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Psarianos A, Chryssanthopoulos C, Theocharis A, Paparrigopoulos T, Philippou A. Effects of a Two-Month Exercise Training Program on Concurrent Non-Opiate Substance Use in Opioid-Dependent Patients during Substitution Treatment. J Clin Med 2024; 13:941. [PMID: 38398255 PMCID: PMC10888880 DOI: 10.3390/jcm13040941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/14/2024] [Accepted: 01/25/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND This randomized controlled trial aimed to evaluate the effects of a two-month exercise intervention on the concurrent non-opiate substance use (alcohol, cocaine, cannabis, and benzodiazepines) in opioid users during their medication treatment. METHODS Ninety opioid users (41 females) in methadone and buprenorphine medication treatment were randomly divided into four groups: (a) buprenorphine experimental (BEX; n = 26, aged 41.9 ± 6.1 yrs); (b) buprenorphine control (BCON; n = 25, aged 41.9 ± 5.6 yrs); (c) methadone experimental (MEX; n = 20, aged 46.7 ± 6.6 yrs); and (d) methadone control (MCON; n = 19, aged 46.1 ± 7.5 yrs). The experimental groups (BEX and MEX) followed an aerobic exercise training program on a treadmill for 20 min at 70% HRmax, 3 days/week for 8 weeks. Socio-demographic, anthropometric, and clinical characteristics, as well as non-opioid drug use in days and quantity per week, were assessed before and after the intervention period. RESULTS Following the exercise training, the weekly non-opioid substance consumption (days) decreased (p < 0.05) in both exercise groups and was lower in BEX compared to MEX, while no differences were observed (p > 0.05) between the control groups (BCON vs. MCON) or compared to their baseline levels. Similarly, the daily amount of non-opiate substance intake was reduced (p < 0.05) post-training in BEX and MEX, whereas it did not differ (p > 0.05) in BCON and MCON compared to the baseline. CONCLUSIONS The two-month exercise intervention reduced the non-opioid drug use in both the methadone and buprenorphine substitution groups compared to the controls, suggesting that aerobic exercise training may be an effective strategy for treating patients with OUDs.
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Affiliation(s)
- Alexandros Psarianos
- 1st Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.P.); (T.P.)
- Greek Organization Against Drugs (OΚAΝA), 10433 Athens, Greece;
| | - Costas Chryssanthopoulos
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | | | - Thomas Paparrigopoulos
- 1st Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece; (A.P.); (T.P.)
| | - Anastassios Philippou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
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2
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Brevers D, Billieux J, de Timary P, Desmedt O, Maurage P, Perales JC, Suárez-Suárez S, Bechara A. Physical Exercise to Redynamize Interoception in Substance use Disorders. Curr Neuropharmacol 2024; 22:1047-1063. [PMID: 36918784 PMCID: PMC10964100 DOI: 10.2174/1570159x21666230314143803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/19/2022] [Accepted: 12/23/2022] [Indexed: 03/16/2023] Open
Abstract
Physical exercise is considered a promising medication-free and cost-effective adjunct treatment for substance use disorders (SUD). Nevertheless, evidence regarding the effectiveness of these interventions is currently limited, thereby signaling the need to better understand the mechanisms underlying their impact on SUD, in order to reframe and optimize them. Here we advance that physical exercise could be re-conceptualized as an "interoception booster", namely as a way to help people with SUD to better decode and interpret bodily-related signals associated with transient states of homeostatic imbalances that usually trigger consumption. We first discuss how mismatches between current and desired bodily states influence the formation of reward-seeking states in SUD, in light of the insular cortex brain networks. Next, we detail effort perception during physical exercise and discuss how it can be used as a relevant framework for re-dynamizing interoception in SUD. We conclude by providing perspectives and methodological considerations for applying the proposed approach to mixed-design neurocognitive research on SUD.
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Affiliation(s)
- Damien Brevers
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Sciences Research Institute (IPSY), UCLouvain, Louvain-La-Neuve, Belgium
- Department of Behavioural and Cognitive Sciences, Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- Centre for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
| | - Philippe de Timary
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Sciences Research Institute (IPSY), UCLouvain, Louvain-La-Neuve, Belgium
- Department of Adult Psychiatry, Cliniques universitaires Saint-Luc and Institute of Neuroscience (IoNS), UCLouvain, Brussels, Belgium
| | - Olivier Desmedt
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
| | - Pierre Maurage
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Sciences Research Institute (IPSY), UCLouvain, Louvain-La-Neuve, Belgium
| | - José Cesar Perales
- Mind, Brain, and Behavior Research Center (CIMCYC), Department of Experimental Psychology, University of Granada, Granada, Spain
| | - Samuel Suárez-Suárez
- Louvain Experimental Psychopathology Research Group (LEP), Psychological Sciences Research Institute (IPSY), UCLouvain, Louvain-La-Neuve, Belgium
- Department of Clinical Psychology and Psychobiology, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Antoine Bechara
- Department of Psychology, University of Southern California, Los Angeles, California, CA, USA
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Psarianos A, Chryssanthopoulos C, Paparrigopoulos T, Philippou A. The Role of Physical Exercise in Opioid Substitution Therapy: Mechanisms of Sequential Effects. Int J Mol Sci 2023; 24:ijms24054763. [PMID: 36902190 PMCID: PMC10003472 DOI: 10.3390/ijms24054763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023] Open
Abstract
It is generally accepted that chronic opioid use is associated with structural and functional changes in the human brain that lead to an enhancement of impulsive behavior for immediate satisfaction. Interestingly, in recent years, physical exercise interventions have been used as an adjunctive treatment for patients with opioid use disorders (OUDs). Indeed, exercise has positive effects on both the biological and psychosocial basis of addiction, modifying neural circuits such as the reward, inhibition, and stress systems, and thus causing behavioral changes. This review focuses on the possible mechanisms that contribute to the beneficial effects of exercise on the treatment of OUDs, with emphasis placed on the description of a sequential consolidation of these mechanisms. Exercise is thought to act initially as a factor of internal activation and self-regulation and eventually as a factor of commitment. This approach suggests a sequential (temporal) consolidation of the functions of exercise in favor of gradual disengagement from addiction. Particularly, the sequence in which the exercise-induced mechanisms are consolidated follows the pattern of internal activation-self-regulation-commitment, eventually resulting in stimulation of the endocannabinoid and endogenous opioid systems. Additionally, this is accompanied by modification of molecular and behavioral aspects of opioid addiction. Overall, the neurobiological actions of exercise in combination with certain psychological mechanisms appear to promote its beneficial effects. Given the positive effects of exercise on both physical and mental health, exercise prescription is recommended as a complement to conventional therapy for patients on opioid maintenance treatment.
