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Hov H, Eithun G, Wang E, Helgerud J. Aerobic high-intensity interval training and maximal strength training in patients with unspecific musculoskeletal disorders improve V̇O 2peak and maximal strength more than moderate training. Eur J Sport Sci 2024; 24:1010-1020. [PMID: 38956785 PMCID: PMC11235885 DOI: 10.1002/ejsc.12126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 04/27/2024] [Accepted: 05/06/2024] [Indexed: 07/04/2024]
Abstract
Improving peak oxygen uptake (V̇O2peak) and maximal strength are key objectives of rehabilitation for patients with unspecific musculoskeletal disorders (MSDs). Although high-intensity training yield superior outcomes for these factors, patients with MSDs may not tolerate high-intensity due to pain and fear. Therefore, we examined the effect and feasibility of incorporating aerobic high-intensity intervals (HIITs) and maximal strength training (MST) in a standard clinical rehabilitation program for patients with unspecific MSDs. 73 patients (45 ± 10 years) with MSDs partaking in a standard, public, and 4-week rehabilitation program were randomized to high-intensity training (HG: 4 × 4 minutes intervals at ∼90% of maximal heart rate; HRmax, and 4 × 4 repetitions leg press at ∼90% of 1 repetition maximum; 1RM, with maximal intended velocity) or keep todays treatment of low-to moderate-intensity training (MG: various cycling, walking, and/or running activities at ∼70%-80% of HRmax and 3 × 8 - 10 repetitions leg press at ∼75% of 1RM without maximal intended velocity). HG improved V̇O2peak (12 ± 7%) and leg press 1RM (43 ± 34%) more than moderate-intensity group (V̇O2peak; 5 ± 6%, 1RM; 19 ± 18%, both p < 0.001). We observed that no adverse events and no between-group differences in dropout rate or self-reported quality of life (both p > 0.05). There were positive correlations between improved V̇O2peak and improved physical (p = 0.024) and emotional (0.016) role functioning. We conclude that both high-intensity interval training and MST are feasible and improve V̇O2peak and maximal strength more than standard low-to moderate-intensity treatment of patients with unspecific MSDs. Our findings suggest that high-intensity training should be implemented as a part of standard clinical care of this patient population.
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Affiliation(s)
- Håkon Hov
- TreningsklinikkenMedical Rehabilitation ClinicTrondheimNorway
- Faculty of Health Sciences and Social CareMolde University CollegeMoldeNorway
| | - Geir Eithun
- Department of Circulation and Medical ImagingFaculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway
- Unicare HokksundMedical Rehabilitation CentreHokksundNorway
| | - Eivind Wang
- Faculty of Health Sciences and Social CareMolde University CollegeMoldeNorway
- Department of Psychosis and RehabilitationPsychiatry ClinicSt. Olavs University HospitalTrondheimNorway
| | - Jan Helgerud
- TreningsklinikkenMedical Rehabilitation ClinicTrondheimNorway
- Department of Circulation and Medical ImagingFaculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway
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Mustafaoglu R, Gorek Dilektaslı A, Demir R, Zirek E, Birinci T, Kaya Mutlu E, Evren C, Razak Ozdincler A. Exercise capacity, lung and respiratory muscle function in substance use disorders. Pulmonology 2024; 30:254-264. [PMID: 35115279 DOI: 10.1016/j.pulmoe.2021.12.009] [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: 07/10/2021] [Revised: 12/16/2021] [Accepted: 12/20/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Substance use disorder (SUD) causes conditions such as cognitive and behavioral disorders, anxiety, depression, and social isolation it also causes acute airway inflammation by affecting airway bronchial dynamics. The current study aimed to investigate the lung function, respiratory muscle strength, and exercise capacity in patients with SUD. METHODS One hundred-eighty three patients with SUD, a total of 119 healthy controls, 54 of whom were cigarette smokers and 65 of whom were non-smokers were included in the study. Spirometric tests, respiratory muscle strength (MIP and MEP), and the 6-Minute Walk Test (6-MWT) were assessed. The III National Health and Nutrition Examination Survey were used to evaluate respiratory symptoms in patients with SUD and cigarette smokers. RESULTS 86.3% of the SUD patients included in the study were using heroin, 9.2% were cannabis, and 5.5% were spice. The most common symptom in both SUD patients and cigarette smokers was shortness of breath, wheezing, and sputum production. After post-hoc tests, the FVC (p = 0.002), FVC (%predicted) (p < 0.0001), FEV1 (p = 0.002), FEV1 (%predicted) (p < 0.0001), FEV1/FVC (%) (p < 0.0001), PEF (p < 0.0001) and FEF%25-75 (p < 0.0001) lung function parameters were significantly lower in SUD patients than non-smokers. In addition, it was found that MIP (p < 0.0001), MIP (%predicted) (p < 0.0001), MEP (p < 0.0001), and MEP (%predicted) (p < 0.0001) values of SUD patients were significantly lower than non-smokers. CONCLUSION The study findings indicate that substance use has an effect on lung functions and the most commonly reported symptoms are shortness of breath, wheezing, and sputum production. In addition, respiratory muscle strength and exercise capacity were decreased in SUD patients compared to non-smokers.
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Affiliation(s)
- R Mustafaoglu
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - A Gorek Dilektaslı
- Department of Pulmonary Medicine, Uludağ University School of Medicine, Bursa, Turkey
| | - R Demir
- Department of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - E Zirek
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bingol University, Bingol, Turkey
| | - T Birinci
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Medeniyet University, Istanbul, Turkey
| | - E Kaya Mutlu
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Bandirma Onyedi Eylul University, Balikesir, Turkey
| | - C Evren
- Research, Treatment, and Training Center for Alcohol and Substance Dependence, Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey
| | - A Razak Ozdincler
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Biruni University, Istanbul, Turkey
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Tao Y, Lu J, Lv J, Zhang L. Effects of high-intensity interval training on depressive symptoms: A systematic review and meta-analysis. J Psychosom Res 2024; 180:111652. [PMID: 38603999 DOI: 10.1016/j.jpsychores.2024.111652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 03/12/2024] [Accepted: 03/20/2024] [Indexed: 04/13/2024]
Abstract
The objective of this systematic review and meta-analysis is to investigate the effect of high-intensity interval training (HIIT) on depressive symptoms, including an examination of its impact across different populations, intervention durations, and control groups through subgroup analysis. METHODS A systematic literature search was conducted using the following databases: Cochrane, Embase, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Data Knowledge Service Platform. The search covered the period from January 1, 2000, to December 31, 2022. RESULTS The meta-analysis included 34 randomized controlled trials, involving a total of N = 1607 participants. HIIT had a small but significant effect on depressive symptoms compared to the control group [SMD = -0.40, 95%CI (-0.60, -0.20), I2 = 73%]. However, subgroup analyses revealed no moderating effect of health status or exercise duration on depressive symptoms. HIIT did not have a statistically significant effect on depressive symptoms when compared with other types of exercise [SMD = -0.15, 95% CI (-0.30, 0.01), I2 = 10%]. HIIT demonstrated a medium effect size in reducing depressive symptoms compared to a non-active control group [SMD = -0.53, 95% CI (-0.84, -0.21), I2 = 80%]. CONCLUSIONS HIIT confers benefits in mitigating depressive symptoms. Compared to non-active control group, HIIT yields moderate improvements in depressive symptoms. We look forward to exploring more moderating effects in the future, such as HIIT modalities, frequency, and so on. In summation, these findings substantiate the use of HIIT as a means to alleviate symptoms of depression.
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Affiliation(s)
- Yingying Tao
- Key Laboratory of Psychological and Physiological Regulation in Competitive Sports, Tianjin University of Sport, China
| | - Jiayao Lu
- Key Laboratory of Psychological and Physiological Regulation in Competitive Sports, Tianjin University of Sport, China
| | - Jiayu Lv
- Key Laboratory of Psychological and Physiological Regulation in Competitive Sports, Tianjin University of Sport, China
| | - Liancheng Zhang
- Key Laboratory of Psychological and Physiological Regulation in Competitive Sports, Tianjin University of Sport, China.
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Zheng Y, Zhao Y, Chen X, Li S. Effect of physical exercise on the emotional and cognitive levels of patients with substance use disorder: a meta-analysis. Front Psychol 2024; 15:1348224. [PMID: 38406301 PMCID: PMC10884270 DOI: 10.3389/fpsyg.2024.1348224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 01/22/2024] [Indexed: 02/27/2024] Open
Abstract
Introduction This study investigated the impact of different modes of physical exercise on the emotional and cognitive levels of patients with Substance Use Disorder (SUD). By exploring the most effective intervention types, cycle, frequency, and duration, we aimed to provide evidence-based recommendations for the adjunctive treatment of SUD. Methods We conducted a systematic search in five databases, including PubMed, Web of Science, The Cochrane Library, ScienceDirect, and EBSCO, from database inception up to May 2023, and identified 4,255 randomized controlled trials addressing the influence of physical exercise on the emotional and cognitive levels of SUD patients. Data extraction and analysis were performed using Review Manager 5.4 software, focusing on 11 studies that met the inclusion criteria and included 895 participants. Subsequently, a meta-analysis was conducted using Stata 16.0 software, presenting the results in the form of standardized mean differences (SMD) and 95% confidence intervals (CI). Results Our findings indicate that physical exercise significantly alleviates anxiety and depression in SUD patients while improving their cognitive function. Specifically, physical exercise was found to reduce anxiety (SMD = -0.726 [-1.349, -0.103], p < 0.05) and depression (SMD = -0.666 [-1.077, -0.255], p < 0.05) and enhance cognitive levels (SMD = -0.523 [-0.887, -0.159], p < 0.05) among patients. Subgroup analysis further revealed that SUD patients benefitted most from physical exercise when engaging in aerobic exercises lasting over 12 weeks, with a frequency exceeding 40 sessions and each session lasting more than 60 min. Discussion In conclusion, our study affirms that physical exercise mitigates anxiety and depression while enhancing cognitive function in SUD patients, making it an effective measure for adjunctive clinical treatment.
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Affiliation(s)
- Yamiao Zheng
- School of Sports Science, Qufu Normal University, Qufu, China
| | - Yiyang Zhao
- School of Sports Science, Qufu Normal University, Qufu, China
| | - Xilian Chen
- School of Physical Education, Sichuan University, Chengdu, China
| | - Shanshan Li
- School of Physical Education, Sichuan University, Chengdu, China
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Xu Y, Li Y, Wang C, Han T, Wu Y, Wang S, Wei J. Clinical value and mechanistic analysis of HIIT on modulating risk and symptoms of depression: A systematic review. Int J Clin Health Psychol 2024; 24:100433. [PMID: 38226005 PMCID: PMC10788816 DOI: 10.1016/j.ijchp.2023.100433] [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: 05/23/2023] [Accepted: 12/28/2023] [Indexed: 01/17/2024] Open
Abstract
Background The exact causal mechanisms of depression remain unclear due to the complexity of the triggers, which has led to limitations in treating depression using modern drugs. High-intensity interval training (HIIT) is as effective as medication in treating depression without toxic side effects. Typically, HIIT requires less time commitment (i.e., shorter exercise duration) and exhibits pronounced benefits on depressive symptoms than other forms of physical exercise. This review summarizes the risk reduction and clinical effects of HIIT for depression and discusses the underlying mechanisms, providing a theoretical basis for utilizing HIIT in treating depression. Methods A database search was conducted in PubMed, Embase, Web of Science, and Scopus from inception up to October 2022. The methodological quality of the included literature was evaluated by the physiotherapy evidence database (PEDro) scale criteria. The review focused on evaluating the changes in depression risk or symptoms of HIIT interventions in healthy individuals, patients with depression, and patients with other disorders co-morbid with depression. Consequently, the mechanisms associated with depression related HIIT were summarized. Results A total of 586 participants (52 % female; mean age: 43.58±8.93 years) from 22 studies were included. Implementing HIIT using different exercise types alleviates depressive symptoms in individuals with depression and in individuals with depression who have exhibited comorbidities and reduced depression scale scores in subjects immediately after acute exercise. In addition, the long-interval HIIT and short-interval HIIT in the treatment of patients with cardiovascular or psychiatric disorders may reduce depressive symptoms via complex exercise-related changes on several levels, including by effecting the following measures: releasing monoamines, reducing neuronal death, inducing neurogenesis, modulating the functional homeostasis of the HPA axis, and enhancing the level of inflammation in the body. Conclusion HIIT is a relatively safe and effective antidepressant, which may involve multiple neurobiological mechanisms (release of monoamines, reducing neuronal death, inducing neurogenesis, modulating the functional homeostasis of the HPA axis, and enhancing the level of inflammation in the body), thereby reducing the risk or symptoms of depression in participants.
