Exercise for anxiety disorders: systematic review

• Published in: British journal of sports medicine Vol. 48; no. 3; p. 187
• Main Authors: Jayakody, Kaushadh, Gunadasa, Shalmini, Hosker, Christian
• Format: Journal Article
• Language: English
• Published: England 01-02-2014
• Subjects: Adjustment Disorders - therapy; Adolescent; Adult; Aged; Antidepressive Agents - therapeutic use; Anxiety Disorders - therapy; Cognitive Behavioral Therapy - methods; Exercise Therapy - methods; General Practice; Humans; Obsessive-Compulsive Disorder - therapy; Occupational Therapy - methods; Randomized Controlled Trials as Topic; Risk Reduction Behavior; Selection Bias; Stress Disorders, Post-Traumatic - therapy; Stress, Psychological - therapy; Young Adult; Physical activity and exercise methodology; Psychology; Exercise
• ISSN: 1473-0480
• DOI: 10.1136/bjsports-2012-091287

Anxiety disorders are commonly treated with antidepressants and psychological treatments. Some patients may prefer alternative approaches such as exercise.
To investigate the treatment effects of exercise compared with other treatments for anxiety disorders.
Randomised controlled trials (RCTs) of exercise interventions for anxiety disorders were identified by searching six online databases (July 2011). A number of journals were also hand searched.
Eight RCTs were included. For panic disorder: exercise appears to reduce anxiety symptoms but it is less effective than antidepressant medication (1 RCT); exercise combined with antidepressant medication improves the Clinical Global Impression outcomes (1 RCT, p<0.05); exercise combined with occupational therapy and lifestyle changes reduces Beck Anxiety Inventory outcomes (1 RCT, p=0.0002). For social phobias, added benefits of exercise when combined with group cognitive behavioural therapy (CBT) were shown (p<0.05). There was no significant difference between aerobic and anaerobic exercise groups (1 RCT, p>0.1) with both seeming to reduce anxiety symptoms (1 RCT, p<0.001). It remains unclear as to which type of exercise; moderate to hard or very light to light, is more effective in anxiety reduction (2 RCTs).
Exercise seems to be effective as an adjunctive treatment for anxiety disorders but it is less effective compared with antidepressant treatment. Both aerobic and non-aerobic exercise seems to reduce anxiety symptoms. Social phobics may benefit from exercise when combined with group CBT. Further well-conducted RCTs are needed.