Mechanisms through which exercise reduces symptom severity and/or functional impairment in posttraumatic stress disorder (PTSD): Protocol for a living systematic review of human and non-human studies [version 3; peer review: 2 approved, 1 not approved]

Background Exercise can play an important role in reducing symptom severity and improving functional impairment in patients with posttraumatic stress disorder (PTSD). However, the precise mechanisms underpinning the effect of exercise in PTSD management are not fully understood. This living systemat...

Full description

Saved in:
Bibliographic Details
Main Authors: Fiona J. Ramage, Edoardo G. Ostinelli, Claire Stainsfield, Spyridon Siafis, Virginia Chiocchia, Simonne Wright, Francesca Tinsdeall, Claire Friedrich, James Thomas, Malcolm Macleod, Toshi A. Furukawa, Georgia Salanti, Soraya Seedat, Olufisayo Elugbadebo, Andrea Cipriani, Ouma Simple, Jennifer Potts
Format: Article
Language:English
Published: Wellcome 2025-04-01
Series:Wellcome Open Research
Subjects:
Online Access:https://wellcomeopenresearch.org/articles/8-494/v3
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850269889863876608
author Fiona J. Ramage
Edoardo G. Ostinelli
Claire Stainsfield
Spyridon Siafis
Virginia Chiocchia
Simonne Wright
Francesca Tinsdeall
Claire Friedrich
James Thomas
Malcolm Macleod
Toshi A. Furukawa
Georgia Salanti
Soraya Seedat
Olufisayo Elugbadebo
Andrea Cipriani
Ouma Simple
Jennifer Potts
author_facet Fiona J. Ramage
Edoardo G. Ostinelli
Claire Stainsfield
Spyridon Siafis
Virginia Chiocchia
Simonne Wright
Francesca Tinsdeall
Claire Friedrich
James Thomas
Malcolm Macleod
Toshi A. Furukawa
Georgia Salanti
Soraya Seedat
Olufisayo Elugbadebo
Andrea Cipriani
Ouma Simple
Jennifer Potts
author_sort Fiona J. Ramage
collection DOAJ
description Background Exercise can play an important role in reducing symptom severity and improving functional impairment in patients with posttraumatic stress disorder (PTSD). However, the precise mechanisms underpinning the effect of exercise in PTSD management are not fully understood. This living systematic review aims to synthesize and triangulate the evidence from non-human and human studies to gain insight into the biopsychosocial mechanisms through which exercise reduces symptom severity and functional impairment. Methods Independent searches will be conducted in electronic databases to identify eligible studies. Two reviewers will independently conduct the study selection, data extraction, and risk of bias assessment. We will extract outcome data and variables that can act as effect modifiers or as mediators of the effect of exercise. For the non-human studies, outcome data will include the non-human equivalents of PTSD symptom clusters. For human studies, the primary outcome will be PTSD symptom severity. The secondary outcomes will be avoidance symptom severity, reexperiencing symptom severity, hyperarousal symptom severity, negative cognitions and mood severity, functional impairment, loss of PTSD diagnosis, and dropout rates. To explain the biopsychosocial mechanisms through which exercise affects the outcome of interest, we will extract effects that relate to the impact of exercise on potential mediating variables and the effect of the later outcomes. Comparison of within-study direct and indirect effects obtained from mediation analysis, when reported, will provide insight into the importance of the examined mediator. If appropriate, we will synthesize study results using meta-analyses. We will examine potential effect modifiers of the total exercise effect to understand better the impact of exercise on PTSD symptoms and function impairment (when possible). The evidence about the potential mediators of the association between exercise and PTSD-related outcomes will be considered in a consensus meeting when sufficient evidence is available. Protocol registration PROSPERO-ID: 453615
