Effects of Basic Body Awareness Therapy on Pain, Work Stress, Quality of Life, and Eating Attitudes in Adults: A Randomized Controlled Trial

Modern working conditions - prolonged desk-based work, high mental workload, insufficient physical activity, and psychosocial stress - are thought to reduce body awareness and contribute to the development of chronic pain, elevated stress levels, and disordered eating attitudes. Basic Body Awareness Therapy (BBAT) is a movement-awareness-based physiotherapy approach, originating in Sweden in the late 1970s-1980s from the work of psychoanalyst and movement educator Jacques Dropsy, which aims to help individuals consciously perceive and reinterpret bodily sensations. BBAT incorporates core movement principles such as balance, free breathing, coordination, and awareness, delivered through simple, gentle, and safe movements performed in lying, sitting, standing, and walking positions, as well as paired exercises. The approach has been applied across a range of conditions, including chronic pain, psychosomatic disorders, and eating disorders, with prior studies suggesting potential benefits for emotion regulation, self-esteem, and quality of life, and for supporting a healthier relationship with the body in disordered eating populations.

While previous research has examined the relationship between body awareness therapy and pain, work stress, eating attitudes, and quality of life separately, few studies have examined these outcomes jointly within a single controlled trial. This study addresses that gap using a two-arm, parallel-group, randomized controlled design.

Participants will be academic staff at Amasya University, aged 25-55, who do not currently participate in a regular structured exercise program (e.g., yoga, pilates). Individuals with a diagnosed chronic illness or those on regular medication will be excluded. Participation is voluntary, and written informed consent will be obtained prior to enrollment. Baseline assessments will be conducted before randomization.

Participants will be randomly assigned in a 1:1 ratio to an intervention group or a no-intervention control group (10 participants per group; 20 total). The intervention group will receive one 60-minute BBAT group session per week for 12 weeks, conducted in a university exercise room at room temperature. Sessions will include supine awareness and breath-focused exercises, midline awareness exercises (bringing the legs together), symmetric, asymmetric, and star-shaped stretches, breath-coordinated opening/closing movements, seated balance exercises, standing weight-shift and rhythmic movement exercises, rotational coordination, wave-like movement, pushing exercises, various walking exercises, "cat walk" massage, and a closing meditation. The control group will not receive any intervention during the same 12-week period. Participants in either group who miss two consecutive weekly sessions, or who begin another treatment program during the study, will be withdrawn from the study.

Quantitative outcomes will be assessed at baseline and after the 12-week period in both groups using the following validated instruments: the Visual Analog Scale (VAS) and the Short-Form McGill Pain Questionnaire for pain intensity and quality; the Job Content Questionnaire (Job Stress Scale, Karasek et al., adapted into Turkish by Demiral et al., 2007) for work-related stress (workload, job control, and social support subscales); the Short Form-36 (SF-36) for health-related quality of life across eight subdomains; and the Eating Attitudes Test-26 (EAT-26) for disordered eating attitudes, with a cutoff score of 20 indicating attitudes consistent with disordered eating risk.

In addition to these quantitative measures, participants in the intervention group will complete a structured exercise diary after each of the 12 weekly sessions, recording their subjective experience of the session. These diary entries and participants' written reflections will be analyzed qualitatively to provide contextual insight into how participants experienced the BBAT intervention, complementing and helping to interpret the quantitative findings. This mixed-methods approach is intended to provide both statistical evidence of intervention effects and a richer, experience-based understanding of the mechanisms through which BBAT may influence pain, stress, quality of life, and eating attitudes.

Statistical analysis will be performed using SPSS. Descriptive statistics will be reported as mean ± standard deviation for normally distributed variables, median and range for non-normally distributed variables, and frequency/percentage for categorical variables. Within-group pre-post comparisons will be analyzed using the paired t-test (or the Wilcoxon signed-rank test where parametric assumptions are not met); between-group comparisons will use appropriate independent-samples tests. Categorical variables will be compared using the chi-square test, or Fisher's exact test where chi-square assumptions are not met. A significance level of p<0.05 (95% confidence interval) will be used for all statistical tests.

Inclusion criteria

• Employed as academic staff at Amasya University
• Not currently participating in a regular structured exercise program (e.g., yoga, pilates)

Exclusion criteria

• Diagnosed chronic illness
• Regular use of medication
• Missing two consecutive weekly sessions during the study (applies to -intervention group; results in withdrawal)
• Beginning another treatment program during the study period