to health-related factors in patients with non-specific musculoskeletal disorders. Disabil Rehabil. 2002;24:308–17.CrossRefPubMed
32.
Price CJ, McBride B, Hyerle L, Kivlahan DR. Mindful awareness in body-oriented therapy for female veterans with post-traumatic stress disorder taking prescription analgesics for chronic pain: a feasibility study. Altern Ther Health Med. 2007;13:32–40.PubMedPubMedCentral
33.
Carson JW, Carson KM, Jones KD, Bennett RM, Wright CL, Mist SD. A pilot randomized controlled trial of the Yoga of Awareness program in the management of fibromyalgia. Pain. 2010;151:530–9.CrossRefPubMed
34.
35.
King SJ, Wessel J, Bhambhani Y, Sholter D, Maksymowych W. The effects of exercise and education, individually or combined, in women with fibromyalgia. J Rheumatol. 2002;29:2620–7.PubMed
36.
National Institute of Clinical Exellence: Post-Traumatic Stress Disorder (PTSD) The Management of PTSD in Adults and Children in Primary and Secondary Care. National Institute for Clinical Excellence; 2005.
37.
Liedl A, Müller J, Morina N, Karl A, Denke C, Knaevelsrud C. Physical Activity within a CBT Intervention Improves Coping with Pain in Traumatized Refugees: Results of a Randomized Controlled Design. Pain Med. 2011;12:234–45.CrossRefPubMed
38.
Danielsson L, Papoulias I, Petersson E-L, Carlsson J, Waern M. Exercise or basic body awareness therapy as add-on treatment for major depression: A controlled study. J Affect Disord. 2014;168:98–106.CrossRefPubMed
39.
Roxendal G. Body awareness therapy and the body awareness scale: treatment and evaluation in psychiatric physiotherapy. 1985.
40.
Roxendal G. Psychosomatically Oriented Physiotherapy. Lund Studentlitteratur: Psychosoma Lund; 1995.
41.
Stade K, Skammeritz S, Hjortkjær C, Carlsson J. “After all the traumas my body has been through, I feel good that it is still working.” –Basic Body Awareness Therapy for traumatised refugees. Torture 2015, In press
42.
Grahn B, Ekdahl C, Borgquist L. Effects of a multidisciplinary rehabilitation programme on health-related quality of life in patients with prolonged musculoskeletal disorders; a 6-month follow-up of a prospective controlled study. Disabil Rehabil. 1998;20:285–97.CrossRefPubMed
43.
Carlsson J, Sonne C, Silove D. From pioneers to scientists: challenges in establishing evidence-gathering models in torture and trauma mental health services for refugees. J Nerv Ment Dis. 2014;202:630–7.CrossRefPubMed
44.
Sonne C, Carlsson J, Elklit A, Mortensen EL, Ekstrøm M. Treatment of traumatized refugees with sertraline versus venlafaxine in combination with psychotherapy - study protocol for a randomized clinical trial. Trials. 2013;14:137.CrossRefPubMedPubMedCentral
45.
46.
Grootenboer EMV, Giltay EJ, van der Lem R, van Veen T, van der Wee NJA, Zitman FG. Reliability and validity of the Global Assessment of Functioning Scale in clinical outpatients with depressive disorders. J Eval Clin Pract. 2012;18:502–7.CrossRefPubMed
47.
Palic S, Kappel ML, Nielsen MS, Carlsson J, Bech P. Comparison of Psychiatric Disability on the Health of Nation Outcome Scales (HoNOS) in Resettled Traumatized Refugee Patients and Danish Inpatients. BMC Psychiatry 2014, In press.
48.
Buhmann C, Mortensen EL, Lundstrøm S, Ryberg J, Nordentoft M, Ekstrøm M. Symptoms, Quality of Life and level of functioning of traumatized refugees at Psychiatric Trauma Clinic in Copenhagen. Torture. 2014;24:25–39.
49.
50.
Davidson J, Rothbaum BO, Tucker P, Asnis G, Benattia I, Musgnung JJ. Venlafaxine extended release in posttraumatic stress disorder: a sertraline- and placebo-controlled study. J Clin Psychopharmacol. 2006;26:259–67.CrossRefPubMed
51.
Davidson J, Baldwin D, Stein DJ, Kuper E, Benattia I, Ahmed S, et al. Treatment of posttraumatic stress disorder with venlafaxine extended release: a 6-month randomized controlled trial. Arch Gen Psychiatry. 2006;63:1158–65.CrossRefPubMed
52.
Buhmann C, Andersen I, Mortensen EL, Ryberg J, Nordentoft M, Ekstrøm M. Cognitive behavioral psychotherapeutic treatment at a psychiatric trauma clinic for Refugees: description and evaluation. Torture. 2015;25:17–32.PubMed
53.
Gyllensten A: Basic Body Awareness Therapy: Assessment, Treatment and Interaction. Lund University; 2001.l
54.
Buhmann CB: Traumatized refugees: Morbidity, treatment and predictors of outcome. University of Copenhagen, Graduate School of Health and Medical Sciences; 2013.
55.