format Article
id doaj-art-918f35e5dff447c39cb485b7d4a7489b
institution OA Journals
issn 2398-502X
language English
publishDate 2025-04-01
publisher Wellcome
record_format Article
series Wellcome Open Research
spelling doaj-art-918f35e5dff447c39cb485b7d4a7489b2025-08-20T01:52:54ZengWellcomeWellcome Open Research2398-502X2025-04-01810.12688/wellcomeopenres.19903.326151Mechanisms through which exercise reduces symptom severity and/or functional impairment in posttraumatic stress disorder (PTSD): Protocol for a living systematic review of human and non-human studies [version 3; peer review: 2 approved, 1 not approved]Fiona J. Ramage0https://orcid.org/0000-0002-4855-7911Edoardo G. Ostinelli1https://orcid.org/0000-0002-8717-0832Claire Stainsfield2Spyridon Siafis3https://orcid.org/0000-0001-8264-2039Virginia Chiocchia4https://orcid.org/0000-0002-6196-3308Simonne Wright5https://orcid.org/0000-0003-3295-256XFrancesca Tinsdeall6https://orcid.org/0009-0008-9248-2954Claire Friedrich7https://orcid.org/0000-0002-5841-4324James Thomas8https://orcid.org/0000-0003-4805-4190Malcolm Macleod9https://orcid.org/0000-0001-9187-9839Toshi A. Furukawa10https://orcid.org/0000-0003-2159-3776Georgia Salanti11Soraya Seedat12Olufisayo Elugbadebo13https://orcid.org/0000-0003-3221-1323Andrea Cipriani14Ouma Simple15https://orcid.org/0000-0002-4510-6736Jennifer Potts16Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, EH8 9YL, UKDepartment of Psychiatry, University of Oxford, Oxford, England, OX3 7JX, UKEPPI Centre, Social Research Institute, University College London, London, England, WC1H 0NS, UKDepartment of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Bavaria, 81675, GermanyInstitute of Social and Preventive Medicine, University of Bern, Bern, Canton of Bern, 3012, SwitzerlandSouth African Medical Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, Western Cape, 7500, South AfricaCentre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, EH8 9YL, UKOxford Precision Psychiatry Lab, NIHR Oxford Health Biomedical Research Centre, University of Oxford, Oxford, England, OX3 7JX, UKEPPI Centre, Social Research Institute, University College London, London, England, WC1H 0NS, UKCentre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, EH8 9YL, UKDepartment of Health Promotion and Human Behavior, Graduate School of Medicine / School of Public Health, Kyoto University, Kyoto, Kyoto Prefecture, 606-8303, JapanInstitute of Social and Preventive Medicine, University of Bern, Bern, Canton of Bern, 3012, SwitzerlandSouth African Medical Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, Western Cape, 7500, South AfricaCollege of Medicine, University of Ibadan, Ibadan, Oyo, 200132, NigeriaDepartment of Psychiatry, University of Oxford, Oxford, England, OX3 7JX, UKSchool of Medicine, College of Health Sciences, Makerere University, Kampala, Central Region, 8HQG+FPF, UgandaDepartment of Psychiatry, University of Oxford, Oxford, England, OX3 7JX, UKBackground Exercise can play an important role in reducing symptom severity and improving functional impairment in patients with posttraumatic stress disorder (PTSD). However, the precise mechanisms underpinning the effect of exercise in PTSD management are not fully understood. This living systematic review aims to synthesize and triangulate the evidence from non-human and human studies to gain insight into the biopsychosocial mechanisms through which exercise reduces symptom severity and functional impairment. Methods Independent searches will be conducted in electronic databases to identify eligible studies. Two reviewers will independently conduct the study selection, data extraction, and risk of bias assessment. We will extract outcome data and variables that can act as effect modifiers or as