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Affiliation(s)
- Alexandros Psarianos
- 1st Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Costas Chryssanthopoulos
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Thomas Paparrigopoulos
- 1st Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Anastassios Philippou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Correspondence:
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Lynch WJ, Bakhti-Suroosh A, Abel JM. Impact of high-access exercise prior to and during early adolescence on later vulnerability to opioid use and relapse in male rats. Transl Psychiatry 2022; 12:425. [PMID: 36192388 PMCID: PMC9529880 DOI: 10.1038/s41398-022-02180-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 09/07/2022] [Accepted: 09/13/2022] [Indexed: 11/15/2022] Open
Abstract
Middle- and high-school athletes participating in certain team sports are at greater risk of opioid misuse and addiction than those who do not. While this risk is thought to be due to increased access to opioids, in this study we explored the possibility that the sensitizing effects of discontinued high-intensity exercise may also contribute. Specifically, using male rat models with fentanyl, we tested the hypothesis that high-access exercise (24 h/day access to a running wheel) during pre/early adolescence (two weeks, postnatal-day 24-37) would enhance vulnerability to opioid use and relapse during late adolescence/adulthood. Rats with a history of high-access exercise showed stronger fentanyl-associated lever discrimination during acquisition, greater motivation to obtain infusions of fentanyl following acquisition, and had an enhanced sensitivity to the reinstating effects of fentanyl-associated cues following extended (24 h/day), intermittent-access self-administration and protracted abstinence (14 days) compared to sedentary controls. In contrast, sedentary rats had greater overall responding (active- and inactive-lever) during acquisition and greater non-specific (inactive-lever) responding during extended-access self-administration. Molecular markers associated with opioid seeking/relapse were also differentially expressed in the nucleus accumbens core of rats with versus without a history of high-access exercise following relapse testing (e.g., Bdnf-IV and Drd2 expression). Together, these findings demonstrate that high-access exercise prior to and throughout early-adolescence enhances vulnerability to the reinforcing and cue-induced reinstating effects of opioids during later adolescence/adulthood. Thus, it is possible that the discontinuation of high intensity exercise contributes to the enhanced vulnerability observed in middle- and high-school athletes.
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Affiliation(s)
- Wendy J Lynch
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, 22904, USA.
| | - Anousheh Bakhti-Suroosh
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, 22904, USA
| | - Jean M Abel
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, 22904, USA
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5
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Liu S, Zhang R. Aerobic Exercise Alleviates the Impairment of Cognitive Control Ability Induced by Sleep Deprivation in College Students: Research Based on Go/NoGo Task. Front Psychol 2022; 13:914568. [PMID: 35846633 PMCID: PMC9280485 DOI: 10.3389/fpsyg.2022.914568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was to observe whether aerobic exercise is able to alleviate the impairment of cognitive control ability in college students by sleep deprivation through cognitive control (Go-NoGo task) and blood-based markers. Taking 30 healthy college students (15 males and 15 females) as participants, using a random cross-over design within groups, respectively perform one night of sleep deprivation and one night of normal sleep (8 h). The exercise intervention modality was to complete a 30-min session of moderate-intensity aerobic exercise on a power bicycle. Change in cognitive control was assessed using the Go/NoGo task paradigm; 5-ht and blood glucose contentwere determined by enzyme-linked immuno sorbent assay and glucose oxidase electrode Measurement, respectively. The results showed that sleep deprivation could significantly reduce the response inhibition ability and response execution ability, and significantly reduce the blood 5-ht content (p< 0.01). Thirty minutes of moderate intensity aerobic exercise intervention significantly increased response inhibition ability and response execution ability, significantly increased blood 5-ht content (p<0.01), and did not change serum glucose levels. Conclusion: An acute aerobic exercise can alleviate the cognitive control impairment caused by sleep deprivation, and 5-ht may be one of the possible mechanisms by which aerobic exercise alleviates the cognitive control impairment caused by sleep deprivation.
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Affiliation(s)
- Shangwu Liu
- Department of Physical Education, Luliang University, Luliang, China
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Shreffler J, Genova G, Huecker M. Physical activity and exercise interventions for individuals with opioid use disorder: a scoping review. J Addict Dis 2022; 40:452-462. [DOI: 10.1080/10550887.2022.2044735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Jacob Shreffler
- Department of Emergency Medicine, University of Louisville, Louisville, KY, USA
| | - Gina Genova
- University of Louisville Kornhauser Health Sciences Library, Louisville, KY, USA
| | - Martin Huecker
- Department of Emergency Medicine, University of Louisville, Louisville, KY, USA
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7
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Zhang Z, Liu X. A Systematic Review of Exercise Intervention Program for People With Substance Use Disorder. Front Psychiatry 2022; 13:817927. [PMID: 35360135 PMCID: PMC8962945 DOI: 10.3389/fpsyt.2022.817927] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 02/15/2022] [Indexed: 11/13/2022] Open
Abstract
Addiction has been attributed to development of habit-based neural circuits that promote continued substance use despite a conscious wish to abstain. The goal of this study was to determine if physical exercise could serve as an alternative habit to replace habitual substance use, and whether this exercise intervention methods differed for opioid vs. amphetamine Dependents. A total of 14 randomized controlled experimental literatures on exercise intervention in people with opioid and amphetamine use disorder were screened, the 14 literature included 4 opioids and 10 amphetamines. From the 14 literature, the information of intervention program elements were counted, respectively. Independent sample t-test was used to compare the similarities and differences between the two intervention methods, and intervention mechanism of dependents were discussed. All rehabilitation exercises for opioid dependents use aerobic exercise, while most rehabilitation exercises for amphetamine dependents use aerobic exercise, and a few use aerobic and anaerobic mixed exercise. There is no significant difference in exercise time, exercise frequency and cycle between the two intervention schemes (P > 0.05). The rehabilitation indicators of opioid and amphetamine dependents generally include psychological indicators and physiological indicators, and most of the tests mainly focus on measuring psychological indicators such as mood and drug craving of dependents. The goal of exercise intervention for opioid and amphetamine dependents is similar, the first is to improve mood, reduce craving, improve sleep, and the second is to enhance physical fitness. In the treatment of Substance use disorder, exercise intervention can be used as an auxiliary treatment. Exercise intervention emphasizes low intensity and high frequency. Exercise intervention tends to cultivate long-term exercise habits or exercise lifestyle. Based on this "habit" mechanism, exercise can complete the substitution of material dependence.