Gordon JS, Staples JK, Blyta A, Bytyqi M, Wilson AT. Treatment of Posttraumatic Stress Disorder in Postwar Kosovar Adolescents Using Mind-Body Skills Groups. J Clin Psychiatry. 2008;69:1469–76.CrossRefPubMed
56.
Carlsson JM, Olsen DR, Kastrup M, Mortensen EL. Late mental health changes in tortured refugees in multidisciplinary treatment. J Nerv Ment Dis. 2010;198:824–8.CrossRefPubMed
57.
Hollifield M, Warner TD, Lian N, Jenkins JH, Kesler J, Stevenson J. Measuring Trauma and Health Status in Refugees. J Am Med Assoc. 2002;288:611–21.CrossRef
58.
Shoeb M, Weinstein H, Mollica R. The Harvard Trauma Questionnaire: Adapting a Cross-Cultural Instrument for Measuring Torture, Trauma and Posttraumatic Stress Disorder in Iraqi Refugees. Int J Soc Psychiatry. 2007;53:447–63.CrossRefPubMed
59.
Palic S, Elklit A. An explorative outcome study of CBT-based multidisciplinary treatment in a diverse group of refugees from a Danish treatment centre for rehabilitation of traumatized refugees. Torture. 2009;19:248–70.PubMed
60.
Lhewa D, Banu S, Rosenfeld B, Keller A. Validation of a Tibetan translation of the Hopkins Symptom Checklist 25 and the Harvard Trauma Questionnaire. Assessment. 2007;14:223–30.CrossRefPubMed
61.
Buhmann C, Mortensen EL, Nordentoft M, Ryberg J, Ekstrøm M. Follow-up study of the treatment outcomes at a psychiatric trauma clinic for refugees. Torture. 2015;25:1–16.PubMed
62.
Muller J, Karl A, Denke C, Mathier F, Dittmann J, Rohleder N, et al. Biofeedback for pain management in traumatised refugees. Cogn Behav Ther. 2009;38:184–90.CrossRefPubMed
63.
Carlsson JM, Mortensen EL, Kastrup M. A follow-up study of mental health and health-related quality of life in tortured refugees in multidisciplinary treatment. J Nerv Ment Dis. 2005;193:651–7.CrossRefPubMed
64.
Palic S, Carlsson J, Armour C, Elklit A. Assessment of dissociation in Bosnian treatment-seeking refugees in Denmark. Nord J Psychiatry. 2014;69:1–8.
65.
Liedl A, O’Donnell M, Creamer M, Silove D, McFarlane A, Knaevelsrud C, et al. Support for the mutual maintenance of pain and post-traumatic stress disorder symptoms. Psychol Med. 2010;40:1215–23.CrossRefPubMed
66.
Palic S, Kappel M, Nielsen M, Carlsson J, Bech P. Comparison of psychiatric disability on the health of nation outcome scales (HoNOS) in resettled traumatized refugee outpatients and Danish inpatients. BMC Psychiatry. 2014;14:330.CrossRefPubMedPubMedCentral
67.
Mollica RF, Chernoff MC, Megan Berthold S, Lavelle J, Lyoo IK, Renshaw P. The mental health sequelae of traumatic head injury in South Vietnamese ex-political detainees who survived torture. Compr Psychiatry. 2014;55:1626–38.CrossRefPubMedPubMedCentral
68.
Mollica RF, Caspi-Yavin Y, Bollini P, Truong T, Tor S, Lavelle J. The Harvard Trauma Questionnaire. Validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. J Nerv Ment Dis. 1992;180:111–6.CrossRefPubMed
69.
De Fouchier C, Blanchet A, Hopkins W, Bui E, Ait-Aoudia M, Jehel L: Validation of a French adaptation of the Harvard Trauma Questionnaire among torture survivors from sub-Saharan African countries. Eur J Psychotraumatol 2012, 3 doi:10.​3402/​ejpt.
70.
Mollica RF, Wyshak G, de Marneffe D, Khuon F, Lavelle J. Indochinese versions of the Hopkins Symptom Checklist-25: a screening instrument for the psychiatric care of refugees. Am J Psychiatry. 1987;144:497–500.CrossRefPubMed
71.
Glaesmer H, Braehler E, Grande G, Hinz A, Petermann F, Romppel M. The German Version of the Hopkins Symptoms Checklist-25 (HSCL-25) --factorial structure, psychometric properties, and population-based norms. Compr Psychiatry. 2014;55:396–403.CrossRefPubMed
72.
Lipman RS, Covi L, Shapiro AK. The Hopkins Symptom Checklist (HSCL). J Affect Disord. 1979;1:9–24.CrossRefPubMed
73.
Ventevogel P, De Vries G, Scholte WF, Shinwari NR, Faiz H, Nassery R, et al. Properties of the Hopkins Symptom Checklist-25 (HSCL-25) and the Self-Reporting Questionnaire (SRQ-20) as screening instruments used in primary care in Afghanistan. Soc Psychiatry Psychiatr Epidemiol. 2007;42:328–35.CrossRefPubMed
74.
