Understanding physical exercise among individuals with substance use disorders using an integrated theoretical perspective of the health action process approach and theory of planned behavior.

Introduction: Physical exercise is considered a useful non-pharmacological adjunctive treatment for promoting recovery from substance use disorders (SUD). However, adherence to physical exercise treatments is low, and little is known about what factors are associated with the initiation and maintenance of physical exercise behaviors. The aim of this study was to explore the psychosocial factors underlying these behaviors in individuals with SUD using an integrated theoretical model based on the health action process approach (HAPA) and the theory of planned behavior (TPB). Methods: A total of 1,197 individuals with SUDs (aged 37.20 ± 8.62 years) were recruited from 10 compulsory isolation drug rehabilitation centers in Zhejiang Province via convenience sampling according to a set of inclusion criteria. Self-reported data were collected to assess task self-efficacy (TSE), maintenance self-efficacy (MSE), recovery self-efficacy (RSE), outcome expectations (OE), action planning (AP), coping planning (CP), social support (SS), subjective norms (SN), attitude behavior (AB), behavioral intention (BI), perceived behavioral control (PBC), risk perception (RP), exercise stage, and exercise behavior in this integrated model. ANOVA and structural equation modeling (SEM) were used to evaluate this model. Results: One-way ANOVA revealed that the majority of the moderating variables were significantly different in the exercise phase. Further SEM showed that the model fit the data and revealed several important relationships. TSE, RP, SS, AB, and SN were indirectly associated with physical exercise behavior in individuals with SUD through the BI in the SUD initiation stage. In addition, PBC was directly related to physical exercise behavior in individuals with SUD. In the maintenance stage, MSE, AP, CP and exercise behavior were significantly related. Moreover, AP and CP were mediators of BI and MSE. Conclusion: This study is the first attempt to integrate patterns of physical exercise behavior in individuals with SUD. The HAPA-TPB integration model provides a useful framework for identifying determinants of physical exercise behavioral intentions and behaviors in individuals with SUD and for explaining and predicting the initiation and maintenance of physical exercise behaviors in these individuals. Moreover, the model provides scientific guidance for the enhancement of physical exercise adherence in individuals with SUD.

The Effects of Tai Chi on the Executive Functions and Physical Fitness in Middle-Aged Adults with Depression: A Randomized Controlled Trial.

Objective: The present study examined the effects of Tai Chi exercise on the executive functions (EFs) and physical fitness of middle-aged adults with depression. Methods: A total of 39 middle-aged adults with depression (M age = 50.59, SD = 7.38) were randomly assigned to the Tai Chi group (n = 20) or the waiting-list control group (n = 19). The Tai Chi group engaged in two 90 min sessions of Tai Chi exercise per week for 12 weeks; the waiting-list control group was asked to maintain their usual daily routines for 12 weeks. Depression symptoms, EFs (i.e., inhibitory control, planning, working memory, and cognitive flexibility), and physical fitness (i.e., cardiovascular fitness, muscular strength, muscular endurance, power, and flexibility) were evaluated at the baseline (pretest), 6-week (mid-test), and 12-week (post-test) marks. Results: Both groups showed decreased depression symptoms over time. Compared with the control group, the Tai Chi group showed decreased reaction times for incongruent conditions in the Stroop test from pretest to mid- and post-test, and shorter reaction time for incongruent conditions in the Stroop test than the control group at post-test; the Tai Chi group performed significantly better than the control group in overall total move score of Tower of London (TOL). The Tai Chi group also showed increased total correct scores of TOL from pretest to mid- and post-test, and greater total correct scores of TOL than the control group at post-test. Additionally, results indicated that Tai Chi exercise comprehensively improved physical fitness from pretest to mid- and post-test. Greater performance in terms of cardiovascular fitness, muscular strength, and power was also found in the Tai Chi group at post-test than in the control group. Conclusions: These findings suggest that the 12-week Tai Chi exercise improved inhibitory control, planning and working memory aspects of executive functions, and physical fitness in middle-aged adults with depression.

Effects of Acute High-Intensity Interval Exercise and High-Intensity Continuous Exercise on Inhibitory Function of Overweight and Obese Children.

This study aimed to examine whether a single bout each of high-intensity interval exercise (HIIE) and high-intensity continuous exercise (HICE) could improve inhibitory functions of overweight and obese children, and which mode of exercise was more beneficial. Seventy-two overweight and obese children, with (26.02 ± 1.05 kg/m2), aged 10-14 years (11.56 ± 1.03 years), were randomly assigned to three groups. The HIIE group completed a 30-min treadmill exercise session (5-min warm up, 20-min HIIE, and 5-min cool-down). The HICE group performed 30 min of rope skipping, while the control (CON) group watched a designated cartoon on a tablet computer for the same duration. Reaction time and number of errors in the Stroop test were determined before and after the intervention. The difference between pre- and post-test reaction time scores was higher in the HIIE and HICE groups than in the CON group, while the pre- and post-test difference in the number of errors was similar between groups. Overall, it is likely that both acute HIIE and HICE were similarly efficient in facilitating cognitive and inhibitory functions of children with overweight and obesity conditions, supporting the benefits of acute high-intensity exercise probability for cognitive functions of children in general, as well as of the population with overweight and obesity conditions.

Acute Aerobic Exercise Ameliorates Cravings and Inhibitory Control in Heroin Addicts: Evidence From Event-Related Potentials and Frequency Bands.