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Affiliation(s)
- Zhilei Zhang
- Department of Physical Education and Health, Heze University, Heze, China
| | - Xiujuan Liu
- Department of Politics and Law, Heze University, Heze, China
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8
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Alpers SE, Furulund E, Pallesen S, Mamen A, Dyrstad SM, Fadnes LT. The Role of Physical Activity in Opioid Substitution Therapy: A Systematic Review of Interventional and Observational Studies. Subst Abuse 2022; 16:11782218221111840. [PMID: 35845970 PMCID: PMC9280793 DOI: 10.1177/11782218221111840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 06/08/2022] [Indexed: 11/15/2022]
Abstract
Background: Use of physical activity in the treatment and follow-up of people receiving opioid substitution therapy is an understudied area of research. Therefore, the objective of this systematic review was to synthesize the currently available research on the role of physical activity in opioid substitution therapy and proper adaptions for the group. Methods: A systematic search was performed on PsycINFO, EMBASE, MEDLINE, CINAHL, and Web of Science until September 2021 (PROSPERO-reg.no: CRD42020109873). The inclusion criteria were studies involving physical activity interventions for opioid substitution patients. Reference lists of relevant studies were screened to identify additional relevant studies. Data extracted were compiled into tables and descriptively presented. Results: The search yielded 2105 unique records. A total of 10 studies were included, whose methodological quality ranged from satisfactory to very good. Study quality was assessed using a 7-/8-point quality score. The agreement between the reviewers, assessed with Cohen’s kappa, was 0.91. Overall, the results suggest that physical activity increases physical fitness of patients in opioid substitution therapy and decreases substance use. The minority of studies in this field are of high quality with sufficient power. Conclusions: The findings of this systematic review suggest beneficial effects of physical activity on physical fitness, substance use, and mental health for patients in opioid substitution therapy. Although the findings are quite consistent across studies, high-quality studies and sufficiently powered clinical trials are needed to confirm and validate the findings and to conclude on the degree of impact.
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Affiliation(s)
- Silvia Eiken Alpers
- Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Einar Furulund
- Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
- Optentia Research Focus Area, North-West University, Vanderbijlpark, South Africa
| | - Asgeir Mamen
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Sindre M Dyrstad
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Department of Education and Sport Science, University of Stavanger, Stavanger, Norway
| | - Lars Thore Fadnes
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
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Marrero-Cristobal G, Gelpi-Dominguez U, Morales-Silva R, Alvarado-Torres J, Perez-Torres J, Perez-Perez Y, Sepulveda-Orengo M. Aerobic exercise as a promising nonpharmacological therapy for the treatment of substance use disorders. J Neurosci Res 2021; 100:1602-1642. [PMID: 34850988 PMCID: PMC9156662 DOI: 10.1002/jnr.24990] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 10/06/2021] [Accepted: 10/14/2021] [Indexed: 12/12/2022]
Abstract
Despite the prevalence and public health impact of substance use disorders (SUDs), effective long-term treatments remain elusive. Aerobic exercise is a promising, nonpharmacological treatment currently under investigation as a strategy for preventing drug relapse. Aerobic exercise could be incorporated into the comprehensive treatment regimens for people with substance abuse disorders. Preclinical studies of SUD with animal models have shown that aerobic exercise diminishes drug-seeking behavior, which leads to relapse, in both male and female rats. Nevertheless, little is known regarding the effects of substance abuse-induced cellular and physiological adaptations believed to be responsible for drug-seeking behavior. Accordingly, the overall goal of this review is to provide a summary and an assessment of findings to date, highlighting evidence of the molecular and neurological effects of exercise on adaptations associated with SUD.
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Affiliation(s)
| | - Ursula Gelpi-Dominguez
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, PR, USA
| | - Roberto Morales-Silva
- Department of Basic Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, PR, USA
| | - John Alvarado-Torres
- Department of Basic Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, PR, USA
| | - Joshua Perez-Torres
- Department of Basic Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, PR, USA
| | - Yobet Perez-Perez
- Department of Basic Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, PR, USA
| | - Marian Sepulveda-Orengo
- Department of Basic Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, PR, USA
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Abrantes AM, Van Noppen D, Bailey G, Uebelacker LA, Buman M, Stein MD. A Feasibility Study of a Peer-Facilitated Physical Activity Intervention in Methadone Maintenance. Ment Health Phys Act 2021; 21:100419. [PMID: 34552664 PMCID: PMC8452230 DOI: 10.1016/j.mhpa.2021.100419] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE While methadone maintenance treatment (MMT) has been effective in improving opioid use outcomes, most patients continue to engage in unhealthy lifestyles that lead to significant mental and physical health consequences. Interventions targeting increases in physical activity (PA) in MMT patients could have a significant impact on reducing the overall morbidity in these individuals. The purpose of this study was to assess acceptability and feasibility of a 12-week peer-facilitated PA intervention for MMT patients called TREC (Transforming Recovery with Exercise and Community). METHOD We developed and then pilot-tested TREC in 26 low-active MMT clients (73% female; mean age=41.2 years). TREC included: 1) an orientation session and intervention materials, 2) weekly PA discussion groups led by trained MMT clients, 3) peer-led walking groups and 4) a Fitbit activity tracker to facilitate self-monitoring of PA. RESULTS Participants attended 63% of eligible TREC sessions. Sixty-nine percent of the sample wore the Fitbit for at least 6 weeks (of the 12-week intervention). Participants reported that they enjoyed the group walks and that it was helpful to have a peer-facilitated PA group. There were small-to-moderate effect sizes for increases in PA, positive affect, and benefits of PA, and decreases in illicit opioid use and barriers to PA. No changes in depression, anxiety, and negative affect were observed from baseline to the end of the 12-week intervention. CONCLUSION Indicators of feasibility and acceptability suggest that a peer-facilitated PA intervention can be incorporated in the context of MMT. Low active, opioid dependent clients showed increases in PA during the 12-week intervention. A future randomized clinical trial is necessary to determine the efficacy of TREC on long-term maintenance of PA and ancillary mental health and substance use outcomes.