mediators of the effect of exercise. For the non-human studies, outcome data will include the non-human equivalents of PTSD symptom clusters. For human studies, the primary outcome will be PTSD symptom severity. The secondary outcomes will be avoidance symptom severity, reexperiencing symptom severity, hyperarousal symptom severity, negative cognitions and mood severity, functional impairment, loss of PTSD diagnosis, and dropout rates. To explain the biopsychosocial mechanisms through which exercise affects the outcome of interest, we will extract effects that relate to the impact of exercise on potential mediating variables and the effect of the later outcomes. Comparison of within-study direct and indirect effects obtained from mediation analysis, when reported, will provide insight into the importance of the examined mediator. If appropriate, we will synthesize study results using meta-analyses. We will examine potential effect modifiers of the total exercise effect to understand better the impact of exercise on PTSD symptoms and function impairment (when possible). The evidence about the potential mediators of the association between exercise and PTSD-related outcomes will be considered in a consensus meeting when sufficient evidence is available. Protocol registration PROSPERO-ID: 453615https://wellcomeopenresearch.org/articles/8-494/v3GALENOS PTSD exercise extinction learning memory regulation emotion regulationeng
spellingShingle Fiona J. Ramage
Edoardo G. Ostinelli
Claire Stainsfield
Spyridon Siafis
Virginia Chiocchia
Simonne Wright
Francesca Tinsdeall
Claire Friedrich
James Thomas
Malcolm Macleod
Toshi A. Furukawa
Georgia Salanti
Soraya Seedat
Olufisayo Elugbadebo
Andrea Cipriani
Ouma Simple
Jennifer Potts
Mechanisms through which exercise reduces symptom severity and/or functional impairment in posttraumatic stress disorder (PTSD): Protocol for a living systematic review of human and non-human studies [version 3; peer review: 2 approved, 1 not approved]
Wellcome Open Research
GALENOS
PTSD
exercise
extinction learning
memory regulation
emotion regulation
eng
title Mechanisms through which exercise reduces symptom severity and/or functional impairment in posttraumatic stress disorder (PTSD): Protocol for a living systematic review of human and non-human studies [version 3; peer review: 2 approved, 1 not approved]
title_full Mechanisms through which exercise reduces symptom severity and/or functional impairment in posttraumatic stress disorder (PTSD): Protocol for a living systematic review of human and non-human studies [version 3; peer review: 2 approved, 1 not approved]
title_fullStr Mechanisms through which exercise reduces symptom severity and/or functional impairment in posttraumatic stress disorder (PTSD): Protocol for a living systematic review of human and non-human studies [version 3; peer review: 2 approved, 1 not approved]
title_full_unstemmed Mechanisms through which exercise reduces symptom severity and/or functional impairment in posttraumatic stress disorder (PTSD): Protocol for a living systematic review of human and non-human studies [version 3; peer review: 2 approved, 1 not approved]
title_short Mechanisms through which exercise reduces symptom severity and/or functional impairment in posttraumatic stress disorder (PTSD): Protocol for a living systematic review of human and non-human studies [version 3; peer review: 2 approved, 1 not approved]
title_sort mechanisms through which exercise reduces symptom severity and or functional impairment in posttraumatic stress disorder ptsd protocol for a living systematic review of human and non human studies version 3 peer review 2 approved 1 not approved
topic GALENOS
PTSD
exercise
extinction learning
memory regulation
emotion regulation
eng
url https://wellcomeopenresearch.org/articles/8-494/v3
