By T. Schweitzer, SPTA
At Virginian Rehabilitation and Wellness, we have a proud tradition of raising up the next generation of physical, occupational, and speech therapists and therapist assistants. This Spring/Summer we have been fortunate enough to have Student Physical Therapist, serving and learning alongside clinical instructor Kelley Grant, LPTA and the rest of our team. Although Stress Awareness Month was in April, we wanted to share this wonderful blog written by our recent Student Physical Therapist Assistant.
Physical therapy (PT) is the field of allied health concerned with movement. PT treatment preserves, enhances, or restores physical function impaired or threatened by disease, injury, or disability. It addresses impairments that reduce functional activities such as sitting, standing, walking, and running. Physical therapy uses exercise, physical modalities (such as soft tissue manipulation or electrical stimulation), and patient education and training, to help people be able to move their bodies in order to participate in activities of daily living and activities of choice. Impairments treated with PT are frequently associated with pain, stress and anxiety, and abnormal muscle tension.
Conditions treated with physical therapy: Link: https://www.choosept.com/symptoms-conditions/all-symptoms-conditions
WHAT IS ANXIETY?
Stress is a feeling of emotional or physical tension in response to an existing challenge or demand. The stress response in the body is caused by a release of hormones that make the brain more alert, make the muscles more tense, and increase the heart rate. This is also called the sympathetic response of the nervous system. Chronic stress can lead to health problems, including anxiety. Anxiety is a normal reaction to stress. It is a feeling of fear or unease in anticipation of an upcoming concern (future stressor). An anxiety disorder is persistent anxiety, and involves more than occasional, normal feelings of anxiety or fear. Anxiety disorders are the most common types of mental disorders, and it is estimated that globally, about 30% of all persons will be affected by an anxiety disorder in the course of their life.
Link: Mental health America stress screener: https://mhanational.org/get-involved/stress-screener
THE COMPONENTS OF ANXIETY
Anxiety can cause people to avoid situations that trigger or worsen their symptoms, affecting their participation in work, school, and personal activities. In an anxiety disorder, anxiety interferes with the ability to function normally. This ongoing worry and tension may be accompanied by physical symptoms such as fatigue, muscle tension, or difficulty sleeping. Panic attacks are a symptom of an anxiety disorder and can include a combination of sweating, trembling, dizziness, numbness or tingling, nausea, and feeling detached. Common avoidances due to anxiety disorders include situations and activities that cause anxiety such as public speaking, being in a crowd, or meeting new people. Anxiety often occurs together with depression, which also comes with symptoms of reduced participation in activities. The most widely recognized physical symptom of anxiety is muscle tension.
HOW PHYSICAL THERAPY CAN REDUCE ANXIETY
Some of the impairments caused by anxiety are the same type of impairments that physical therapy can improve. Anxiety causes muscle tension, pain, changes in social and movement behavior, and reduced participation in activities. Physical therapy routinely focuses on normalizing muscle tension, reducing pain, and facilitating independence in activities of daily life and participation in activities of choice. The hallmark of physical therapy is therapeutic exercise, and exercise is an effective intervention to reduce anxiety. Resistance exercise specifically is the most effective exercise treatment for anxiety disorder. Reducing anxiety is one more justification for therapeutic exercise prescription. Muscle tension and physical pain are additional symptoms of anxiety that are frequently the focus of physical therapy interventions. Physical therapy treatment often includes soft tissue manipulation, stretching, cupping, icing, traction, joint mobilization, and electric stimulation to reduce these symptoms. A personalized physical therapy plan of care will include goals of reducing barriers to participation in activities. When the symptoms of anxiety are causing avoidance of situations, physical therapy can, by reducing movement impairments, make it easier to modify behavior and increase participation. Anxiety disorders are frequently treated by in-person psychotherapy. Physical therapy does not include “talk therapy” but it does provide the social connection necessary for effective exercise training.
SUMMARY
Stress is a normal part of the human experience, and anxiety is a common outcome of stress. Physical therapists are trained in many modalities that will address symptoms of anxiety and their related impairments as part of an evidence-based treatment plan. Research has shown that physical therapy can help treat anxiety symptoms quicker.
SOURCES / FURTHER READING
https://hr.nih.gov/working-nih/civil/national-stress-awareness-month
National Library of Medicine webpage: Anxiety https://medlineplus.gov/anxiety.html
American Psychiatric Association: What are Anxiety Disorders? www.psychiatry.org/patients-families/anxiety-disorders/what-are-anxiety-disorders
Yang, X., Fang, Y., Chen, H., Zhang, T., Yin, X., Man, J., Yang, L., & Lu, M. (2021). Global, regional and national burden of anxiety disorders from 1990 to 2019: results from the Global Burden of Disease Study 2019. Epidemiology and psychiatric sciences, 30, e36. https://doi.org/10.1017/S2045796021000275
Bratberg, G., Leira, K., Granan, L.-P., Jonsbu, E., Fadnes, B. L., Thuland, S. F., & Myklebust, T. Å. (2021). Learning oriented physiotherapy (LOP) in anxiety and depression: an 18 months multicentre randomised controlled trial (RCT). European Journal of Physiotherapy, 23(5), 295–304. https://doi-org.eznvcc.vccs.edu/10.1080/21679169.2020.1739747
Yu, Q., Wong, K.-K., Lei, O.-K., Nie, J., Shi, Q., Zou, L., & Kong, Z. (2022). Comparative Effectiveness of Multiple Exercise Interventions in the Treatment of Mental Health Disorders: A Systematic Review and Network Meta-Analysis. Sports Medicine - Open, 8(1), 1–16. https://doi-org.eznvcc.vccs.edu/10.1186/s40798-022-00529-5