David L. Bronson, MD, FACP; Kathleen S. Franco, MD, FACP
Does exercise training reduce anxiety in patients with chronic illness? Which features of exercise interventions are associated with reduced anxiety?
Included studies compared exercise interventions lasting ≥ 3 weeks with a nonexercise option in adults who had a chronic illness and were sedentary. Studies had to measure anxiety at baseline and after exercise interventions. Exclusion criteria were multicomponent interventions if the additional components were not included in the comparison group, education or promotion interventions that did not show increased physical activity, active comparators (e.g., medication, cognitive behavioral therapy, or other exercise interventions) if compared with exercise alone, and use of phobia-specific anxiety outcomes.
MEDLINE, PsycINFO, Google Scholar, and Web of Science (all to Dec 2008), and the Physical Activity Guidelines for Americans Scientific Database (1995 to Aug 2007) were searched for English-language randomized controlled trials (RCTs). 40 RCTs (n = 2914, 75 comparisons, mean age 50 y, mean 59% women) met the selection criteria. Various exercise interventions were used (mean duration 16 wk, mean 3 sessions/wk, mean 42 min/session).
Pooled data showed that exercise interventions reduced anxiety (Table). Planned comparisons showed that shorter interventions (3 to 12 wk), longer training sessions (> 30 min), and evaluation of anxiety recalled over > 1 week were associated with greater reductions in anxiety (Table).
Exercise interventions reduce anxiety in patients with chronic illness. Benefits are greatest with interventions lasting 3 to 12 weeks and exercise sessions > 30 minutes in duration.
Exercise training vs no exercise training for anxiety symptoms in chronic illness
*For 40 trials including 2914 patients. Number of patients included in some comparisons exceeds the total number of patients for all studies because some studies had multiple comparisons.
†Effect size for exercise training vs no exercise training. Positive effect size indicates decreased anxiety with exercise training. Effect size (difference between exercise and no exercise groups in mean score change divided by the pooled standard deviation of baseline scores) calculated using a random-effects model.
Bronson DL, Franco KS. Review: Exercise interventions reduce anxiety in patients with chronic illness. Ann Intern Med. ;152:JC6–4. doi: 10.7326/0003-4819-152-12-201006150-02004
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Published: Ann Intern Med. 2010;152(12):JC6-4.
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