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Affiliation(s)
- Yuxiang Xu
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng 475004, China
| | - Yongjie Li
- Department of rehabilitation medicine, Beijing Jishuitan Hospital Guizhou Hospital, Guiyang, China
| | - Changqing Wang
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng 475004, China
| | - Tingting Han
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng 475004, China
| | - Yue Wu
- Hubei Superior Discipline Group of Exercise and Brain Science from Hubei Provincial, Wuhan Sports University, Wuhan 430079, China
| | - Song Wang
- Hubei Superior Discipline Group of Exercise and Brain Science from Hubei Provincial, Wuhan Sports University, Wuhan 430079, China
| | - Jianshe Wei
- Institute for Brain Sciences Research, School of Life Sciences, Henan University, Kaifeng 475004, China
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Tyler J, Podaras M, Richardson B, Roeder N, Hammond N, Hamilton J, Blum K, Gold M, Baron DA, Thanos PK. High intensity interval training exercise increases dopamine D2 levels and modulates brain dopamine signaling. Front Public Health 2023; 11:1257629. [PMID: 38192549 PMCID: PMC10773799 DOI: 10.3389/fpubh.2023.1257629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/30/2023] [Indexed: 01/10/2024] Open
Abstract
Background Previous research has outlined the health benefits of exercise including its therapeutic potential for substance use disorders (SUD). These data have already been utilized and it is now common to find exercise as part of SUD treatment and relapse prevention programs. However, we need to better understand different exercise regimens and determine which would be the most beneficial for SUDs. Recently, high intensity interval training (HIIT) has gained attention in comparison with aerobic and resistance exercise. Little is known regarding the neurobiological mechanisms of HIIT, including its effects on dopamine signaling and receptor levels in the brain. The present study examined the effects of chronic HIIT exercise on dopamine signaling as measured by dopamine type 1-like receptor (D1R)-like, dopamine type 2-like receptor (D2R)-like, and tyrosine hydroxylase (TH) quantification in the brains of male and female rats as measured by [3H] SCH 23390 and [3H] spiperone autoradiography, and TH-immunoreactive optical density values. Methods Rats were separated in two groups: sedentary and HIIT exercise. Exercise was on a treadmill for 30 min daily (10 3 min cycles) for six weeks with progressive speed increased up to 0.8 mph (21.5 m/min). Results Results showed for D2R-like binding, a significant effect across the ventral caudate putamen (V CPU) between sexes, such that mean D2R-like binding was 14% greater for males than females. In the nucleus accumbens shell (Nac Shell), the HIIT Exercise rats showed 16% greater D2R-like binding as compared to the sedentary rats. No significant effects of HIIT exercise were found across groups for brain D1R-like binding levels or TH expression. Conclusion These results suggest that HIIT exercise can modulate dopamine signaling by way of increased D2R. These findings support the premise that HIIT exercise plays an important role in dopamine signaling and, may provide a potential mechanism for how HIIT exercise can impact the brain and behavior.
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Affiliation(s)
- John Tyler
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
- Department of Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
| | - Madeline Podaras
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
- Department of Engineering and Applied Sciences, University at Buffalo, Buffalo, NY, United States
| | - Brittany Richardson
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
- Department of Psychology, University at Buffalo, Buffalo, NY, United States
| | - Nicole Roeder
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
- Department of Psychology, University at Buffalo, Buffalo, NY, United States
| | - Nikki Hammond
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
| | - John Hamilton
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
| | - Kenneth Blum
- Center for Sports, Exercsie and Mental Health, Western University of Health Sciences, Pomona, CA, United States
| | - Mark Gold
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - David A. Baron
- Center for Sports, Exercsie and Mental Health, Western University of Health Sciences, Pomona, CA, United States
| | - Panayotis K. Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions (BNNLA), Research Institute on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
- Department of Psychology, University at Buffalo, Buffalo, NY, United States
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Santos A, Braaten K, MacPherson M, Vasconcellos D, Vis-Dunbar M, Lonsdale C, Lubans D, Jung ME. Rates of compliance and adherence to high-intensity interval training: a systematic review and Meta-analyses. Int J Behav Nutr Phys Act 2023; 20:134. [PMID: 37990239 PMCID: PMC10664287 DOI: 10.1186/s12966-023-01535-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 11/07/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND To determine rates of compliance (i.e., supervised intervention attendance) and adherence (i.e., unsupervised physical activity completion) to high-intensity interval training (HIIT) among insufficiently active adults and adults with a medical condition, and determine whether compliance and adherence rates were different between HIIT and moderate-intensity continuous training (MICT). METHODS Articles on adults in a HIIT intervention and who were either insufficiently active or had a medical condition were included. MEDLINE, EMBASE, PsychINFO, SPORTDiscus, CINAHL, and Web of Science were searched. Article screening and data extraction were completed by two independent reviewers. Risk of bias was assessed using RoB 2.0 or ROBINS-I. Meta-analyses were conducted to discern differences in compliance and adherence between HIIT vs. MICT. Sensitivity analyses, publication bias, sub-group analyses, and quality appraisal were conducted for each meta-analysis. RESULTS One hundred eighty-eight unique studies were included (n = 8928 participants). Compliance to HIIT interventions averaged 89.4% (SD:11.8%), while adherence to HIIT averaged 63% (SD: 21.1%). Compliance and adherence to MICT averaged 92.5% (SD:10.6%) and 68.2% (SD:16.2%), respectively. Based on 65 studies included in the meta-analysis, compliance rates were not different between supervised HIIT and MICT interventions [Hedge's g = 0.015 (95%CI: - 0.088-0.118), p = .78]. Results were robust and low risk of publication bias was detected. No differences were detected based on sub-group analyses comparing medical conditions or risk of bias of studies. Quality of the evidence was rated as moderate over concerns in the directness of the evidence. Based on 10 studies, adherence rates were not different between unsupervised HIIT and MICT interventions [Hedge's g = - 0.313 (95%CI: - 0.681-0.056), p = .096]. Sub-group analysis points to differences in adherence rates dependent on the method of outcome measurement. Adherence results should be interpreted with caution due to very low quality of evidence. CONCLUSIONS Compliance to HIIT and MICT was high among insufficiently active adults and adults with a medical condition. Adherence to HIIT and MICT was relatively moderate, although there was high heterogeneity and very low quality of evidence. Further research should take into consideration exercise protocols employed, methods of outcome measurement, and measurement timepoints. REGISTRATION This review was registered in the PROSPERO database and given the identifier CRD42019103313.
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Affiliation(s)
- Alexandre Santos
- Faculty of Health and Social Development, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada
| | - Kyra Braaten
- Faculty of Health and Social Development, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada
| | - Megan MacPherson
- Faculty of Health and Social Development, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada
| | - Diego Vasconcellos
- Institute for Positive Psychology & Education, Australian Catholic University, Melbourne, Victoria, Australia
| | - Mathew Vis-Dunbar
- Library, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada
| | - Chris Lonsdale
- Institute for Positive Psychology & Education, Australian Catholic University, Melbourne, Victoria, Australia
| | - David Lubans
- School of Education, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Mary E Jung
- Faculty of Health and Social Development, University of British Columbia - Okanagan Campus, Kelowna, British Columbia, Canada.
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Piché F, Daneau C, Plourde C, Girard S, Romain AJ. Characteristics and impact of physical activity interventions during substance use disorder treatment excluding tobacco: A systematic review. PLoS One 2023; 18:e0283861. [PMID: 37099488 PMCID: PMC10132651 DOI: 10.1371/journal.pone.0283861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 03/19/2023] [Indexed: 04/27/2023] Open
Abstract
Substance use disorder is a worldwide issue that entails negative health and physical activity is a promising complementary therapy for alleviating the consequences. The objective of this reviews is to characterize physical activity interventions offered in the literature and explore their effects during treatment for people with substance use disorders with excluding studies focusing only on tobacco use. A systematic search of seven databases on articles including a physical activity intervention during a treatment for substance use disorder was done and an examination of the presence of bias was performed. A total of 43 articles including 3135 participants were identified. Most studies were randomized controlled trial (81%), followed by pre-post design (14%) and cohort studies (5%). The most common physical activity intervention identified was of moderate intensity, 3 times per week (≈ 1 hour) for 13 weeks. Cessation/reduction of substance use was the most studied outcome (21 studies, 49%), and 75% showed a decrease in substance use following physical activity intervention. Aerobic capacity was the second most studied effect (14 studies, 33%), with more than 71% of studies showing improvement. Twelve studies (28%) reported a decrease of depressive symptoms. Physical activity interventions in a treatment for substance use disorder seem to be a promising, but more methodologically rigorous scientific studies are needed.
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Affiliation(s)
- Florence Piché
- Department of Human Kinetics, University of Quebec in Trois-Rivières, Trois-Rivières, Québec, Canada
- Faculty of Medicine, University of Montreal, Montreal, Québec, Canada
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Québec, Canada
| | - Catherine Daneau
- Department of Human Kinetics, University of Quebec in Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Chantal Plourde
- Department of Psychoeducation, University of Quebec in Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Stéphanie Girard
- Department of Human Kinetics, University of Quebec in Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Ahmed Jérôme Romain
- Faculty of Medicine, University of Montreal, Montreal, Québec, Canada
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Québec, Canada
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Haberstroh C, Weider S, Flemmen G, Loe H, Andersson HW, Hallgren M, Mosti MP. The effect of high-intensity interval training on cognitive function in patients with substance use disorder: Study protocol for a two-armed randomized controlled trial. Front Sports Act Living 2022; 4:954561. [PMID: 36570498 PMCID: PMC9780390 DOI: 10.3389/fspor.2022.954561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 11/21/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction Substance use disorder (SUD) is characterized by cognitive impairment, especially executive dysfunction. Executive function is recognized as an important determinant of treatment outcome as it is associated with dropout rate, attendance to therapy and potential relapse after treatment termination. Physical activity can have beneficial effects on cognitive function, but there is still a lack of knowledge regarding potential benefits of aerobic exercise for executive function in SUD treatment. The aim of this study is to examine the effect of aerobic high-intensity interval training (HIIT) on cognitive function and the subsequent effect on treatment outcome in patients with SUD. Methods and analysis This study is a randomized controlled trial, including men and women ≥18 years with diagnosed SUD by ICD-10. The patients will be recruited from the department for inpatient treatment at Blue Cross - Lade Addiction Treatment Center, Trondheim, Norway. Participants will be randomized 1:1 into either HIIT (3x/week) + treatment as usual (TAU), or TAU alone. Study outcomes will be assessed at baseline, after eight weeks of intervention, and at 3- and 12-months follow-up. The primary outcome is to compare the change in executive function (via altered BRIEF-A score, Behavior Rating Inventory of Executive Function-Adult) measured between the two study groups after eight weeks. Secondary outcomes include mapping of cognitive function in different subgroups (e.g. type of substance, age, fitness level), collecting self-reported information about quality of life, craving, sleep quality, etc., as well as assessing compliance to TAU and long-term treatment outcome. Ethics and dissemination The project was approved by the Regional Ethical Committee and will be performed in accordance with this protocol and the Declaration of Helsinki. Written informed consent will be obtained from all participants prior to inclusion. This project will explore a novel approach to how exercise can be applied in SUD treatment, beyond the well-known effects on physical health. We expect to achieve new knowledge in regard to what extent HIIT can improve cognitive abilities and subsequent treatment outcome in SUD. Trial registration number https://www.clinicaltrials.gov/NCT05324085.