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Affiliation(s)
- Ana M. Abrantes
- Butler Hospital, Providence, RI, USA
- Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Genie Bailey
- Alpert Medical School of Brown University, Providence, RI, USA
| | - Lisa A. Uebelacker
- Butler Hospital, Providence, RI, USA
- Alpert Medical School of Brown University, Providence, RI, USA
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Fitzgerald C, Barley R, Hunt J, Klasto SP, West R. A Mixed-Method Investigation into Therapeutic Yoga as an Adjunctive Treatment for People Recovering from Substance Use Disorders. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-020-00228-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
AbstractMind Body Connect (MBC) is a charity which uses therapeutic yoga as a vehicle of change for marginalized populations. Alongside MBC, Sheffield Hallam University’s SHU Strength researchers carried out this study aiming to: (1) Gauge the impact of therapeutic yoga classes upon the mood state of people with a Substance Use Disorder (SUD) and (2) Explore the perceived benefits of therapeutic yoga class participation. An adapted shortened Profile of Mood States (POMS) was completed before and after each yoga class. A comparison of means with paired sample T-Test and Cohen’s D was then carried out. Participants who attended 6+ classes were interviewed. Findings were then converged. Before and after measurements of anger, sadness, tiredness, worry, confusion, energy and relaxation were taken, Classes were held at SHU for service users from a Phoenix Future’s (PF) rehabilitation centre. A single yoga class significantly relaxed participants and reduced negative mood states. Interview data covered a range of perceived benefits including the use of yogic down-regulation techniques as daily coping strategies. The MBC yoga programme appears beneficial as an adjunctive therapy for PF residents. Future SHU Strength research shall focus on the mid-long-term exercise habits of the recovery community and the impact of the MBC yoga programme upon the early recovery period of detoxification.
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12
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Master H, Pennings JS, Coronado RA, Bley J, Robinette PE, Haug CM, Skolasky RL, Riley LH, Neuman BJ, Cheng JS, Aaronson OS, Devin CJ, Wegener ST, Archer KR. How Many Steps Per Day During the Early Postoperative Period are Associated With Patient-Reported Outcomes of Disability, Pain, and Opioid Use After Lumbar Spine Surgery? Arch Phys Med Rehabil 2021; 102:1873-1879. [PMID: 34175276 DOI: 10.1016/j.apmr.2021.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/28/2021] [Accepted: 06/08/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To investigate whether early postoperative walking is associated with "best outcome" and no opioid use at 1 year after lumbar spine surgery and establish a threshold for steps/day to inform clinical practice. DESIGN Secondary analysis from randomized controlled trial. SETTING Two academic medical centers in the United States. PARTICIPANTS We enrolled 248 participants undergoing surgery for a degenerative lumbar spine condition (N=248). A total of 212 participants (mean age, 62.8±11.4y, 53.3% female) had valid walking data at baseline. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Disability (Oswestry Disability Index), back and leg pain (Brief Pain Inventory), and opioid use (yes vs no) were assessed at baseline and 1 year after surgery. "Best outcome" was defined as Oswestry Disability Index ≤20, back pain ≤2, and leg pain ≤2. Steps/day (walking) was assessed with an accelerometer worn for at least 3 days and 10 h/d at 6 weeks after spine surgery, which was considered as study baseline. Separate multivariable logistic regression analyses were conducted to determine the association between steps/day at 6 weeks and "best outcome" and no opioid use at 1-year. Receiver operating characteristic curves identified a steps/day threshold for achieving outcomes. RESULTS Each additional 1000 steps/d at 6 weeks after spine surgery was associated with 41% higher odds of achieving "best outcome" (95% confidence interval [CI], 1.15-1.74) and 38% higher odds of no opioid use (95% CI, 1.09-1.76) at 1 year. Walking ≥3500 steps/d was associated with 3.75 times the odds (95% CI, 1.56-9.02) of achieving "best outcome" and 2.37 times the odds (95% CI, 1.07-5.24) of not using opioids. CONCLUSIONS Walking early after surgery may optimize patient-reported outcomes after lumbar spine surgery. A 3500 steps/d threshold may serve as an initial recommendation during early postoperative counseling.
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Affiliation(s)
- Hiral Master
- Department of Orthopaedic Surgery, Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, TN; Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN
| | - Jacquelyn S Pennings
- Department of Orthopaedic Surgery, Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, TN
| | - Rogelio A Coronado
- Department of Orthopaedic Surgery, Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, TN; Department of Physical Medicine and Rehabilitation, Osher Center for Integrative Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Jordan Bley
- Department of Orthopaedic Surgery, Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, TN
| | - Payton E Robinette
- Department of Orthopaedic Surgery, Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, TN
| | - Christine M Haug
- Department of Orthopaedic Surgery, Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, TN
| | - Richard L Skolasky
- Department of Orthopaedic Surgery, Johns Hopkins Medicine, Baltimore, MD
| | - Lee H Riley
- Department of Orthopaedic Surgery, Johns Hopkins Medicine, Baltimore, MD
| | - Brian J Neuman
- Department of Orthopaedic Surgery, Johns Hopkins Medicine, Baltimore, MD
| | - Joseph S Cheng
- Department of Neurological Surgery, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Oran S Aaronson
- Howell Allen Clinic, Saint Thomas Medical Partners, Nashville, TN
| | - Clinton J Devin
- Department of Orthopaedic Surgery, Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, TN; Steamboat Orthopedic and Spine Institute, Steamboat Springs, CO
| | - Stephen T Wegener
- Department of Physical Medicine and Rehabilitation, Johns Hopkins Medicine, Baltimore, MD
| | - Kristin R Archer
- Department of Orthopaedic Surgery, Center for Musculoskeletal Research, Vanderbilt University Medical Center, Nashville, TN; Department of Physical Medicine and Rehabilitation, Osher Center for Integrative Medicine, Vanderbilt University Medical Center, Nashville, TN.
