title: PTSD symptom reduction with mindfulness-based stretching and deep breathing exercise: randomized controlled clinical trial of efficacy.
abstract: BACKGROUND
  Abnormal cortisol levels are a key pathophysiological indicator of post-traumatic stress disorder (PTSD). Endogenous normalization of cortisol concentration through exercise may be associated with PTSD symptom reduction.
  
  
  OBJECTIVE
  The aim of the study was to determine whether mindfulness-based stretching and deep breathing exercise (MBX) normalizes cortisol levels and reduces PTSD symptom severity among individuals with subclinical features of PTSD.
  
  
  METHODS
  A randomized controlled trial was conducted at the University of New Mexico Health Sciences Center.
  
  
  METHODS
  Twenty-nine nurses (28 female) aged 45-66 years participated in the study.
  
  
  METHODS
  Sixty-minute MBX sessions were conducted semiweekly for 8 weeks.
  
  
  METHODS
  Serum cortisol was measured, and the PTSD Checklist-Civilian version (PCL-C) was performed at baseline and weeks 4, 8, and 16.
  
  
  RESULTS
  Twenty-nine participants completed the study procedures, 22 (79%) with PTSD symptoms (MBX, n = 11; control, n = 11), and 7 (21%) without PTSD (BASE group). Eight-week outcomes for the MBX group were superior to those for the control group (mean difference for PCL-C scores, -13.6; 95% confidence interval [CI], -25.6, -1.6; P = .01; mean difference for serum cortisol, 5.8; 95% CI, 0.83, 10.8; P = .01). No significant differences were identified between groups in any other items. The changes in the MBX group were maintained at the 16-week follow-up (P = .85 for PCL-C; P = .21 for cortisol). Our data show that improved PTSD scores were associated with normalization of cortisol levels (P < .05).
  
  
  CONCLUSIONS
  The results suggest that MBX appears to reduce the prevalence of PTSD-like symptoms in individuals exhibiting subclinical features of PTSD.
authors.affiliation: National Institutes of Health, Clinical Center, Bethesda, Maryland 20892, USA. sanghk@gmail.com
authors.forename: Sang Hwan
authors.initials: SH
authors.lastname: Kim
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Schneider
authors.forename: Margaret
authors.initials: M
authors.lastname: Bevans
authors.forename: Len
authors.initials: L
authors.lastname: Kravitz
authors.forename: Christine
authors.initials: C
authors.lastname: Mermier
authors.forename: Clifford
authors.initials: C
authors.lastname: Qualls
authors.forename: Mark R
authors.initials: MR
authors.lastname: Burge
mesh_terms: D000046:Academic Medical Centers; D000324:Adrenocorticotropic Hormone / Q000097:blood / Q000378:metabolism; D000368:Aged; D001945:Breathing Exercises; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D015536:Down-Regulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006854:Hydrocortisone / Q000097:blood* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D052580:Muscle Stretching Exercises; D009490:Neurosecretory Systems / Q000503:physiopathology*; D009516:New Mexico; D009726:Nurses; D011569:Psychiatric Status Rating Scales; D011603:Psychophysiology; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000097:blood / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*
chemical_list: D019314:Dehydroepiandrosterone Sulfate; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone