Psicologia do Esporte

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From: Ken Pope <ken@kenpope.com>
Date: Mon, Feb 22, 2010 at 4:50 PM
Subject: Review: Exercise Training’s Effects on Pts’ Anxiety Symptoms

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 adults 23-26 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 (<mph8@uga.edu>).

Ken Pope

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