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Affiliation(s)
- Carolin Haberstroh
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St Olavs University Hospital, Trondheim, Norway,Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway,Correspondence: Carolin Haberstroh Mats Peder Mosti
| | - Siri Weider
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Grete Flemmen
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St Olavs University Hospital, Trondheim, Norway,Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Henrik Loe
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St Olavs University Hospital, Trondheim, Norway
| | - Helle Wessel Andersson
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St Olavs University Hospital, Trondheim, Norway
| | - Mats Hallgren
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Mats Peder Mosti
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St Olavs University Hospital, Trondheim, Norway,Correspondence: Carolin Haberstroh Mats Peder Mosti
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10
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Yin Y, Yang S, Xiao K, Wang T, Wang J, Schöllhorn WI, Zhu D, Pang X. Comparison of the acute effects of Tai chi versus high-intensity interval training on inhibitory control in individuals with substance use disorder. Front Psychol 2022; 13:941719. [PMID: 36267065 PMCID: PMC9577467 DOI: 10.3389/fpsyg.2022.941719] [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: 05/12/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
Abstract
Objective The purpose of this study is to investigate the effects of a single session of Tai chi (TC) exercise and high-intensity interval training (HIIT) on inhibitory control in individuals with substance use disorder (SUD). Methods A total 47 males with methamphetamine dependence were recruited from a compulsory drug rehabilitation center; participation in this study was voluntary. The participants were randomly assigned to the TC group or the HIIT group, and computer-based Go/No-go and Stroop tasks were used to assess inhibitory control in an indoor setting prior to and following exercise. Independent sample t-test was applied for baseline comparison of continuous variables, while analysis of variance was applied to test differences in the effect of each intervention before and after a single session of exercise. Results In Go/No-go test, the reaction time of the TC and HIIT groups in the post-test was shorter than that at the baseline, and the response accuracy of the post-test were higher than that of the baseline. In the Stroop task, the reaction time of two groups in the post-test was shorter than that at the baseline; while, greater improvement in response accuracy was observed in HIIT group in the post-test than that of the baseline. Conclusion Both TC and HIIT can promote inhibitory control in individuals with SUD. Compared with the TC group, the HIIT group showed greater improvements in response accuracy. These findings demonstrate the potential of TC and HIIT in improving cognition in SUD. Clinical trial registration [http://www.chictr.org.cn/], identifier [ChiCTR1900022158].
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Affiliation(s)
- Yanqiang Yin
- Department of PE and Military Training, Zhejiang Sci-Tech University, Hangzhou, China
| | - Suyong Yang
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Ke Xiao
- Department of Physiological Rehabilitation, Shanghai Drug Administration, Shanghai, China
| | - Tianyuan Wang
- College of Wushu, Shanghai University of Sport, Shanghai, China
| | - Jiabin Wang
- College of Wushu, Shanghai University of Sport, Shanghai, China
| | - Wolfgang I. Schöllhorn
- Department of Training and Movement Science, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Dong Zhu
- School of International Education, Shanghai University of Sport, Shanghai, China
| | - Xiaowu Pang
- Department of Physical Education, Hangzhou Medical College, Hangzhou, China
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11
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Loe H, Mosti MP, Wisløff U, Haberstroh C, Flemmen G. Cardiopulmonary and muscular effects of different doses of high-intensity physical training in substance use disorder patients: study protocol for a block allocated controlled endurance and strength training trial in an inpatient setting. BMJ Open 2022; 12:e061014. [PMID: 36167363 PMCID: PMC9516060 DOI: 10.1136/bmjopen-2022-061014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Patients with substance use disorder (SUD) have high prevalence of lifestyle-related comorbidities. Physical exercise is known to yield substantial prophylactic impact on disease and premature mortality, and there seems to be an inverse association between physical fitness and adverse health outcomes. High-intensity training is regarded as most effective for improving physical fitness, but less is known concerning the ideal training dose necessary to achieve clinically relevant effects in these patients. The aim of this study is to compare the effect of low-dose and high-dose, high-intensity training, on physical fitness in patients diagnosed with SUD. METHODS AND ANALYSIS This study will recruit 40 in-patients of mixed genders, aged 18-70 years. Participants will be block allocated to low-dose or high-dose training, encompassing 24 high-intensity interval and maximal strength training sessions (3/week × 8 weeks). After a 10 min warm-up, the low-dose group will perform 1×4 min intervals at ⁓90% of maximal heart rate and 2×4 repetitions strength training at ⁓90% of 1 repetition maximum. The high-dose group will perform 4×4 min intervals at ⁓90% of maximal heart rate and 4×4 repetitions strength training at ⁓90% of 1 repetition maximum. Clinical measurements and physical tests will be conducted at baseline, midway and on completion and a questionnaire on physical activity will be administered at baseline. ETHICS AND DISSEMINATION This protocol is in accordance with the Standard Protocol Items: Recommendations for Interventional Trials statement. All participants will sign a written informed consent. The Regional Committee of Medical Research Ethics, Norway has approved the study. A study of this kind is warranted, and the results will be published in an open access journal to ensure public access, and presented at national and international conferences. TRIAL REGISTRATION NUMBER NCT04065334.
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Affiliation(s)
- Henrik Loe
- Department of Research and Development, Clinic of Substance use and Addicition Medicine, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway
| | - Mats Peder Mosti
- Department of Research and Development, Clinic of Substance use and Addicition Medicine, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ulrik Wisløff
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Carolin Haberstroh
- Department of Research and Development, Clinic of Substance use and Addicition Medicine, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway
| | - Grete Flemmen
- Department of Research and Development, Clinic of Substance use and Addicition Medicine, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway
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12
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Brobakken MF, Nygård M, Wang E. Physical Health Impairment and Exercise as Medicine in Severe Mental Disorders: A Narrative Review. SPORTS MEDICINE - OPEN 2022; 8:115. [PMID: 36107334 PMCID: PMC9478018 DOI: 10.1186/s40798-022-00490-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/17/2022] [Indexed: 01/20/2023]
Abstract
BACKGROUND Individuals with severe mental disorders (SMDs; schizophrenia spectrum disorders, bipolar disorder, and major depressive disorder) are not only suffering from their mental conditions; they also have an attenuated physical health, augmenting their overall critical condition. OBJECTIVES We review and critically appraise the evidence based on (1) key physiological factors relating to aerobic endurance and skeletal muscle strength; (2) implications for physical function and health; and (3) effects of training interventions with different intensities evaluated in individuals with SMDs. FINDINGS Reductions in aerobic endurance factors, peak oxygen uptake (VO2peak) and walking work efficiency, are paralleled by reductions in maximal skeletal muscle strength and power. In turn, the poor aerobic endurance and muscle strength lead to impaired physical function, increased risk of lifestyle-related diseases, and ultimately early death. Exercise has the potential to counteract the attenuated physical health in people with SMDs. While aerobic endurance training is shown to increase VO2peak due to plasticity of the oxygen transport system, strength training is documented to improve maximal muscle strength, power, and walking work efficiency as a result of adaptations in neuromuscular force developing factors. CONCLUSIONS In conclusion, improvements in these key determinants for physical health appear to be achievable in people with SMDs despite many being challenged by motivational difficulties with attending regular exercise and have beneficial implications for physical function during activities of daily living, lifestyle-related diseases, and early death.
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Affiliation(s)
- Mathias Forsberg Brobakken
- grid.411834.b0000 0004 0434 9525Faculty of Health and Social Sciences, Molde University College, Molde, Norway ,grid.52522.320000 0004 0627 3560Department of Psychosis and Rehabilitation, Psychiatry Clinic, St. Olavs University Hospital, Trondheim, Norway
| | - Mona Nygård
- grid.52522.320000 0004 0627 3560Department of Psychosis and Rehabilitation, Psychiatry Clinic, St. Olavs University Hospital, Trondheim, Norway ,grid.5947.f0000 0001 1516 2393Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - Eivind Wang
- grid.411834.b0000 0004 0434 9525Faculty of Health and Social Sciences, Molde University College, Molde, Norway ,grid.52522.320000 0004 0627 3560Department of Psychosis and Rehabilitation, Psychiatry Clinic, St. Olavs University Hospital, Trondheim, Norway
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13
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Ribeiro JA, Schuch FB, Vargas KFM, Müller PT, Boullosa D. A Rapid Review of Randomized Trials Assessing the Effects of High-Intensity Interval Training on Depressive Symptoms in People with Mental Illness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10581. [PMID: 36078299 PMCID: PMC9518083 DOI: 10.3390/ijerph191710581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE to systematically search for randomized controlled trials comparing the effects of high-intensity interval training (HIIT) protocols vs. control without exercise or other exercise protocols, in patients with mental disorders experiencing depressive symptoms, and to provide some guidance based on the current HIIT literature to improve further interventions. METHODS we searched for relevant studies, published by 18 August 2022 on PubMed, Embase, PsycINFO and SPORTDiscus databases, that used a HIIT protocol, involving adults (≥18 years) with a diagnosis of a mental disorder, participating in a HIIT or a control condition, and assessed for depressive symptoms. RESULTS Four studies accounting for 108 participants (n HIIT = 55; n comparison groups = 53) met the inclusion criteria. Three out of the four studies included found significant improvements of depressive symptoms after 12 days to 8 weeks of intervention. However, there were no differences to other forms of low-to-moderate continuous exercise in 2/3 studies. CONCLUSIONS The limited evidence suggests the effectiveness of HIIT interventions for improving depressive symptoms in people with mental illness. However, HIIT was not superior to other exercise treatments, although a trend for its superiority may be recognized. A number of methodological issues should be considered in further interventions to better characterize and identify the most efficient HIIT modalities for the treatment of depressive symptoms in these patients.
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Affiliation(s)
- Jéssica Alves Ribeiro
- Program of Movement Sciences, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Felipe Barreto Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria 97105, Brazil
| | - Kleber F. Meneghel Vargas
- Maria Aparecida Pedrossian Hospital, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Paulo T. Müller
- Program of Movement Sciences, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
- Maria Aparecida Pedrossian Hospital, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
| | - Daniel Boullosa
- Program of Movement Sciences, Federal University of Mato Grosso do Sul, Campo Grande 79070-900, Brazil
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14
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Huhn AS, Ellis JD, Dunn KE, Sholler DJ, Tabaschek P, Burns R, Strain EC. Patient-reported sleep outcomes in randomized-controlled trials in persons with substance use disorders: A systematic review. Drug Alcohol Depend 2022; 237:109508. [PMID: 35660223 DOI: 10.1016/j.drugalcdep.2022.109508] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 05/18/2022] [Accepted: 05/18/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Sleep disturbances and disorders are a common and sometimes recalcitrant problem in persons recovering from substance use disorders (SUDs). As such, several randomized-controlled trials (RCTs) have been conducted to address sleep disturbances in a variety of SUD subpopulations and clinical scenarios. The goal of this systematic review was to collate patient-reported sleep outcomes used in past SUD-related RCTs to provide guidance for future sleep research in persons with SUDs. METHODS This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) on May 7th, 2020 (CRD42020182004). Studies were included if they were peer-reviewed manuscripts describing RCTs in an SUD population. RESULTS The initial search yielded 13,403 candidate articles, and 76 met a priori criteria and were included in this review. Thirty-five (46.1%) assessed sleep as a primary outcome (i.e., sleep improvement was the primary goal of the research) and 41 (53.9%) assessed sleep as a secondary outcome (i.e., sleep improvement was an important outcome, but not the primary outcome). The most commonly used measures included the Pittsburgh Sleep Quality Index, the Insomnia Severity Index, and sleep diaries. However, multiple additional sleep assessments were also used, including visual analogue and Likert scales. CONCLUSIONS The field of addiction medicine would benefit from a streamlined approach in assessing patient-reported sleep in RCTs, including commonly used and validated assessments of sleep quality, inserting daily or repeated measures into RCTs, and including questionnaires that assess clinically relevant insomnia or other sleep disorders.
