06.08.2024.
Braining is group training with heart rate-raising focus on at least a moderate degree of effort, which corresponds to approximately 75% of the maximum heart rate. The method was invented at the Psychiatry Division Southwest at Huddinge Hospital in 2017 and involves staff and patients doing pulse-raising exercises together.
The goal is for the patients to train three times a week during a defined training period of three months, which is preceded and ended by a meeting with a discussion about goals and motivation, as well as measurement of mental and physical status, blood tests and psychiatric rating scales.
Specially trained staff from psychiatry, a leader and a host, lead the sessions two by two during working hours and train together with patients from both outpatient care and round-the-clock care. Other staff at the clinic can also participate in the sessions.
Before each training session, the patient meets the leader or host and has a motivational check-in conversation where the physical and mental form of the day is checked and the patient can ask questions.
Iniciators:
Lina Martinsson is a specialist in psychiatry and director of operations at Psykiatri Sydväst in the Stockholm region. She is the author of Braining. Lina is a doctoral researcher in bipolar disorder and lithium response and now leads the research in the Braining project. Lina has long experience as a group training instructor.
Åsa Anger is a specialist in psychiatry and senior physician at the Addiction Center Stockholm. Åsa has been involved in designing Braining at Psychiatry Sydväst. She is a PhD student in the Braining project and works at the Center for Psychiatry Research spreading Braining to more psychiatric clinics in the Stockholm Region. Åsa has been a group exercise instructor in her spare time for many years.
How was Braining invented?
At Affective Reception Psykiatri Sydväst, located at Karolinska Huddinge (Sweden), there were several employees under the leadership of Lina Martinsson who themselves liked to exercise and wanted to offer physical activity to their patients.
After asking the patients, Lina Martinsson and co-workers came up with a method where the patients could participate in simple group training sessions, which until then had functioned as “staff gym”, at lunch in a conference room at the reception. Patients at the clinic were invited to an inspiring lecture on research and knowledge about exercise and the brain and could then book training sessions.
Patients with e.g. bipolar disorder and depression, of all ages, both men and women, participated and appreciated the treatment, which led to us being able to expand with more sessions and eventually gain access to a sports hall at the Rehab Clinic at Huddinge Hospital. Braining has now been expanded so that there are also simpler sessions for the sickest patients, which are carried out in all round-the-clock care departments.
Research shows that physical activity, especially pulse-raising exercise, has a positive effect on the brain. For mild to moderate depression, exercise is as effective as medication and therapy.
In the case of anxiety, exercise works directly and lowers the anxiety level, and exercise also has an effect as part of the treatment in the longer term. Exercise also improves concentration and learning ability, which can be particularly important in, for example, ADHD. In addition to the effect on the brain, there are many years of research showing that physical activity works as a prevention and treatment for several chronic diseases, such as diabetes, cardiovascular disease and certain forms of cancer.
Although our patients know that exercise is good for depression and anxiety, it is difficult for them to implement exercise as a treatment, which may be partly due to the conditions themselves, with a lot of avoidance, fatigue and difficulty getting started and completing activities. One way for health care to help patients get started with physical activity is by prescribing physical activity on prescription (FaR), but previous studies suggest that prescriptions are rarely written and that patients rarely use the prescription. Many who work in healthcare have a high workload and experience stress. And for the staff, it can be difficult to move around enough, despite knowing that it offers effective protection against stress and psychological problems
Results and follow-up
Braining has reached over 700 patients aged 18-80 during 2017-2022. Clinical follow-ups have been made on collected data and we see interesting changes regarding weight, blood pressure, blood sugar and degree of inflammation. Patients enjoy the treatment.
30 patients who had ongoing depression at the start of training managed to complete tough training and participated in pre- and post-measurements and were significantly improved in depression symptoms. The working environment became healthier for the staff.
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