Journal
JOURNAL OF AFFECTIVE DISORDERS
Volume 282, Issue -, Pages 996-1004Publisher
ELSEVIER
DOI: 10.1016/j.jad.2021.01.003
Keywords
Anxiety; Dropout; Exercise; Physical activity; PTSD; Stress
Categories
Funding
- University of Manchester Presidential Fellowship [P123958]
- UK Research and Innovation Future Leaders Fellowship [MR/T021780/1]
- Health Education England (HEE) [ICA-CL-2017-03-001]
- National Institute for Health Research (NIHR) [ICA-CL-2017-03-001]
- NIHR Biomedical Research Centre at South London and Maudsley NHS Foundation Trust
- Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior - Brasil (CAPES) [001]
- NHMRC
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Exercise is well tolerated by individuals with anxiety and stress-related disorders, and dropout rates in randomized controlled trials are comparable to control conditions. When exercise interventions are supervised by fitness experts and autonomous motivation strategies are applied, dropout rates are lower.
Objective:. Exercise has established efficacy in people with anxiety and stress-related disorders. Dropouts from randomized controlled trials (RCT's) pose a threat to the validity of the evidence, with dropout rates varying across studies. We conducted a meta-analysis to investigate the prevalence and predictors of dropout rates among adults with anxiety and stress-related disorders participating in exercise RCT's. Methods:. Two authors searched major electronic databases up to 07/2020. We included RCT's of exercise interventions in people with anxiety and stress-related disorders that reported dropout rates. A random effects meta-analysis and meta-regression were conducted. Results:. Fourteen RCT's involving 16 exercise interventions (n=369, mean age 20.7 to 67.7years; 38.4% male) were included. The trim-and-fill-adjusted prevalence of dropout across all studies was 22.4% (95%CI = 15.0% to 32.0%). Applying controlled motivation strategies (P<0.001) predicted higher dropout. Supervision during all sessions and by an expert in exercise prescription and applying autonomous motivation strategies predicted lower dropout (all P<0.001). Dropout was similar in exercise versus control conditions (OR = 0.84, 95%CI = 0.54 to 1.29, p = 0.42, I-2 = 0%; N=16). Limitations:. Potentially important moderators of dropout, such as the severity of mental health symptoms and illness duration were insufficiently available. Conclusions:. Exercise is well tolerated by people with anxiety and stress-related disorders and drop out in RCT's is comparable to control conditions. Thus, exercise is a feasible treatment, in particular when autonomous motivation strategies are included and when the intervention is delivered by healthcare professionals with expertise in exercise prescription.
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