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Affiliation(s)
- Andrew S Huhn
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA.
| | - Jennifer D Ellis
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
| | - Kelly E Dunn
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
| | - Dennis J Sholler
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
| | - Paula Tabaschek
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
| | - Rachel Burns
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
| | - Eric C Strain
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA
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15
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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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16
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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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17
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Dowla R, Sinmaz H, Mavros Y, Murnion B, Cayanan E, Rooney K. The Effectiveness of Exercise as an Adjunct Intervention to Improve Quality of Life and Mood in Substance Use Disorder: A Systematic Review. Subst Use Misuse 2022; 57:911-928. [PMID: 35354366 DOI: 10.1080/10826084.2022.2052098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Introduction: Quality of life and affective outcomes offer a perspective of the burden of disease experienced by people with substance use disorder. This can be considered an alternative measure of substance use disorder severity. This review aims to evaluate the impact of exercise as a novel intervention on quality of life and affect in substance use disorder. Method: Medline, CINAHL, Amed, Web of Science core collections, Embase, PsychINFO and SportDISCUS databases were searched from inception to August 2021 for studies that assessed the impact of exercise on mood, depression, anxiety and quality of life outcomes in substance use disorder. Exercise interventions of any duration were included. Results: Forty-two studies met the inclusion criteria. Quality of life scores improved with larger effects seen in studies with two or more sessions per week. Depression and anxiety scores decreased, with 19 of the 25 data sets reporting a reduction in depression (effect size 0.2-1.86) and 13 of the 17 data sets reporting a reduction in anxiety (effect sizes 0.2-1.42). Mood improved in six of the seven data sets reviewed with effect sizes ranging from 0.34 to 1.13. Discussion: Included studies had numerous methodological flaws therefore results need to be interpreted with caution. Further research needs to be completed with more rigorous methodologies to support these results. Conclusions: Results indicate promising responses to exercise as a novel intervention for quality of life and mood in substance use disorder, however further research of high methodological quality is needed to confirm.
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Affiliation(s)
- Rhiannon Dowla
- Faculty of Medicine and Health, Susan Wakil Health Building, University of Sydney, Sydney, Australia.,Missenden Mental Health Service, Sydney Local Health District, Sydney, Australia
| | - Hulya Sinmaz
- Faculty of Medicine and Health, Susan Wakil Health Building, University of Sydney, Sydney, Australia
| | - Yorgi Mavros
- Faculty of Medicine and Health, Susan Wakil Health Building, University of Sydney, Sydney, Australia
| | - Bridin Murnion
- Faculty of Medicine and Health, Susan Wakil Health Building, University of Sydney, Sydney, Australia.,Central Coast Local Health District, Gosford, Australia
| | - Elizabeth Cayanan
- Faculty of Medicine and Health, Susan Wakil Health Building, University of Sydney, Sydney, Australia.,The Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
| | - Kieron Rooney
- Faculty of Medicine and Health, Susan Wakil Health Building, University of Sydney, Sydney, Australia
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18
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Effects of High-Intensity Interval Training on Sleep: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010973. [PMID: 34682718 PMCID: PMC8535574 DOI: 10.3390/ijerph182010973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/07/2021] [Accepted: 10/13/2021] [Indexed: 12/14/2022]
Abstract
Objectives: To use a quantitative approach to examine the effects of high-intensity interval training (HIIT) interventions on sleep for adults. Methods: PubMed, Ebsco, Web of Science, Cochrane Central Register of Controlled Trials, the China National Knowledge Infrastructure, and Wanfang Data were searched from their inception to December 2020. Intervention studies with a control group that examined the effects of HIIT interventions on sleep were included in this meta-analysis. The risk of bias was assessed using the tool provided by the Cochrane Handbook for Systematic Reviews of Interventions. Effect sizes (ESs), calculated as weighted mean difference (WMD) and standardized mean difference (SMD), were used to examine the effects of objective outcomes and subjective outcomes separately. Results: A large increase in sleep quality (SQ) reflected by the Pittsburgh Sleep Quality Index global scores [WMD = −0.90, 95%CI (−1.72, −0.07), p = 0.03, n = 8] and a small-to-medium favorable effect on sleep efficiency (SE) [SMD = 0.43, 95%CI (0.20, 0.65), p = 0.0002, n = 10] were found after HIIT intervention. In addition, sub-analyses results suggest that ESs were moderated by the type, duration and frequency, as well as the length of the HIIT intervention. Conclusions: HIIT may be a promising way to improve overall subjective SQ and objective SE. PROSPERO, protocol registration number: CRD42021241734.
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19
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Yan-Guang Y, Jing-Yi C, Xiao-Wu P, Meng-Lu S, Su-Yong Y, Ding X, Ke X, Tian-Yuan W, Jia-Bin W, Dong Z. Comparison of physical effect between two training methods for individuals with substance use disorder. BMC Sports Sci Med Rehabil 2021; 13:6. [PMID: 33478548 PMCID: PMC7818546 DOI: 10.1186/s13102-021-00234-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 01/14/2021] [Indexed: 12/11/2022]
Abstract
Background HIIT has recently been widely used for health promotion in healthy people and patients with chronic diseases. Exercise can help SUD reduce drug cravings, enhance mental health and return to normal life. However, whether HIIT can bring better physical rehabilitation benefits to individuals with SUD than MICT is unclear. The study aimed to compare the effects of HIIT versus MICT on the physical fitness of individuals with SUD. Methods One hundred twenty individuals with amphetamine-type stimulant dependence voluntarily participated in this study. They were randomly assigned to the HIIT group and MICT group. Both groups received training three times a week. The intervention lasted from January 2019 to December 2019. Physical fitness was assessed at the baseline, 3 months, 6 months, 9 months and 12 months, including blood pressure (BP), vital capacity(VC), hand grip, push-up, sit-and-reach, one-leg standing with eyes closed and choice reaction time. The craving level was assessed using the Visual Analog Scale at baseline, 6 months and 12 months to see any change along with the improvement in physical fitness. Two-way repeated measures ANOVA was applied to analyse the differences in change by group (HIIT and MICT) and time (baseline, 3 months, 6 months, 9 months and 12 months). Results The within-group factor displayed significant changes in the HIIT and MICT groups in terms of systolic BP (F (4,336) = 12.799, P < 0.001,η2 = 0.204), diastolic BP (F(4,336) = 9.495, P < 0.001, η2 = 0.16), VC (F(4,336) = 18.121, P < 0.001, η2 = 0.177), hand grip (F(4,336) = 34.815, P < 0.001, η2 = 0.293), sit-and-reach (F(4,336) = 13.871, P < 0.001, η2 = 0.142), push-up (F(4,336) = 28.805, P < 0.001, η2 = 0.255), one-leg standing with eyes closed (F(4,336) = 14.495, P < 0.001, η2 = 0.156) and choice reaction time (F(4,336) = 20.603, P < 0.001, η2 = 0.197). The craving level decreased after 12 months of intervention in both groups (F(2,168) = 11.25, P < 0.001, η2 = 0.118), but no significant differences in physical fitness and craving level were found in between groups and the interactions of group × time. Conclusions After 12 months of intervention, physical fitness improved while craving level decreased in the two groups. These findings suggest that both HIIT and MICT have positive effects on individuals with SUD in terms of physical fitness. Trial registration ChiCTR1900022158 Chinese Clinical Trial Registry: Registered 27th March, 2019.
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Affiliation(s)
- Yang Yan-Guang
- Wushu College, Shanghai University of Sport, 200438, Shanghai, China
| | - Chen Jing-Yi
- Wushu College, Shanghai University of Sport, 200438, Shanghai, China
| | - Pang Xiao-Wu
- Wushu College, Shanghai University of Sport, 200438, Shanghai, China
| | - Shen Meng-Lu
- Wushu College, Shanghai University of Sport, 200438, Shanghai, China
| | - Yang Su-Yong
- School of Sport Psychology, Shanghai University of Sport, 200438, Shanghai, China
| | - Xu Ding
- Shanghai Drug Administration, 200080, Shanghai, China
| | - Xiao Ke
- Shanghai Gaojing Drug Compulsory Detoxification and Rehabilitation Center, 200439, Shanghai, China
| | - Wang Tian-Yuan
- Wushu College, Shanghai University of Sport, 200438, Shanghai, China
| | - Wang Jia-Bin
- Wushu College, Shanghai University of Sport, 200438, Shanghai, China
| | - Zhu Dong
- School of International Education, Shanghai University of Sport, 200438, 650 Qing Yuan Huan road, Yang Pu District, Shanghai, China.
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20
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Brobakken MF, Nygård M, Güzey IC, Morken G, Reitan SK, Heggelund J, Vedul-Kjelsaas E, Wang E. One-year aerobic interval training in outpatients with schizophrenia: A randomized controlled trial. Scand J Med Sci Sports 2020; 30:2420-2436. [PMID: 33108030 DOI: 10.1111/sms.13808] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 08/03/2020] [Accepted: 08/11/2020] [Indexed: 12/25/2022]
Abstract
Although aerobic interval training (AIT) is recognized to attenuate the risk of cardiovascular disease (CVD) and premature mortality, it appears that it rarely arrives at patients' doorsteps. Thus, this study investigated 1-year effects and feasibility of AIT delivered with adherence support in collaborative care of outpatients with schizophrenia. Forty-eight outpatients (28 men, 35 [31-38] (mean [95% confidence intervals]) years; 20 women, 36 [30-41] years) with schizophrenia spectrum disorders (ICD-10) were randomized to either a collaborative care group provided with municipal transportation service and training supervision (walking/running 4 × 4 minutes at ~90% of peak heart rate; HRpeak ) 2 d wk-1 at the clinic (TG) or a control group (CG) given 2 introductory AIT sessions and advised to continue training. Directly assessed peak oxygen uptake ( V ˙ O 2 peak ) increased in the TG after 3 months (2.3 [0.6-4.4] mL kg-1 min-1 , Cohen's d = 0.33[-4.63 to 4.30], P = 0.04), 6 months (2.7 [0.5-4.8] mL kg-1 min-1 , Cohen's d = 0.42[-4.73 to 4.11], P = 0.02) and 1 year (4.6 [2.3-6.8] mL kg-1 min-1 , Cohen's d = 0.70[-4.31 to 4.10], P < 0.001) compared to the CG. One-year cardiac effects revealed higher HRpeak (7 [2-11] b min-1 , Cohen's d = 0.34[-8.48 to 8.65], P = 0.01), while peak stroke volume tended to be higher (0.9 [-0.2 to 2.0] mL b-1 , Cohen's d = 0.35[-1.62 to 2.01], P = 0.11) in the TG compared to the CG. Conventional risk factors (body weight, waist circumference, blood pressure, and lipids/glucose) remained unaltered in both groups. One-year AIT adherence rates were 15/25 (TG; different from CG: P < 0.001) and 0/23 (CG). AIT was successfully included in long-term collaborative care of outpatients with schizophrenia and yielded improved V ˙ O 2 peak , advocating this model for aerobic capacity improvement and CVD risk reduction in future treatment.
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Affiliation(s)
- Mathias Forsberg Brobakken
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Østmarka, Division of Mental Health Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Mona Nygård
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Østmarka, Division of Mental Health Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Ismail Cüneyt Güzey
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Research and Development, Division of Mental Health Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Gunnar Morken
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Østmarka, Division of Mental Health Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Solveig Klaebo Reitan
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Research and Development, Division of Mental Health Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Jørn Heggelund
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Regional Centre for Healthcare Improvement, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Einar Vedul-Kjelsaas
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Research and Development, Division of Mental Health Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Eivind Wang
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Faculty of Health and Social Sciences, Molde University College, Molde, Norway.,Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
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21
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Giménez-Meseguer J, Tortosa-Martínez J, Cortell-Tormo JM. The Benefits of Physical Exercise on Mental Disorders and Quality of Life in Substance Use Disorders Patients. Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3680. [PMID: 32456164 PMCID: PMC7277811 DOI: 10.3390/ijerph17103680] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 12/16/2022]
Abstract
Physical exercise seems to have a promising effect on numerous variables related to the recovery of drug-dependent patients. However, some contradictions are found in the literature. The aim of this study was to perform a systematic review and meta-analysis in order to identify the effect of physical exercise on mental disorders, quality of life, abstinence, and craving, and make a comparison of the effect of exercise depending on the type of program. A search for articles was conducted using PubMed, Web of Science, and Scopus databases. Studies were selected that measured the acute effects or long-term effect (≥2 weeks) of exercise in patients who met criteria for alcohol use disorders or substance use disorders. A total of 59 studies were included. An effect of exercise on quality of life and mental disorders was identified. Subgroup analysis revealed an effect of exercise on stress (SMD = 1.11 (CI: 0.31, 1.91); z = 2.73; p = 0.006), anxiety (SMD = 0.50 (CI: 0.16, 0.84); z = 2.88; p = 0.004) and depression (SMD = 0.63 (CI: 0.34, 0.92); z = 4.31; p < 0.0001), and an effect of exercise on the eight variables included in the SF36 test. The results also showed a trend towards a positive effect on craving (SMD = 0.89 (CI: −0.05, 1.82); z = 1.85, p = 0.06). Body-mind activities and programs based on improving physical conditions produced similar results in mental disorders and quality of life. Available evidence indicates that physical exercise, both body-mind and physical fitness programs, can be effective in improving mental disorders, craving, and quality of life in drug-dependent patients.
