According to a systematic review published in the Archives of Internal Medicine, exercise training in sedentary patients with chronic conditions may significantly reduce their anxiety, regardless of whether the exercise was classified as moderate or vigorous.
A team of Georgia-based researchers reviewed 40 studies done between 1997 and 2005 that measured anxiety at baseline and then again after patients were randomly assigned to either an exercise intervention of at least 3 weeks versus a no exercise intervention. A total of 2914 patients with chronic illnesses that included heart disease, fibromyalgia, multiple sclerosis, cancer, chronic obstructive pulmonary disease, psychiatric conditions, and three “miscellaneous conditions,” as well as chronic osteoarthritis and back pain were included among the 40 studies. The mean age of the participants was 50 years, and the participants included more women than men (mean percentage for women, 59%). On average, the exercise training in the combined studies worked out to 3 sessions per week at 42 minutes per session for 16 weeks.
Compared with no exercise, the researchers found that exercise was associated with significantly reduced anxiety symptoms (mean effect size, 0.29; 95% confidence interval [CI], 0.23 to 0.36). The factors associated with the greatest improvements included exercise programs lasting between 3 and 12 weeks versus programs longer than 12 weeks (P=0.02) and exercise sessions lasting longer than 30 minutes, compared with those less than 30 minutes (P=0.04). In addition, exercise was more likely to produce improvements in anxiety levels when the time frame used to report the anxiety was longer than just the past week (P=0.005). The authors hypothesize that the improved effect of the shorter exercise program (3 to 12 weeks) may be due to better psychological adherence to the shorter program. The only illness that did not significantly respond to the effect of exercise was multiple sclerosis. A key lmitation to the study includes that only a single study actually reported the duration of time spent exercising; the others used the exercise intervention, itself, as the proxy measurement for exercise completion.
Based on these results, the authors suggest that exercise should be a therapeutic option for patients with chronic illness who may desire a nonpharmacologic option, as it appears to pose little risk and promise much benefit. In addition, additional research is necessary to better validate the measures of anxiety, and more studies are needed to investigate the effects of various training intensities on anxiety relief.