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“Crawling Out of the Cocoon”: Patients' Experiences of a Physical Therapy Exercise Intervention in the Treatment of Major Depression

Louise Danielsson, Birgitta Kihlbom, Susanne Rosberg
DOI: 10.2522/ptj.20150076 Published 1 August 2016
Louise Danielsson
L. Danielsson, PT, PhD, Institute of Medicine, Department of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden; University of Gothenburg Centre for Person-Centred Care (GPCC), Gothenburg, Sweden; and Närhälsan Gibraltar Rehabilitation Centre, Gibraltargatan 1C, 411 32 Gothenburg, Sweden.
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Birgitta Kihlbom
B. Kihlbom, PT, Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, University of Gothenburg and Närhälsan Gibraltar Rehabilitation Centre.
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Susanne Rosberg
S. Rosberg, PT, PhD, Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, University of Gothenburg, and University of Gothenburg Centre for Person-Centred Care (GPCC).
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Abstract

Background Although the effectiveness of physical exercise for depression has been studied for many years, few studies have described patients' experiences of what exercise means to them, beyond the biological focus. Moreover, exercise as a treatment for depression is rarely explored in a physical therapy context.

Objectives The purpose of this study was to explore a physical therapy exercise intervention, as experienced by people with major depression.

Design This study had an inductive approach and used qualitative content analysis.

Methods Semistructured interviews were conducted with 13 people who participated in physical therapist–guided aerobic exercise in a randomized controlled trial. All participants were diagnosed with major depression according to the Diagnostic and Statistical Manual of Mental Disorders. Data were collected and analyzed in an inductive manner using qualitative content analysis according to Graneheim and Lundman.

Results Four categories emerged: (1) struggling toward a healthy self, (2) challenging the resistance, (3) feeling alive but not euphoric, and (4) needing someone to be there for you. The participants experienced that although the exercise intervention was hard work, it enhanced the feeling of being alive and made them feel that they were doing something good for themselves. These feelings were a welcome contrast to the numbness and stagnation they experienced during depression.

Limitations The study was conducted in Swedish primary care. Transferability of results must be viewed in relation to context.

Conclusions Exercise in a physical therapy context can improve the patients' perception of their physical ability and create a sense of liveliness, improving their depressed state. The therapeutic relationship is essential for supporting the patient's vulnerability and ambiguity in an empathic and perceptive way.

Footnotes

  • All authors provided concept/idea/research design and data analysis. Mrs Danielsson and Mrs Rosberg provided writing. Mrs Danielsson and Ms Kihlbom provided data collection and participants. Mrs Rosberg provided consultation (including review of manuscript before submission). The authors thank the participants for generously sharing their experiences.

  • The regional ethics review board approved the study.

  • The study was financially supported by regional funds from Västra Götaland, the University of Gothenburg Centre for Person-Centred Care, and the Renée Eander's Fund, Sweden.

  • Received February 6, 2015.
  • Accepted January 25, 2016.
  • © 2016 American Physical Therapy Association
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Vol 96 Issue 8 Table of Contents
Physical Therapy: 96 (8)

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“Crawling Out of the Cocoon”: Patients' Experiences of a Physical Therapy Exercise Intervention in the Treatment of Major Depression
Louise Danielsson, Birgitta Kihlbom, Susanne Rosberg
Physical Therapy Aug 2016, 96 (8) 1241-1250; DOI: 10.2522/ptj.20150076

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“Crawling Out of the Cocoon”: Patients' Experiences of a Physical Therapy Exercise Intervention in the Treatment of Major Depression
Louise Danielsson, Birgitta Kihlbom, Susanne Rosberg
Physical Therapy Aug 2016, 96 (8) 1241-1250; DOI: 10.2522/ptj.20150076
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Subjects

  • Psychosocial
    • Psychosocial: Other
  • Intervention
    • Therapeutic Exercise
  • Other Diseases/Conditions
    • Other Diseases or Conditions

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