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Affiliation(s)
| | - Juan Tortosa-Martínez
- Faculty of Education, University of Alicante, 03690 San Vicente del Raspeig, Spain; (J.G.-M.); (J.M.C.-T.)
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22
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Eather N, Beauchamp MR, Rhodes RE, Diallo TMO, Smith JJ, Jung ME, Plotnikoff RC, Noetel M, Harris N, Graham E, Lubans DR. Development and Evaluation of the High-Intensity Interval Training Self-Efficacy Questionnaire. JOURNAL OF SPORT & EXERCISE PSYCHOLOGY 2020; 42:114-122. [PMID: 32150720 DOI: 10.1123/jsep.2019-0166] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 11/06/2019] [Accepted: 12/05/2019] [Indexed: 06/10/2023]
Abstract
This study involved the design and evaluation of the High-Intensity Interval Training Self-Efficacy Questionnaire (HIIT-SQ). Phase 1: Questionnaire items were developed. Phase 2: Australian adolescents (N = 389, 16.0 ± 0.4 years, 41.10% female) completed the HIIT-SQ, and factorial validity of the measurement model was explored. Phase 3: Adolescents (N = 100, age 12-14 years, 44% female) completed the HIIT-SQ twice (1 week apart) to evaluate test-retest reliability. Confirmatory factor analysis of the final six items (mean = 3.43-6.73, SD = 0.99-25.30) revealed adequate fit, χ2(21) = 21, p = .01, comparative fit index = .99, Tucker-Lewis index = .99, root mean square of approximation = .07, 90% confidence interval [.04, .11]. Factor loading estimates showed that all items were highly related to the factor (estimates range: 0.81-0.90). Intraclass coefficients and typical error values were .99 (95% confidence interval [.99, 1.00]) and .22, respectively. This study provides preliminary evidence for the validity and reliability of scores derived from the HIIT-SQ in adolescents.
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23
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Martland R, Mondelli V, Gaughran F, Stubbs B. Can high intensity interval training improve health outcomes among people with mental illness? A systematic review and preliminary meta-analysis of intervention studies across a range of mental illnesses. J Affect Disord 2020; 263:629-660. [PMID: 31780128 DOI: 10.1016/j.jad.2019.11.039] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 11/04/2019] [Accepted: 11/09/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND High intensity interval training (HIIT) may have beneficial effects among people with mental illnesses. The aim of this systematic review was to establish the benefits, safety and adherence of HIIT interventions across all categories of mental illness. METHODS Major databases were searched from inception to 18/2/2019 for intervention studies investigating HIIT among people with mental illnesses. Study quality was assessed via the PEDro scale, intervention characteristics were reported using the TIDier and CERT checklists and findings narratively summarised. A preliminary meta-analysis was undertaken where possible. RESULTS 12 intervention studies, (including 7 RCTs), were included. Evidence suggested HIIT improved cardiorespiratory fitness (5/8 intervention studies,63%), anthropometric variables (3/4,75%), mental health outcomes (9/12, 75%), cardiovascular fitness (5/9,56%), physical fitness (1/1,100%) and motor skills (1/1,100%), compare to pre-training. The preliminary meta-analysis of pre-post changes found HIIT reduced depression severity (Standardised mean difference (SMD):-1.36 [95%CI-1.63;-1.089], p<0.0001) and possibly improved VO2max (SMD:0.18 [95%CI -0.02; 0.37], p = 0.08) in people with depression. HIIT increased High-Density-Lipoprotein (SMD:0.373 [95%CI 0.18; 0.57], p = 0.0002) and possibly reduced general psychopathology (SMD:-1.58 [95%CI -3.35; 0.18], p = 0.08) in people with schizophrenia-spectrum disorders. No acute injuries were reported, mean adherence to HIIT sessions ranged from 64-94%, and dropout ranged from 0--50%. LIMITATIONS Results were limited to a small number of low-to-moderate quality intervention studies. CONCLUSION These findings suggest HIIT may improve a range of physical and mental health outcomes among people with mental illnesses. Nonetheless, high-quality well-powered trials are needed to reaffirm these findings, and future research should address the seemingly high rate of dropout.
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Affiliation(s)
- Rebecca Martland
- Department of Psychosis Studies, King's College London, London, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London, United Kingdom.
| | - Valeria Mondelli
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London, United Kingdom
| | - Fiona Gaughran
- Department of Psychosis Studies, King's College London, London, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London, United Kingdom; South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom
| | - Brendon Stubbs
- Department of Psychological Medicine, King's College London, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), London, United Kingdom; South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, United Kingdom
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24
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Korman N, Armour M, Chapman J, Rosenbaum S, Kisely S, Suetani S, Firth J, Siskind D. High Intensity Interval training (HIIT) for people with severe mental illness: A systematic review & meta-analysis of intervention studies- considering diverse approaches for mental and physical recovery. Psychiatry Res 2020; 284:112601. [PMID: 31883740 DOI: 10.1016/j.psychres.2019.112601] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 10/03/2019] [Accepted: 10/03/2019] [Indexed: 12/22/2022]
Abstract
There is a mortality gap of 15 to 20 years for people with severe mental illness (SMI - psychotic spectrum, bipolar, major depressive disorders). Modifiable risk factors include inactivity and low cardiorespiratory fitness (CRF). Exercise can improve mental and physical outcomes; optimal type and intensity of exercise for people with SMI has yet to be determined. High Intensity Interval training (HIIT) is an exercise with distinct cardio-metabolic advantages in other disease populations compared to traditional moderate intensity continuous training (MCT). We investigated the feasibility and efficacy of HIIT for people with SMI. Major electronic databases were searched, identifying HIIT studies for adults experiencing SMI.Data on feasibility, safety, study design, sample characteristics, and physical and psychological outcomes were extracted and systematically reviewed. Meta-analyses were conducted within group, pre and post HIIT interventions, and between group, to compare HIIT with control conditions. Nine articles were identified including three pre/post studies, one non randomised and five randomised trials, (366 participants, 45.1% female). HIIT appears as feasible as MCT, with few safety concerns. Following HIIT, there was a moderate improvement in CRF and depression. There was no difference between HIIT and MCT for adherence or CRF.HIIT improved depression more than MCT.
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Affiliation(s)
- Nicole Korman
- Metro South Addiction and Mental Health Services, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia.
| | - Michael Armour
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia
| | - Justin Chapman
- Metro South Addiction and Mental Health Services, Brisbane, Australia; Queensland Institute of Medical Research, Brisbane, Australia
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Australia
| | - Steve Kisely
- Metro South Addiction and Mental Health Services, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia
| | - Shuichi Suetani
- Metro South Addiction and Mental Health Services, Brisbane, Australia; Queensland Institute of Medical Research, Brisbane, Australia
| | - Joseph Firth
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia; Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Dan Siskind
- Metro South Addiction and Mental Health Services, Brisbane, Australia; School of Medicine, University of Queensland, Brisbane, Australia
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25
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Brobakken MF, Nygård M, Güzey IC, Morken G, Reitan SK, Heggelund J, Wang E, Vedul-Kjelsaas E. Aerobic interval training in standard treatment of out-patients with schizophrenia: a randomized controlled trial. Acta Psychiatr Scand 2019; 140:498-507. [PMID: 31565796 DOI: 10.1111/acps.13105] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/24/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To evaluate the feasibility and effects of integrating aerobic interval training (AIT) in standard care of out-patients with schizophrenia on aerobic capacity and conventional cardiovascular disease (CVD) risk factors. METHODS Out-patients with schizophrenia spectrum disorder were randomized to the following: 1) a training group (TG), performing AIT 2 day/week at the clinic with adherence support from municipal services; or 2) a control group (CG), given two AIT sessions and encouraged to exercise on their own. Feasibility was assessed through retention/adherence. V˙O2peak was measured directly along with conventional CVD risk factors before and after 12 weeks. RESULTS Of 48 out-patients, 16/25 and 18/23 completed the TG and CG respectively. After 12 weeks, V˙O2peak was higher (2.7 ± 4.8 ml/kg/min, P < 0.01) in the TG compared with the CG. The TG improved V˙O2peak by 3.1 ± 3.7 ml/kg/min (P < 0.01), while no change in the CG was observed. No intergroup difference in weight, body mass index (BMI), waist circumference, blood pressure, lipids, or glucose at posttest was observed. Weight (1.9 ± 4.0 kg, P < 0.05) and BMI (0.5 ± 1.1 kg/m2 , P < 0.05) increased in the CG, with no change in the TG. CONCLUSION AIT, combined with adherence support, of out-patients with schizophrenia was feasible, improved V˙O2peak , and may be integrated in standard care. (ClinicalTrials.gov identifier: NCT02743143).
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Affiliation(s)
- M F Brobakken
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Østmarka, Division of Mental Health Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - M Nygård
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Østmarka, Division of Mental Health Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - I C Güzey
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Research and Development, Division of Mental Health Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - G Morken
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Østmarka, Division of Mental Health Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - S K Reitan
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Research and Development, Division of Mental Health Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - J Heggelund
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Regional Center for Healthcare Improvement, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - E Wang
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Faculty of Health and Social Sciences, Molde University College, Molde, Norway.,Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - E Vedul-Kjelsaas
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Research and Development, Division of Mental Health Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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26
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Andreassen Ø, Brønnick K, Njå AL, Furulund E, Nesvåg S. The Effect of High-Intensity Interval/Circuit Training on Cognitive Functioning and Quality of Life During Recovery From Substance Abuse Disorder. A Study Protocol. Front Psychol 2019; 10:2564. [PMID: 31803108 PMCID: PMC6873325 DOI: 10.3389/fpsyg.2019.02564] [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: 07/24/2019] [Accepted: 10/30/2019] [Indexed: 01/07/2023] Open
Abstract
This proposed study will examine whether structured physical activity reduces the recovery time of cognitive functioning during the early phase of substance use disorder treatment. Addiction or substance dependence is associated with neurobiological changes and cognitive impairment that can affect quality of life and the efficacy of therapy for up to a year after clinical detoxification. The biological, psychological, and social effects of physical exercise have the potential to be a therapeutic approach to increase quality of life and relieve symptoms associated with substance abuse, such as psychosis, depression, and anxiety. There is a dearth of research on physical activity and exercise in clinical substance use disorder patients. This protocol describes a clinical study that will examine cognitive recovery after substance abuse using physical exercise as a treatment intervention. We will use a quasi-experimental longitudinal clinical trial, with a pretest and multiple posttests, on naturally randomized sequential groups. Patients will be consecutively be recruited into the study groups, with a control group that is completed, before its followed by an intervention group, each with 30 patients. Patients will be enrolled 2 weeks after the start of detoxification, at which time all subjects will be inpatients at the Stavanger Salvation Army Treatment Center in the Norwegian specialized healthcare system. Cognition will be evaluated with a comprehensive battery of cognitive tests, including several tests of executive function. Physical fitness will be tested with the Rockport 1-Mile Walk Test, the 30-S Chair Stand Test, the 1-Min Burpee Test at baseline (within the first 2 weeks of admittance) and after 4 weeks. The intervention will be a 30-min workout at 70–90% of maximum heart rate (134–170 bpm), recorded and calculated by a Polar heart rate monitor. The intervention treatment will be administered four times a week for 4 weeks and will consist of high-intensity circuit training, high-intensity interval training, functional movement, and primitive reflex training. We anticipate improvement in both the control and intervention groups, with the exercise intervention group having the greatest increase in recovery of cognitive function because of the combination of functional full body movements and primitive movement training in an intense interval training program. Clinical Trial Registration ID: ISRCTN74750479, Retrospectively Registered.