OBJECTIVE: Aerobic exercise is considered a potential adjunctive treatment for heroin addicts, but little is known about its mechanisms. Less severe cravings and greater inhibitory control have been associated with reduced substance use. The aim of the current study was to determine the effects, as measured by behavioral and neuroelectric measurements, of acute aerobic exercise on heroin cravings and inhibitory control induced by heroin-related conditions among heroin addicts. DESIGN: The present study used a randomized controlled design. METHODS: Sixty male heroin addicts who met the DSM-V criteria were recruited from the Isolated Detoxification Center in China and randomly assigned to one of two groups; one group completed a 20-min bout of acute stationary cycle exercise with vigorous intensity (70-80% of maximum heart rate, exercise group), and the other group rested (control group). The self-reported heroin craving levels and inhibitory control outcomes (measured by a heroin-related Go/No-Go task) were assessed pre- and post-exercise. RESULTS: The heroin craving levels in the exercise group were significantly attenuated during, immediately following, and 40 min after vigorous exercise compared with before exercise; moreover, during exercise, a smaller craving was observed in the exercise group than in the control group. Acute exercise also facilitated inhibition performance in the No-Go task. After exercise, the participants' accuracy, the N2d amplitudes, and the theta two band spectral power during the No-Go conditions were higher in the exercise group than in the control group. Interestingly, significant correlations between the changes in these sensitive measurements and the changes in cravings were observed. CONCLUSIONS: This is the first empirical study to demonstrate that aerobic exercise may be efficacious for reducing heroin cravings and promoting inhibitory control among heroin addicts.

Dose-response relationships between exercise intensity, cravings, and inhibitory control in methamphetamine dependence: An ERPs study.

BACKGROUND: The present study integrated behavioral and neuroelectric approaches for determining the dose-response relationships between exercise intensity and methamphetamine (MA) craving and between exercise intensity and inhibitory control in individuals with MA dependence. METHODS: Ninety-two individuals with MA dependence were randomly assigned to an exercise group (light, moderate, or vigorous intensity) or to a reading control group. The participants then completed a craving self-report at four time points: before exercise, during exercise, immediately after exercise, and 50 min after exercise. Event-related potentials were also recorded while the participants completed a standard Go/NoGo task and an MA-related Go/NoGo task approximately 20 min after exercise cessation. RESULTS: The reduction in self-reported MA craving scores of the moderate and vigorous intensity groups was greater than that of the light intensity and control groups during acute exercise as well as immediately and 50 min following exercise termination. Additionally, an inverted-U-shaped relationship between exercise intensity and inhibitory control was generally observed for the behavioral and neuroelectric indices, with the moderate intensity group exhibiting shorter Go reaction times, increased NoGo accuracy, and larger NoGo-N2 amplitudes. CONCLUSIONS: Acute exercise may provide benefits for MA-associated craving and inhibitory control in MA-dependent individuals, as revealed by behavioral and neuroelectric measures. Moderate-intensity exercise may be associated with more positive effects, providing preliminary evidence for the establishment of an exercise prescription regarding intensity for MA dependence.

Acute exercise ameliorates craving and inhibitory deficits in methamphetamine: An ERP study.

This study aimed to determine the effect of acute exercise in the potential context of non-pharmacological intervention for methamphetamine (MA)-related craving; we additionally determine its effect on the inhibitory control induced by standard and MA-related tasks according to behavioral and neuroelectric measurements among MA-dependent individuals. The present study employed a within-subjects, counterbalanced design. A total of 24 participants who met the DSM-IV criteria for MA dependence were recruited. The craving level, reaction time, and response accuracy, as well as the event-related potential (ERP) components N2 and P3, were measured following exercise and the control treatment in a counterbalanced order. The exercise session consisted of an acute stationary cycle exercise at a moderate intensity, whereas the control treatment consisted of an active reading session. The self-reported MA craving was significantly attenuated during, immediately following, and 50min after the exercise session compared with the pre-exercise ratings, whereas the craving scores at these time points following exercise were lower than those for the reading control session. Acute exercise also facilitated inhibitory performance in both the standard and MA-related Go/Nogo tasks. A larger N2 amplitude, but not a larger P3 amplitude, was observed during both tasks in the exercise session and the Nogo condition compared with the reading control session and the Go condition. This is the first empirical study to demonstrate these beneficial effects of acute aerobic exercise at a moderate intensity on MA-related craving and inhibitory control in MA-dependent individuals. These results suggest a potential role for acute aerobic exercise in treating this specific type of substance abuse.

Impact of physical exercise on substance use disorders: a meta-analysis.

OBJECTIVE: The goal of this meta-analysis was to examine whether long-term physical exercise could be a potential effective treatment for substance use disorders (SUD). METHODS: The PubMed, Web of Science, Elsevier, CNKI and China Info were searched for randomized controlled trials (RCT) studies in regards to the effects of physical exercise on SUD between the years 1990 and 2013. Four main outcome measures including abstinence rate, withdrawal symptoms, anxiety, and depression were evaluated. RESULTS: Twenty-two studies were integrated in the meta-analysis. The results indicated that physical exercise can effectively increase the abstinence rate (OR = 1.69 (95% CI: 1.44, 1.99), z = 6.33, p < 0.001), ease withdrawal symptoms (SMD = -1.24 (95% CI: -2.46, -0.02), z = -2, p<0.05), and reduce anxiety (SMD = -0.31 (95% CI: -0.45, -0.16), z  =  -4.12, p < 0.001) and depression (SMD  =  -0.47 (95% CI: -0.80, -0.14), z = -2.76, p<0.01). The physical exercise can more ease the depression symptoms on alcohol and illicit drug abusers than nicotine abusers, and more improve the abstinence rate on illicit drug abusers than the others. Similar treatment effects were found in three categories: exercise intensity, types of exercise, and follow-up periods. CONCLUSIONS: The moderate and high-intensity aerobic exercises, designed according to the Guidelines of American College of Sports Medicine, and the mind-body exercises can be an effective and persistent treatment for those with SUD.