Effectiveness of Basic Body Awareness Therapy in Survivors of Covid-19, Health Workers and Women Suffering From Gender-based Violence Regarding Post-traumatic Stress Disorders: A Randomized Clinical Trial

This protocol of research is addressed to assess the effectiveness of Basic Body Awareness Therapy (BBAT) as physiotherapist intervention adjunct treatment as usual with the aim to improve the symptoms of post-traumatic stress disorder (PTSD) in survivors of Covid-19, health workers and women suffering from gender-based violence.

Nowadays the world lives a pandemic of unknown diseases with a high mortality and propagation. It results a huge number of patients admitted in intensive care unity. Health workers and patients suffering the fact of unknown the outcome of Covid-19 as such as, the treatment and prevention of it. The level of stress of that situation and the isolation could generate a breeding ground for develop the PTSD.

Post-traumatic stress disorder (PTSD) includes symptoms such as persistent re-experiencing, sleep pattern disorders, nightmares, hyperarousal, avoidance of stimuli associated with trauma or phobia occurring after a traumatic experience. Some situations that could provoke PTSD are sexual abuse, gender-based violence or danger of death situations such as wars, kidnapping.

Otherwise some diseases could trigger PTSD, in the epidermal necrolysis comprising Stevens-Johnson syndrome is usual the life-threatening reaction with a prevalence of 65% of patients presents PTSD and 29% possible clinical of PTSD. Also PTSD has been assessed in other situations such as gender-based violence in american students with a prevalence of 40.4%, moreover in war veterans the prevalence is between 11-20% while in war refugees the prevalence is 68% in Denmark. More else, a new context of gender-based violence emerges during the lockdown time in our society.

The pharmacological treatment for PTSD is based in fluoxetine, paroxetine, sertraline and venlafaxine. There is insufficient evidence to recommend for or against offering risperidone and topiramate. Regarding non-pharmacological treatment the strongly recommendations are cognitive-behavioural therapy, cognitive processing therapy, cognitive therapy and prolonged exposure therapy. Additionally, the clinical practice guideline conditionally recommends the use of brief eclectic psychotherapy, eye movement desensitization and reprocessing (EMDR), and narrative exposure therapy (NET) Basic Body Awareness Therapy (BBAT), a health oriented, multi-perspective and person-centred approach with a focus on the patient's resources, is a movement awareness training approach in physiotherapy, aiming to promote movement quality in daily life through self-exploration and self-experience enabling the learning of new movement habits. Understanding movement quality as the art of consciously being, doing and relating to oneself and others will result in more functional daily life, relationships and actions. The features of movement quality as a phenomenon in the physiotherapeutic context are classified into four perspectives- biomechanical, physiological, bio-psycho-social and existential. BBAT consists of a broad scope of movements in the following positions: lying, sitting, standing and walking. Relational movements are practiced in therapy with components such as rhythm, form, elasticity, flow, intention and voice. To gain more functional movement quality, the physiotherapist focuses the guidance on postural balance, free breathing, and awareness, seeking to integrate them into movement. This method is applied in conditions such as psychosomatic, eating disorders, schizophrenia, depression, chronic pain and PTSD.