No Evidence of Anxiolytic Effects From Exercise in Stress- or Anxiety-Related Disorders

A review did not find compelling evidence to support anxiolytic effects from exercise among adults with anxiety- or stress-related disorders.

A systematic review and meta-analysis did not find compelling evidence to support any anxiolytic effects from exercise among adults with anxiety- or stress-related disorders. These findings were published in Psychiatry Research.

This study sourced data from randomized controlled trials published between February 2021 to May 2022, investigating aerobic exercise, resistance training, or combined aerobic and resistance exercise among adults with anxiety- or stress-related disorders. Newer studies were combined with studies extracted for a previous meta-analysis, published in 2021. Interindividual differences (IIDs) of the anxiolytic effects were evaluated using data from 7 trials.

Together, the studies included 8 treatment arms. A total of 4 arms focused on aerobic training, 3 on resistance training, and 1 on combined exercise. The control conditions included usual care, wait list, medication, or health education. The sample sizes ranged from 5 to 39 for active treatment arms and 5 to 42 for control arms. The interventions lasted between 3 and 12 weeks.

Symptom severity on a 100-point scale was 67.85 (SD, 14.91) for the aerobic exercise and 71.58 (SD, 12.23) for the resistance exercise cohorts.

There is currently a lack of convincing evidence to support the hypothesis that true exercise-associated IID exist with respect to the reduction of anxiety symptoms following aerobic exercise or resistance training in patients with anxiety- and stress-related disorders.

Both aerobic (mean difference [MD], -14.95; 95% CI, -25.48 to -2.80; P <.001; I2, 86.79) and resistance (MD, -7.39; 95% CI, -10.86 to -3.92; P <.001; I2, 0%) had significant effects on symptom severity scores compared with controls, but neither aerobic (MD, 0.45; 95% CI, -5.71 to 5.75; P =.99) nor resistance (MD, 1.62; 95% CI, -6.10 to 6.52; P =.89) training had significant IIDs.

For individual studies, the IID ranged between -4.24 to 4.80.

The major limitation was the small sample sizes in the underlying studies.

Study authors concluded, “There is currently a lack of convincing evidence to support the hypothesis that true exercise-associated IID exist with respect to the reduction of anxiety symptoms following aerobic exercise or resistance training in patients with anxiety- and stress-related disorders. Therefore, a search for potential mediators and moderators associated with aerobic exercise and strength training changes in anxiety among patients with anxiety- and stress-related disorders may not be warranted.”

References:

Vancampfort D, Heissel A, Waclawovsky A, et al. Precision-based exercise in people with anxiety and stress related disorders: are there interindividual differences in anxiolytic effects? an ancillary meta-analysis of randomized controlled trials. Psychiatry Res. 2022;317:114803. doi:10.1016/j.psychres.2022.114803