work_keys_str_mv AT fionajramage mechanismsthroughwhichexercisereducessymptomseverityandorfunctionalimpairmentinposttraumaticstressdisorderptsdprotocolforalivingsystematicreviewofhumanandnonhumanstudiesversion3peerreview2approved1notapproved
AT edoardogostinelli mechanismsthroughwhichexercisereducessymptomseverityandorfunctionalimpairmentinposttraumaticstressdisorderptsdprotocolforalivingsystematicreviewofhumanandnonhumanstudiesversion3peerreview2approved1notapproved
AT clairestainsfield mechanismsthroughwhichexercisereducessymptomseverityandorfunctionalimpairmentinposttraumaticstressdisorderptsdprotocolforalivingsystematicreviewofhumanandnonhumanstudiesversion3peerreview2approved1notapproved
AT spyridonsiafis mechanismsthroughwhichexercisereducessymptomseverityandorfunctionalimpairmentinposttraumaticstressdisorderptsdprotocolforalivingsystematicreviewofhumanandnonhumanstudiesversion3peerreview2approved1notapproved
AT virginiachiocchia mechanismsthroughwhichexercisereducessymptomseverityandorfunctionalimpairmentinposttraumaticstressdisorderptsdprotocolforalivingsystematicreviewofhumanandnonhumanstudiesversion3peerreview2approved1notapproved
AT simonnewright mechanismsthroughwhichexercisereducessymptomseverityandorfunctionalimpairmentinposttraumaticstressdisorderptsdprotocolforalivingsystematicreviewofhumanandnonhumanstudiesversion3peerreview2approved1notapproved
AT francescatinsdeall mechanismsthroughwhichexercisereducessymptomseverityandorfunctionalimpairmentinposttraumaticstressdisorderptsdprotocolforalivingsystematicreviewofhumanandnonhumanstudiesversion3peerreview2approved1notapproved
AT clairefriedrich mechanismsthroughwhichexercisereducessymptomseverityandorfunctionalimpairmentinposttraumaticstressdisorderptsdprotocolforalivingsystematicreviewofhumanandnonhumanstudiesversion3peerreview2approved1notapproved
AT jamesthomas mechanismsthroughwhichexercisereducessymptomseverityandorfunctionalimpairmentinposttraumaticstressdisorderptsdprotocolforalivingsystematicreviewofhumanandnonhumanstudiesversion3peerreview2approved1notapproved
AT malcolmmacleod mechanismsthroughwhichexercisereducessymptomseverityandorfunctionalimpairmentinposttraumaticstressdisorderptsdprotocolforalivingsystematicreviewofhumanandnonhumanstudiesversion3peerreview2approved1notapproved
AT toshiafurukawa mechanismsthroughwhichexercisereducessymptomseverityandorfunctionalimpairmentinposttraumaticstressdisorderptsdprotocolforalivingsystematicreviewofhumanandnonhumanstudiesversion3peerreview2approved1notapproved
AT georgiasalanti mechanismsthroughwhichexercisereducessymptomseverityandorfunctionalimpairmentinposttraumaticstressdisorderptsdprotocolforalivingsystematicreviewofhumanandnonhumanstudiesversion3peerreview2approved1notapproved
AT sorayaseedat mechanismsthroughwhichexercisereducessymptomseverityandorfunctionalimpairmentinposttraumaticstressdisorderptsdprotocolforalivingsystematicreviewofhumanandnonhumanstudiesversion3peerreview2approved1notapproved
AT olufisayoelugbadebo mechanismsthroughwhichexercisereducessymptomseverityandorfunctionalimpairmentinposttraumaticstressdisorderptsdprotocolforalivingsystematicreviewofhumanandnonhumanstudiesversion3peerreview2approved1notapproved
AT andreacipriani mechanismsthroughwhichexercisereducessymptomseverityandorfunctionalimpairmentinposttraumaticstressdisorderptsdprotocolforalivingsystematicreviewofhumanandnonhumanstudiesversion3peerreview2approved1notapproved
AT oumasimple mechanismsthroughwhichexercisereducessymptomseverityandorfunctionalimpairmentinposttraumaticstressdisorderptsdprotocolforalivingsystematicreviewofhumanandnonhumanstudiesversion3peerreview2approved1notapproved
AT jenniferpotts mechanismsthroughwhichexercisereducessymptomseverityandorfunctionalimpairmentinposttraumaticstressdisorderptsdprotocolforalivingsystematicreviewofhumanandnonhumanstudiesversion3peerreview2approved1notapproved