Outpatient heart sports club - beyond physical activity

Germany´s first outpatient heart club (OHC) was founded as a member of the German Sports Association in 1968. Up to now there have been more than 6000 OHCs evenly distributed throughout Germany. What health gain is to be expected for members of an OHC One hour training per week is not of much help to set measurable positive cardiovascular, muscular-skeletal, or biochemical effects. However, experience of medical doctors who are in charge of OHCs show that the group gives shelter for the survivors of a life-threatening heart attack with psychological trauma. A more recent US meta-analysis of 4000 patients underlines the significance of emotional stress. Depressive symptoms occurred in 30% of critical illness survivors. Neither preventing nor treating depressive symptoms through verbal psychotherapy is supported by strong evidence, whilst physical rehabilitation (e.g. OHC) after discharge seems to be successful and deserves further investigation.Purpose / Methods: We have learned from neuroscience (van der Kolk) that trauma is not a mere psychological phenomenon. Trauma has changed the brain´s hardware especially in the brain´s older part, in the reptilian brain, the so-called brain stem, and also in the so-called limbic system. Results: Under therapeutic aspects it is crucial that arguments or words cannot be heard by these parts of the brain. However, Somatic Experiencing (Levine) e.g. physical activity on the one hand (reptilian brain) and bonding (trust,shelter) on the other hand (limbic system) can modulate the evaluation of the emotional content of these brain structures. Conclusions: Word trauma psychotherapy does not work with coronary patients. OHC is an accepted structure of therapyfor many of these traumatized patients. Social shelter (bonding, trust, safety) and somatic experiencing (e.g. physical activity) are basic for health gain through OHC. Perhaps that is why the Heidelberg OHC, the so-called Ludens Club, still exists after nearly 50 years.