Feasibility of Exercise Training for the Short-Term Treatment of Generalized Anxiety Disorder: A Randomized Controlled Trial

Abstract

Background: Exercise training may be especially helpful for patients with generalized anxiety disorder (GAD). We conducted a randomized controlled trial to quantify the effects of 6 weeks of resistance (RET) or aerobic exercise training (AET) on remission and worry symptoms among sedentary patients with GAD. Methods: Thirty sedentary women aged 18–37 years, diagnosed by clinicians blinded to treatment allocation with a primary DSM-IV diagnosis of GAD and not engaged in any treatment other than pharmacotherapy, were randomly allocated to RET, AET, or a wait list (WL). RET involved 2 weekly sessions of lower-body weightlifting. AET involved 2 weekly sessions of leg cycling matched with RET for body region, positive work, time actively engaged in exercise, and load progression. Remission was measured by the number needed to treat (NNT). Worry symptoms were measured by the Penn State Worry Questionnaire. Results: There were no adverse events. Remission rates were 60%, 40%, and 30% for RET, AET, and WL, respectively. The NNT was 3 (95% CI 2 to 56) for RET and 10 (95% CI –7 to 3) for AET. A significant condition-by-time interaction was found for worry symptoms. A follow-up contrast showed significant reductions in worry symptoms for combined exercise conditions versus the WL. Conclusions: Exercise training, including RET, is a feasible, low-risk treatment that can potentially reduce worry symptoms among GAD patients and may be an effective adjuvant, short-term treatment or augmentation for GAD. Preliminary findings warrant further investigation.

Effects of Aerobic Exercise on Anxiety Disorders: A Systematic Review

“…The factors that may be related to this fact are numerous, such as: severity of symptoms of anxiety, duration of intervention, volume and intensity of exercise and even the fact that the exercise is aerobic or strength. Studies that had their focus on samples with anxiety disorders [13][14][15][16][17][18][19][20][21][22] also showed mixed results. Of these, three studies [20][21][22] analyzed the efficacy of aerobic exercise compared to non-aerobic exercise in reducing anxiety disorders, the first study [20] showed a significant reduction of anxiety disorders for both groups, aerobic and non-aerobic compared the baseline, but with no difference between the groups, with the following exercise protocol: (3x week, 60min, for 8 weeks) aerobic 70% of VO2max (high intensity) and strength (low intensity).…”

“…Studies that had their focus on samples with anxiety disorders [13][14][15][16][17][18][19][20][21][22] also showed mixed results. Of these, three studies [20][21][22] analyzed the efficacy of aerobic exercise compared to non-aerobic exercise in reducing anxiety disorders, the first study [20] showed a significant reduction of anxiety disorders for both groups, aerobic and non-aerobic compared the baseline, but with no difference between the groups, with the following exercise protocol: (3x week, 60min, for 8 weeks) aerobic 70% of VO2max (high intensity) and strength (low intensity). The second study [21] used the aerobic exercise (TAE), strength (TRE) and control (CG), one for each group and assessed the effect of these exercises in remission symptoms in patients with generalized anxiety disorder, finding reduction 60, 40 and 30% respectively for (TRE), (TAE) and (GC), although a protocol for short-term, low-intensity, aerobic with (2x week, 46min, for 6 weeks) and exercise with the same methodology, but with intensity 50-75% 1RM, 3 exercises with 7x10 repetitions, were effective in remission.…”

“…Of these, three studies [20][21][22] analyzed the efficacy of aerobic exercise compared to non-aerobic exercise in reducing anxiety disorders, the first study [20] showed a significant reduction of anxiety disorders for both groups, aerobic and non-aerobic compared the baseline, but with no difference between the groups, with the following exercise protocol: (3x week, 60min, for 8 weeks) aerobic 70% of VO2max (high intensity) and strength (low intensity). The second study [21] used the aerobic exercise (TAE), strength (TRE) and control (CG), one for each group and assessed the effect of these exercises in remission symptoms in patients with generalized anxiety disorder, finding reduction 60, 40 and 30% respectively for (TRE), (TAE) and (GC), although a protocol for short-term, low-intensity, aerobic with (2x week, 46min, for 6 weeks) and exercise with the same methodology, but with intensity 50-75% 1RM, 3 exercises with 7x10 repetitions, were effective in remission. The third study [22] didn't show such consistent results, with a slight decline in symptoms, however no significant difference in exercise groups, this finding may be related to methodological differences between studies because the last used mindfulness-based stress reduction (MBSR) and aerobic exercise group only 2x a week with moderate intensity for 8 weeks.…”

“…The authors concluded by suggesting that the mechanisms responsible for the improvement in anxiety in the present study appear to be psychological, the distraction of the stimuli that causes anxiety, greater self-efficacy and mastery experiences. Herring and colleagues [21] performed a research on 30 women aged between 18 and 39 years, and generalized anxiety disorders (GAD), the aim of this study was to compare the rate of remission and reduction of symptoms of concern among exercise groups and control. The sample was randomly divided into 3 equal groups: endurance training group (TRE), group exercise training (TAE) and control group (CG).…”

The Moderating Effect of Physical Exercise in Anxiety Disorder: A review

“…Herring et al (2012) found that women who were suffering from anxiety disorders, or were being treated with antidepressant medications have reduced significantly the worry symptoms compared to the control group, after participating in six weeks of aerobic and resistance training. Merom et al (2008) found that patients diagnosed with panic disorder, social phobia, and generalized anxiety disorder have experienced a significant reduction in anxiety after complementing a home-based walking program.…”