In a recent study published within the journal Progress in Cardiovascular Diseases, researchers explore whether exercise might be used to treat anxiety.

Study: Is exercise a viable therapy for anxiety? Systematic review of recent literature and significant evaluation. Image Credit: GP PIXSTOCK / Shutterstock.com

The mental health advantages of exercise

Lifestyle psychiatry acknowledges the impact of assorted health behaviors, akin to nutrition, sleep, smoking, and physical activity on mental health.

Physical exertion is a well known health behavior that gives each physical and psychological advantages. In reality, exercise is now beneficial as the first treatment for mild to moderate depression and as an adjunctive treatment for severe mental illness. Nonetheless, the impact of exercise on anxiety has not been studied as extensively as its effect on depression.

Concerning the study

The present review included studies that evaluated the impact of long-term exercise on anxiety outcomes in individuals with anxiety disorders or high levels of hysteria symptoms. To this end, a scientific search was conducted in April 2022 on MEDLINE, EMBASE, CINAHL, and PsycINFO for peer-reviewed studies in English. The chosen studies obtained measurements from participants for anxiety-related disorder symptoms or elevated symptoms of hysteria.

Only randomized clinical trials (RCTs) that fulfilled specified criteria were included within the review. These included articles published in English in a peer-reviewed journal, articles published between January 2014 and December 2021, eligible participants were at the least 18 years old, at the least 30 participants were included within the study, exercise interventions included multiple round of resistance training or aerobic exercise, the first consequence measure was anxiety, and elevated anxiety symptoms were estimated using a validated assessment instrument or diagnosed using a longtime procedure like a psychiatric interview.

Along with the inclusion criteria, any chosen study provided information on the control condition, exercise intervention, participant demographics, percent attrition, primary consequence, anxiety measures, and anxiety-related results, including an objective to find out if exercise contributed to reduced anxiety.

Unclear impact of exercise on anxiety

A complete of seven,240 records were identified throughout the electronic database search; nevertheless, after removing 1,952 duplicate entries, 5,288 unique articles remained.

Of those, 98.7% were excluded after the title and abstract were reviewed. Finally, the review examined 70 studies and 25 RCTs that met the eligibility criteria.

Nineteen of those studies relied on self-report questionnaires to evaluate anxiety levels before the intervention. These questionnaires included the Spielberger State-Trait Anxiety Scale (STAI), Beck Anxiety Inventory (BAI), anxiety subscale of the Hospital Anxiety and Depression Scale (HADS), Anxiety Sensitivity Index (ASI), Psychiatric Diagnostic Screening Questionnaire (PDSQ), and Posttraumatic Stress Disorder (PTSD) Checklist (PCL).

Baseline anxiety was evaluated in 4 studies using structured interviews akin to the Clinician-Administered PTSD Scale (CAPS), Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (DSM), and Hamilton Anxiety Rating Scale (HAM-A).

Seven provided conclusive evidence that exercise intervention groups experienced improvements of their disorder status or anxiety symptoms as in comparison with controls. In two of the 13 studies conducted on anxious individuals, no clear reductions in anxiety levels were observed for the exercise cohort as in comparison with controls.

Six studies reported insignificant or no variations in anxiety levels between those that exercised and those that didn’t. In 12 studies, including eight trials involving anxious individuals, the findings were considered inconclusive or equivocal. A lot of the studies yielded mixed results, as a discount in anxiety was observed for certain measures or assessment periods.

Three studies reported positive findings; nevertheless, attributable to significant methodological limitations, it was difficult to find out whether exercise equivocally reduced anxiety. Furthermore, 4 studies analyzed potential mediators or moderators of the anxiety-exercise correlation.

Three studies found that the extent of hysteria reduction attributable to exercise was influenced by the variety of exercise sessions attended or the initial level of hysteria. Specifically, attending more exercise sessions was related to greater anxiety reduction, while higher baseline anxiety levels were also related to greater anxiety reduction.

Two studies examined potential mediators, including participants’ each day steps and increased aerobic fitness levels; nevertheless, these analyses didn’t produce a major consequence.

Conclusions

The limited variety of reliable studies and absence of positive ends in over half of the reviewed studies limit the flexibility to attract definite conclusions concerning the effectiveness of exercise as a treatment for anxiety in patients.

Further research is required to find out some great benefits of exercise for individuals with anxiety. Clinicians who recommend exercise as therapy for anxiety must prioritize patient safety, establish clear and achievable exercise goals, and closely monitor symptoms.

Journal reference:

• Stonerock, G. L., Gupta, R. P., & Blumenthal, J. A. (2023). Is exercise a viable therapy for anxiety? Systematic review of recent literature and significant evaluation. Progress in Cardiovascular Diseases. doi:10.1016/j.pcad.2023.05.006