The Effectiveness of Exercise as an Adjunct Intervention to Improve Quality of Life and Mood in Substance Use Disorder: A Systematic Review.

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.

Physical Activity Assessment in Clinical Studies of Substance Use Disorder.

The therapeutic effect of exercise in promoting mental health is well known, and there is a growing body of evidence for incorporating physical activity-based interventions in the management of substance use disorders (SUD). A particular challenge in this area is a lack of standardized testing protocols between studies and clear descriptive statistics on the capacity of the SUD patient to perform exercise. Therefore, an essential starting point for new studies that seek to incorporate exercise into usual care therapy for SUD is an appropriate suite of baseline fitness assessments that include measures of aerobic capacity as well as muscular strength and/or endurance. We present here the methods and notes of our recent experiences in implementing baseline fitness testing of a patient population undergoing in-patient treatment for SUD. The tests described here have been adapted from freely available standardized tests that were developed for implementation with the general population. It is hoped that these experiences aid in the development of patient-specific physical activity programs that assist in the management of SUD.