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13
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Effect of Taijiquan Exercise on Rehabilitation of Male Amphetamine-Type Addicts. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:8886562. [PMID: 33293997 PMCID: PMC7690993 DOI: 10.1155/2020/8886562] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/26/2020] [Accepted: 10/31/2020] [Indexed: 11/18/2022]
Abstract
Taijiquan is a traditional Chinese sport that is classified as a moderate exercise. Recent studies have evaluated the effectiveness of Taijiquan in substance abuse rehabilitation. Objective. To test the rehabilitation effect of Taijiquan exercise in patients with amphetamine (ATS) drug dependence. Methods. The effect of Taijiquan intervention was tested by parallel control experiment: Taijiquan group (n = 38) and control group (n = 38). The factors between the experimental groups were the group (Taijiquan group and the control group), and the factors within the group were the test time (before and after intervention). Repeated measurement analysis of variance was used to compare the two groups, and the factors that may affect the results were included in the covariance. Results. Taijiquan exercise promoted the balance control ability of ATS dependent patients (p = 0.014, η 2 = 0.064), increased the overall sense of health (p = 0.029, η 2 = 0.100), vitality (p = 0.030, η 2 = 0.056), and mental health (p = 0.016, η 2 = 0.061), improved trait anxiety (p = 0.028, η 2 = 0.053), and reduced drug craving (p = 0.048, η 2 = 0.048). Conclusion. Taijiquan exercise is beneficial to the physical and mental recovery of dependent patients, and the physical and mental benefits of exercise may have an effect on drug craving, which is of the most important significance for addicts to quit drugs and prevent relapse. The study is registered on the Chinese Clinical Trial Registry (No. ChiCTR1800015777).
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Jake-Schoffman DE, Berry MS, Donahue ML, Christou DD, Dallery J, Rung JM. Aerobic Exercise Interventions for Patients in Opioid Maintenance Treatment: A Systematic Review. Subst Abuse 2020; 14:1178221820918885. [PMID: 35153484 PMCID: PMC8832319 DOI: 10.1177/1178221820918885] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 03/23/2020] [Indexed: 11/30/2022]
Abstract
Background: Opioid maintenance treatment (OMT) is the standard for treatment of opioid
use disorder, but some individuals on OMT experience disrupted sleep,
heightened sensitivity to pain, and continued relapse to non-medical opioid
use. An adjunctive treatment that has potential to address these
shortcomings of OMT is aerobic exercise. Objective: The aim of the present review was to identify and evaluate components of
aerobic exercise interventions targeting OMT patients. Methods: For this PROSPERO-registered review (ID CRD42020139626), studies were
identified via electronic bibliographic databases, funded research
(NIH RePORTER) and clinical trials databases
(ClinicalTrials.gov), and reference sections of
relevant manuscripts. Studies that evaluated the effects of an aerobic
exercise intervention using a comparison condition or pretest-posttest
design in adult OMT patients were included. Results: Of 2971 unique records, three primary studies and one supplemental manuscript
comprised the final sample. All studies were randomized trials involving
supervised exercise interventions enrolling small samples of middle-aged OMT
patients. Exercise interventions included a variety of aerobic and
non-aerobic activities (e.g. flexibility exercises), and none controlled the
dose of aerobic exercise. Few studies used objective measures of physical
activity or cardiorespiratory fitness and there were no significant effects
of adjunctive exercise on substance use outcomes, but tests of the latter
were likely underpowered. Conclusions: Though early in the accumulation of evidence, interventions targeting aerobic
exercise for OMT patients appear feasible, acceptable to patients, and
beneficial. Longer-term studies that employ larger samples, include
assessments of behavioral and biological mechanisms of change, more rigorous
measurement of physical activity, and controlled doses of aerobic activity
are warranted.
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Affiliation(s)
- Danielle E Jake-Schoffman
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Meredith S Berry
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
- Department of Psychology, College of Liberal Arts and Sciences, University of Florida, Gainesville, FL, USA
| | - Marissa L Donahue
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Demetra D Christou
- Department of Applied Physiology and Kinesiology, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Jesse Dallery
- Department of Psychology, College of Liberal Arts and Sciences, University of Florida, Gainesville, FL, USA
| | - Jillian M Rung
- Department of Epidemiology, School of Public Health and Health Professions & College of Medicine, University of Florida, Gainesville, FL, USA
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15
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Sari S, Bilberg R, Søgaard Nielsen A, Roessler KK. The effect of exercise as adjunctive treatment on quality of life for individuals with alcohol use disorders: a randomized controlled trial. BMC Public Health 2019; 19:727. [PMID: 31185955 PMCID: PMC6558793 DOI: 10.1186/s12889-019-7083-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 05/31/2019] [Indexed: 11/24/2022] Open
Abstract
Background A physically active lifestyle contributes to the prevention of lifestyle diseases, promotion of physical health, and reduction of pain, among other benefits. Being physically active also promotes mental health for many individuals, in the form of improved mood, increased self-efficacy and reduced risk of depression. Alcohol-dependent individuals may experience a better quality of life when supplementing their treatment with physical exercise. This study aimed to evaluate the effect of exercise on Quality of Life among patients with alcohol use disorder in a large randomized controlled trial. Methods The study had three arms: Patients were allocated to (A) treatment as usual, (B) treatment as usual and supervised group exercise two days a week of one hour each, (C) treatment as usual and individual physical exercise minimum two days a week. Duration of the intervention was six months. Data on values of Quality of Life were collected at baseline (before treatment start and at time of enrollment in the study), and at follow-up (at six months after enrollment in the study) using the EQ-5D questionnaire and the EQ-VAS. The sample consisted of 117 consecutive patients, and the follow-up rate was 66.6%. Intention-to-treat analyses were conducted to evaluate the effect of exercise on quality of life. Results Although not statistically significant, a substantial portion of the participants in the individual exercise condition reported that they had no pain or discomfort (one of the five quality of life dimensions measured by EQ-5D questionnaire) compared to the controls at follow-up. No difference was found between the groups regarding the EQ-VAS. Conclusion The exercise intervention had no effect on quality of life for patients with alcohol use disorder, nor was quality of life improved across the total sample. More research in how to improve quality of life for patients with alcohol use disorder is needed. Trial registration ISRCTN74889852 (retrospectively registered, date: 16/05/2013).