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Affiliation(s)
- Øyvind Andreassen
- Salvation Army Treatment Center Stavanger, Stavanger, Norway.,Center for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Kolbjørn Brønnick
- Department of Public Health, Faculty of Health Sciences, Stavanger, Norway.,Centre for Age-Related Medicine (SESAM), Stavanger University Hospital, Stavanger, Norway
| | - Anne-Lill Njå
- Center for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Einar Furulund
- Center for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
| | - Sverre Nesvåg
- Center for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway.,Department of Public Health, Faculty of Health Sciences, Stavanger, Norway
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27
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Brellenthin AG, Crombie KM, Hillard CJ, Brown RT, Koltyn KF. Psychological and endocannabinoid responses to aerobic exercise in substance use disorder patients. Subst Abus 2019; 42:272-283. [PMID: 31729933 DOI: 10.1080/08897077.2019.1680480] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Exercise has been examined as an adjunctive treatment for substance use disorders (SUDs), yet few exercise interventions have been conducted among patients undergoing intensive outpatient (IOP) treatment, who may be the most vulnerable to relapse and for whom exercise could provide the most benefits. This study examined the effects of aerobic exercise, in addition to IOP treatment, on psychological variables and endocannabinoids in individuals with SUDs. Methods: Twenty-one SUD patients (mean age 35 years) were recruited from local IOPs. Participants were randomized to either treatment-as-usual (TAU, at their outpatient clinic) or TAU plus aerobic exercise training (EX). EX participants engaged in supervised, moderate-intensity exercise for 30 min, 3 times/week for 6 weeks. TAU participants came into the laboratory once per week for assessments and a 30-min quiet rest session. Participants provided blood samples and completed questionnaires evaluating substance use, mood states, depression, anxiety, perceived stress, self-efficacy to abstain from substance use, and craving. Data were analyzed with Mann-Whitney U tests or mixed model ANOVAs to determine group differences in outcomes acutely and over 6 weeks. Results: Over 6 weeks, there were reductions in perceived stress (p < 0.01) and craving (p < 0.05) for both groups. There were no group differences in abstinence rates or changes from baseline in self-efficacy, depression, or anxiety (p > 0.05). Acutely, both exercise and quiet rest sessions led to reductions in craving, tension, depression, anger, confusion, and total mood disturbance (all ps < 0.05). In addition, the EX group experienced acute increases in vigor and circulating concentrations of the endocannabinoid, anandamide (p < 0.01). Conclusions: An adjunctive aerobic exercise program during SUD treatment was associated with similar reductions in perceived stress and drug craving as standard care. Thirty minutes of exercise or quiet rest led to acute improvements in mood, but exercise produced the additional benefit of increases in vigor and circulating anandamide.
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Affiliation(s)
- Angelique G Brellenthin
- Department of Kinesiology, University of Wisconsin, Madison, Wisconsin, USA.,Department of Kinesiology, Iowa State University, Ames, Iowa, USA
| | - Kevin M Crombie
- Department of Kinesiology, University of Wisconsin, Madison, Wisconsin, USA
| | - Cecilia J Hillard
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Randall T Brown
- Department of Family Medicine, University of Wisconsin, Madison, Wisconsin, USA
| | - Kelli F Koltyn
- Department of Kinesiology, University of Wisconsin, Madison, Wisconsin, USA
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28
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Brown J, Del Pozzi AT, Hicks-Little C. Anxiety Disorders and Exercise: The Role for Health and Fitness Professionals. Strength Cond J 2019. [DOI: 10.1519/ssc.0000000000000465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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29
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Mustafaoglu R, Demir R, Demirci AC, Yigit Z. Effects of core stabilization exercises on pulmonary function, respiratory muscle strength, and functional capacity in adolescents with substance use disorder: Randomized controlled trial. Pediatr Pulmonol 2019; 54:1002-1011. [PMID: 31026384 DOI: 10.1002/ppul.24330] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Revised: 02/16/2019] [Accepted: 03/24/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND Adolescent substance abuse is a serious and growing problem worldwide. The aim of this study was to investigate the effects of core stabilization exercises on pulmonary function, respiratory muscle strength, and functional capacity in adolescents with substance use disorder (SUD). METHODS This was a prospective randomized controlled trial. A total of 49 adolescent male patients with SUD were randomly assigned to either the exercise group (n = 25; mean age 16.6 years) or the control group (n = 24; mean age 16.7 years), for 6 weeks. All participants underwent a medical and behavioral therapy program 5 days a week for 6 weeks. The exercise group received five core stabilization exercises combined with deep breathing as a group training for 45 to 60 minutes, twice a week for 6 weeks, and the control group received recreational activities in addition to the usual care for 45 to 60 minutes, twice a week for 6 weeks. Spirometry, maximal inspiratory and expiratory pressures, and the 6-minute walk test were performed and measured at baseline and after training. RESULTS There were significant improvements in maximal inspiratory pressure (24.16 cm H2 O; P < 0.0001), maximal expiratory pressure (30.28 cm H2 O; P < 0.0001), forced vital capacity (5.80% predicted, P < 0.0001), forced expiratory volume in 1 second (7.34% predicted; P = 0.002), peak expiratory flow (13.32% predicted; P = 0.0003), forced expiratory flow 25%-75% (11.84% predicted; P = 0.027), and the 6-minute walking distance (65.84 m; P < 0.0001) in the exercise group compared with the control group. CONCLUSIONS Core stabilization exercise can improve pulmonary function, respiratory muscle strength, and functional capacity in adolescents with SUD.
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Affiliation(s)
- Rustem Mustafaoglu
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Rengin Demir
- Department of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Arzu Ciftci Demirci
- Department of Child and Adolescent Psychiatry, Bakirkoy Prof. Dr Mazhar Osman Mental and Neurological Diseases Research and Training Hospital, Istanbul, Turkey
| | - Zerrin Yigit
- Department of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
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30
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Abrantes AM, Blevins CE. Exercise in the context of substance use treatment: key issues and future directions. Curr Opin Psychol 2019; 30:103-108. [PMID: 31079012 DOI: 10.1016/j.copsyc.2019.04.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 03/19/2019] [Accepted: 04/01/2019] [Indexed: 01/09/2023]
Abstract
Substance Use Disorders (SUD) continue to be a significant public health concern. Exercise has been examined as an adjunctive approach to addiction treatment in an effort to improve mental health, physical health, and substance use outcomes. This review will present the existing evidence for the efficacy of exercise in the context of SUD treatment. In addition, we identify key factors, specific to this population, that may be contributing to treatment outcomes of exercise intervention studies. Lastly, we present a number of considerations for the development of more effective exercise interventions, in the future, with patients in SUD treatment.
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Affiliation(s)
- Ana M Abrantes
- Butler Hospital/Alpert Medical School of Brown University, United States.
| | - Claire E Blevins
- Butler Hospital/Alpert Medical School of Brown University, United States
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31
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Lederman O, Ward PB, Firth J, Maloney C, Carney R, Vancampfort D, Stubbs B, Kalucy M, Rosenbaum S. Does exercise improve sleep quality in individuals with mental illness? A systematic review and meta-analysis. J Psychiatr Res 2019; 109:96-106. [PMID: 30513490 DOI: 10.1016/j.jpsychires.2018.11.004] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 11/01/2018] [Accepted: 11/02/2018] [Indexed: 01/16/2023]
Abstract
People living with mental illness often experience poor sleep quality compared to the general population. Poor sleep quality exacerbates symptoms of mental illness and contributes to increased physical comorbidities. Exercise has been shown to be an effective non-pharmacological treatment for managing poor sleep in the general population. Little is known regarding the efficacy of targeted exercise interventions for improving sleep quality amongst individuals with a mental illness. We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) examining the impact of exercise on sleep quality in people with mental illness. Major electronic databases were searched from inception until June 2018 for exercise-based RCTs that included either subjective and/or objective measures of sleep quality in people with severe mental illness (SMI). Eight RCT's were included in the meta-analysis, involving use of a range of exercise modalities in people with SMI diagnoses. Overall, exercise had a large statistically significant effect on sleep quality (hedges g = 0.73, 95% CI; (0.18, 1.28), p-value = 0.01; N = 8, n = 1,329, I2 = 91.15%). The beneficial effect of exercise on sleep quality outlined in this study highlights the important role exercise has in improving health outcomes for people living with mental illness. Further research is required to determine the efficacy of exercise on sleep in people experiencing a psychiatric illness and to explore the effects of exercise intervention elements such as modality, frequency, intensity and delivery settings.
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Affiliation(s)
- Oscar Lederman
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia; School of Medical Science, UNSW Sydney, NSW, Australia.
| | - Philip B Ward
- School of Psychiatry, UNSW Sydney, NSW, Australia; Schizophrenia Research Unit, Liverpool Hospital and Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
| | - Joseph Firth
- NICM Health Research Institute, University of Western Sydney, Sydney, Australia; Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom
| | | | - Rebekah Carney
- Youth Mental Health Research Unit, Greater Manchester Mental Health NHS Foundation Trust, United Kingdom
| | - Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Tervuursevest 101, 3001, Leuven, Belgium; KU Leuven, University Psychiatric Center KU Leuven, Leuvensesteenweg 517, 3070, Kortenberg, Belgium
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, United Kingdom; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom
| | - Megan Kalucy
- School of Psychiatry, UNSW Sydney, NSW, Australia
| | - Simon Rosenbaum
- School of Psychiatry, UNSW Sydney, NSW, Australia; Black Dog Institute, Randwick, NSW, Australia
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Brobakken MF, Nygård M, Taylor JL, Güzey IC, Morken G, Reitan SK, Heggelund J, Vedul-Kjelsaas E, Wang E. A comprehensive cardiovascular disease risk profile in patients with schizophrenia. Scand J Med Sci Sports 2019; 29:575-585. [DOI: 10.1111/sms.13371] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 12/11/2018] [Indexed: 12/23/2022]
Affiliation(s)
- Mathias Forsberg Brobakken
- Department of Mental Health, Faculty of Medicine and Health Sciences; Norwegian University of Science and Technology (NTNU); Trondheim Norway
- Department of Østmarka, Division of Mental Health Care; St. Olavs University Hospital; Trondheim Norway
| | - Mona Nygård
- Department of Mental Health, Faculty of Medicine and Health Sciences; Norwegian University of Science and Technology (NTNU); Trondheim Norway
- Department of Østmarka, Division of Mental Health Care; St. Olavs University Hospital; Trondheim Norway
| | - Joshua Landen Taylor
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences; Norwegian University of Science and Technology (NTNU); Trondheim Norway
| | - Ismail Cüneyt Güzey
- Department of Mental Health, Faculty of Medicine and Health Sciences; Norwegian University of Science and Technology (NTNU); Trondheim Norway
- Department of Research and Development; Division of Mental Health Care; St. Olavs University Hospital; Trondheim Norway
| | - Gunnar Morken
- Department of Mental Health, Faculty of Medicine and Health Sciences; Norwegian University of Science and Technology (NTNU); Trondheim Norway
- Department of Østmarka, Division of Mental Health Care; St. Olavs University Hospital; Trondheim Norway
| | - Solveig Klaebo Reitan
- Department of Mental Health, Faculty of Medicine and Health Sciences; Norwegian University of Science and Technology (NTNU); Trondheim Norway
- Department of Research and Development; Division of Mental Health Care; St. Olavs University Hospital; Trondheim Norway
| | - Jørn Heggelund
- Department of Mental Health, Faculty of Medicine and Health Sciences; Norwegian University of Science and Technology (NTNU); Trondheim Norway
- Department of Østmarka, Division of Mental Health Care; St. Olavs University Hospital; Trondheim Norway
| | - Einar Vedul-Kjelsaas
- Department of Mental Health, Faculty of Medicine and Health Sciences; Norwegian University of Science and Technology (NTNU); Trondheim Norway
- Department of Research and Development; Division of Mental Health Care; St. Olavs University Hospital; Trondheim Norway
| | - Eivind Wang
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences; Norwegian University of Science and Technology (NTNU); Trondheim Norway
- Faculty of Health and Social Sciences; Molde University College; Molde Norway
- Department of Internal Medicine; University of Utah; Salt Lake City, Utah
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Colledge F, Gerber M, Pühse U, Ludyga S. Anaerobic Exercise Training in the Therapy of Substance Use Disorders: A Systematic Review. Front Psychiatry 2018; 9:644. [PMID: 30564150 PMCID: PMC6288373 DOI: 10.3389/fpsyt.2018.00644] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 11/15/2018] [Indexed: 12/15/2022] Open
Abstract
Background: In the past 3 decades, there has been an increase in the number of studies assessing exercise as a form of treatment for substance use disorders (SUDs). While a variety of substance types and outcomes have been assessed, exercise intensities have never been systematically examined. Consequently, it remains unclear whether particular forms of exercise are better suited to the treatment of these populations. Anaerobic exercise has been shown to have positive effects in populations with psychiatric disorders, but its effectiveness in the treatment of SUDs has to date not been reviewed. Methods: The aim of this systematic review is to identify and evaluate studies which have employed either an acute or chronic anaerobic exercise component as a therapy modality for SUDs. The primary outcomes are abstinence, craving, withdrawal, consumption, quality of life, and the following psychological symptoms and disorders: depression, anxiety, stress, and mood. A secondary objective is to assess whether the type of training described in the study protocol can be reliably categorized as anaerobic training. Results: Twenty-six studies are included in this review. Twelve studies addressed nicotine dependence, one addressed alcohol dependence, and 13 addressed dependence on various illicit drugs. Thirteen studies reported the intensity at which participants actually exercised, but only one employed a test to determine whether training was carried out above the anaerobic threshold (AT). The risk of bias in the included studies was generally high. Results of the studies were mixed, with the most positive effects being found for abstinence in nicotine dependence. Conclusion: The evidence for the effects of anaerobic exercise in SUDs is weak, although a tendency toward positive effects on abstinence in nicotine dependent individuals was observable. The majority of studies do not report data on exercise intensity, making a categorization of anaerobic exercise impossible in all but one case. This means that the effects of this form of exercise cannot be determined, and therefore not evaluated or compared with other forms. In order to improve the quality of evidence for exercise in SUD treatment, clearly defined and objectively assessed evaluations of anaerobic and anaerobic exercise are necessary.
