Anorexia Nervosa Clinical Trial
Official title:
Physical Therapy for In-patients With Severe Anorexia Nervosa: A Randomized Feasibility Study
In-patients with severe anorexia nervosa (AN) often drop out of treatment, because of ambivalence towards treatment and anxiety for weight gain. However, physical therapy has shown some positive effects on symptoms of AN. This study aims to investigate the feasibility of a randomized control trial (RCT) of a standardized physiotherapeutic program for patients with severe AN with compliance to nutritional therapy as the primary outcome measure.
Anorexia nervosa (AN) is a serious and complex disease with unknown etiology. It is
characterised by disturbed body image and extreme and devastating fear of gaining weight. The
illness leads to a considerable and sometimes dangerous weight loss because of the limited
food intake and often an exaggerated exercise behavior. AN can affect people of all ages and
of both sexes, but girls or young women are more at risk. The prevalence among young women in
Denmark is estimated to be between 0.4% and 1%. AN is associated with a high rate of
comorbidity and mortality.
The treatment of AN consist of re-feeding and psychotherapy. Different therapeutic methods
and theories have been applied, but none have shown to be superior. The patient alliance and
motivation for treatment seem to be essential for a successful treatment. Drop-out is a
common challenge. Hence, attention must be directed to how the therapeutic alliance and the
patient's motivation can be optimized in order to secure a better treatment effect.
Studies have shown that physical therapy, including supervised exercise and bodily focused
interventions, may have a positive effect on symptoms of AN. It may reduce the distorted body
image and anxiety. However, it is unknown whether physical therapy can affect compliance and
drop out rate to the nutrition therapy. The objective of this study is to investigate the
feasibility of a RCT design in this group of patients with severe AN at a specialized unit.
The intervention is supervised, standardized physical therapeutic exercises mainly consisting
of light strength training. The development of the intervention is based partly on the
literature, and partly on interviews and observations with two patients with severe AN.
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