Department of Exercise, Sport and Lifestyle Medicine

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Browsing Department of Exercise, Sport and Lifestyle Medicine by browse.metadata.advisor "Atterbury, Elizabeth Maria"

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    The acute effect of self-induced unclassified therapeutic tremors on cardiac autonomi responses and interictal state anxiety symptoms in individuals with epilepsy
    (Stellenbosch : Stellenbosch University, 2022-12) Botha, Annette Jacolien; Welman, Karen Estelle; Atterbury, Elizabeth Maria; Stellenbosch University. Faculty of Medical and Health Sciences. Dept. of Exercise, Sport and Lifestyle Medication.
    ENGLISH ABSTRACT: Introduction: Individuals with epilepsy (IwE) are diagnosed with comorbidities up to eight times more than the general population, of which anxiety disorders are one of the most frequently reported. Interictal anxiety is unique to IwE and includes anticipatory anxiety of epileptic seizures, seizure phobia, epileptic social phobia, and epileptic panic disorder, which leads to avoidance behaviour compromising quality of life. Further, health and wellness practitioners (HWP) are reported to feel inadequately resourced in treating anxiety in epilepsy. There is growing evidence that complementary and alternative medicine (CAM) may reduce anxiety in IwE by inducing parasympathetic activation, and thus increase heart rate variability (HRV) and reduce state anxiety. One such therapy is Tension and Trauma Release Exercises (TRE®), which employs self-initiated unclassified therapeutic tremors (SUTT), which assist the body in releasing deep muscular patterns of tension originating from stressful and traumatic experiences. Studies suggest that SUTT has a regulating effect on the stress response, reducing anxiety and improving autonomic regulation in populations experiencing chronic stress. However, no studies to date have investigated the effect of SUTT on cardiac autonomic responses (CAR) and state anxiety in IwE. Aims: The primary aim of the research was to investigate the acute effects of a single TRE® session on CAR, as well as interictal state anxiety in IwE. The secondary aims included determining the allostatic load index of the participants, their perceived stress and anxiety and their comfort during the TRE® session. In addition, a survey distributed to HWP determined their attitudes and perceptions towards CAM, specifically the use of TRE® in the treatment of anxiety in IwE. Methods: A RedCap survey was distributed to HWP (n = 52; age: 41.15 ± 13.59 years) to gain insights into their perceptions of and attitudes towards CAM, in particular TRE®. The experimental study was a cross-over randomized study design in IwE (n = 11; age: 23.18 ± 2.36 years) with a confirmed diagnosis, but seizure free for at least three months. Discriptive information was collected pre-intervention. Cardiac autonomic responses ((HRV, heart rate (HR) and blood pressure (BP)) were measured at 5, 10 and 15 minutes pre- and post-intervention (i.e. TRE® session and control), via H10, Polar Electro Oy®, Finland. Perceived interictal state anxiety symptoms were measured (STAI-S) pre-and post-intervention. The potential comfort of the TRE® session was also measured using a subjective VAS comfort rating scale. Results: Survey results reported that 94% of HWP believed CAM therapies to be useful in treating anxiety in IwE and the most preferred CAM therapies included Breathing Methods (96%), Physical Activity (90%) and Yoga (81%). Furthermore, 48% of HWPs were familiar with SUTT, 52% knew of TRE® and 17% were qualified, TRE® practitioners. The intervention’s eleven participants presented with moderate perceived stress (16.55 ± 7.79 A.U) and anxiety (8.55 ± 4.50 A.U) levels as well as a moderate descriptive allostatic load index. State anxiety symptoms improved (p = 0.04) as well as comfort levels (p = 0.04) after a single TRE® session. No treatment effect was observed in the CAR between the control and treatment group thus, Systolic BP (p = 0.60); Diastolic BP (p = 0.54); HR (p= 0.88); nLF (p = 0.41); nHF (p = 0.84); nLF/nHF (p = 0.80); Mean R-R (p = 0.96); RMSSD (p = 0.87) and SDNN (p = 0.68). Conclusion: Generally, HWPs agree that CAM therapies are effective in treating anxiety in IwE. Most are hesitant, however, to use TRE® as a treatment option, suggesting that additional substantiation is needed. In this intervention, a single TRE® session did not influence the CAR acutely, requiring longer-term investigation. Interictal state anxiety symptoms were significantly reduced, and comfort levels increased, without adverse events. Therefore, promoting TRE® as a possible immediate state anxiety intervention for individuals with controlled epilepsy.