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Affiliation(s)
- Flora Colledge
- Departement für Sport, Bewegung und Gesundheit, Universität Basel, Basel, Switzerland
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Nygård M, Mosti MP, Brose L, Flemmen G, Stunes AK, Sørskår-Venæs A, Heggelund J, Wang E. Maximal strength training improves musculoskeletal health in amphetamine users in clinical treatment. Osteoporos Int 2018; 29:2289-2298. [PMID: 29978257 DOI: 10.1007/s00198-018-4623-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 06/26/2018] [Indexed: 12/01/2022]
Abstract
UNLABELLED Amphetamine use leads to impaired skeletal health and elevated risk of osteoporosis. In the current study, we document that maximal strength training (MST), as a part of clinical treatment, works as a countermeasure, improving muscle force generating capacity, body composition, and skeletal health at sites particularly prone to osteoporotic fractures. INTRODUCTION Amphetamine users have attenuated musculoskeletal health. MST with heavy loads, few repetitions, and emphasis on maximal mobilization in the concentric phase may increase muscle force generating capacity and skeletal health. This study investigated if MST-induced improvements in force generating capacity improved bone mineral density (BMD), trabecular bone score, and body composition in amphetamine users participating in 3-months clinical treatment. METHODS Of 40 randomized patients, 23 completed the study: 11 in the supervised training group (TG; 8 men, 3 women, 34 ± 10 years) and 12 in the control group (CG; 9 men, 3 women, 32 ± 8 years). The TG performed hack-squat MST three times a week for 12 weeks with an intensity of ~90% of one repetition maximum (1RM). Both groups attended conventional clinical treatment. Pre-training and post-training, we assessed hack-squat 1RM and rate of force development (RFD), BMD, body composition and trabecular bone score by dual X-ray absorptiometry, and serum bone metabolism markers. RESULTS MST induced increases in 1RM (70%) and RFD (86%), and resulted in BMD improvements at lumbar spine (3.6%) and total hip (2.4%); all improvements were different from CG (p < 0.05). Both the 1RM and RFD increases were associated with BMD improvements (lumbar spine: r = 0.73 (1RM), r = 0.60 (RFD); total hip: r = 0.61 (1RM); all p < 0.05). No differences were observed in trabecular bone score or bone metabolism markers. CONCLUSIONS MST improved force generating capacity and skeletal health at sites prone to bone loss in amphetamine users, and advocate that MST should be implemented as a clinical strategy to restore the patients' musculoskeletal health.
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Affiliation(s)
- M Nygård
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
- Department of Mental Health, St. Olav's University Hospital, Trondheim, Norway.
| | - M P Mosti
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- St. Olav's University Hospital, Trondheim, Norway
| | - L Brose
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - G Flemmen
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olav's University Hospital, Trondheim, Norway
| | - A K Stunes
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- St. Olav's University Hospital, Trondheim, Norway
| | - A Sørskår-Venæs
- Clinic of Substance Use and Addiction Medicine, St. Olav's University Hospital, Trondheim, Norway
| | - J Heggelund
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Mental Health, St. Olav's University Hospital, Trondheim, Norway
| | - E Wang
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Faculty of Health and Social Sciences, Molde University College, Molde, Norway
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
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Blackwell JEM, Doleman B, Herrod PJJ, Ricketts S, Phillips BE, Lund JN, Williams JP. Short-Term (<8 wk) High-Intensity Interval Training in Diseased Cohorts. Med Sci Sports Exerc 2018; 50:1740-1749. [PMID: 29683925 PMCID: PMC6133203 DOI: 10.1249/mss.0000000000001634] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIM Exercise training regimes can lead to improvements in measures of cardiorespiratory fitness (CRF), improved general health, and reduced morbidity and overall mortality risk. High-intensity interval training (HIIT) offers a time-efficient approach to improve CRF in healthy individuals, but the relative benefits of HIIT compared with traditional training methods are unknown in across different disease cohorts. METHODS This systematic review and meta-analysis compares CRF gains in randomized controlled trials of short-term (<8 wk) HIIT versus either no exercise control (CON) or moderate continuous training (MCT) within diseased cohorts. Literature searches of the following databases were performed: MEDLINE, EMBASE, CINAHL, AMED, and PubMed (all from inception to December 1, 2017), with further searches of Clinicaltrials.gov and citations via Google Scholar. Primary outcomes were effect on CRF variables: V˙O2peak and anaerobic threshold. RESULTS Thirty-nine studies met the inclusion criteria. HIIT resulted in a clinically significant increase in V˙O2peak compared with CON (mean difference [MD] = 3.32 mL·kg·min, 95% confidence interval [CI] = 2.56-2.08). Overall HIIT provided added benefit to V˙O2peak over MCT (MD = 0.79 mL·kg·min, 95% CI = 0.20-1.39). The benefit of HIIT was most marked in patients with cardiovascular disease when compared with MCT (V˙O2peak: MD = 1.66 mL·kg·min, 95% CI = 0.60-2.73; anaerobic threshold: MD = 1.61 mL·kg·min, 95% CI = 0.33-2.90). CONCLUSIONS HIIT elicits improvements in objective measures of CRF within 8 wk in diseased cohorts compared with no intervention. When compared with MCT, HIIT imparts statistically significant additional improvements in measures of CRF, with clinically important additional improvements in V˙O2peak in cardiovascular patients. Comparative efficacy of HIIT versus MCT combined with an often reduced time commitment may warrant HIIT's promotion as a viable clinical exercise intervention.
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Affiliation(s)
- James E M Blackwell
- University of Nottingham, Nottingham, UNITED KINGDOM
- Royal Derby Hospital, Derby, UNITED KINGDOM
| | - Brett Doleman
- University of Nottingham, Nottingham, UNITED KINGDOM
- Royal Derby Hospital, Derby, UNITED KINGDOM
| | - Philip J J Herrod
- University of Nottingham, Nottingham, UNITED KINGDOM
- Royal Derby Hospital, Derby, UNITED KINGDOM
| | | | | | - Jonathan N Lund
- University of Nottingham, Nottingham, UNITED KINGDOM
- Royal Derby Hospital, Derby, UNITED KINGDOM
| | - John P Williams
- University of Nottingham, Nottingham, UNITED KINGDOM
- Royal Derby Hospital, Derby, UNITED KINGDOM
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Lynch WJ, Abel J, Robinson AM, Smith MA. Exercise as a Sex-Specific Treatment for Substance Use Disorder. CURRENT ADDICTION REPORTS 2017; 4:467-481. [PMID: 29404264 PMCID: PMC5796660 DOI: 10.1007/s40429-017-0177-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW Exercise is a promising treatment for substance use disorder that may reduce withdrawal symptoms and prevent relapse. In this review, we discuss recent evidence from clinical and preclinical studies for its efficacy, from a behavioral to a molecular level, in order to understand the exercise conditions that lead to beneficial effects. We also highlight the few recent findings of sex-specific differences. RECENT FINDINGS Clinical and preclinical findings show that exercise decreases withdrawal symptoms, including craving, in both males and females. Evidence from clinical studies support the efficacy of exercise to prevent relapse to smoking, although further research is needed to examine sex differences, establish long-term efficacy, and to determine if effects extend to other substance use disorders. Preclinical findings also support the potential utility of exercise to prevent relapse with evidence suggesting that its efficacy is enhanced in males, and mediated by blocking drug-induced adaptations that occur during early abstinence. SUMMARY Sex differences and timing of exercise availability during abstinence should be considered in future studies examining exercise as an intervention for relapse. A better understanding of the neurobiological mechanisms underlying the efficacy of exercise to reduce withdrawal symptoms and prevent relapse is needed to guide its development as a sex-specific treatment.
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Affiliation(s)
- Wendy J Lynch
- Associate Professor of Psychiatry and Neurobehavioral Sciences University of Virginia: P.O. Box 801402, Charlottesville, VA 22904 434-243-0580 (phone); 434-973-7031 (fax)
| | - Jean Abel
- Assistant Professor of Psychiatry and Neurobehavioral Sciences University of Virginia; P.O. Box 801402, Charlottesville, VA 22904-1402 434) 243-5767 (phone); 434-973-7031 (fax)
| | - Andrea M Robinson
- Postdoctoral Fellow of Psychology Davidson College: Box 7136 Davidson, NC 28035 704-894-3012 (phone); 704-894-2512 (fax)
| | - Mark A Smith
- Professor of Psychology Davidson College, Davidson, NC 28035 704-894-2470 (phone); 704-894-2512 (fax)
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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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STØREN ØYVIND, HELGERUD JAN, SÆBØ MONA, STØA EVAMARIA, BRATLAND-SANDA SOLFRID, UNHJEM RUNARJ, HOFF JAN, WANG EIVIND. The Effect of Age on the V˙O2max Response to High-Intensity Interval Training. Med Sci Sports Exerc 2017; 49:78-85. [DOI: 10.1249/mss.0000000000001070] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Brellenthin AG, Koltyn KF. Exercise as an adjunctive treatment for cannabis use disorder. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 42:481-489. [PMID: 27314543 PMCID: PMC5055462 DOI: 10.1080/00952990.2016.1185434] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 04/22/2016] [Accepted: 04/29/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND Despite cannabis being the most widely used illicit substance in the United States, individuals diagnosed with cannabis use disorder (CUD) have few well-researched, affordable treatment options available to them. Although found to be effective for improving treatment outcomes in other drug populations, exercise is an affordable and highly accessible treatment approach that has not been routinely investigated in cannabis users. OBJECTIVES The aim of this paper is to inform the topic regarding exercise's potential as an adjunctive treatment for individuals with CUD. METHODS We reviewed the evidence surrounding cannabis use and its current treatment in the United States, explored the rationale for including exercise in the treatment of substance use disorders (SUDs), and in particular, proposed a biological mechanism (i.e., endocannabinoids (eCBs)) that should be examined when utilizing exercise for the treatment of CUD. RESULTS Cannabis use is widespread and increasing in the United States. Chronic, heavy cannabis use may dysregulate the endogenous cannabinoid system, which has implications for several psychobiological processes that interact with the eCB system such as reward processing and the stress response. Given that exercise is a potent activator of the eCB system, it is mechanistically plausible that exercise could be an optimal method to supplement cessation efforts by reducing psychophysical withdrawal, managing stress, and attenuating drug cravings. CONCLUSION We suggest there is a strong behavioral and physiological rationale to design studies which specifically assess the efficacy of exercise, in combination with other therapies, in treating CUD. Moreover, it will be especially important to include the investigation of psychobiological mechanisms (e.g., eCBs, hippocampal volume), which have been associated with both exercise and SUDs, to examine the broader impact of exercise on behavioral and physiological responses to treatment.