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Affiliation(s)
- Sengül Sari
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen, Denmark.
| | - Randi Bilberg
- Unit of Clinical Alcohol Research, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.,Department of Psychiatry, Odense University Hospital, Winsløwsvej 20, 5000, Odense C, Denmark
| | - Anette Søgaard Nielsen
- Unit of Clinical Alcohol Research, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.,Department of Psychiatry, Odense University Hospital, Winsløwsvej 20, 5000, Odense C, Denmark
| | - Kirsten Kaya Roessler
- Department of Psychology, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
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16
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Inmates with Harmful Substance Use Increase Both Exercise and Nicotine Use Under Incarceration. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122663. [PMID: 30486386 PMCID: PMC6313574 DOI: 10.3390/ijerph15122663] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 11/22/2018] [Accepted: 11/23/2018] [Indexed: 12/21/2022]
Abstract
Exercise is increasingly understood as an important resource for people who engage in harmful substance use, including those in prison. Little is known about how inmates adopt various health behaviors during incarceration, without interventions. This cross-sectional study analyzed self-reports from 1464 inmates in Norwegian prisons in 2013–2014, compared them according to harmful substance use pre-incarceration, and explored changes in exercise and nicotine use during incarceration. Results were presented in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Inmates with harmful substance use reported higher rates of smoking, smokeless tobacco, and physical inactivity pre-incarceration than inmates without harmful use. However, inmates with harmful use also exhibited more behavioral changes: they adopted exercise, ceased smoking, and adopted smokeless tobacco at higher rates during incarceration than the non-harmful group, to the extent that inmates with harmful use exercised during incarceration more. Exercise is being taken up by a significant proportion of inmates, and may in particular be a replacement behavior for substance use. However, unhealthy behaviors also begin or are maintained. If prisons were used as an arena to facilitate healthy behaviors, the public health benefits to a marginalized group such as substance-using inmates could be substantial.
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17
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Salehi I, Zarrinkalam E, Mirzaei F, Abbasi Oshaghi E, Ranjbar K, Asl SS. Effects of Resistance, Endurance, and Concurrent Exercise on Oxidative Stress Markers and the Histological Changes of Intestine After Morphine Withdrawal in Rats. AVICENNA JOURNAL OF MEDICAL BIOCHEMISTRY 2018. [DOI: 10.15171/ajmb.2018.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objectives: The aim of this study was to evaluate the effects of resistance, endurance, and concurrent exercise on oxidative stress markers and histological changes of the intestine after morphine withdrawal in rats. Methods: A total of 30 male Wistar rats were randomly divided into 5 groups (n=6) including healthy control, withdrawal (rat received morphine for 21 days and 8 weeks of withdrawal period), withdrawal + endurance exercises, withdrawal + resistance exercises, and withdrawal + concurrent exercises. The rats practiced endurance, resistance, and concurrent exercises for 10 weeks. Then, their intestines were removed and used for biochemical and histological analysis. Next, several factors were measured such as total protein levels, malondialdehyde (MDA), reduced glutathione (GSH), total antioxidant capacity (TAC), and total oxidant status (TOS). Finally, the morphological alteration of intestine was examined under the light microscope. Results: Morphine withdrawal significantly increased the levels of MDA in the intestine of withdrawal rats compared to those of the control group while endurance, resistance, and concurrent exercise reduced the MDA levels in the intestine. In addition, morphine withdrawal led to a decrease in TAC and GSH levels in the intestine compared to control rats whereas endurance, resistance, and concurrent exercise noticeably increased TAC and GSH levels. Interestingly, the change in the concurrent group was more significant. Moreover, the levels of TOS demonstrated a significant increase in the addicted rat as compared to the control group. Conversely, endurance, resistance, and concurrent exercise significantly decreased TOS levels and the reduction was more significant in the concurrent group. Finally, the intestine of withdrawal rat was morphologically abnormal while it restored by the exercise. Conclusion: Overall, endurance, resistance, and concurrent exercise significantly normalized oxidative stress and the morphological changes of the intestine in withdrawal rats.
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Affiliation(s)
- Iraj Salehi
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ebrahim Zarrinkalam
- Department of Physical Education and Sport Sciences, Islamic Azad University, Hamedan Branch, Hamedan, Iran
| | - Fatemeh Mirzaei
- Department of Anatomy, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Kamal Ranjbar
- Young Researchers and Elite Club, Hamedan Branch, Islamic Azad University, Hamedan, Iran
| | - Sara Soleimani Asl
- Endometrium and Endometriosis Research Centre , Hamadan University of Medical Sciences, Hamadan, Iran
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18
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Simonton AJ, Young CC, Brown RA. Physical Activity Preferences and Attitudes of Individuals With Substance Use Disorders: A Review of the Literature. Issues Ment Health Nurs 2018; 39:657-666. [PMID: 29505733 DOI: 10.1080/01612840.2018.1429510] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Substance use disorders (SUDs) are prevalent in the United States and costly to society. SUDs contribute significantly to decreased quality of life and overdose deaths. Physical activity (PA) interventions may be one efficacious method to improve recovery and long-term abstinence from substance use; although PA interventions have resulted in positive physical and psychological outcomes, their adherence and attrition rates have been problematic. To address lack of adherence and high attrition rates, it is important to understand the preferences and attitudes for PA among patients in SUD treatment. We, therefore, conducted a literature review to examine preferences and attitudes for PA among adults with SUDs. Five articles met inclusion and exclusion criteria. The findings from this small sample of studies suggest that adults with SUDs are interested in PA. Walking, strength training, and cycling were the activities preferred most frequently. Participants said that they would like to engage in these activities either alone or with small groups and would prefer their exercise options to be located at facilities they already frequented, such as treatment clinics. Nurses are well positioned to assess patient preferences and attitudes and to enhance recovery efforts in this population. Further exploration of this population's unique preferences and attitudes regarding PA may lay the groundwork for efficacious PA interventions with improved adherence and attrition rates, which may lead to improved recovery outcomes.
