The new issue of *Archives of Internal Medicine* (Vol. 170, No. 4,
February 22) includes an article: “The Effect of Exercise Training on
Anxiety Symptoms Among Patients: A Systematic Review.”

The authors are Matthew P. Herring, MS, MEd, Patrick J. O’Connor, PhD, & Rodney K. Dishman, PhD.

Here’s how the article starts:

[begin excerpt]

Anxiety, an unpleasant mood characterized by thoughts of worry, is an
adaptive response to perceived threats that can develop into a
maladaptive anxiety disorder if it becomes severe and chronic.1

Anxiety symptoms and disorders are common among individuals with a
chronic illness,2-8  yet health care providers often fail to recognize
or treat anxiety and may consider it to be an unimportant response to a
chronic illness.9

Anxiety symptoms can have a negative impact on treatment outcomes in
part because anxious patients can be less likely to adhere to prescribed
medical treatments.10-11

Personal costs of anxiety among patients include reduced health-related
quality of life12 and increased disability, role impairment,13 and
health care visits.14

Adequate evidence is available to justify screening for anxiety problems
in primary care settings and prescribing effective treatments for those
likely to benefit.9, 14

While pharmacological and cognitive behavioral therapies are both
efficacious in reducing anxiety,15-16 there continues to be interest in
alternative therapies such as relaxation and exercise.17-19

Exercise training is a healthful behavior with a minimal risk of adverse
events that could be an effective and practical tool for reducing
anxiety among patients.20-22

Meta-analytic reviews have summarized the association between exercise
and anxiety symptoms both in samples of primarily healthy adults23-26
and exercise training studies of patients with fibromyalgia and
cardiovascular disease, but these analyses did not focus on the best
available evidence.27-29

We used the results from randomized controlled trials to evaluate the
effects of exercise training on anxiety.

One goal was to estimate the population effect size for anxiety outcomes.

A second goal was to learn whether variables of theoretical or practical
importance, such as features of the exercise stimulus and the method for
measuring anxiety, account for variation in the estimated population effect.

[end excerpt]

Here’s how the Discussion section starts: “The analysis revealed that
exercise training significantly decreased anxiety scores among patients
with a chronic illness.  The magnitude of the overall mean effect
({Delta} = 0.29) is similar to the effect of exercise training on
fatigue symptoms among patients ({Delta} = 0.37)77 and on cognitive
function among older adults (g = 0.30).81”

Here’s how the article ends: “Increasingly, efforts are being made to
provide mental health treatments consistent with the available
scientific evidence in primary care settings.105  The present results
provide clinicians with solid evidence to recommend exercise training to
patients as a means for reducing anxiety symptoms with minimal risk of
adverse events. Exercise training may be especially useful for patients
who prefer nonpharmacologic treatments106  because such preferences may
influence the magnitude of the treatment outcomes.107  Perhaps most
importantly, the results show that anxiety reduction is a favorable,
adventitious outcome of exercise interventions that were designed as a
primary treatment or adjuvant for medical conditions other than anxiety.”

The author note provides the following contact info: Matthew P. Herring,
MS, MEd, Department of Kinesiology, Ramsey Center, The University of
Georgia, 330 River Rd, Athens, GA 30602-6554 (<m p h 8 @ u g a . e d u >).

Courtesy of Ken Pope.

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