: Mentoring and Training Activities The proposed CDA-2 is designed to promote Dr. Hall's transition to an independent Rehabilitation Research career under the mentorship of leading researchers in the areas of physical function, PTSD, and chronic disease management. The training plan for this CDA-2 includes a mix of didactic and experiential learning activities. The primary objectives of this training plan include: develop competency in cognitive- behavioral approaches to reducing PTSD symptoms; develop hands-on experience and utilize innovative mobile health technologies; develop expertise in physical activity interventions for Veterans with PTSD and the development of comparative effectiveness clinical trials; and continued professional development in the areas of manuscript preparation, grant proposals, and the responsible conduct of research. There is substantial evidence that physical inactivity contributes to poorer physical health outcomes in older adults. There is a paucity of work examining physical activity in Veterans with PTSD. Consequently, the efficacy of exercise as a beneficial adjunctive therapy in the treatment for PTSD symptoms and related health sequelae has not been established. Methods: Eighty Veterans 60 years and older with PTSD will be recruited from the Durham VAMC PTSD clinic to participate in a 12-week physical activity program consisting of aerobic and strength-training activities. Participants will be randomized to an intervention arm or usual care. Outcomes: Changes in physical function, PTSD symptom severity, and aerobic endurance will be assessed between the two study arms. Secondary outcomes include compliance with the intervention, pain, sleep, and psychological well-being. Summary: This pilot trial will extend our understanding of the physical and psychological benefits of physical activity in Veterans with PTSD. The results from this study will be used to be used to develop a larger, randomized controlled exercise trial for Veterans with PTSD. Once new, effective exercise therapies for Veterans with PTSD are established, we can augment traditional PTSD therapy with exercise therapy to promote the prevention and treatment of chronic diseases common in this vulnerable population.

Public Health Relevance

This work has direct relevance to the health of Veterans and aligns closely with the research interests of the VHA, where multisymptom illnesses such as PTSD are prevalent and where research on patient-centered treatment strategies for chronic disease management are a high priority. Examining the impact that PTSD has on adherence to rehabilitative interventions has tremendous potential for improving health care and optimally directing rehabilitation services. Evidence-based physical activity programs that improve physical function and health in older Veterans with PTSD is imperative given what we know about the prevalence of cardiovascular and metabolic diseases in this population. Our findings could potentially guide new rehabilitation models for those with psychiatric morbidities. Furthermore, our development of a mobile app that integrates exercise promotion with PTSD symptom management can increase the reach of these services. The proposed project is highly relevant, serving as a vital link between the physical and mental health services provided to Veterans.

National Institute of Health (NIH)
Veterans Affairs (VA)
Veterans Administration (IK2)
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Career Development Program - Panel II (RRD9)
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Durham VA Medical Center
United States
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Kanach, Frances A; Pastva, Amy M; Hall, Katherine S et al. (2018) Effects of Structured Exercise Interventions for Older Adults Hospitalized With Acute Medical Illness: A Systematic Review. J Aging Phys Act 26:284-303
Hall, Katherine S; Morey, Miriam C; Beckham, Jean C et al. (2018) The Warrior Wellness Study: A Randomized Controlled Exercise Trial for Older Veterans with PTSD. Transl J Am Coll Sports Med 3:43-51
Cowper, Patricia A; Peterson, Matthew J; Pieper, Carl F et al. (2017) Economic Analysis of Primary Care-Based Physical Activity Counseling in Older Men: The VA-LIFE Trial. J Am Geriatr Soc 65:533-539
Hall, Katherine S; Cohen, Harvey J; Pieper, Carl F et al. (2017) Physical Performance Across the Adult Life Span: Correlates With Age and Physical Activity. J Gerontol A Biol Sci Med Sci 72:572-578
Hall, Katherine S; Gregg, Jeffrey; Bosworth, Hayden B et al. (2016) Physical Activity Counseling Promotes Physical and Psychological Resilience in Older Veterans with Posttraumatic Stress Disorder. Ment Health Phys Act 11:53-59
Hoerster, Katherine D; Millstein, Rachel A; Hall, Katherine S et al. (2015) Individual and contextual correlates of physical activity among a clinical sample of United States Veterans. Soc Sci Med 142:100-8
Hoerster, Katherine D; Jakupcak, Matthew; Hanson, Robert et al. (2015) PTSD and depression symptoms are associated with binge eating among US Iraq and Afghanistan veterans. Eat Behav 17:115-8
Hall, Katherine S; Hoerster, Katherine D; Yancy Jr, William S (2015) Post-traumatic stress disorder, physical activity, and eating behaviors. Epidemiol Rev 37:103-15