Hollifield M, Warner TD, Lian N, Krakow B, Jenkins JH, Kesler J, et al. Measuring trauma and health status in refugees: a critical review. JAMA. 2002;288:611–21.CrossRefPubMed
75.
Blom EH, Bech P, Högberg G, Larsson JO, Serlachius E. Screening for depressed mood in an adolescent psychiatric context by brief self-assessment scales -- testing psychometric validity of WHO-5 and BDI-6 indices by latent trait analyses. Health Qual Life Outcomes. 2012;10:149.CrossRefPubMedPubMedCentral
76.
Folker H: WHO-5 as a simple method for measuring quality of life in daily psychiatric clinics. Ugeskr læger. 2008;170:830–4.PubMed
77.
Sisask M, Värnik A, Kõlves K, Konstabel K, Wasserman D. Subjective psychological well-being (WHO-5) in assessment of the severity of suicide attempt. Nord J Psychiatry. 2008;62:431–5.CrossRefPubMed
78.
Löwe B, Spitzer RL, Gräfe K, Kroenke K, Quenter A, Zipfel S, et al. Comparative validity of three screening questionnaires for DSM-IV depressive disorders and physicians’ diagnoses. J Affect Disord. 2004;78:131–40.CrossRefPubMed
79.
Bech P, Olsen LR, Kjoller M, Rasmussen NK. Measuring well-being rather than the absence of distress symptoms: a comparison of the SF-36 Mental Health subscale and the WHO-Five Well-Being Scale. Int J Methods Psychiatr Res. 2003;12:85–91.CrossRefPubMed
80.
Sheehan KH, Sheehan DV. Assessing treatment effects in clinical trials with the discan metric of the Sheehan Disability Scale. Int Clin Psychopharmacol. 2008;23:70–83.CrossRefPubMed
81.
Arbuckle R, Frye MA, Brecher M, Paulsson B, Rajagopalan K, Palmer S, et al. The psychometric validation of the Sheehan Disability Scale (SDS) in patients with bipolar disorder. Psychiatry Res. 2009;165:163–74.CrossRefPubMed
82.
Sheehan DV, Harnett-Sheehan K, Spann ME, Thompson HF, Prakash A. Assessing remission in major depressive disorder and generalized anxiety disorder clinical trials with the discan metric of the Sheehan disability scale. Int Clin Psychopharmacol. 2011;26:75–83.CrossRefPubMed
83.
Song SJ, Kaplan C, Tol WA, Subica A, de Jong J. Psychological distress in torture survivors: pre- and post-migration risk factors in a US sample. Soc Psychiatry Psychiatr Epidemiol. 2014;50(4):549–60.CrossRefPubMed
84.
Jones SH, Thornicroft G, Coffey M, Dunn G. A brief mental health outcome scale-reliability and validity of the Global Assessment of Functioning (GAF). Br J Psychiatry. 1995;166:654–9.CrossRefPubMed
85.
English BA, Jewell M, Jewell G, Ambrose S, Davis LL. Treatment of chronic posttraumatic stress disorder in combat veterans with citalopram: an open trial. J Clin Psychopharmacol. 2006;26:84–8.CrossRefPubMed
86.
Schütte N, Bär O, Weiss U, Heuft G. Prediction of PTSD in police officers after six months--a prospective study. Span J Psychol. 2012;15:1339–48.CrossRefPubMed
87.
Krieger T, Zimmermann J, Huffziger S, Ubl B, Diener C, Kuehner C, et al. Measuring depression with a well-being index: further evidence for the validity of the WHO Well-Being Index (WHO-5) as a measure of the severity of depression. J Affect Disord. 2014;156:240–4.CrossRefPubMed
88.
89.
Boonstra AM, Schiphorst Preuper HR, Reneman MF, Posthumus JB, Stewart RE. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. Int J Rehabil Res. 2008;31:165–9.CrossRefPubMed
90.
Cleeland CS, Ryan KM. Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singapore. 1994;23:129–38.PubMed
91.
Atkinson TM, Rosenfeld BD, Sit L, Mendoza TR, Fruscione M, Lavene D, et al. Using confirmatory factor analysis to evaluate construct validity of the Brief Pain Inventory (BPI). J Pain Symptom Manage. 2011;41:558–65.CrossRefPubMed
92.
Marchetti GF, Whitney SL. Construction and validation of the 4-item dynamic gait index. Phys Ther. 2006;86:1651–60.CrossRefPubMed
93.
Goggin NL. Senior fitness test manual. Choice Rev Online. 2002;39:39–3447. 39–3447.
94.
Macri EM, Lewis JA, Khan KM, Ashe MC, de Morton NA. The de morton mobility index: normative data for a clinically useful mobility instrument. J Aging Res. 2012;2012:353252.CrossRefPubMedPubMedCentral
Metadata
Title
Treatment of traumatised refugees with basic body awareness therapy versus mixed physical activity as add-on treatment: Study protocol of a randomised controlled trial
Authors
Maja Sticker Nordbrandt
Jessica Carlsson
Laura Glahder Lindberg
Hinuga Sandahl
Erik Lykke Mortensen
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Trials / Issue 1/2015
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-015-0974-9

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