Impact of Physical Exercise on Substance Use Disorders: A Meta-Analysis

<div><p>Objective</p><p>The goal of this meta-analysis was to examine whether long-term physical exercise could be a potential effective treatment for substance use disorders (SUD).</p><p>Methods</p><p>The PubMed, Web of Science, Elsevier, CNKI and China Info were searched for randomized controlled trials (RCT) studies in regards to the effects of physical exercise on SUD between the years 1990 and 2013. Four main outcome measures including abstinence rate, withdrawal symptoms, anxiety, and depression were evaluated.</p><p>Results</p><p>Twenty-two studies were integrated in the meta-analysis. The results indicated that physical exercise can effectively increase the abstinence rate (OR = 1.69 (95% CI: 1.44, 1.99), z = 6.33, <i>p</i><0.001), ease withdrawal symptoms (SMD = −1.24 (95% CI: −2.46, −0.02), z = −2, <i>p</i><0.05), and reduce anxiety (SMD = −0.31 (95% CI: −0.45, −0.16), z  =  −4.12, <i>p</i><0.001) and depression (SMD  =  −0.47 (95% CI: −0.80, −0.14), z = −2.76, <i>p</i><0.01). The physical exercise can more ease the depression symptoms on alcohol and illicit drug abusers than nicotine abusers, and more improve the abstinence rate on illicit drug abusers than the others. Similar treatment effects were found in three categories: exercise intensity, types of exercise, and follow-up periods.</p><p>Conclusions</p><p>The moderate and high-intensity aerobic exercises, designed according to the Guidelines of American College of Sports Medicine, and the mind-body exercises can be an effective and persistent treatment for those with SUD.</p></div

The grand-mean ERP waveforms at the occipito-temporal electrode sites of P7 and P8.

<p>The grand-mean ERP waveforms at the occipito-temporal electrode sites of P7 and P8.</p

The grand-mean ERP waveforms at the occipital electrode sites of O1 and O2.

<p>The grand-mean ERP waveforms at the occipital electrode sites of O1 and O2.</p

Assessment of Methodological Quality of Included Studies.

a<p>Was randomization performed?</p>b<p>Were the groups similar at baseline regarding important prognostic indicators?</p>c<p>Were the eligibility criteria specified?</p>d<p>Was the outcome assessor blinded?</p>e<p>Was allocation concealment adequate?</p>f<p>Were point estimates and measures of variability presented for the primary outcome measures?</p>g<p>Did the analysis include an intention to treat analysis?</p><p>Assessment of Methodological Quality of Included Studies.</p

Characteristics of included studies.

<p>Exp: Experimental; Ctrl: Control; F: Female subjects; NR: No Reported; HR: Heart Rate; VO_{2 max}: maximal oxygen consumption; BDI: Beck Depression Inventory; SAIS: State-Trait Anxiety Inventory-State; TAIS: Trait Anxiety Inventory-State; SAS: Self-Rating Anxiety Scale; SDS: Self-rating depression scale; HAS: Hamilton Anxiety Scores; MPSS: Mood and Physical Symptoms Scale-anxiety; HRSD: Hamilton Rating Scale for Depression; CESD: Center for Epidemiologic Studies Depression Scale; POMS: Profile of Mood States.</p>a<p>Continual abstinence;</p>b<p>Borg index;</p>c<p>Rating scale of heroin withdrawal symptoms;</p>d<p>Tobacco withdrawal symptoms.</p><p>Characteristics of included studies.</p

The forest plot about the effect of physical exercise on depression status.

<p>The forest plot about the effect of physical exercise on depression status.</p

The forest plot about the effect of physical exercise on anxiety status.

<p>The forest plot about the effect of physical exercise on anxiety status.</p

The forest plot about the effect of physical exercise on abstinence rate.

<p>The abstinence rate of past physical exercise treat, and differences follow-up periods were used odds ratio analysis.</p

Sub-group analysis results.

<p>Exp: Experimental; Ctrl: Control; Ex: Exercise; SMD: Standardized Mean Difference; OR: Odds Ratio; CI: Confidence Interval.</p><p>*<i>p</i><0.05, **<i>p</i><0.01</p><p>Sub-group analysis results.</p

Illustration of one experimental trial in this study.

<p>Illustration of one experimental trial in this study.</p