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Chamberlain D.1, Parent Nichols J.1
1Franklin Pierce University, DPT, Rindge, United States
Background: Chronic stress associated with lingering health conditions negatively affects not only the individuals with these conditions, but also their caregivers. While the physiological effects of stress on the body has been well known and described, the neurological effects on the brain has been less reported or discussed. Current research indicates damaging effects to the brain due to chronic stress are present as revealed through scientific study in individuals of all ages. As physical therapists working with individuals dealing with this stress, we need evidenced based interventions to help them manage their stress in order to enable them to achieve the most optimal outcomes and live an abundant life.
Purpose: To review the literature to define the effects of chronic stress on the brain and to identify evidenced based interventions to manage stress.
Methods: An extensive search of the literature was conducted using CINAHL Complete, PubMed, and Google Scholar. A Boolean/Phrase search strategy was used with keywords stress, stress management, relaxation training, mindfulness, yoga, eye movement desensitization and reprocessing therapy (EMDR), biofeedback, visualization, autogenic training, physical therapy, and mind/body therapies. Peer reviewed RCTs and systematic reviews were analyzed and included in the findings.
Results: Brain changes due to chronic stress include a shifting of power/control of the left hemisphere to the right hemisphere as indicated by a shrinking left hemisphere with smaller dendrites and impaired neurogenesis along with atrophy of the hippocampus and corpus callosum. As the right hemisphere becomes more active, less perception of language and analytic thinking occurs and more emotional responses occur. Chronic stress also leads to toxic amounts of cortisol being released due to over activity of the HPA (hypothalamus-pituitary-adrenal) axis resulting in decreased learning and memory abilities.
Using stress management techniques, research indicates brain changes may be reversible over time; thought to be due to structural remodeling in brain regions. Using mindfulness, a shift from right brain to left brain can be seen along with decreased anxiety, enhanced coping strategies, and increased QOL. Relaxation training was seen effective with significant reductions in medication/hospital costs/pain/anxiety/depression/fatigue. Biofeedback was seen to decrease anxiety/headaches/chronic pain/hypertension/constipation/ADHD. Autogenic training was seen to increase energy, decrease physical and emotional issues, and increase left brain activity. EDMR was seen to activate the thalamus and re-wire parts of the brain associated with fear and memory and is the treatment of choice for PTSD by the WHO and National Institute for Health and Clinical Excellence. Yoga and physical activity also demonstrated healing effects on the brain with effective stress reduction.
Conclusion(s): Fortunately, research in the field of neurology indicates that specific, positive brain changes can result with participation in activities such as physical activity, progressive relaxation, meditation, deep breathing, mindfulness, biofeedback, yoga, and eye movement desensitization and reprocessing therapy (EMDR).
Future research is needed to examine how physical therapists can effectively integrate these interventions into their practice.
Implications: Promoting health and healing using evidenced based stress management interventions for individuals dealing with chronic stress is not just a hope, but can be a reality thanks to current neuroscience and behavioral research.
Funding acknowledgements: There was no funding provided for this research.
Topic: Professional issues
Ethics approval: Ethics approval was not needed for this research.
All authors, affiliations and abstracts have been published as submitted.
