Augmenting PTSD treatment with physical activity: study protocol of the APPART study (Augmentation for PTSD with Physical Activity in a Randomized Trial)

E. M. Voorendonk*, S. A. Sanches, M. S. Tollenaar, A. De Jongh, A. Van Minnen

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Background: New intensive trauma-focused treatment (TFT) programmes that incorporate physical activity have been developed for people with post-traumatic stress disorder (PTSD). However, the unique contribution of physical activity within these intensive TFT programmes has never been investigated in a controlled manner. Objectives: This randomized controlled trial will investigate the effectiveness of physical activity added to an intensive TFT programme. In addition, the study aims to investigate the underlying mechanisms of the effects of physical activity on the change in PTSD symptoms. Methods: Individuals with PTSD (N = 120) will be randomly allocated to two conditions: a physical activity or a non-physical active control condition. All participants will receive the same intensive TFT lasting eight days within two consecutive weeks, in which daily prolonged exposure and EMDR therapy sessions, and psycho-education are combined. The amount of physical activity will differ per condition. While the physical activity condition induces daily physical activities with moderate intensity, in the non-physical active control condition no physical activity is prescribed; but instead, a controlled mixture of guided (creative) tasks is performed. The two primary outcome measures are change in PTSD symptoms from pre- to post-treatment and at six months follow-up, measured with the Clinician-Administered PTSD Scale (CAPS-5), and the PTSD Checklist for DSM-5 (PCL-5). Additionally, self-reported sleep problems, depressive symptoms, emotion regulation, dissociation symptoms and anxiety sensitivity will be measured as potential underlying mechanisms. Conclusions: This study will contribute to the research field of augmentation strategies for PTSD treatment by investigating the effectiveness of physical activity added to intensive TFT. Trial registration: This trial is registered in the Netherlands Trial Register (Trial NL9120).

Original languageEnglish
Article number2016219
Pages (from-to)1-11
Number of pages11
JournalEuropean Journal of Psychotraumatology
Issue number1
Early online date31 Jan 2022
Publication statusPublished - 2022

Bibliographical note

Spanish title: Tratamiento de potenciación para el TEPT con actividad física: protocolo de estudio del estudio APPART (potenciación para TEPT con actividad física en un ensayo aleatorizado).

Chinese titel: 用身体活动增强 PTSD 治疗: APPART 研究的研究方案 (随机试验中用体育活动增强 PTSD).

Funding Information:
This work was supported by EMDR Research Foundation, Vereniging EMDR Nederland. We would like to thank Ella Hoogendoorn and Georgy Gomon for their assistance in the data analysis plan.

Publisher Copyright:
© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.


  • EMDR therapy
  • exercise
  • intensive trauma-focused treatment
  • mediators
  • physical activity
  • Post-traumatic stress disorder
  • prolonged exposure
  • randomized controlled trial


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