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Affiliation(s)
- Amanda J Simonton
- a School of Nursing , The University of Texas at Austin , Austin , Texas , USA
| | - Cara C Young
- a School of Nursing , The University of Texas at Austin , Austin , Texas , USA
| | - Richard A Brown
- a School of Nursing , The University of Texas at Austin , Austin , Texas , USA
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19
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Wenger S, Drott J, Fillipo R, Findlay A, Genung A, Heiden J, Bradt J. Reducing Opioid Use for Patients With Chronic Pain: An Evidence-Based Perspective. Phys Ther 2018; 98:424-433. [PMID: 29669085 DOI: 10.1093/ptj/pzy025] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 02/09/2018] [Indexed: 02/09/2023]
Abstract
The implementation of recent Centers for Disease Control and Prevention recommendations to move away from opioids and toward nonpharmacological therapies for the treatment of chronic pain could involve a difficult transition period for patients and practitioners. The focus of treatment should shift from eliminating pain completely to minimizing the impact of pain on quality of life. Many patients with chronic pain take opioids either because opioids were previously prescribed as a first-line treatment for chronic pain, on the basis of old standards of care, or because opioids were initially prescribed for acute pain. Patients currently taking opioids will need a tapering period during which they transition their pain management to interdisciplinary care and nonpharmacological treatments. To provide useful treatment options, physical therapists need to have a good understanding of the neuroscientific mechanisms of chronic pain, biopsychosocial components of chronic pain management, issues related to opioid use, and pain management strategies used by other health care professionals. Armed with knowledge and good communication skills, physical therapists can work within an interdisciplinary team to adapt care to each patient's needs and abilities. This perspective article provides guidance for physical therapists to effectively treat patients with chronic pain during the opioid tapering process. A framework has been created to help health care providers structure their reasoning as they collaborate to develop a unique approach for each patient.
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Affiliation(s)
- Sarah Wenger
- Department of Physical Therapy and Rehabilitation, Drexel University, 1601 Cherry Street, Room 758, MS 7-502, Philadelphia, PA 19102 (USA). Dr Wenger is a board-certified orthopaedic clinical specialist
| | - Jason Drott
- Department of Physical Therapy and Rehabilitation, Drexel University
| | - Rebecca Fillipo
- Department of Physical Therapy and Rehabilitation, Drexel University
| | - Alyssa Findlay
- Department of Physical Therapy and Rehabilitation, Drexel University
| | - Amanda Genung
- Department of Physical Therapy and Rehabilitation, Drexel University
| | - Jessica Heiden
- Department of Physical Therapy and Rehabilitation, Drexel University
| | - Joke Bradt
- Department of Creative Arts Therapies, Drexel University. Dr Bradt is a board-certified music therapist
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20
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More A, Jackson B, Dimmock JA, Thornton AL, Colthart A, Furzer BJ. Exercise in the Treatment of Youth Substance Use Disorders: Review and Recommendations. Front Psychol 2017; 8:1839. [PMID: 29089915 PMCID: PMC5651015 DOI: 10.3389/fpsyg.2017.01839] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 10/03/2017] [Indexed: 01/26/2023] Open
Abstract
Substance use disorders among youth represent a significant public health concern. It is well established that regular exercise provides important physical and mental health benefits; however, evidence for the role of exercise as an adjunct component within substance use disorder treatment is scarce. In this review, we identify factors associated with the development and persistence of substance use disorders among youth, identify current treatment modalities, and present evidence to support the efficacy of incorporating exercise participation during rehabilitation. We also provide a series of recommendations for future research that explores the feasibility and effectiveness of exercise participation as a complement to substance use disorder treatment among youth.
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Affiliation(s)
- Alissa More
- School of Human Sciences (Exercise & Sport Science), The University of Western Australia, Perth, WA, Australia
| | - Ben Jackson
- School of Human Sciences (Exercise & Sport Science), The University of Western Australia, Perth, WA, Australia
| | - James A Dimmock
- School of Human Sciences (Exercise & Sport Science), The University of Western Australia, Perth, WA, Australia
| | - Ashleigh L Thornton
- School of Human Sciences (Exercise & Sport Science), The University of Western Australia, Perth, WA, Australia
| | - Allan Colthart
- Drug and Alcohol Youth Service, Mental Health Commission and Mission Australia, Perth, WA, Australia
| | - Bonnie J Furzer
- School of Human Sciences (Exercise & Sport Science), The University of Western Australia, Perth, WA, Australia
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21
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Beitel M, Stults-Kolehmainen M, Cutter CJ, Schottenfeld RS, Eggert K, Madden LM, Kerns RD, Liong C, Ginn J, Barry DT. Physical activity, psychiatric distress, and interest in exercise group participation among individuals seeking methadone maintenance treatment with and without chronic pain. Am J Addict 2016; 25:125-31. [PMID: 26824197 DOI: 10.1111/ajad.12336] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 12/30/2015] [Accepted: 12/31/2015] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Physical activity may improve chronic pain, anxiety, and depression, which are prevalent among patients in methadone maintenance treatment (MMT), but relatively little is known about the physical activity levels or interest in exercise of patients in MMT. METHODS We used a brief self-report instrument to assess physical activity levels, chronic pain, psychiatric distress, and interest in exercise group participation among 303 adults seeking MMT. RESULTS Most (73%) reported no moderate or vigorous intensity physical activity in the past week; 27% met recommended physical activity levels, and 24% reported interest in exercise group participation. Participants with (compared to those without) chronic pain had higher levels of psychiatric distress and were less likely to meet recommended levels of physical activity (p < .05), but did not differ significantly in their interest in participating in an exercise group. Participants who met recommended levels of physical activity in the past week were more likely to be men and had lower levels of depression than others (p < .05). CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE Low levels of physical activity and low interest in exercise group participation among patients entering MMT point to the need for and likely challenges of implementing exercise interventions in MMT.