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Affiliation(s)
| | - Kelli F Koltyn
- a Department of Kinesiology , University of Wisconsin-Madison , Madison , WI , USA
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Unhjem R, Flemmen G, Hoff J, Wang E. Maximal strength training as physical rehabilitation for patients with substance use disorder; a randomized controlled trial. BMC Sports Sci Med Rehabil 2016; 8:7. [PMID: 27042312 PMCID: PMC4818502 DOI: 10.1186/s13102-016-0032-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 02/29/2016] [Indexed: 12/30/2022]
Abstract
Background Patients with substance use disorder (SUD) suffer from multiple health and psychosocial problems. Because poor physical capacities following an inactive lifestyle may indeed contribute to these problems, physical training is often suggested as an attractive supplement to conventional SUD treatment. Strength training is shown to increase muscle strength and effectively improve health and longevity. Therefore we investigated the feasibility and effect of a maximal strength training intervention for SUD patients in clinical treatment. Methods 16 males and 8 females were randomized into a training group (TG) and a control group (CG). The TG performed lower extremities maximal strength training (85-90 % of 1 repetition maximum (1RM)) 3 times a week for 8 weeks, while the CG participated in conventional clinical activities. Results The TG increased hack squat 1RM (88 ± 54 %), plantar flexion 1RM (26 ± 20 %), hack squat rate of force development (82 ± 29 %) and peak force (11 ± 5 %). Additionally, the TG improved neural function, expressed as voluntary V-wave (88 ± 83 %). The CG displayed no change in any physical parameters. The TG also reduced anxiety and insomnia, while the CG reduced anxiety. Conclusion Maximal strength training was feasible for SUD patients in treatment, and improved multiple risk factors for falls, fractures and lifestyle related diseases. As conventional treatment appears to have no effect on muscle strength, systematic strength training should be implemented as part of clinical practice. Trial regestration ClinicalTrials.gov Identifier: NCT02218970 (August 14, 2014).
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Affiliation(s)
- Runar Unhjem
- Department of Circulation and Medical imaging, Faculty of Medicine, the Norwegian University of Science and Technology, Prinsesse Kristinas gt. 3, 7006 Trondheim, Norway
| | - Grete Flemmen
- Department of Circulation and Medical imaging, Faculty of Medicine, the Norwegian University of Science and Technology, Prinsesse Kristinas gt. 3, 7006 Trondheim, Norway ; Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olav University Hospital, Trondheim, Norway
| | - Jan Hoff
- Department of Circulation and Medical imaging, Faculty of Medicine, the Norwegian University of Science and Technology, Prinsesse Kristinas gt. 3, 7006 Trondheim, Norway ; Department of Physical Medicine and Rehabilitation, St. Olav University Hospital, Trondheim, Norway
| | - Eivind Wang
- Department of Circulation and Medical imaging, Faculty of Medicine, the Norwegian University of Science and Technology, Prinsesse Kristinas gt. 3, 7006 Trondheim, Norway ; Division of Psychiatry, Department of Østmarka, St. Olav University Hospital, Trondheim, Norway ; Department of Internal Medicine, University of Utah, Salt Lake City, Utah USA
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Mosti MP, Flemmen G, Hoff J, Stunes AK, Syversen U, Wang E. Impaired skeletal health and neuromuscular function among amphetamine users in clinical treatment. Osteoporos Int 2016; 27:1003-1010. [PMID: 26501558 DOI: 10.1007/s00198-015-3371-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 10/11/2015] [Indexed: 11/25/2022]
Abstract
SUMMARY This study examined musculoskeletal health in amphetamine users, compared with healthy age-matched controls. We show that amphetamine users have reduced bone mass at several skeletal sites and attenuated maximal muscle strength and force development capacity in the lower extremities. INTRODUCTION Amphetamine use may cause poor bone quality and elevated risk of osteoporosis. The purpose of this study was to investigate whether amphetamine users exhibit reduced regional and whole body bone mineral density (BMD), altered bone metabolism, and how muscle function may relate to the patient groups' skeletal health. METHODS We assessed hip, lumbar spine and whole body BMD, and trabecular bone score (TBS) by dual x-ray absorptiometry (DXA), and bone metabolism markers in serum and maximal strength and force development capacity in 36 amphetamine users (25 men, 30 ± 7 years; 11 women 35 ± 10 years) and in 37 healthy controls (23 men, 31 ± 9 years; 14 women, 35 ± 7 years). RESULTS Whole body BMD was lower in amphetamine users (8% in males and 7% females, p < 0.01), as were BMD at the total hip and sub-regions of the hip (9-11% in men and 10-11 % in women, p < 0.05). Male users had 4% lower TBS (p < 0.05) and higher serum level of type 1 collagen amino-terminal propeptide (p < 0.01). This coincided with reduced lower extremity maximal strength of 30% (males, p < 0.001) and 25% (females, p < 0.05) and 27% slower muscular force development in males compared to controls (p < 0.01). CONCLUSIONS These findings demonstrate that amphetamine users suffer from a generalized reduction in bone mass, which was associated with attenuated maximal muscle strength and force development capacity in the lower extremities.
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Affiliation(s)
- M P Mosti
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
| | - G Flemmen
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olav's University Hospital, Trondheim, Norway
| | - J Hoff
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Physical Medicine and Rehabilitation, St. Olav's University Hospital, Trondheim, Norway
| | - A K Stunes
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - U Syversen
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Endocrinology, St. Olav's University Hospital, Trondheim, Norway
| | - E Wang
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
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Rosenbaum S, Tiedemann A, Stanton R, Parker A, Waterreus A, Curtis J, Ward PB. Implementing evidence-based physical activity interventions for people with mental illness: an Australian perspective. Australas Psychiatry 2016; 24:49-54. [PMID: 26139698 DOI: 10.1177/1039856215590252] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES Physical activity (PA) and exercise is increasingly being recognised as an efficacious component of treatment for various mental disorders. The association between PA and cardiometabolic disease is well established, as is the strong link between mental illness, sedentary behaviour and poor cardiometabolic health. Examples of successful integration of clinical PA programs within mental health treatment facilities are increasing. The aim of this review was to summarise the evidence regarding PA and mental illness, and to present examples of clinical exercise programs within Australian mental health facilities. METHODS A narrative synthesis of systematic reviews and clinical trials was conducted. RESULTS Evidence supporting the inclusion of PA programs as an adjunct to treatment for various conditions was presented; including depression, schizophrenia, anxiety disorders, post-traumatic stress disorder and substance abuse. In light of the available evidence, the inclusion of clinical PA programs within mental health treatment, facilitated by dedicated clinicians (exercise physiologists / physiotherapists) was justified. CONCLUSIONS PA is a feasible, effective and acceptable adjunct to usual care for a variety of mental disorders. There is a clear need for greater investment in initiatives aiming to increase PA among people experiencing mental illness, given the benefits to both mental and physical health outcomes.
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Affiliation(s)
- Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, NSW, and; Early Psychosis Programme, The Bondi Centre, South Eastern Sydney Local Health District, Sydney, NSW, and; Musculoskeletal Division, George Institute for Global Health and Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Anne Tiedemann
- Musculoskeletal Division, George Institute for Global Health and Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Robert Stanton
- School of Medical and Applied Sciences Central Queensland University, Rockhampton, QLD, Australia
| | - Alexandra Parker
- Orygen, the National Centre of Excellence in Youth Mental Health, University of Melbourne, Parkville, VIC, and; Headspace National Youth Mental Health Foundation Ltd, Melbourne, VIC, Australia
| | - Anna Waterreus
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, Australia
| | - Jackie Curtis
- School of Psychiatry, University of New South Wales, Sydney, NSW, and; Early Psychosis Programme, The Bondi Centre, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Philip B Ward
- School of Psychiatry, University of New South Wales, Sydney, NSW, and; Schizophrenia Research Unit, Ingham Institute for Applied Medical Research, South Western Sydney Local Health District, Liverpool, NSW, Australia
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Flemmen G, Wang E. Impaired Aerobic Endurance and Muscular Strength in Substance Use Disorder Patients: Implications for Health and Premature Death. Medicine (Baltimore) 2015; 94:e1914. [PMID: 26554792 PMCID: PMC4915893 DOI: 10.1097/md.0000000000001914] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Although substance use disorder (SUD) patients are documented to have an inactive lifestyle, which is associated with cardiovascular disease, other lifestyle-related diseases and premature death, evidence regarding their aerobic endurance and muscular strength is limited. Therefore, the authors aimed to evaluate directly assessed maximal oxygen consumption, walking efficiency, as well as maximal strength in a group of SUD patients.A total of 44 SUD patients in residential treatment, 31 men (31 ± 8 years) and 13 women (34 ± 10 years), were included and completed the physical testing. The patients were compared with an age- and sex-matched reference group.Male and female SUD patients exhibited a maximal oxygen consumption of 44.6 ± 6.2 and 33.8 ± 6.6 mL· min kg, respectively. This was significantly lower than the reference group, 15% (P = 0.03) for men and 25% (P = 0.001) for women. In addition, the SUD patients had a 13% significantly reduced walking efficiency (P = 0.02), compared with healthy controls. The impairments in aerobic endurance were accompanied by significant reductions in maximal strength of 30% (P = 0.001) and 33% (P = 0.01) for men and women, respectively. In combination, these results imply that SUD patients have impaired endurance and muscular strength compared with what is typically observed in the population, and consequently suffer a higher risk of developing cardiovascular and other lifestyle-related diseases and early death. Effective physical exercise should be advocated as an essential part of the clinical practice of SUD treatment to improve the patient's health and consequently reduce the costs because of the high use of emergency departments, hospital, and medical care.
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Affiliation(s)
- Grete Flemmen
- From the Department of Circulation and Medical Imaging, Faculty of Medicine, the Norwegian University of Science and Technology (GF, EW); and Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olav's University Hospital, Trondheim, Norway (GF); Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA (EW)
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Heggelund J, Kleppe KD, Morken G, Vedul-Kjelsås E. High aerobic intensity training and psychological States in patients with depression or schizophrenia. Front Psychiatry 2014; 5:148. [PMID: 25400592 PMCID: PMC4214195 DOI: 10.3389/fpsyt.2014.00148] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 10/11/2014] [Indexed: 11/13/2022] Open
Abstract
AIM To explore changes in psychological states in response to a bout of high aerobic intensity training (HIT) in patients with depression or schizophrenia compared to healthy individuals. METHODS After familiarization training of HIT, 20 patients with schizophrenia, 13 patients with depression, and 20 healthy individuals performed a no-training day followed by a training day. HIT was 4 × 4 min intervals at 85-95% of peak heart rate, intermitted by 3 min active rest periods at 70% of peak heart rate. Self-evaluation questionnaires of positive affect, negative affect, state anxiety, well-being, distress, and fatigue were completed before training, 15 min after, and 3 h after training. The two latter measures were also completed the no-training day. RESULTS All three groups improved in positive affect and well-being 15 min after HIT (p < 0.01), but only patients with depression had maintained the effect after 3 h (p = 0.007, p = 0.012). The duration of the improved positive affect was longer in depression (p = 0.002) and schizophrenia (p = 0.025) than in healthy individuals (F 2.50 = 5.83, p < 0.01). Patients with depression or schizophrenia had reduced distress and state anxiety 15 min after HIT and 3 h after HIT (p < 0.05). The improvement in distress 15 min after HIT was larger in patients with depression (p = 0.028) compared to healthy individuals (F 2.50 = 5.05, p < 0.01). No changes were found during the no-training day (p > 0.05). CONCLUSION High aerobic intensity training used as an acute intervention improved positive affect and well-being and reduced distress and state anxiety in patients with depression and schizophrenia. ClinicalTrials.gov identifier: NCT01310998.
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Affiliation(s)
- Jørn Heggelund
- Division of Psychiatry, Department of Østmarka, St. Olavs University Hospital, Trondheim, Norway
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kim Daniel Kleppe
- Hamar District Psychiatric Centre, Innlandet Hospital Trust, Ottestad, Norway
| | - Gunnar Morken
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Division of Psychiatry, Department of Research and Development (AFFU), St. Olavs University Hospital, Trondheim, Norway
| | - Einar Vedul-Kjelsås
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Division of Psychiatry, Department of Research and Development (AFFU), St. Olavs University Hospital, Trondheim, Norway
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