ImPuls - health services research project: a strong mind through motivation and exercise

In 2014, about 28% of the population was affected by mental illnesses. The most common diseases include anxiety disorders (approx. 15%) and unipolar depression (approx. 8%). In the meantime, mental illnesses, together with musculoskeletal, cancer and cardiovascular diseases, are the diseases with the most significant negative consequences for health and quality of life. Nevertheless, only 10% of all patients with mental illness in Germany receive evidence-based, i.e. guideline-based psychopharmacological or psychotherapeutic treatment. Although the effectiveness of endurance-oriented physical activity on mental health in the case of depressive illnesses, PTSD, panic disorder and insomnia is now well documented, sport and movement therapy concepts have not yet been established in the outpatient care of mentally ill patients.

"ImPuls - a strong mind through motivation and exercise (short: ImPuls)" is a sports and movement therapy program based on the current evidence for the effectiveness and promotion of (regular) endurance-oriented physical activity in people with mental illness.

ImPuls combines endurance-oriented physical activity with behaviour change techniques, which aim to build up motivation regarding the initiation of physical activity and to integrate phyiscal activity permanently into everyday life. The program consists of a four-week supervised and a five-month partially supervised phase. During the supervised phase, two to three units of running training take place each week in small groups of six people. The running units are supplemented by the behaviour change modules described above. The small groups are supervised by sports and movement therapists with 3 to 5 years of academic training who have completed DVGS specific training courses in the subject areas of psychiatry, psychosomatics and addiction as well as an ImPuls training courses lasting several days. Furthermore, an ImPuls App developed at the University of Tübingen supports the implementation of ImPuls.

During the partially supervised phase physical activity will be continued. In order to support the transfer of physical activity into everyday life, the patients are supported in this phase by regular telephone contacts and the ImPuls App.

In a randomized controlled trial, 600 patients with depression, panic disorder, post-traumatic stress disorder and insomnia will be enrolled in ten study centers in Baden-Württemberg. The study will examine whether ImPuls is transdiagnostically effective as an additional service compared to standard care and whether it can be implemented in the healthcare system. Furthermore, the cost-effectiveness of the ImPuls program is analyzed in cooperation with the health insurance companies TK and AOK BW. The evaluation is carried out externally by the Ludwig-Maximilians-University Munich and the Technical University Munich.

If the evaluation is positive, ImPuls could be implemented in outpatient care nationwide and thus contribute to closing the gap in mental health care.

ImPuls is primarily aimed at patients aged 18 to 65 years with the described disorders. Participation in the study is possible from March 1, 2021 on at 10 regional sport and movement therapy centers in Baden-Württemberg (Bietigheim-Bissingen, Crailsheim, Freiburg, Heidelberg, Heilbronn, Karlsruhe, Göppingen, Tübingen, Ulm, Weingarten). Patients are primarily referred to one of the study centers by the treating physician (family doctor) or the treating psychotherapeutic staff (psychiatrist, psychotherapist).

• Wolf, S., Seiffer, B., Zeibig, J.-M., Welkerling, J. Bauer, L. L., Frei, A. K., Studnitz, T., Rosenstiel, S., Fiedler, D. V., Helmhold, F., Ray, A., Herzog, E., Takano, K., Nakagawa, T., Kropp, S., Franke, S., Peters, S., El-Kurd, N., Zwanzleitner, L., Sundmacher, L., Ramos-Murguialday, A., Hautzinger, M., Sudeck, G., & Ehring, T. (2021). Efficacy and Cost-Effectiveness of a Transdiagnostic Group-Based Exercise Intervention: Study Protocol for a Pragmatic Multi-Site Randomized Controlled Trial, BMC Psychiatry, 21, 540. doi: 10.1186/s12888-021-03541-3