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Affiliation(s)
- Mark Beitel
- Yale University School of Medicine, New Haven, Connecticut.,APT Foundation Pain Treatment Services, New Haven, Connecticut
| | | | - Christopher J Cutter
- Yale University School of Medicine, New Haven, Connecticut.,APT Foundation Pain Treatment Services, New Haven, Connecticut
| | | | - Kathy Eggert
- APT Foundation Pain Treatment Services, New Haven, Connecticut
| | - Lynn M Madden
- Yale University School of Medicine, New Haven, Connecticut.,APT Foundation Pain Treatment Services, New Haven, Connecticut
| | - Robert D Kerns
- Yale University School of Medicine, New Haven, Connecticut.,VA Connecticut Healthcare System, West Haven, Connecticut
| | | | - Joel Ginn
- APT Foundation Pain Treatment Services, New Haven, Connecticut
| | - Declan T Barry
- Yale University School of Medicine, New Haven, Connecticut.,APT Foundation Pain Treatment Services, New Haven, Connecticut
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22
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Brown MN. Physical Medicine and Rehabilitation in the Opioid Addicted Patient. Subst Abus 2015. [DOI: 10.1007/978-1-4939-1951-2_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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23
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Muller AE, Clausen T. Group exercise to improve quality of life among substance use disorder patients. Scand J Public Health 2014; 43:146-52. [DOI: 10.1177/1403494814561819] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Quality of life (QoL) is a well-established outcome within clinical practice. Despite the adverse effects of substance use disorders on a wide range of patients’ functionality and the multidimensional composition of QoL, the treatment field does not yet systematically assess QoL among patients. Exercise has established positive effects on the QoL of healthy and numerous clinical populations. The potential to integrate exercise within treatment, in order to improve QoL has not been satisfactorily explored. Aims: To measure changes in QoL after group exercise among residential substance use disorder patients and to explore the feasibility of the program within a treatment setting. Methods: We enrolled 35 patients in four long-term residential substance use disorder treatment facilities in Oslo, into a 10-week group exercise program. We analyzed the 24 participants who exercised as completers, while the 11 participants who did not were analyzed as non-completers. We measured QoL, mental distress, somatic health burden and addiction severity at the beginning and end of the program. Results: The program was feasible for participants and the completion rate was 69%. Completers’ physical health domain and psychological health domain of QoL improved significantly. The program engaged the most physically and mentally vulnerable participants, and flexibility and motivational factors were important elements. Conclusions: This study provided promising evidence that low doses of group exercise can yield appreciable benefits, even to patients with more severe health problems.
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Affiliation(s)
- Ashley E. Muller
- Oslo University College, Oslo, Norway
- Norwegian Center for Addiction Research, Oslo, Norway
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24
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Wang D, Wang Y, Wang Y, Li R, Zhou C. Impact of physical exercise on substance use disorders: a meta-analysis. PLoS One 2014; 9:e110728. [PMID: 25330437 PMCID: PMC4199732 DOI: 10.1371/journal.pone.0110728] [Citation(s) in RCA: 138] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 09/16/2014] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The goal of this meta-analysis was to examine whether long-term physical exercise could be a potential effective treatment for substance use disorders (SUD). METHODS The PubMed, Web of Science, Elsevier, CNKI and China Info were searched for randomized controlled trials (RCT) studies in regards to the effects of physical exercise on SUD between the years 1990 and 2013. Four main outcome measures including abstinence rate, withdrawal symptoms, anxiety, and depression were evaluated. RESULTS Twenty-two studies were integrated in the meta-analysis. The results indicated that physical exercise can effectively increase the abstinence rate (OR = 1.69 (95% CI: 1.44, 1.99), z = 6.33, p < 0.001), ease withdrawal symptoms (SMD = -1.24 (95% CI: -2.46, -0.02), z = -2, p<0.05), and reduce anxiety (SMD = -0.31 (95% CI: -0.45, -0.16), z = -4.12, p < 0.001) and depression (SMD = -0.47 (95% CI: -0.80, -0.14), z = -2.76, p<0.01). The physical exercise can more ease the depression symptoms on alcohol and illicit drug abusers than nicotine abusers, and more improve the abstinence rate on illicit drug abusers than the others. Similar treatment effects were found in three categories: exercise intensity, types of exercise, and follow-up periods. CONCLUSIONS The moderate and high-intensity aerobic exercises, designed according to the Guidelines of American College of Sports Medicine, and the mind-body exercises can be an effective and persistent treatment for those with SUD.
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Affiliation(s)
- Dongshi Wang
- Department of Sport Psychology, School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Yanqiu Wang
- Department of Sport Psychology, School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Yingying Wang
- Department of Sport Psychology, School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Rena Li
- Department of Sport Psychology, School of Kinesiology, Shanghai University of Sport, Shanghai, China
- Center for Hormone Advanced Science and Education, Roskamp Institute, Sarasota, Florida, United States of America
| | - Chenglin Zhou
- Department of Sport Psychology, School of Kinesiology, Shanghai University of Sport, Shanghai, China
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25
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Pareja-Galeano H, Sanchis-Gomar F, Mayero S. Exercise as an adjuvant intervention in opiate dependence. Subst Abus 2014; 34:87-8. [PMID: 23577897 DOI: 10.1080/08897077.2012.752778] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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26
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Pang TY, Renoir T, Du X, Lawrence AJ, Hannan AJ. Depression-related behaviours displayed by female C57BL/6J mice during abstinence from chronic ethanol consumption are rescued by wheel-running. Eur J Neurosci 2013; 37:1803-10. [PMID: 23551162 DOI: 10.1111/ejn.12195] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 01/31/2013] [Accepted: 02/19/2013] [Indexed: 12/22/2022]
Abstract
Withdrawal from a chronic period of alcohol consumption is commonly associated with the manifestation of depression, potentially exerting a significant influence on treatment prospects and increasing the likelihood of relapse. Better therapeutic strategies need to be developed to assist with rehabilitation. Here, we report the detection of depression-related behaviours in a mouse model of 6-week free-choice ethanol (10%, v/v) consumption followed by 2-week abstinence. Mice abstinent from alcohol showed increased immobility time on the forced-swim test, reduced saccharin consumption and increased latency to feed in the novelty-suppressed feeding test. By comparison, there was no significant effect on anxiety-related behaviours as determined by testing on the light-dark box and elevated plus maze. We found that the provision of running-wheels through the duration of abstinence attenuated depressive behaviour in the forced-swim and novelty-suppressed feeding tests, and increased saccharin consumption. Given the link between withdrawal from addictive substances and depression, this model will be useful for the study of the pathophysiology underlying alcohol-related depression. The findings of this study establish an interaction between physical activity and the development of behavioural changes following cessation of alcohol consumption that could have implications for the development of rehabilitative therapies.
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Affiliation(s)
- Terence Y Pang
- Behavioural Neurosciences Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Vic., Australia.
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